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Öğe Amifostine use in radiation-induced kidney damage(Springer Heidelberg, 2008) Kaldir, Mine; Cosar-Alas, Rusen; Cermik, Tevfik Fikret; Yurut-Caloglu, Vuslat; Saynak, Mert; Altaner, Semsi; Caloglu, MuratPurpose: To assess the degree of protective effects of amifostine on kidney functions via semiquantitative static renal scintigraphy and histopathologic analysis. Material and Methods: 30 female albino rats were divided into three equal groups as control (CL), radiotherapy alone (RT), and radiotherapy + amifostine (RT+AMI). The animals in the CL and RT groups were given phosphate-buffered saline, whereas the animals in the RT+AMI group received amifostine (200 mg/kg) by intraperitoneal injection 30 min before irradiation. RT and RT+AMI groups were irradiated with a single dose of 6 Gy using a Co-60 unit at a source-skin distance of 80 cm to the whole right kidney. They were followed up for 6 months. CL, RT, and RT+AMI groups underwent static kidney scintigraphy at the beginning of the experiment and, again, on the day before sacrificing. Histopathologically, tubular atrophy and fibrosis of the kidney damage were evaluated. Results: After irradiation, the median value of right kidney function was 48% (44-49%) and 50.5% (49%-52%) in RT and RT+AMI groups, respectively (p = 0.0002). Grade 1 kidney fibrosis was observed to be 60% in the RT group, while it was only 30% in the RT+AMI group. Grade 2 kidney fibrosis was 30% and 0% in the RT and RT+AMI group, respectively. Grade 1 tubular atrophy was 70% and 50% in the RT and RT+AMI group, respectively. Grade 2 tubular atrophy effect was the same in both groups (10%). Conclusion: Static kidney scintigraphy represents an objective and reproducible method to noninvasively investigate kidney function following irradiation. Amifostine produced a significant reduction in radiation-induced loss of renal function.Öğe Assessment of regional blood flow in cerebral motor and sensory areas in patients with spinal cord injury(Elsevier Science Bv, 2006) Cermik, Tevfik Fikret; Hakan, Tuna; Kaya, Meryem; Tuna, Filiz; Gultekin, Aziz; Yigitbasi, Omer Necmi; Alavi, AbassWe assessed the presence and the degree of alteration of the regional blood flow (rCBF) as visualized by Tc-99m HMPAO brain rest SPECT in the sensory motor cortex and subcortical structure in spinal cord injury (SCI) patients, who suffered from various levels of motor and sensory function loss. Twenty-two patients (mean age: 42.1 +/- 13.4 years, 18 M, 4 F) and 11 control subjects (mean age: 32.2 +/- 6.4 years, 8 M, 3 F) participated in this study. The spinal cord injury group was consisted of 2 groups (14 paraplegic and 8 tetraplegic patients). The corticocortical rCBF ratios were calculated by using region of interests obtained from 34 cortical areas on coronal slices. Significantly reduced rCBF were measured from 11 cortical areas in tetraplegic patients and 11 cortical areas in paraplegic patients. Some of these areas different in each group. In the tetraplegic group, significant reduction was observed in the following rCBF areas: left anterior cingulate gyrus, left medial supplementary motor area, bilateral front and back aspects of posterior cingulate gyrus, right lateral primary motor area, right medial primary sensory area, bilateral putamen, and right cerebellum. In the paraplegic group, reduced rCBF areas were as follows: bilateral anterior cingulate gyrus, lateral supplementary motor area, left front aspect of posterior cingulate gyrus, left primary motor area, bilateral back aspects of posterior cingulate gyrus, right medial sensory area, left lateral primary sensory area and bilateral putamen. In conclusion, some of the movement-cortical and subcortical areas having significantly reduced blood in SCI may be helpful to demonstrate the disrupted areas of rCBF by SPECT. We believe it may be useful if these findings should be considered during the evaluations related to reorganization in SCI cases. (c) 2006 Elsevier B.V. All rights reserved.Öğe A new clinical model in pulmonary embolism and its correlation with V/P scan results(Sage Publications Inc, 2006) Hatipoglu, Osman N.; Hanci, Emel; Tabakoglu, Erhan; Altiay, Gundeniz; Cermik, Tevfik Fikret; Caglar, TuncayThe study was prospectively designed to assess the correlation between a new clinical model empirically developed for acute pulmonary embolism (PE) and ventilation/perfusion (V/P) scan results. One hundred sixty consecutive patients with suspected acute PE underwent clinical evaluation before V/P scintigraphy. The clinical probability of PE was categorized according to a structured clinical model empirically developed as low, intermediate, or high, and the results were compared with those of V/P scintigraphy. Forty, 61, and 59 patients were classified as low, intermediate, and high clinical probability, respectively. Seventy-five percent (30/40) of the patients with low clinical probability were also of low scintigraphic probability or had a normal result (r(s): 0.39, p=0.000); 28% (17/61) of the patients with intermediate clinical probability demonstrated intermediate scintigraphic probability (r(s): 0.20, p=0.012); and 68% (40/59) of the patients with high clinical probability were also of high scintigraphic probability (r(s): 0.43, p=0.000). Overall, the correlation of two scoring systems was statistically significant (r(s): 0.39, p=0.000). Unilateral leg swelling (p=0.027), syncope or near syncope (p=0.002), amputation of a hilar artery (p=0.007), and electrocardiographic signs of right ventricular overload (p=0.000) prevailed in patients with high scintigraphic probability. Syncope-near syncope or hemodynamic collapse PLUS electrocardiographic signs of right ventricular overload or hypoxemia combination had the most significant correlation with a high scintigraphic probability (r(s): 0.31; p=0.000). In conclusion, the new clinical model empirically developed was significantly successful to provide comparable results with V/P scan. This consistency was particularly prominent in patients with low or high clinical probability for PE.Öğe Pelvic Rib: Developmental Anomaly, A Case Report(Aves Yayincilik, Ibrahim Kara, 2008) Tuna, Hakan; Tastekin, Nurettin; Uenlue, Ercuement; Cermik, Tevfik Fikret; Saridogan, KenanPelvic rib is a rare and benign developmental abnormality. It typically appears as a rib or phalanx-like bone in radiological evaluation. Cortical type bone is pronounced in its structure and pseudoarticulation can exist. It is generally asymptomatic and does not require surgical treatment. In differential diagnosis, myositis ossificans and avulsion injury must be ruled out. In our case, this developmental abnormality was identified accidentally by radiographic evaluation of a patient who had trauma. Therefore, pelvic rib should be remembered in differential diagnosis of developmental skeletal abnormalities. (Rheumatism 2008; 23: 151-3)Öğe Prevention of radiation-induced liver and kiney toxicity: a role for amifostine(Kare Publ, 2007) Uguzalp-Kaldir, Mine; Yurut-Caloglu, Vuslat; Cosar-Alas, Rusen; Cermik, Tevfik Fikret; Altaner, Semsi; Eskiocak, Sevgi; Saynak, MertOBJECTIVES To investigate the protective effect of amifostine against radiation induced liver and kidney injury of rats, using scintigraphic and histopathologic parameters. METHODS Female Wistar Albino rats were randomly allocated to 3 groups: control, radiotherapy alone (RT), and amifostine+RT (n=10). Single-dose of 600 cGy X-ray was performed with a single field compromised liver and right kidney. Amifostine was administered intraperitoneally at a dose of 400 mg/kg, 30 minutes before irradiation. Scintigraphic evaluation was performed before irradiation and the end of the study at 6 nd month. Histopathologic examinations were performed post mortem. RESULTS A clear protective effect of amifostine against radiation-induced late dam age in liver and kidney was found with scintigraphic evaluaticn. In addition, amifostine reduced the decrease of histopathologic changes for both of the tissues. CONCLUSION The results showed that amifostine significantly reduced radiation-induced liver and kidney toxicity and therefore warrant additional study in a clinically relevant fractionated model.Öğe Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism(Springer, 2007) Cermik, Tevfik Fikret; Kaya, Meryem; Ugur-Altun, Betuel; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N.Introduction We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography ( SPECT) images. Methods Included in this prospective study were 14 patients ( mean age 47.6 +/- 10.4 years; 3 male, 11 female) and 10 control subjects ( mean age 36.0 +/- 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60 - 90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Results Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R= 0.75 and P= 0.001, and R= 0.75, P= 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior temporal cortex. Conclusion Our results indicate that alterations in rCBF in patients with PHP can be demonstrated with brain SPECT. The correlation between serum calcium, PTH levels and the sum of hypoperfused regions indicates that there may be a strong relationship between rCBF abnormalities and increased levels of serum calcium and PTH. In addition, the degree of rCBF abnormalities could be determined by brain SPECT in PHP patients with or without psychiatric symptoms.Öğe Scintigraphic findings in plant thorn tenosynovitis of finger(Lippincott Williams & Wilkins, 2008) Kaya, Meryem; Tuna, Hakan; Tuncbilek, Nermin; Cermik, Tevfik Fikret; Saridogan, KenanA 37-year-old women with pain and swelling in the third finger of the left hand for 10 months secondary to a plant-thorn injury in her garden is presented. Three-phase bone scintigraphy was subsequently requested after the results of plain radiography were reported as normal. Dynamic bone scintigraphy showed increased activity in the proximal phalanx on the 3 phases of the study. Magnetic resonance imaging described the inflammatory soft tissue formation around the third flexor tendon as tenosynovitis. Culture of biopsy material was negative, and the histology was consistent with chronic inflammatory changes.
