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Öğe 99mTc-HMPAO brain perfusion single-photon emission computed tomography in children with Down syndrome(Sage Publications Inc, 2006) Altiay, Suriye; Kaya, Meryem; Karasalihoglu, Serap; Gultekin, Aziz; Oner, Naci; Biner, BetulIn recent years, it has been possible for patients with Down syndrome to live longer with advanced medical treatment and social support. As a result, the problems of these patients, such as thyroid diseases, leukemia, and Alzheimer disease, would be encountered more frequently. In this study, we aimed to perform the brain perfusion of children with Down syndrome by technetium 99m hexamethylpropylene amine oxime (Tc-99m-HMPAO) single-photon emission computed tomography (SPECT) and to determine the relationship between brain perfusion and epilepsy, thyroid function tests, congenital heart disease, and level of mental and motor development. Thirty patients with Down syndrome, aged between 1 and 15 years, were included in our study. Demographic data, the existence of epilepsy and congenital heart defects, the level of mental and motor development, serum. levels of thyroid hormones, and autoantibodies were determined. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI). Cerebral SPECT was per-formed in all cases to evaluate the brain perfusion pattern. According to the visual evaluation of cerebral SPECT results, hypoperfusion was detected in 11 cases (37%). Patients with cerebral hypoperfusion (group 1) and patients with normal cerebral perfusion (group 2) were compared. There was no difference between group 1 and group 2 in terms of demographic data, congenital heart defects, IQ levels, thyroid hormones, and autoantibodies, but the incidence of epilepsy was significantly higher in group 1 (P < .001). When motor and mental development levels were compared, it was found that cases in group 1 were significantly more retarded in personal-social and fine motor skills (P < .05). The present study showed that cerebral hypoperfusion in children with Down syndrome is mostly related to epilepsy and the other coexisting conditions, congenital heart disease and hypothyroidism. Patients with cerebral hypoperfusion also have more retarded developmental levels, especially in personal-social and fine motor skills.Öğe Akciğer kanserli hastalarda 99mTc-sestamibi ve 99mTc-DMSA (V) sintigrafisinin karşılaştırılması(1999) Gümüşer, F. Gül; Sarıkaya, Ali; Pekindil, Gökhan; Yüksel, Mahmut; Kaya, Meryem; Çağlar, Tuncay; Berkarda, ŞakirTechnetium-99m methoxyisobutylisonitrile (99mTc-sestamibi) ve Technetium-99m pentavalent dimercaptosuccinic asid (99mTc-DMSA(V))'in akciğer kanseri tanısındaki rolünü saptamak için sırasıyla 30 ve 22 hastaya planar sintigrafi ve single photon emission computerized tomography (SPECT) görüntüleme yapıldı. Bütün hastalara bronkoskopi ve bilgisayarlı tomografi (BT) yapıldı ve sintigrafi görüntüleri kalitatif kantitatif olarak değerlendirildi. Primer tümör için 99mTc-sestamibi'nin duyarlılığı planarda %97, SPECT'te %100, 99mTc-DMSA(V)'inki ise %82'ue %91 olarak bulundu. Hiler ve mediastinal tutulum için 99mTc-sestamibi'nin duyarlılığı planarda %42, SPECT'te %100, 99mTc-DMSA(V) SPECT'in ki ise %12 idi. Beş hastada sintigrafide her iki radyofarmasötik'le de tümörde nekrozu düşündüren aktinite düşüklüğü tespit edildi. Yassı küçük hücreli kanserler arasında tümör uptake oranı (TUO) açısından bir fark bulunamadı. Sonuç olarak 99mTc-sestamibi hem primer tümörü hem de hiler ve mediastinal tutulumu değerlendirmede 99mTc-DMSA (V)'den daha duyarlı idi her iki ajan için SPECT, planar görüntülemeden daha hassastı.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 Complicated xanthogranulomatous pyelonephritis in a child(Wiley-Blackwell Publishing, Inc, 2010) Ozkayin, Nese; Inan, Mustafa; Aladag, Nukhet; Kaya, Meryem; Iscan, Burcin; Yalcin, Omer[Abstract Not Available]Öğe Do the Brain Perfusion SPECT Findings Reflect the Outcome of Rehabilitation in Stroke Patients?(Lippincott Williams & Wilkins, 2009) Kabayel, Derya Demirbag; Ozdemir, Ferda; Kaya, MeryemThe purpose of this study is to investigate the association between brain perfusion single-photon emission computed tomography (SPECT) changes and the observed improvement in the clinical parameters, and therefore evaluate whether or not SPECT can predict the outcome of the rehabilitation of patients. Nineteen stroke patients were included in the prospective study. Patients were hospitalized within the first month after their stroke and were in the rehabilitation program for 2 months. A clinical evaluation and a brain perfusion SPECT was conducted during the admission, and on the completion of the rehabilitation program. The outcome measurements included Brunnstrom stage, Modified Ashworth Scale, functional independence measurement, functional ambulation categories, and mini-mental state examination. The brain perfusion SPECT was conducted by the evaluation of the regional cerebral blood flow on 12 different regions on both of the hemispheres. The comparison of the first and the third month clinical scores showed a statistically significant difference. However, the brain perfusion SPECT values' first and third month comparisons showed no difference on any of the measured parameters. Furthermore, there was no correlation between the clinical scores and SPECT values, for both the first month measures and the third month measures. The observed clinical improvement observed during the rehabilitation process of the stroke patients has no association to brain perfusion SPECT evaluations. Brain perfusion SPECT could not be a very good predictor for measuring clinical outcomes for stroke patients.Öğe Does valproate therapy decrease the bone mineral density in one-year follow-up in children?(2009) Bostancıoğlu, Musa; Öner, Naci; Küçükuğurluoğlu, Yasemin; Kaya, Meryem; Çiftdemir, Nükhet Aladağ; Çeltik, Coşkun; Karasalihoğlu, Serap TevhideAmaç: Epilepsi uzun sureli antiepileptik tedavi gerektiren kronik bir hastalıktır. Bu çalışmanın amacı, en sık kullanılan antiepileptik ilaç olan valproatın kemik mineral metabolizmasına olan yan etkilerini değerlendirmektir. Hastalar ve Yöntemler: Bu çalışma epilepsi veya febril konvulziyon profilaksisi amacıyla valproat başlanan 61 hastada (38 kız, 28 erkek; ort. yaş 81.2±44.5 ay; dağılım 12-168 ay) yapıldı. Bütün olgularda valproat tedavisi öncesinde ve 12 ay sonrasında, kemik mineral metabolizmasındaki bozukluklar açısından kemik mineral dansitesi ve biyokimyasal parametrelere bakıldı. Bulgular: Bir yıllık valporat tedavisi sonrasında kemik mineralizasyon bozukluğunu gösterebilecek kalsiyum, fosfor, alkalen fosfatazda istatistiksel olarak anlamlı farklılık tespit edilmemiştir. İki hastada (%3.3) osteoporoz tespit edilmiştir. Sonuç: Valproatın kemik mineral metabolizması üzerine yan etkileri tartışmalıdır. Osteopeni belirtilerini değerlendirmek için, kemik biyokimyası, 25-hidroksi D vitamini, hormonal parametreler ve kemik mineral dansitesinin tek başlarına değerlendirilmesi yetersizdir, mutlaka bu parametreler birlikte değerlendirilmelidir. Biyokimyasal parametreler bozulmadan, kemik mineral dansitesi değişiklikleri olacağından, valproat tedavisi alan hastalarda yıllık kemik mineral dansitesi ölçümleri yapılmalıdır.Öğe The effectiveness of splenic autotransplantation(Turkish Assoc Trauma Emergency Surgery, 2007) Karaguelle, Erdal; Hoscoskun, Zeki; Kutlu, Ali Kemal; Kaya, Meryem; Baybar, SerkanBACKGROUND The purpose of this study was to establish the effects of spleen autotransplantation on immunity and to examine the viability of autotransplanted spleen tissue. METHODS Three groups were assigned and following operations were performed in twenty New Zealand rabbits. 1st group: sham laparotomy, 2nd group: splenectomy and 3rd group: splenectomy and splenic autotransplantation. Scintigraphic methods, hematological-immunological tests and histopathological examination were used to evaluate the effects of splenic autotransplantation. RESULTS Histopathological findings showed that eight rabbits had splenic regrowth and two had necrosis of autotransplanted splenic tissue. Preoperative hematological and immunological findings compared with those at sixth week postoperatively. In group 3, postoperative immunoglobulin G, immunoglobulin M and interleukin-1 levels were significantly increased when compared with preoperative levels. Between all groups, postoperative leukocyte counts were found to be significantly higher in group 2 comparing with group 1. In group 2, postoperative platelet counts were significantly higher in comparison to group 1 and 3. No statistically significant difference was detected between the groups for immunoglobulin G, immunoglobulin M and interleukin-1 levels. CONCLUSION Conservative treatment is important in patients with splenic injury. However when splenectomy is indicated, splenic autotransplantation into the omentum pouch could be a reliable method for reconstruction of splenic functions and the viability of the implanted spleen tissue can be monitored by scintigraphy and laboratory examination.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.Öğe Serebral palsili çocuklarda Tc-99m HMPAO ile beyin perfüzyon SPECT'nin değerlendirilmesi(Trakya Üniversitesi, 1997) Kaya, Meryem; Berkarda, ŞakirStatik ensefalopatilerden olan CP'rıin teşhisinde nörolojik muayene, EEG ve CT gibi günümüzde yaygın olarak kullanılan teşhis yöntemlerine ek olarak beyin perfüzyon SPECT çalışmasının bu hastalığın teşhisindeki yerini değerlendirmek üzere çalışmaya 34 CP'li hasta [18 hasta spastik quadripleji, 3 hasta spastik dipleji, 8 hasta spastik hemipleji, 2 hasta koreoatetoid (diskinetik), 3 hasta ataksik tip] ve 10 normal çocuk alındı. Tüm hastalara ve normal gruba iv Tc- 99m HMPAO verilerek beyin perfüzyon SPECT'i çekildi. Beyin perfüzyon SPECT'i ile elde edilen görüntüler semikantitatif olarak analiz edildi. Spastik quadriplejik, diplejik, hemiplejik CP'li olgularda serebellum tutulumu olmadığı için referans nokta seçilerek hastaların kortikoserebellar oranları alındı. Ayrıca spastik hemiplejik olgularda tek taraflı (unilateral) tutulum olacağı göz önünde bulundurularak sağ ve sol hemisfer arasındaki yüzde farklarıda hesaplandı. Ataksik ve koreoatetoid CP'li hastalarda serebellum tutulumu beklendiği için sadece sağ ve sol hemisferler arasındaki yüzde farkları hesaplandı ve % 12'den yüksek bulunan farklar kortikal bölgesel CBF perfüzyon defekti lehine kabul edildi. Sonuç olarak CP'nin erken teşhisinde ve uygulanılan tedavinin etkinliğinin değerlendirilmesinde beyin perfüzyon SPECT'inin rutin kullanımda olan nörolojik muayene, EEG ve CT gibi teşhis metodlarına ek bilgiler sağlayacağı ve klinikte kolaylıkla uygulanılabilen noninvazif bir yöntem olduğunu düşünmekteyiz.Öğe Sonographic volume measurement of the thyroid gland in healthy Turkish adult women(1999) Kaya, Meryem; Kutoğlu, Tunç; Altun, Gülay D.; Yüksel, Mahmut; Uğur, H. Betül; Çiftçi, ŞükranAmaç: Tiroid bezinin ekografisi noninvazif ve kontrendikasyonu olmayan basit bir metoddur. Bu metodun güvenilir, ucuz ve teşhis etkinliği oldukça yüksektir. Ultrasonografi ile sağlanan yapısal bilgi laboratuvar testlerinin ve diğer invivo tekniklerin sonuçlarını tamamlamaktadır. Bu çalışmanın amacı normal ve ötiroid yetişkin Türk kadınlarında tiroid volümünü tespit etmekti. Metod: Bu çalışma 87 yetişkin Türk kadını üzerinde yapıldı Tüm hastalar klinik muayene ve radyoimmünassay tekniği ile hesaplanan fT3, fT4, TSH değerleri ışığında değerlendirildi. Tiroid bezinin sağ ve sol loblarının volümleri Brunn ve arkadaşlarının formülü (genişlik x uzunluk x derinlik x 0.479) kullanılarak tüm hastalar için real-time sonografik değerlerinden hesaplandı. Bulgular: Sağ lobun boyutları, sol lobun boyutlarından anlamlı olarak daha yüksekti (p<0.05). Bu çalışma grubunda, tiroid volümü 12.22±6.21 ml. olarak hesaplandı. Ortalama fT3, fT4, TSH değerleri sırasıyla 4.37±0.73 pg/dl, 1.29±0.22 ng/dl, 1.43±1.04 olarak hesaplandı. Sonuç: Bu çalışmada elde ettiğimiz sonuçlar literatürde yer alan araştırmalarla uyumlu bulundu.Öğe Tc-99m MIBI scintigraphy in tall cell variant of papillary thyroid carcinoma with negative radioiodine scan(Lippincott Williams & Wilkins, 2008) Kaya, Meryem; Cermik, Teyfik FikretWe report on a 45-year-old man who had a mass on the wall of the anterior right hemithorax. An excisional biopsy indicated carcinoma metastasis from thyroid malignancy. Tc-99m methoxy-isobutyl isonitrile (MIBI) scintigraphy revealed markedly increased activity on the left side of the thyroid and the thoracic wall mass. Postoperative histology revealed a tall cell variant of papillary thyroid carcinoma. Whole body scintigraphy after radioiodine treatment was negative twice. However, Tc-99m MIBI and bone scintigraphy showed multiple soft tissue and bone metastases in the follow-up period. He died 3 years later because of complications of distant lung metastases.
