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Öğe Aortic valve calcification: association with bone mineral density and cardiovascular risk factors(Lippincott Williams & Wilkins, 2005) Aksoy, Y; Yagmur, C; Tekin, GO; Yagmur, J; Topal, E; Kekilli, E; Turhan, HBackground: Cardiovascular risk factors are reported to increase the incidence of aortic valve calcification. Among older women, low bone mineral density appears to be associated with increased prevalence of aortic calcification. We aimed to assess and compare cardiovascular risk factors and bone mineral density of patients with and without aortic valve calcification. Materials: and methods Cardiovascular risk factors and bone mineral density measurements have been assessed in 49 patients with aortic valve calcification and in 65 patients without aortic valve calcification. All patients were subsequently referred to the nuclear medicine department to measure bone mineral density after echocardiographic evaluation. Results: No statistically significant differences were observed between the two groups with respect to sex, body mass index, history of coronary artery disease, diabetes mellitus, hypercholesterolemia, and smoking status. Although height and weight of the patients with aortic valve calcification were significantly lower than those of patients without aortic valve calcification, they were not independent risk factors. Age and hypertension were found to be independent positive risk factors for aortic valve calcification, whereas T score was found to be negatively associated with aortic valve calcification. Conclusion: We have shown that aortic valve calcification is positively associated with age and hypertension, whereas bone mineral density is negatively associated with aortic valve calcification. The mechanism underlying the association between decreased bone mineral density and aortic valve calcification remains to be clarified in further studies.Öğe Calculating colon transit time with radionuclide-filled capsules in constipated patients: a new method for colon transit study(Springer, 2005) Kekilli, E; Yagmur, C; Isik, B; Aydin, OMBackground: Colon motility disorders require reliable methods for calculating segmental colonic transit time. This study evaluated bowel transit time by means of a safe, easy, cheap, nondigestive, and nondisintegrating radionuclide-filled capsule that provided accurate and clear images. Methods: Radionuclide-filled minicontainers (MCs) were prepared from infusion sets by an apparatus used for sealing blood bags or plasmapheresis sets. In vitro stability studies were performed by immersing 5% methylene blue dye-filled MCs in buffers of variable pH and enzymes simulating the conditions in the stomach and the small bowel. Colon transit scintigraphy was performed with MCs filled with iodine 131 (n = 5) and thallium 201 (n = 8) that were placed in a commercially available capsule. Results: By in vitro acid, base, and intestinal enzyme resistance tests, no methylene blue leakage was determined visually and by spectrophotometric analysis. Accurate and clear images were obtained for colon transit study in constipated patients. After excretion of MCs in the feces, abdominal, myocardial, thyroid, and urinary bladder region counts were found to show the same activity as the background. Radionuclide leakage from MCs was not determined in vivo by gamma camera. Conclusion: This is a suitable, safe, easy, and cheap method to provide accurate and clear images for colon transit study in constipated patients.Öğe Cervical involvement in juvenile-onset ankylosing spondylitis with bone scintigraphy(Springer, 2004) Kekilli, E; Yagmur, C; Aydin, OMJuvenile-onset ankylosing spondylitis is an unusual disorder which can present with either peripheral arthritis or more classic hip girdle and back symptoms. A 12-year-old child with this disease was admitted with walking disorder, cervical pain, restricted cervical motion, and right ankle swelling. Diffusely increased accumulation of radioactivity in the cervical spine, focally increased accumulation in bilateral sacroiliac joints, and diminished irregular uptake in thoracal spine were detected on technetium 99m methylene diphosphonate bone scintigraphy. As a result, this imaging technique may give important information for diagnosis and differential diagnosis in juvenile chronic arthritis.Öğe Decreased Tc-99m MDP uptake in myelonecrosis(Lippincott Williams & Wilkins, 2006) Kekilli, E; Yagmur, C; Kaya, E; Kuku, I; Ertem, K; Aydogdu, I[Abstract Not Available]Öğe Delayed gastric emptying in gastroesophageal reflux disease(Springer, 2005) Demirbilek, S; Karaman, A; Gürünlüoglu, K; Akin, M; Tas, E; Aksoy, RT; Kekilli, EThe association between gastroesophageal reflux (GER) and intestinal malrotation (IM) has been well described. Delayed or impaired gastric emptying in IM is thought to be a contributing factor in the development of gastroesophageal reflux disease (GERD). The current study assessed the role of malrotation in delayed gastric emptying in children with GERD. We also evaluated the interactions between GERD, malrotation, gastric pH abnormalities, and gastric dysmotility. Sixty-seven patients between 1 and 5 years of age ( mean 3.08 +/- 1.2) and with symptoms of GER, such as emesis, reactive or recurrent lung disease, and/or growth retardation, were studied in 2001 - 2005. Upper and lower gastrointestinal contrast studies were performed for the diagnosis of malrotation. Gastric motility was evaluated with a liquid gastric emptying protocol. GER was documented by upper gastrointestinal studies, scintigraphy, and/or 24- h pH monitoring. In our series of 44 children with GERD, there was an unexpectedly high incidence of IM: 54.5% (24/44). IM has previously been known to occur in 25% of patients with GERD. GERD was found in 24 (82.7%) of 29 patients with IM. Mean nuclear gastric emptying (MNGE) was 51.6 +/- 8.04 min in patients with isolated GERD and 96.6 +/- 20.5 min in children with IM and GERD. There was a statistically significant difference in MNGE time ( p< 0.05) between children with primary GERD and in those with GERD and IM. Esophageal pH monitoring showed that mean fraction time below pH 4 was 7.06 +/- 1.1% in patients with isolated GERD and 14.7 +/- 4.1% in patients with IM and GERD. GERD is common in children between 1 and 5 years old. Using gastric emptying studies and esophageal pH monitoring, we have shown that gastric dysmotility and esophageal pH abnormalities are highly prevalent, especially in children with malrotation compared with children with isolated GERD. These findings suggest that malrotation is an important factor responsible for delayed gastric emptying in GERD. Hence, we recommend that all infants and children with GERD and delayed gastric emptying undergo careful evaluation for malrotation.Öğe Induced angiogenesis with intramedullary direct current: experimental research(Amer Physiological Soc, 2005) Inan, M; Alat, I; Gurses, I; Kekilli, E; Kutlu, R; Eskin, A; Aydin, OMThe purpose of this study was to evaluate angiogenesis after the use of intramedullary direct electrical current in rabbit tibia. Thirty-two New Zealand rabbits were divided into four groups: group 1, false electrode group; group 2, hole group; group 3, control group; and group 4, intramedullary electrical stimulation group. One-half of the rabbits in each group were evaluated angiographically, pathologically, and scintigraphically on day 7, and the rest were evaluated on day 21. Results proved that electrical stimulation was not capable of the induction of angiogenesis in the subjects killed on day 7 and day 21. Furthermore, we found some fibrotic changes secondary to electrical stimulation on day 7 ( P = 0.04) and day 21 ( P = 0.01). However, an increase in new capillary vessels occurred in the false electrode group ( P = 0.02). We found no useful effect of electrical stimulation in our study, a finding that is possibly due to our use of a method previously undocumented in the literature. We believe that this study can be the new baseline for further studies into the stimulation or inhibition of angiogenesis using intramedullary wire with or without electrical stimulation.Öğe The mechanical or electrical induction of medullary angiogenesis - Will it improve sternal wound healing?(Texas Heart Inst, 2004) Alat, I; Inan, M; Gurses, I; Kekilli, E; Germen, B; Harma, A; Eskin, AWe induced angiogenesis in the tibial medulla and cortex of rabbits by electrical and mechanical stimulation, with the aim of future application to ischemic disease. Sixteen New Zealand rabbits were divided into 4 groups: in Group 1, a wire was inserted into the medullary channel; in Group 2 a hole was drilled into the tibia; in Group 3, electrical stimulation was applied to the medullary channel; and in Group 4 (the control group), nothing was done. The interventions were applied during a 21-day period, after which all animals were evaluated scintigraphically and histopathologically. All 3 interventional groups were significantly superior to the control group in regard to medullary and cortical vascularity: the P values were 0.021 in all comparisons to control. However the most fibrotic changes in the medulla occurred in the group that had been treated with electricity (P=0.008). Slight fibrotic changes occurred in the hole group (P=0.040), and none occurred in the K-wire group. In sum, all 3 interventions are capable of inducing medullary angiogenesis, but electricity is inferior in regard to fibrotic change. We believe that this present study can establish a baseline for further work that explores clinical applications to problematic ischemic conditions, including delayed sternal wound healing after cardiac surgery.Öğe Pathologic hepatic Tc-99m-MDP uptake in polyostotic fibrous dysplasia(Springer, 2004) Kekilli, E; Yagmur, C; Kuzucu, A; Soysal, O; Cikim, AS; Ertem, KFibrous dysplasia of bone is a congenital, sporadic developmental disorder characterized by immature fibrous connective tissue and bone deformities. Hepatic Tc-99m-MDP uptake is a rare, serendipitous finding during bone scanning studies. The present patient was a 25-year-old male who had severe polyostotic fibrous dysplasia. On Tc-99m-MDP (methylene diphosphonate) bone scintigraphy, increased activity accumulations were seen on multiple ribs, vertebrae and base of the cranium. In addition, diffuse increased pathologic uptake of Tc-99m-MDP in the liver was shown. Intravenous pamidronate was administered monthly for two months. In the third week of the last administration Tc-99m-MDP bone scintigraphy was performed again, but despite sustained bone involvement, pathologic hepatic uptake was not seen on the scan. We thought that pathologic hepatic Tc-99m-MDP accumulation, may be related to the formation and aggregation of calcium oxalate and phosphate crystals which improved with pamidromat treatment.
