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Öğe Assessment of chemotherapy-induced changes in bone sarcomas: Clinical experience with Tc-99(m)-MDP three-phase dynamic bone scintigraphy(Lippincott Williams & Wilkins, 1999) Ozcan, Z; Burak, Z; Kumanlioglu, K; Sabah, D; Basdemir, G; Bilkay, B; Cetingul, N; Ozkilic, HThe aim of this study was to evaluate the value of three-phase dynamic bone scintigraphy (TPBS) in the assessment of the response of bone sarcomas to pre-operative chemotherapy and to correlate serial scintigraphic changes with histological findings. The study group comprised 27 patients (osteogenic sarcoma, n = 20; Ewing's sarcoma, n = 5; malignant fibrous histiocytoma, (n = 2) with a mean age of 19.2 years. All patients received (99T)c(m)-methylene diphosphonate TPBS before and after pre-operative chem otherapy. Each phase of the imaging procedure was interpreted qualitatively and quantitatively. The percentage of tumour necrosis was analysed on resection materials following surgery. Histologically, 12 patients were non-responsive (tumour necrosis less than 90%) and 15 patients were responsive (tumour necrosis more than 90%). A decrease in the tumour blood flow ratio and extension were the most notable findings in the responders. The moan change in the tumour blood flow ratio following therapy was 58.7 +/- 8.3% and 19.9 +/- 26.6% (P < 0.005) in responders and non-responders respectively. The accuracy of three-phase imaging and static bone scintigraphy was 88% and 74% respectively Since bone scintigraphy is a valuable technique owing to its ability to detect distant metastases in clinically early disease, TPBS should be helpful in monitoring therapy effects without any additional cost or radiation dose. ((C) 1999 Lippincott Williams & Wilkins).Öğe Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease(Elsevier Science Bv, 2004) Ozbaran, M; Omay, SB; Nalbantgil, S; Kultursay, H; Kumanlioglu, K; Nart, D; Pektok, EObjective: Ischemic heart disease accounts for 50% of all cardiovascular deaths and is the leading cause of congestive heart failure. Medical therapy, cardiac assist devices and surgical procedures including heart transplantation have limited efficiency and availability. Stem cell transplantation represents a new therapeutic opportunity for such patients. Method: Six patients with the diagnosis of ischemic cardiomyopathy were included in this study. All of the patients had clinical, radiological and echocardiographic signs of heart failure, and reduced left ventricular ejection fraction (LVEF less than or equal to25%). They underwent coronary angiography and stress tests with dobutamine echocardiography, thallium scintigraphy and positron emission tomography to assess myocardial ischemia and viability. Peripheral stem cells were mobilized and collected by apheresis. They were transplanted into areas of injury with open-heart surgery. To increase blood flow to the engrafted areas, coronary artery by-pass surgery was also performed. Results: The patients were followed at least for 4 months. Echocardiography, thallium scintigraphy and positron emission tomography were repeated after at least 6 weeks following surgery. There was a significant increase in life quality and NYHA class. Some benefit was documented on echocardiography, thallium scintigraphy, and positron emission tomography. Conclusion: This approach opens a new window in the treatment of 'no hope' patients with congestive heart failure. (C) 2003 Elsevier B.V. All rights reserved.Öğe Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease.(Amer Soc Hematology, 2003) Omay, SB; Ozbaran, M; Nalbantgil, S; Kultursay, H; Kumanlioglu, K; Nart, D; Pektok, EÖğe Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease.(Amer Soc Hematology, 2003) Omay, SB; Ozbaran, M; Nalbantgil, S; Kultursay, H; Kumanlioglu, K; Nart, D; Pektok, EÖğe Colorectal adenomateous polyps and Helicobacter pylori infection(Elsevier Science Inc, 1999) Aydin, A; Karasu, Z; Zeytinoglu, A; Kumanlioglu, K; Ozacar, TÖğe Comparison of pinhole/high resolution parallel hole and early/late Tc99m-MIBI images in parathyroid imaging(Springer-Verlag, 2001) Yararbas, U; Erinc, R; Karapolat, I; Kumanlioglu, KÖğe Effect of hypo- and hyperthyroidism on gastric myoelectrical activity(Kluwer Academic/Plenum Publ, 2003) Gunsar, F; Yilmaz, S; Bor, S; Kumanlioglu, K; Cetinkalp, S; Kabalak, T; Ozutemiz, OAAlthough hypo- and hyperthyroid patients have different symptoms in the gastrointestinal tract, the mechanism of thyroid action on the gut remains poorly understood. Thus the aim of this study was to investigate the effect of hypo- and hyperthyroidism on gastric myoelectrical activity, gastric emptying, dyspeptic symptoms. Twenty-two hyperthyroid (median age 45, 15 females) and 11 hypothyroid (median age 42, 10 females) patients were included into the study. Dyspepsia score, hypo- and hyperthyroid symptom scale, abdominal ultrasonography and upper gastrointestinal endoscopy were performed. Gastric myoelectrical activity was measured by electrogastrograpy ( EGG) before and after therapy both preprandially and postprandially and compared with age, gender, and body-matched controls (12 for hypothyroid, 15 for hyperthyroid patients). Radionuclide gastric emptying studies were performed with a solid meal. Hypothyroid patients revealed a significant increase in preprandial tachygastria as compared with controls (12.3% vs 4.8%). The percentage of preprandial normal slow waves (2.4-3.7 cpm) was below 70% (dysmotility) in 7 of 11 hypothyroid patients versus 2 of 12 controls (P < 0.05). Hyperthyroid patients revealed a significantly higher preprandial (3.1 vs 2.8) and postprandial (3.4 vs 3) DF when compared with the controls (P < 0.05). A higher percentage of postprandial taschygastria (7.9 vs 0) was present in hyperthyroid patients than in the controls (P < 0.05). The decrease on postprandial EGG power (power ratio < 1) was observed in 7 patients the in hyperthyroid group and 1 in controls (P < 0.05). The percentage of postprandial normal slow waves was below 70% in 10 of 20 hyperthyroid patients vs 1 of 15 controls (P < 0.05). After therapy these differences disappeared in the euthyroid state. The hypo- and hyperthyroid symptom scale correlated to dyspepsia score. Dyspepsia score in hyperthyroidism correlated to power ratios in hyperthyroid patients. We detected some correlations between serum levels of fT3 or fT4 and some EGG parameters in hypo- and hyperthyroidism. Dyspepsia score and hypo- and hyperthyroid symptom scale were improved significantly after therapy in the euthyroid state. In conclusions, we showed gastric dysrhythmia by EGG in both hypo- and hyperthyroid patients. Dyspeptic symptoms correlated to the activity of thyroid disease. After therapy, these findings and dyspeptic symptoms improved in the euthyroid state. Abnormalities of power ratios may be responsible of dyspeptic symptoms in hyperthyroid patients. EGG may be a useful and noninvasive tool for detecting gastric disturbances during hypo- and hyperthyroidism.Öğe Effect of hypo- and hyperthyroidism on gastric myoelectrical activity(Kluwer Academic/Plenum Publ, 2003) Gunsar, F; Yilmaz, S; Bor, S; Kumanlioglu, K; Cetinkalp, S; Kabalak, T; Ozutemiz, OAAlthough hypo- and hyperthyroid patients have different symptoms in the gastrointestinal tract, the mechanism of thyroid action on the gut remains poorly understood. Thus the aim of this study was to investigate the effect of hypo- and hyperthyroidism on gastric myoelectrical activity, gastric emptying, dyspeptic symptoms. Twenty-two hyperthyroid (median age 45, 15 females) and 11 hypothyroid (median age 42, 10 females) patients were included into the study. Dyspepsia score, hypo- and hyperthyroid symptom scale, abdominal ultrasonography and upper gastrointestinal endoscopy were performed. Gastric myoelectrical activity was measured by electrogastrograpy ( EGG) before and after therapy both preprandially and postprandially and compared with age, gender, and body-matched controls (12 for hypothyroid, 15 for hyperthyroid patients). Radionuclide gastric emptying studies were performed with a solid meal. Hypothyroid patients revealed a significant increase in preprandial tachygastria as compared with controls (12.3% vs 4.8%). The percentage of preprandial normal slow waves (2.4-3.7 cpm) was below 70% (dysmotility) in 7 of 11 hypothyroid patients versus 2 of 12 controls (P < 0.05). Hyperthyroid patients revealed a significantly higher preprandial (3.1 vs 2.8) and postprandial (3.4 vs 3) DF when compared with the controls (P < 0.05). A higher percentage of postprandial taschygastria (7.9 vs 0) was present in hyperthyroid patients than in the controls (P < 0.05). The decrease on postprandial EGG power (power ratio < 1) was observed in 7 patients the in hyperthyroid group and 1 in controls (P < 0.05). The percentage of postprandial normal slow waves was below 70% in 10 of 20 hyperthyroid patients vs 1 of 15 controls (P < 0.05). After therapy these differences disappeared in the euthyroid state. The hypo- and hyperthyroid symptom scale correlated to dyspepsia score. Dyspepsia score in hyperthyroidism correlated to power ratios in hyperthyroid patients. We detected some correlations between serum levels of fT3 or fT4 and some EGG parameters in hypo- and hyperthyroidism. Dyspepsia score and hypo- and hyperthyroid symptom scale were improved significantly after therapy in the euthyroid state. In conclusions, we showed gastric dysrhythmia by EGG in both hypo- and hyperthyroid patients. Dyspeptic symptoms correlated to the activity of thyroid disease. After therapy, these findings and dyspeptic symptoms improved in the euthyroid state. Abnormalities of power ratios may be responsible of dyspeptic symptoms in hyperthyroid patients. EGG may be a useful and noninvasive tool for detecting gastric disturbances during hypo- and hyperthyroidism.Öğe The effect of myocardial surgical revascularization on left ventricular late potentials(Futura Publ Co, 2001) Can, L; Kayikcioglu, M; Halil, H; Kultursay, H; Evrengul, H; Kumanlioglu, K; Turkoglu, CBackground: The presence of ventricular late potentials (LP) is an important indicator for the development of ventricular tachyarrhythmias due to ischemic heart disease. The effect of myocardial revascularization on LP has remained controversial. The purpose of this study was to determine whether complete myocardial surgical revascularization (CABG) documented by myocardial perfusion scintigraphy might alter the substrate responsible for LP. Methods: Prospectively, enrolled patients undergoing elective CABG were evaluated with thallium-201 myocardial perfusion scintigraphy and signal- averaged ECG pre- and postoperatively. SAECG recordings were obtained serially: before, 48-72 hours and 3 months after CABG. LPS were defined as positive if SAECG met at least two of Comes criteria. Scintigraphies were performed pre- and 3 months postoperatively for determination of the success of revascularization. Changes observed in SAECG recordings after CABG were compared between those with and without successful revascularization. Results: CABG resulted in successful revascularization in 23 patients and was unsuccessful in 17 (no change or deterioration of the perfusion defects). Preoperative SAECG values were not different between groups except for RMS values. The incidence of LP decreased significantly postoperatively in patients with improved myocardial perfusion, whereas there were no changes in patients who did not have postoperative perfusion improvement (McNemar test, P < 0.05). Conclusions: LPs disappear following the elimination of myocardial ischemia by complete surgical revascularization. Persistence of ischemia following CABG usually results in the persistence of late potentials. The incidence of ventricular arrhythmias is expected to be unchanged in these patients and they should be reevaluated for reinterventions.Öğe The effect of surgical dissection method in callus formation: Experimental study in rabbits.(Springer, 1999) Bilkay, U; Bilkay, U; Erinc, R; Celik, N; Songur, E; Kumanlioglu, KÖğe Effects of methimazole pretreatment on cerulein induced acute pancreatitis in rats(Urban & Fischer Verlag, 2002) Yonetci, N; Oruc, N; Ozutemiz, AO; Kumanlioglu, K; Yuce, G; Batur, YBackground: Many interrelationships exist between the thyroid gland and the gastrointestinal tract. Several past and recent studies have shown that the thyroid gland profoundly influences the structure and function of the exocrine pancreas in the rat. In the present study we investigated the effect of methimazole (METZ), an antithyroid drug, on cerulein induced acute pancreatitis (AP) in rats. Methods: Rats were divided into 3 groups (10-12 weeks age, 200-250 g weight, n: 10). Group B was made hypothyroid with methimazole 5 mg/kg daily for 10 days and the others were untreated euthyroid groups. After 10 days, acute pancreatitis was induced with four doses of 20 mug/kg body weight of cerulein administered s.c at hourly intervals in group A and B while the control group C was given 4 doses of 1 ml saline. Pancreas wet weight (mg), plasma amylase activity (IU/l) and pancreatic histology were used as endpoints to quantify the severity of the AP. Results: Plasma tri-iodothyronine (T3) (ng/dl) and thyroxine (T4) (mug/dl) levels were significantly reduced after METZ treatment for 10 days (p < 0.01). METZ pretreatment reduced significantly the cerulein induced increase in pancreatic weight (1205 +/- 12 mg in METZ treated AP group versus 1617 +/- 14 mg in AP group, p < 0.05) and the rise in amylase activity (7078 +/- 816 IU/l in METZ treated AP group versus 8611 +/- 830 IU/l in AP group p < 0.05). Conclusion: METZ reduces the severity of cerulein induced AP in rats. This effect might be through its antithyroid property.Öğe Intestinal permeability in liver cirrhosis(Lippincott Williams & Wilkins, 1999) Ersoz, G; Aydin, A; Erdem, S; Yuksel, D; Akarca, U; Kumanlioglu, KObjective To determine the changes in intestinal permeability in liver cirrhosis and to investigate whether intestinal permeability relates to the stage and aetiology of cirrhosis or existence of spontaneous bacterial peritonitis (SBP). Design A prospective study of intestinal permeability in patients with cirrhosis. Setting Gastroenterology and Nuclear Medicine Departments of Ege University Hospital. Participants Intestinal permeability was assessed in 44 consecutive patients with cirrhosis and 10 healthy volunteers by measuring 24 h urine excretion of (99m)technetium diethyl triamine penta-acetic acid (Tc-99m DTPA). Cases with an associated disease, impaired renal function, continuing alcohol consumption and drug intake which is known to have an effect on intestinal permeability were excluded. Main outcome measures Comparisons of 24 h urine excretion of Tc-99m DTPA were made between the groups of cirrhotics and controls, different grades of cirrhosis (according to Child-Pugh criteria), alcoholic and nonalcoholic cirrhotics and cirrhotic patients with and without SEP. Results Patients with cirrhosis excreted Tc-99m DTPA significantly more than controls (11.56 +/- 8.96% in cirrhotics and 4.30 +/- 1.49% in controls, P < 0.0001). There was no relationship of 24 h urine excretion of the tracer with the grade and aetiology of cirrhosis (12.20 +/- 9.47%, 11.41 +/- 9.84%, and 11.09 +/- 8.42%, in Child A, B, and C groups and 8.45 +/- 6.57% and 12.05 +/- 9.25% in alcoholic and non-alcoholic cirrhotics, respectively). No significant difference was found between cirrhotic patients with and without SEP in terms of excretion of the administered dose of Tc-99m DTPA (9.98 +/- 9.47% and 12.20 +/- 8.82%, respectively). Conclusions This study shows that intestinal permeability increased in cirrhotic patients regardless of the grade and aetiology of disease. The presence of SEP does not seem to be due to increased intestinal permeability. Eur J Gastroenterol Hepatol 11:409-412 (C) 1999 Lippincott Williams & Wilkins.Öğe Intestinal permeability in obstructive jaundice(W B Saunders Co-Elsevier Inc, 1999) Alev, M; Ersoz, G; Akarca, US; Aydin, A; Kumanlioglu, K; Batur, YÖğe Method comparison in split-sample design and transference of referans intervals of two serum folate assays.(Amer Assoc Clinical Chemistry, 2001) Aslan, D; Akgungor, N; Tanyalcin, T; Gokalp, N; Kurtulmus, Y; Kumanlioglu, KÖğe Reference intervals of serum folate and vitamin B12 developed from data of healthy subjects(Springer-Verlag, 2000) Tanyalcin, T; Aslan, D; Kurtulmus, Y; Gokalp, N; Kumanlioglu, KIn this study the reference intervals for folate and vitamin B-12 were estimated according to the National Committee for Clinical Laboratory Standards Approved Guideline C28-A and International Federation of Clinical Chemistry recommendations. The study included 155 women and 124 men between ages 18-40. The health status was confirmed by history, physical examination and a questionnaire. The central 95% reference intervals of serum folate and vitamin B12 for women, determined non-parametrically, were found to be 3.9-18.1 ng/ml and 101-666.7 pg/ml, respectively: The reference values of serum folate and vitamin B12 for men were also found to be 2,5-17.6 ng/ml and 100-699.57 pg/ml, respectively. We did not observe subclass differences between females and males.Öğe The results of radioiodine therapy in patients with hyperthyroidism after one year follow up(Springer-Verlag, 2001) Argon, M; Ozyurt, O; Kumanlioglu, K; Ozkilic, HÖğe The state of lipid peroxidation and antioxidants following thrombolytic therapy with rt-PA and streptokinase in acute myocardial infarction(Japan Heart Journal, Second Dept Of Internal Med, 1999) Ozmen, D; Boydak, B; Mutaf, I; Zoghi, M; Kumanlioglu, K; Guner, I; Bayindir, OThe role of reactive oxygen products in myocardial damage caused by ischemia-reperfusion has been established in a number of studies performed in animals models. However, studies showing the development of increased free radicals following effective myocardial reperfusion in humans are scarce. In the present study, both the increase of lipid peroxidation (LPO) following early stage thrombolytic therapy which is the current treatment issue performed after acute myocardial infarct (AMI) and the plasma levels of vitamin E and C (chain braker antioxidants) were investigated parallel to time. Forty patients with AMI who were admitted to hospital within six hours from the beginning of symptoms were included in the study and divided into two groups; group 1 (recombinant tissue-Plasminogen Activator, rt-PA group) and group 2 (streptokinase group). Serial serum specimens were drawn before and 30, 90 minutes and 24 hours after thrombolytic therapy for the investigation of LPO, vitamin E and C levels. Echocardiographic examination was performed on the tenth day to evaluate the functions of the left ventricle. Plasma levels of lipid peroxides (LPO) were found to increase 90 minutes after thrombolytic therapy in each group, while the levels of vitamins E and C showed significant decreases. The difference between the two groups was not significant. Similar to this finding, no significant difference in the ejection fraction values was observed between the groups. Further, no correlation was observed between the ejection fraction and LPO values at the 90th minute which is considered to be the time of successful thrombolysis. In conclusion, the occurrence of a series of biochemical changes confirming an increase in free radical development of peripheral blood was observed. Although the decrease in vitamin E and C levels suggests the need for supplementation of these vitamins along with the thrombolytic therapy, the fact that at least a week is needed for an increase of tissue levels of vitamin E confirms the opinion that the daily prophylactic doses of these vitamins is suitable for the decrease of AMI risk.Öğe Tc99m pertechnetate whole body scanning in differentiated thyroid carcinoma in comparison with I-131 whole body scintigraphy(Springer-Verlag, 2001) Dirlik, A; Kayalioglu, M; Erhamamci, S; Omur, O; Ozcan, Z; Kumanlioglu, K; Ozkilic, H
