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Öğe 111In-pentetreotide and 123I-MIBG for detection and resection of lymph node metastases of a carcinoid not visualized by CT, MRI or FDG-PET(Springer, 2005) Yüksel, M; Eziddin, S; Ladwein, E; Haas, S; Biersack, HJA patient with a history of a jejunal carcinoid and resection of liver metastases underwent CT, MRI and FDG-PET as well as somatostatin receptor scintigraphy using In-111-pentetreotide during follow-up. Octreoscan demonstrated one extrahepatic abdominal lesion with pathologic uptake, while the other imaging modalities failed to show a corresponding abnormality. For verification of this finding I-123-MIBG scintigraphy was performed. The MIBG scan confirmed the octreotide positive lesion and showed an additional abdominal lesion in the SPECT study. According to the scintigraphic results, radioguided surgery (RGS) was implemented using I-123-MIBG. This resulted in the intra-operative detection of two para- and pre-aortic lymph node metastases by the gamma probe and successful resection. An additional preaortal lymph node, suspicious by palpation, was also removed. Histopathology revealed metastases of a carcinoid tumor in all three specimens. In conclusion, the use of RGS facilitates successful removal of carcinoid metastatic lesions despite negative conventional imaging results. Secondly, I-123-MIBG scintigraphy may provide advantages over octreoscan for preoperative localization as well as radio-guided surgery of neuroendocrine metastatic lesions, if the involved site is located in proximity to highly octreotide-avid organs such as the kidneys or spleen.Öğe 99mTc-MIBI SPET in non-small cell lung cancer in relationship with Pgp and prognosis(Springer, 2002) Yüksel, M; Çermik, TF; Doganay, L; Karlikaya, C; Çakir, E; Salan, A; Berkarda, SHigher technetium-99m methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) has been reported to be associated with a positive response to chemotherapy. It has previously been found that in tumour cells, P-glycoprotein (Pgp) expression is of importance for tracer uptake. However, some studies have indicated that Pgp expression does not play an important role in Tc-99m-MIBI uptake in NSCLC; indeed, a negative correlation between 99mTc-MIBI uptake and Pgp expression has been reported. Against the background of conflicting results, our aim was to evaluate the relationship between Tc-99m-MIBI uptake, prognosis and Pgp expression in NSCLC. A total of 37 patients with NSCLC underwent Tc-99m-MIBI single-photon emission tomography (SPET) before chemotherapy. In 19 patients both Pgp and p53 expression, and in two patients only p53 expression (due to the limited biopsy material), were measured with immunohistochemical staining. Tc-99m-MIBI uptake was significantly higher in responders than in non-responders: 3.09+/-1.14 vs 2.24+/-0.88 (P<0.03) and 3.09+/-1.08 vs 2.37+/-1.06 (P<0.05) for the early ratio (ER) and the delayed ratio (DR), respectively. The wash-out rate (WR) of responders was not significantly different from that of non-responders. We found no significant differences in ER, DR and WR among the groups positive or negative for Pgp and p53 status. There was a significant positive correlation between the survival rate and both ER and DR: r=0.49 (P=0.003) and r=0.40 (P=0.018), respectively. Patients with ER and DR values above 3 showed significantly longer survival than those with values below 3: 14.7+/-8.5 months vs 7.3+/-5.1 months (P<0.009) and 13.2+/-8.4 months vs 7.4+/-5.3 months (P<0.04) for ER and DR, respectively. However, interestingly, and in contrast to expectations, patients with a Pgp score of +2 showed significantly longer survival (12.9+/-6.7 months) than those with Pgp scores of +1 (4.4+/-3.0 months) or - (negative) (3.8+/-2.2 months) (P<0.009 and P<0.02, respectively). Our results suggest that in NSCLC, patients with higher Tc-99m-MIBI uptake tend to show a positive response to chemotherapy, and patients with ER and DR values above 3 have a significantly better prognosis. We also found that Pgp expression seems to play only a minor role in Tc-99m-MIBI uptake. Our finding that patients with ER and DR values above 3 have a better prognosis needs to be confirmed in larger series of patient.Öğe Bone metastasis from primary splenic angiosarcoma to the sacrum demonstrated by Tc-99m-labeled red blood cell and Tc-99m MDP bone scintigraphy(Lippincott Williams & Wilkins, 2001) Çermik, TF; Yüksel, M; Demir, M; Özyilmaz, F; Kaya, M; Vural, Ö; Berkarda, S[Abstract Not Available]Öğe A case of acute tubular necrosis with intestinal visualization of Tc-99m DMSA(Lippincott Williams & Wilkins, 2000) Yüksel, M; Üstün, F; Salan, A; Sen, S; Berkarda, S[Abstract Not Available]Öğe The comparison of electron microscopy and scintigraphy in determining the protective effect of dimethylsulphoxide (DMSO) on ischemia/reperfusion injury through pringle maneuver(H G E Update Medical Publishing S A, 2001) Hatipoglu, AR; Temiz, E; Yüksel, M; Hoscoskun, Z; Coskun, I; Hüseyinova, GBackground/Aims: We investigated the role of the electron microscopy and hepatobiliary scintigraphy in determining the effect of DMSO (dimethysulphoxide) and ischemia/reperfusion injury in the liver after the Pringle maneuver. Methodology: Twenty-four rabbits were divided into the following groups; A: Control group, B: Pringle, C: 10mg/kg DMSO, D: 1g/kg DMSO + Pringle. Group A was considered as a control group and only laparotomy was applied. Group B was exposed to Pringle maneuver only. Group C:was given 10mg/kg of DMSO via the vena cava inferior. Group D was given 1g/kg of DMSO- A clamp was fastened for the groups of B, C and D in the 30th minute of the Pringle maneuver and a biopsy was applied five minutes later. Fifteen minutes later a dynamic hepatobiliary scintigraphy was applied. From dynamic images, liver peak time and activity half time of the liver were obtained. Results: It was found that liver peak time and liver activity half time values of the group B, C and D were significantly longer than group A. Liver peak time and liver activity half time values of group B was not different from group C. However, some values of group D were found to be significantly shorter than groups B and C. In the electron microscopy examination, only in group B were some specific degenerative changes observed in the sinusoids. We observed less irreversible changes in group C than in group B. Oh the other hand, the least irreversible changes were in group D. Conclusions: As a conclusion, while electron microscopy is regarded as the gold standard, hepatobiliary scintigraphy may be thought of as an easily applicable: method in determining the ischemic reperfusion injury in the clinical comparison of the protective agents.Öğe Comparison of Tc99m MIBI lung and liver uptakes during dipyridamole stress test with or without aminophylline(Springer Verlag, 1999) Yüksel, M; Durmus-Altun, G; Altun, A; Berkarda, S[Abstract Not Available]Öğe Comparison of the protective effects of dimethylsulphoxide and methylprednisolone against the warm ischemia on liver parenchima using hepatobiliary scintigraphy(Springer-Verlag, 2001) Yüksel, M; Hatipoglu, AR; Terniz, E; Saihoglu, YS; Berkarda, S; Yigitbas, ON[Abstract Not Available]Öğe Comparison with clearance of Tc-99m DTPA aerosol, and CO diffusing capacity, and lung function test in house painters(Springer-Verlag, 2001) Kaya, M; Salan, A; Tabakoglu, E; Aydogdu, N; Yüksel, M; Salihoglu, YS; Yigitbas, ON[Abstract Not Available]Öğe Evaluation of alveolo-capillary permeability in thyrotoxicosis using Tc-99m DTPA aerosol scintigraphy(Springer, 2005) Gültekin, A; Yüksel, M; Mert, S; Berkarda, FSurfactant secreted from type II pneumocytes plays an important role in alveolo-capillary permeability. In thyrotoxicosis, high levels of T3 receptors detected at these cells might affect the alveolocapillary permeability due to increased serum thyroid hormone levels. The results by CO-diffusion capacity measurement in thyrotoxicosis are conflicting. Changes in alveolo-capillary membrane permeability resulting from thyrotoxicosis are not well established yet. This prompted us to investigate the alveolo-capillary permeability in thyrotoxic patients in comparison with CO-diffusing capacity. For this aim twenty-two non-smoking thyrotoxic patients (before treatment) and fifteen healthy voluntary controls underwent Tc-99m-DTPA aerosol scintigraphy. CO-diffusing and pulmonary function tests were performed in all subjects. After ventilation of radiotracer through a nebulizer for 15 minutes, 30 dynamic images (1 frame/minute) were taken from both lungs. ROI's were drawn over both lung areas, and the time-activity curves were generated. Then clearance half time (CT1/2) for radioaerosol was obtained. CT1/2 of thyrotoxic patients did not differ from that of the controls: 77.9 +/- 25.9 min vs. 79.4 +/- 22.3 min; p > 0.05. Similar result was found for CO-diffusion parameters. Also there was no significant correlation between CT1/2 and CO-diffusion parameters. We concluded that in patients with thyrotoxicosis, the alveolo-capillary permeability is unaffected. Further experimental research is needed to establish the possible effects of thyroid hormones on alveolo-capillary membrane.Öğe Evaluation of liver parenchimal damage after pringle manoeuvre and protective effect of DMSO using hepatobiliary scintigraphy(Springer Verlag, 1999) Yüksel, M; Hatipoglu, A; Temiz, E; Salihoglu, YS; Hüseyinova, G; Berkarda, S[Abstract Not Available]Öğe Hepatobiliary scintigraphy for evaluating the hepatotoxic effect of halothane and the protective effect of catechin in comparison with histo-chemical analysis of liver tissue(Lippincott Williams & Wilkins, 2002) Karamanlioglu, B; Yüksel, M; Temiz, E; Salihoglu, YS; Çiftçi, SHalothane and its metabolites cause liver damage by decreasing liver blood flow and generating free-radical species. Catechin suppresses lipid peroxidation and increases enzyme activity, therefore it seems to be capable of protecting liver parenchyma against tine direct toxic effect of halothane. The aim of this study was to investigate the role of hepatobiliary scintigraphy in detecting liver damage after halothane anaesthesia and the protective effect of catechin in comparison with histo-chemical analysis. Thirty rabbits, divided into three groups (A, controls; B, halothane; and C, catechin+halothane), were investigated. In group A no anaesthesia was administered. Group B only received halothane, while group C was pretreated with catechin and halothane anaesthesia was administered for 2 h. Dynamic scintigrams were taken for 60 min after injecting Tc-99m-mebrofenin, and the time of peak uptake (TPU) and the time for half of the activity to clear from the liver (T-1/2) were calculated. Rabbits were killed, and malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) levels were measured in hepatic tissue. The TPU and T-1/2 values of group A is significantly lower than in groups B and C (P < 0.0002 and P < 0.0002, respectively, for TPU; and P < 0.0002 and P < 0.0003, respectively, for T-1/2). The TPU and T-1/2 values of group B were significantly higher than in group C (P < 0.0003 and P < 0.0003, respectively). The hepatic MDA level of group A was significantly lower than in groups B and C (P < 0.0002 and P < 0.0002, respectively). SOD, GSH-Px and CAT levels of group A were significantly higher than in groups B and C (P < 0.0002, P < 0.0001 and P < 0.003, respectively, for group A vs group B; and P < 0.0005, P < 0.0002 and P < 0.03, respectively, for group A vs group C). The MDA level of group B was significantly higher than that in group C (P < 0.0002). SOD, GSH-Px and CAT levels of group B were significantly lower than in group C (P < 0.0002, P < 0.0002 and P < 0.003, respectively). According to these results, we suggest that catechin protects liver parenchyma against the toxic effect of halothane and its metabolites, and that, compared to invasive histo-chemical analysis, hepatobiliary scintigraphy is a useful and alternative noninvasive method for detecting the protective effect of catechin on liver parenchyma after halothane anaesthesia. ((C) 2002 Lippincott Williams & Wilkins).Öğe Incidental detection of single vertebral osteomyelitis in a patient operated on for parathyroid hyperplasia(Lippincott Williams & Wilkins, 2001) Çermik, TF; Yüksel, M; Yalniz, E; Kaya, M; Ugur, B; Tugrul, A; Berkarda, S[Abstract Not Available]Öğe Maternal serum cytokine levels in women with hyperemesis gravidarum in the first trimester of pregnancy(Elsevier Science Inc, 2003) Kaplan, PB; Gücer, F; Sayin, NC; Yüksel, M; Yüce, MA; Yardim, TObjective: To compare serum cytokine levels in patients with hyperemesis gravidarum with levels in healthy pregnant and nonpregnant women. Design: Case-control study. Setting: Clinical and academic research center. Patient(s): Thirty women with hyperemesis gravidarum, 30 healthy women in the first trimester of pregnancy, and 30 healthy nonpregnant women. Main Outcome Measure(s): Serum levels of interleukin-1beta, interleukin-2 receptor, interleukin-6, interleukin-8, and tumor necrosis factor (TNF)-alpha. Result(s): Median serum levels of interleukin-2 receptor and interleukin-8 did not differ significantly among the three groups. Serum levels of interleukin-1beta and interleukin-6 were significantly higher in healthy pregnant women than in healthy nonpregnant women. Median TNF-alpha levels were significantly higher in women with hyperemesis (25.8 pg/mL [range, 4.9-140 pg/mL]) than in healthy pregnant and nonpregnant women (10.85 pg/mL [range, 4.1-35.8 pg/mL] and 12 pg/mL [4.3-68.2 pg/mL], respectively). Conclusion(s): Levels of TNF-alpha were significantly higher in patients with hyperemesis gravidarum than in healthy pregnant and nonpregnant women. Thus, TNF-alpha may be involved in the etiology of hyperemesis gravidarum.Öğe Maternal serum levels of tumor necrosis factor-? and interleukin-2 receptor in threatened abortion(Elsevier Science Inc, 2001) Gücer, F; Balkanli-Kaplan, P; Yüksel, M; Sayin, NC; Yüce, MA; Yardim, TObjective: We evaluated tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) receptor levels in patients with threatened abortion and compared the levels with normal and pathologic pregnancies. Design: A prospective, nonrandomized, case-control study. Setting: Academic research setting. Patient(s): Twenty-two patients with threatened abortion, 18 patients with pathologic pregnancies, 20 healthy pregnant women, and 20 nonpregnant women. Intervention (s): Maternal serum TNF-alpha and IL-2 receptor levels were measured with a solid-phase, two-site chemiluminescent enzyme immunometric assay method. Main Outcome Measure(s): TNF-alpha and IL-2 receptor levels. Result(s): The mean SEM maternal serum IL-2 receptor level for patients with threatened abortion was 481.3 +/- 35.7 U/mL, compared with 426.5 +/- 22.4 U/mL in the normal pregnant group. There was no statistically significant difference in the mean SEM serum TNF-alpha level between the patients with threatened abortion and those with normal pregnancies (16.1 +/- 2.7 pg/mL vs. 10.9 +/- 0.8 pg/mL). The mean SEM maternal serum IL-2 receptor level was significantly higher in patients with pathologic pregnancies than in those with normal pregnancies (506.2 +/- 27.6 U/mL vs. 426.5 22.4 U/mL). The mean SEM maternal serum TNF-alpha level was significantly higher in patients with pathologic pregnancies than in those with threatened abortion (39.2 +/- 9.5 pg/mL vs. 16.1 +/- 2.7 pg/mL) and normal pregnancies (39.2 +/- 9.5 pg/mL vs. 10.9 +/- 0.8 pg/mL). Conclusion(s): In comparison with normal pregnancies, maternal serum IL-2 receptor and TNF-alpha levels were not significantly increased in patients with threatened abortion with good outcome. (Fertil Steril(R) 2001;76: 707-11. (C) 2001 by American Society for Reproductive Medicine.).Öğe Maternal serum tumor necrosis factor-? in patients with preterm labor(Sci Printers & Publ Inc, 2001) Gücer, F; Balkanli-Kaplan, P; Yüksel, M; Yüce, MA; Türe, M; Yardim, TOBJECTIVE: To evaluate maternal serum tumor necrosis factor-alpha (TNF alpha) levels in patients with preterm labor without clinical signs of chorioamnionitis and to compare these with levels in nonlaboring controls. STUDY DESIGN: The study group consisted of 44 patients with a singleton pregnancy admitted to our department with the diagnosis of preterm labor between 26 and 36 weeks' gestation. The control group consisted of 25 healthy consecutive patients with a singleton pregnancy without preterm contractions who were seen for routine antenatal visits. Maternal serum TNF alpha was measured using a solid-phase, two-site chemiluminescent enzyme immunometric assay method, and levels were compared in patients with preterm labor and nonlaboring controls. RESULTS: The median maternal serum TNF alpha level for patients with preterm labor was 29.4 pg/mL (range, 12.3-173) as compared with 23 pg/mL (range, 11.9-62.7) in the control group (P = .031). Among 44 patients with preterm labor, 14 (32%) delivered within one week of admission. The median maternal serum TNF alpha level was significantly higher in patients who delivered within one week than in those who delivered after one week and controls (71.3 pg/mL [range, 28-173]) versus 22 pg/mL (range, 12.3-86) versus 23 pg/mL (range, 11.9-62.7) (P < .0001). CONCLUSION: TNF was elevated in patients with preterm labor, suggesting a role for maternal serum TNF alpha in its initiation.Öğe Monitoring the chemotherapeutic response in primary lung cancer using 99mTc-MIBI SPET(Springer-Verlag, 2001) Yüksel, M; Çermik, TF; Karlikaya, C; Salan, A; Çakir, E; Gültekin, A; Berkarda, FPrediction and evaluation of the response to chemotherapy (CTx) are important for the correct and cost-effective treatment of patients with primary lung cancer. Although fluorine-18 fluorodeoxyglucose. positron emission tomography (FDG-PET) is accepted as the most useful and accurate nuclear medicine technique for this purpose, its expense and limited availability restrict its use. Compared with PET agents, technetium-99m methoxyisobutylisonitrile (MIBI), which is used in nuclear oncology, is cheaper and available in any nuclear medicine clinic. With this in mind, in this study we aimed to evaluate the role of Te-99m-MIBI in monitoring the chemotherapeutic response in primary lung cancer. Twenty patients with primary lung cancer underwent Tc-99m-MIBI single-photon emission tomography (SPET) at 15 min (early) and 3-4 h (delayed) after injection of the tracer. All patients underwent 99mTc-MIBI SPET study twice: before and after the 3rd cycle of CTx. Patients were divided into two groups, responders [R(+), n=10] and nonresponders [R(-), n=10], according to the change in tumour size on CT scan taken 2 weeks after the last cycle of the CTx. From the SPET images early and delayed tumour/lung ratios (ER and DR) were obtained before and after CTx. In the R(+) group, ER and DR decreased significantly after CTx, from 3.28 +/-1.55 to 1.78 +/-0.72 (P <0.04) and from 3.23 +/-1.55 to 2.0 +/-0.88 (P <0.05), respectively. However, in the R(-) group, while ER showed a slight and statistically insignificant increase after CTx (from 2.51 +/-1.23 to 2.65 +/-1.86), DR increased significantly, from 2.74 +/-1.37 to 3.27 +/-2.31 (P <0.03). The percentage decreases in ER and DR in the R(+) group after CTx was significantly higher than that in the R(-) group: 34.36%+/- 26.7% vs -13.78%+/- 27.58% (P <0.0002) and 29.45%+/- 25.23% vs -18.58%+/- 20.51% (P <0.0005), respectively. Using a decrease of greater than or equal to 10% as a threshold for monitoring the chemotherapeutic response, Te-99m-MIBI had a sensitivity of 90% and a specificity of 100%. We found a positive correlation in 14 patients between ER and DR and survival: r=0.6754 and P=0.008, and r=0.5755 and P=0.031, respectively. Our results suggest that Te-99m-MIBI might be used in routine practice to monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available.Öğe The relationship between Tc-99m MIBI uptake and chemotherapeutic response, metastasis, Pgp, p53, and prognosis in lung cancer(Springer-Verlag, 2001) Yüksel, M; Çermik, TF; Doganay, L; Karlikaya, C; Salan, A; Çakir, E; Ture, M[Abstract Not Available]Öğe Relationship with plasma neurohormones and dyssynchrony detected by Doppler echocardiography in patients undergoing permanent pacemaker implantation(Taylor & Francis Ltd, 2003) Kürüm, T; Yüksel, M; Özbay, G; Söyük, S; Türe, MObjective - To determine whether isovolumic relaxation flow (IRF) and isovolumic contraction flow (ICF) resulted from asynchrony and asynergy due to VVI and DDD pacemakers modulated neurohormones, we measured neurohormone levels in plasma and investigated the characteristics of IRF and ICF using Doppler echocardiography. Methods and results - We studied 11 patients with dual-chamber pacemakers (DDD) and 11 patients, with ventricular inhibiting mode (VVI). All patients underwent Doppler echocardiography of the left ventricle. Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), renin and aldosteron were measured. The LV was scanned for the presence of intracavitary flow during the isovolumic relaxation and isovolumic contraction period. The plasma levels of BNP and ANP were significantly lower in DDD mode than in VVI mode (56+/-32 pg/ml vs. 94+/-32 pg/ml, p=0.022 and 98+/-20 pg/ml vs. 134+/-17 pg/ml, p=0.042, respectively). There were no significant differences in the plasma level of renin or aldosteron. VVI mode versus DDD mode increased isovolumic relaxation flow time (129+/-41 vs. 111+/-36 sec, p = 0.020) and isovolumic relaxation flow velocity (50+/-4 vs. 37+/-2 cm/s, p=0.018). A strong relationship between blood ANP and BNP levels and IRF velocity was found in patients with a VVI pacemaker (r: 0.632, p: 0.028; r: 0.528, p: 0.024, respectively). Conclusion - VVI mode has a longer isovolumic relaxation time, isovolumic relaxation flow velocity and has higher ANP and BNP plasma levels than DDD mode. IRF resulting from asynergy and asynchrony in VVI mode pacemakers versus DDD mode pacemakers affects the plasma levels of ANP and BNP compared to renin and alclosteron.Öğe The role of hepatobiliary scintigraphy in the evaluation of the protective effects of dimethylsulphoxide in ischaemic/reperfusion injury of liver(Lippincott Williams & Wilkins, 2000) Yüksel, M; Hatipoglu, A; Temiz, E; Salihoglu, YS; Hüseyinova, G; Berkarda, SLiver ischaemia may lead to parenchymal damage depending on the duration of the ischaemia. Dimethylsulphoxide (DMSO), a well-known radical oxygen scavenger, is a protective agent against ischaemia/reperfusion injury. In this study we aimed to investigate the role of hepatobiliary scintigraphy (HBSc) in detecting the protective effect of DMSO. Eighteen rabbits, in three groups of six, were injected with 37 MBq technetium-99m-mebrofenin via the ear veins. Dynamic scintigrams were taken for 60 min (1 frame/min). In group A, HBSc was performed without any surgery. In groups B and C the Pringle manoeuvre (PM) was applied for 30 min, and tissue specimens for electron microscopy were taken from the liver parenchyma 5 min after the end of the PM. In addition, in group C 1 g/kg DMSO was injected into each rabbit 5 min before application of the PM. HBSc was then performed in groups 5 and C. From the dynamic images time-activity curves (TACs) were obtained for each group, and the time of peak uptake (TPU) and time for half of the activity to clear from the liver (T 1/2) were calculated. The TPU and T 1/2 of group B were significantly longer than those of groups A and C (P <0.0005 and P < 0.005 for TPU, and P<0.0005 and P<0.02 for T 1/2 respectively). The TPU and T 1/2 of group C were significantly longer than those of group A (P <0.005 and P<0.02, respectively). While the electron microscopic images in group C showed reversible changes, those in group B showed both irreversible and reversible changes. The electron microscopic findings of groups B and C confirmed the scintigraphic findings. In conclusion, HBSc might be used as a practical quantitative method for detecting the protective effects of DMSO. However, its clinical value should be evaluated by further studies with human subjects. ((C) 2000 Lippincott Williams & Wilkins).Öğe Scintigraphic assessment of pre- and postop nasal mucociliary clearence in patients (Pts.) with nasal septal deviation using Tc-99m MAA(Springer Verlag, 1999) Yüksel, M; Çermik, TF; Özel, ES; Koten, M; Üstün, F; Karasalihoglu, A; Berkarda, S[Abstract Not Available]
