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Öğe Accumulation of Tc-99(m)-polyclonal immunoglobulin in different stages of infection: An experimental study(Chapman Hall Ltd, 1996) Burak, Z; Ozcan, ZB; Ozcan, C; Ozacar, T; Basdemir, G; Erdem, S; Argon, M; Erdener, A; Duman, YIn this experimental study, the utility of Tc-99(m)-polyclonal human immunoglobulin (Tc-99(m)-HIG) for localizing acute and chronic phases of inflammatory lesions was investigated. Three groups of rats were inoculated with Staphylococcus aureus in the right thigh. Then, 24 h (group I, n = 12), 48 h (group II, n = 12) and 72 h (group Ill, n = 12) post-inoculation, the rats received 40 MBq Tc-99(m)-HIG into the jugular vein. In addition, two control rats were studied at 24 h after inoculation of sterile saline. Both visual and quantitative evaluations were undertaken. The acute and chronic stages of inflammation were determined by pathological examination. The mean (+/- S.D.) lesion/contralateral uptake ratios at 4 and 24 h after Tc-99(m)-HIG injection were: group I, 1.22 +/- 0.1 and 2.12 +/- 0.16; group Il, 1.15 +/- 0.08 and 2.25 +/- 0.16; group III, 1.06 +/- 0.09 and 2.08 +/- 0.14. In conclusion, the acute and chronic phases of infection showed non-significant differences in Tc-99(m)-HIG uptake ratios.Öğe Acute alternating hemiplegia - A case report(Turkish J Pediatrics, 1996) Tekgul, H; Tutuncuoglu, S; Muhan, A; Duman, YAcute alternating hemiplegia in childhood is a rare disorder characterized by onset before 18 months of age and frequent attacks of alternating paralysis. In this case report, a 20-month-old boy having the diagnosis of acute alternating hemiplegia is presented. The diagnosis was based on clinical features. The frequency and severity of the hemiplegic attacks decreased following flunarizine therapy. In this case, cerebral perfusion was investigated during ictal and interictal periods. Tc-99m HMPAO-Brain single photon emission computed tomography (SPECT) revealed normal cerebral perfusion in ictal periods and hypoperfusion in interictal periods.Öğe Cerebellar mutism: Report of seven cases and review of the literature(Williams & Wilkins, 1996) Ersahin, Y; Mutluer, S; Cagli, S; Duman, YIT IS WELL known that degenerative disease, hemorrhage, infection, and neoplastic disease of the cerebellum can lead to speech disorders. Mutism after posterior cranial fossa surgery was first reported by Rekate et al. and Yonemasu in 1985. We review and analyze the cases of cerebellar mutism that are reported in the literature that is available in English. We found 39 reported cases that included details regarding mutism. We review and analyze a total of 46 cases, including those of our seven patients. The ages of the patients ranged from 2 to 61 years (mean, 10.4 yr). Ninety-one percent of the patients were children. The vermis was the site of the mass lesions in >90% of the cases. The pathological findings of the lesions were as follows: 33 medulloblastomas, 7 astrocytomas, 4 ependymomas, 1 metastatic tumor, and 1 arteriovenous malformation. All mass lesions were considered to be large or very large. The latency for the development of mutism ranged from 0 to 6 days (mean, 1.7 d). The mutism lasted from 4 days to 4 months (mean, 6.8 wk). Dysarthric speech ensued after the mutism was resolved in 35 of 46 patients. Mutism was transient in all of the cases. Cerebellar mutism is a transient complication of posterior fossa surgery for midline mass lesions.Öğe Clinical-Evaluation of Metastases of Malignant-Melanoma Imaging With Tc-99(M)-Glutathione and Tc-99(M)-Anti-Melanoma Antibody - a Comparative-Study(Chapman Hall Ltd, 1995) Duman, Y; Burak, Z; Ercan, Mt; Dirlik, A; Bilkay, Bc; Akin, Y; Taner, M; Bekdik, CfThe aim of this investigation was to test for the scintigraphic detection of metastases of malignant melanoma with a new radiopharmaceutical, Tc-99(m)-glutathione (Tc-99(m)-GSH), in comparison with Tc-99(m)-anti-melanoma antibody (Tc-99(m)-AMAb). Glutathione was labelled with Tc-99(m) by a Sn2+ reduction method with an efficiency of > 99% as determined by instant thin layer chromatography (ITLC). Anti-melanoma antibody was obtained as a kit from SORIN (Italy) and labelled with (TcO4-)-Tc-99-O-m. Forty-three patients with a total of 55 biopsy-proven metastatic melanoma foci, 1 ocular melanoma and 20 benign pathologic foci, also confirmed by ultrasound, computed tomography and magnetic resonance imaging, were included in the study after giving their informed consent. Following the intravenous (i.v.) injection of 500 MBq Tc-99(m)-AMAb, scintigraphic images of the involved areas were obtained 6 h post-injection. Three days later, the same patients were given 500 MBq Tc-99(m)-GSH i.v, and images were obtained 6 and 24 h post-injection. The images were classified as positive (focal abnormal accumulation) or negative. Quantitative evaluation was also applied. Regions of interest were drawn over the involved areas and nearby soft tissues and the target-to-nontarget (T/NT) ratios obtained with Tc-99(m)-AMAb (T/NT: 1.92 +/- 0.2) and Tc-99(m)-GSH (T/NT: 1.84 +/- 0.2) were compared (0.1 < P less than or equal to 0.3). The sensitivity (and specificity) of Tc-99(m)-AMAb and Tc-99(m)-GSH in the detection of malignant melanoma metastases were 91% (95%) and 84% (90%), respectively. Compared with Tc-99(m)-AMAb, the advantages of Tc-99(m)-GSH are lower levels of blood radioactivity, lower costs and easy in-house preparation. In conclusion, our results show that Tc-99(m)-GSH is a potentially useful radiopharmaceutical for the detection of metastases of malignant melanoma.Öğe Determination of intestinal permeability by 99mTc-DTPA in protozoan infections(Springer-Verlag, 2001) Taner, MS; Argon, M; Koseoglu, K; Dagci, H; Ustun, S; Budak, S; Duman, YÖğe Evaluation of Bladder Functions With Radionuclid Studies (Tc-99M-Dtpa) In Diabetic-Patients(Springer Verlag, 1992) Atalay, M; Akalin, E; Kabalak, T; Dirlik, A; Alper, A; Duman, YÖğe Evaluation of Palpable Breast Masses With Tc-99M-Mibi - a Comparative-Study With Mammography and Ultrasonography(Chapman Hall Ltd, 1994) Burak, Z; Argon, M; Memis, A; Erdem, S; Balkan, Z; Duman, Y; Ustun, Ee; Erhan, Y; Ozkilic, HWe evaluated the feasibility of Tc-99m-methoxyisobutylisonitrile (MIBI) as a tumour localizing agent in patients with palpable breast masses in comparison with mammography and ultrasonography (US). Forty-one patients with palpable masses were studied. An additional 12 women with no palpable breast anomaly also underwent Tc-99m-MIBI breast study. Multiple views were obtained and semiquantitative evaluation was applied. Mammography and US revealed all of the malignant breast masses but differential diagnosis of fibroadenomas could not be achieved. Twenty-five of 27 breast carcinomas were detected using Tc-99m-MIBI scintigraphy. Two patients with invasive lobular carcinoma showed absent MIBI accumulation. Eight of 14 axillary lymph-node metastases showed positive uptake (57%). Twelve of 14 patients with pathologically proven benign breast lesions did not demonstrate any MIBI accumulation. Focal MIBI uptake could be observed in two fibroadenomas. The sensitivity and the specificity of semiquantitative MIBI analysis were 93 and 86%, respectively. Subjective grading offered no additional help in the further differentiation of malignant breast masses. There was no significant difference between histopathological types of breast carcinomas and uptake grades. Our results indicate that Tc-99m-MIBI scintigraphy may provide additional information in the differentiation of malignant pathologies from benign lesions in patients with palpable breast anomalies.Öğe Exercise Whole-Body Tl-201 Scintigraphy In Patients With Insulin-Dependent Diabetes-Mellitus(Springer Verlag, 1992) Derebek, E; Duman, Y; Ozmen, B; Burak, Z; Erdem, S; Kayalioglu, M; Dirlik, A; Unlu, MÖğe Is Tl-201 a reliable agent in tumour imaging?(Chapman Hall Ltd, 1996) Ozcan, Z; Burak, Z; Ozcan, C; Basdemir, G; Ozacar, T; Erdem, S; Duman, YThallium-201 (Tl-201) imaging has been widely used to differentiate post-therapy reactions from residual viable tumour or local recurrence, However, the ability of Tl-201 to discriminate between tumour and posttherapy changes with superimposed infection/inflammation is unclear. This experimental study investigated the localization of Tl-201 in infected/inflamed tissues. Twenty-four rats infected with Staphylococcus aureus and 10 rats injected with a standard volume of saline solution (SS) into the thigh muscles were studied. Twenty-four hours after microorganism or SS administration, 18 MBq Tl-201 was injected intravenously. Images were recorded at 20 min and 3 h post-injection. The increased tracer uptake was evaluated qualitatively and quantitatively by calculating the ratios (L/C) derived from regions of interest drawn over the lesion and the contralateral thigh muscle. After the imaging procedure, histopathological examination was also performed. Whereas the control group showed no abnormal accumulation of activity, the infected rats demonstrated markedly increased activity, especially on the 20 min images. The mean L/C ratios for the 20 min and 3 h images for the infected rats were 2.18 +/- 0.20 and 1.52 +/- 0.04, respectively (P < 0.0005). In conclusion, positive uptake due to an infective process may limit the use of Tl-201 in studies monitoring response to tumour therapy. Although delayed imaging may help to overcome this limitation, further investigations among a large series of patients are required in order to improve the reliability of Tl-201 imaging in oncology.Öğe Labeling of Gly-Gly-L-Alanine with Technetium-99m and the assessment of it's radiopharmaceutical potential(Springer-Verlag, 2001) Taner, MS; Ozdemir, D; Koseoglu, K; Argon, M; Dirlik, A; Duman, YÖğe Labeling of penicillamine di sulfide with technetium-99m(Pergamon-Elsevier Science Ltd, 1998) Unak, P; Tunc, M; Duman, YComplex forming conditions of Penicillamine di sulfide with Tc-99m have been specified. Labeling of penicillamine di sulfide with Tc-99m by direct reduction with SnCl2 did not give favorable good results while the Tc-99m complex of penicillamine can be easily obtained. Ligand exchange reaction with Tc-99m-gluconate was attempted and a 95% labeling efficiency was obtained. Radiopharmaceutical potential of Tc-99m-PADS (Tc-99m-Penicillamine di sulfide) has been investigated with a gamma camera in rabbits and the complex was found to be uptaken mostly by the liver and kidneys. (C) 1998 Elsevier Science Ltd. All rights reserved.Öğe Long-term evaluation of radioisotope synovectomy with Yttrium 90 for chronic synovitis in Turkish haemophiliacs: Izmir experience(Blackwell Publishing, 2006) Kavakli, K; Aydogdu, S; Omay, SB; Duman, Y; Taner, M; Capaci, K; Memis, A; Balkan, C; Karapinar, DSince 2001 we have performed 105 radioisotope synovectomy (RS) in 65 children and young adults, age ranging from 3 to 25 years with a average of 15 years in Ege University Hospital, Izmir, Turkey. One fourth of cases were below 10 years of age. All patients had severe haemophilia A and B. Ten patients (17 joints) had high responder inhibitor. We prefer to use Yttrium 90 for all joints (5 mCi for knees; 2 mCi for others). The knees were injected in 56 cases, elbows in 24 cases, ankles in 23 cases and shoulders in two cases. Steroid injections were not preferred as the principle drug of choice. Mean follow-up period after procedure was 2 years (range: 6 months to 3.5 years). All inhibitor patients had satisfactory results. The best results were obtained in elbows than knees and ankles. Excellent rates (no bleeding) were observed in grade-II synovitis 84% for knees, 93% for elbows and 50% for ankles. Because of the excellent and good response (bleeding reduction to 75%), rates were 100% for knees and elbows and 92% for ankles. In six cases, repeated injections were given at 6-month interval and all of them had good results. The grading of synovitis seems to be an important parameter than the age of the patient. Even in patients below 10 years of age, outcomes are not satisfactory in all joints with grade-III vs. grade-II synovitis (12% vs. 73%). No serious complications were observed during and after procedure except two cases. A mild and transient inflammatory reaction was observed in the ankle. There was a minimal radioisotope leakage to superficial skin in the elbow. RS seems to be a safe and effective treatment for chronic synovitis causing recurrent joint bleedings.Öğe Moyamoya Disease In Twins(Lippincott Williams & Wilkins, 1995) Duman, Y; Dirlik, A; Burak, Z; Tutuncu, STc-99m HMPAO SPECT was used to evaluate regional blood Row in one monozygotic twin who had angiographically proven moyamoya disease, Focal and global reduced regional cerebral perfusion were observed in both patients with Tc-99m HMPAO SPECT studies. There was good correlation between the localization end degree of regional cerebral blood flow abnormalities and the severity and stage of clinical symptoms on angiography. These results suggest that Tc-99m HMPAO SPECT is a useful method in the detection of hemodynamic abnormalities in moyamoya disease.Öğe A New Suture Material For Repair of the Injured Spleen(Springer Verlag, 1994) Erdener, A; Taneli, C; Ozcan, C; Duman, Y; Ozdemir, NParenchyma-Set, a new absorbable collagen-tape suture material, was used in the present study for the repair of experimentally injured spleens and the results compared with polyglactin. Standard splenic injuries were produced in ten mongrel dogs. The spleens of five (group I) were repaired with Parenchyma-Set and those of the other five (group II) with polyglactin. Isotope uptakes of the spleens performed on the 30th postoperative day showed varying degrees of scintigraphic defects in group II in comparison with group I. The histopathologic examinations revealed better healing in group I with better preservation of the splenic architecture. We conclude that Parenchyma-Set appears to be the suture material of choice for repair of the injured spleen.Öğe Radioiodination and preliminary biological tests of aniline-mustard and its glucuronide conjugate as a potential anticancer prodrug(Springer, 2003) Unak, T; Akgun, Z; Duman, Y; Yildirim, Y; Avcibasi, U; Cetinkaya, BAniline-mustard and its glucuronide conjugate were radioiodinated with I-131. The preliminary dynamic tests were carried out on rabbits. The scintigrams showed clearly that the glucuronide conjugate of aniline-mustard was very quickly cleared from the metabolism, accumulating in the bladder in about 15 minutes. The clearance time of radioiodinated aniline-mustard-glucuronide was considerably longer (about 45 min.). The results obtained from the biodistributional studies have represented interesting differences between the metabolic details of radioiodinated compounds, and indicated that the glucuronide conjugate of aniline-mustard may be a promising radioiodinated prodrug, if verification of its selective accumulation in some kinds of tumor cells can be obtained.Öğe The Release of Isoconazole Nitrate From Different Suppository Bases - In-Vivo Release of Drug Labeled With Tc-99M In Rabbits(Royal Pharmaceutical Soc Great Britain, 1995) Asikoglu, M; Ertan, G; Ercan, Mt; Duman, YThe influence of the suppository bases on the in-vivo release of Tc-99m-labelled isoconazole nitrate was investigated. The single-dose vaginal suppository formulations for local treatment of vaginitis were prepared by a fusion method using polyethylene glycols, Witepsol H15, Novata BD and Cremao. Prepared vaginal suppositories containing solid-labelled substance were applied to the vagina of rabbits and at 0, 2 and 24 h after administration, the amounts of radioactivity in the vagina were detected by the SPECT Gamma Camera and the release rates of the drug were calculated. The percent released was found to be in the following order; polyethylene glycol (PEG) 6000 > PEG 4000 > Witepsol > PEG 1500 > Novata BD > Cremao. The results obtained in both in-vitro and in-vivo studies indicated that the vaginal suppository of isoconazole nitrate prepared with polyethylene glycols could confidently be used in therapy.Öğe The role of RFS (Radionuclide fractional shortening) in quantitative evaluations of myocardial infarctions(Springer-Verlag, 2001) Atalay, M; Duman, Y; Altintig, A; Teber, E; Akin, HÖğe The role of Tc-99(m)-tetrofosmin myocardial perfusion scintigraphy in the assessment of patients with previous myocardial infarction: A comparative study with Tl-201(Lippincott Williams & Wilkins, 1998) Burak, Z; Akin, H; Buket, S; Sagcan, A; Argon, M; Atay, Y; Durmaz, I; Duman, YThe aim of this study was to determine the utility of Tc-99(m)-tetrofosmin cardiac imaging in patients with previous myocardial infarction and with significant coronary artery disease (CAD) compared with that of Tl-201 cardiac imaging. Sixteen patients (14 males, 2 females) were studied by same-day exercise-rest Tc-99(m)-tetrofosmin imaging and exercise, rest and reinjection Tl-201 cardiac imaging. For each study, semiquantitative visual analysis was performed in 20 segments using a 4-point scale. The regional distribution and defect reversibility with the two tracers were compared with the results of coronary angiography. A total of 320 segments were analysed. There was a statistically significant concordance between the numbers of fixed and reversible segments in both studies in myocardial segments supplied by totally occluded coronary arteries (Group 1), as well as in segments supplied by significantly stenosed coronary vessels (Group 2). The exercise and rest uptake of both Tc-99(m)-tetrofosmin and Tl-201 in myocardial segments supplied by totally occluded coronary arteries with poor collateral flow was significantly lower compared with segments supplied by totally occluded coronary arteries with efficient collateral flow (P less than or equal to 0.05). When the uptake of both tracers was analysed according to each major vascular territory, the mean exercise and rest uptake grades of Tc-99(m)-tetrofosmin and Tl-201 were similar. There was also no significant difference in defect reversibility between the two tracers. Discordant results were observed in the territory of the right coronary artery in Group 1 (mean exercise grade of Tc-99(m)-tetrofosmin=2.26+/-0.7 and of Tl-201=1.92+/-0.8; P less than or equal to 0.001) and in Group 2 (mean grade of Tc-99(m)-tetrofosmin=0.79+/-0.65 and of Tl-201=0.95+/-0.65; P less than or equal to 0.05). The results of the present study indicate that the overall diagnostic utility of Tc-99(m)-tetrofosmin in the identification of individual stenosed vessels is comparable with Tl-201 in both patients with totally occluded coronary arteries and those with significantly stenosed vessels. The regional distribution of both tracers was lower in myocardial segments supplied by totally occluded coronary arteries with poor collateral flow.Öğe Self-radioiodination of iodogen(Pergamon-Elsevier Science Ltd, 2001) Unak, T; Akgun, Z; Yildirim, Y; Duman, Y; Erenel, GIodogen (1,3,4,6-tetrachloro-3 alpha ,6 alpha -diphenylglucoluril) is commonly used for the radioiodination of proteins as an oxidative agent. The oxidative character of iodogen is not clear, but the two carbonyl groups in its structure probably have an essential role in its oxidizing character. In this study, the self-radioiodination of iodogen has been examined. It was observed that about 10-20% of the initial iodine radioactivity was consumed for the self-radioiodination of iodogen itself. On the other hand, the radioiodinated iodogen removed by ethyl alcohol from the iodogen-coated tubes showed clearly that no thyroid uptake was observed and that it was rapidly cleared out from the whole body of a rabbit administered with the radioiodinated iodogen by injection via the ear vein. (C) 2001 Elsevier Science Ltd. All rights reserved.Öğe Single photon emission tomography following posterior fossa surgery in patients with and without mutism(Springer-Verlag, 2002) Ersahin, Y; Yararbas, U; Duman, Y; Mutluer, SMaterials and methods: We designed a prospective study to investigate single photon emission tomography (SPECT) findings in patients with or without mutism who had undergone posterior fossa surgery. These patients had a Tc-99m-hexamethylpropyleneamine oxime-SPECT scan postoperatively. SPECT was performed between the 1st and. 2nd week after surgery. The patients with cerebellar mutism had a second SPECT scan after regaining their power of speech. The patients were evaluated in terms of age, gender, preoperative and postoperative neurological and radiological findings, tumor size and location, vermian incision and histopathology. Results: Six girls and 5 boys, ranging in age from 3 to I I years who had undergone posterior fossa tumor surgery were included in this study as controls. Their tumors were located in the vermis and fourth ventricle in 8 patients, in the cerebellar hemisphere in 1, fourth ventricle in 1, and I patient had a fourth ventricular tumor extending the cerebello-pontine angle. The histopathology of the tumors was as follows: astrocytoma in 5 patients, ependymoma in 3, medulloblastoma in 1, dermoid tumor in 1, and choroid plexus papilloma in I patient. Postoperative cerebellar mutism developed in 2 girls and I boy whose ages ranged from 2 to 5 years. Pathological examination revealed 2 medulloblastomas and I ependymoma. Mutism developed 2 to 4 days after surgery. All of the patients with cerebellar mutism showed either clinical or radiological signs and symptoms of brain stem involvement. SPECT findings were similar in the patients with cerebellar mutism and in those without. Conclusions: SPECT findings are not specific enough to explain how cerebellar mutism occurs. Clinical signs of brain stem involvement seem to be a significant risk factor in the development of cerebellar mutism.
