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Öğe Aort Kapak kalsifikasyonu: Koroner Anjiografi Yapılan Hastalarda Kardiyovasküler Risk Faktörlerinin ve Kemik Mineral Dansitesinin Değerlendirilmesi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2008) Tekin, Gülaçan Özgün; Yağmur, Jülide; Kekilli, Ersoy; Yağmur, Cengiz; Uçkan, Ahmet; Aksoy, Yüksel; Turhan, Hasan; Yetkin, Ertan; Özdemir, Ramazan; Koşar, FeridunAort kapak kalsifikasyonu (AKK) yüksek kardiyovasküler risk insidansına sahip görünmekte olup, aterosklerozun bir sonucu olarak kabul edilebilir. Düşük kemik mineral dansitesi ve artmış aort kalsifikasyon prevalensi arasındaki ilişki esas olarak toplum tabanlı çalışmalarda yaşlı bayanlarda gösterilmiştir. Ancak bazı çalışmalar kemik mineral dansitesi ile aort kalsifikasyonu arasında ilişki olmadığını bildirmiştir. Bu yüzden. biz koroner angiografi yapılan hastalarda AKK’nu değerlendirmeyi ve AKK olan ve olmayan hastaların kardiyovasküler risk faktörlerini ve kemik mineral dansitelerini karşılaştırmayı amaçladık. Materyal ve metod: Çalışma populasyonu koroner angiografi yapılan 585 ardışık hasta (372 erkek, 213 kadın, ortalama yaş=59±10 yıl) içeriyordu. Bütün hastalara transtorasik ekokardiyografik inceleme yapıldı. AKK bir yada daha fazla küspis üzerinde birden fazla parlak yoğun ekoların izlenmesi ve tutulan küspisin azalmış hareketi olarak tanımlandı. Bütün hastalar dual energy x-ray absorpsiyometri (DEXA) yöntemi ile kemik mineral dansitesi (T scor) ölçümü için Nükleer Tıp bölümüne yönlendirildi. Tüm hastalarda yaş, cinsiyet, vücut kitle indeksi, hipertansiyon, diyabetes mellitus, koroner arter hastalığı, hiperkolesterolemi ve sigara içiciliği kaydedildi. Bulgular: Çalışmamızda AKK prevalensı %27 (160/585) bulundu. Her iki grup arasında diyabetes mellitus, hiperkolesterolemi ve sigara içiciliği yönünden istatistiksel olarak anlamlı fark yoktu (p>0.05 hepsi için). Yaş ve hipertansiyon AKK için bağımsız risk faktörü olmasına karşılık vücut kitle indeksi AKK için bağımsız ve negatif risk faktörü olarak saptandı. AKK ile ilişkili bulunmasada AKK olan grupta koroner arter hastalığı anlamlı oranda yüksek saptandı. Ne T skoru, ne de yaş ve cinsiyete uyarlanmış T skoru AKK ile ilişkili bulunmadı. Sonuç: Biz bu çalışmada yaş, hipertansiyon ve vücut kitle indeksi ile AKK arasında bağımsız ilişki olduğunu gösterdik. Kemik mineral dansite ölçümünde yaş-cinsiyet uyarlanmış T skoru AKK ile ilişkisiz bulundu. Her ne kadar çalışmamızda koroner arter hastalığı ile AKK arasında ilişki olmadığı gösterilmiş olsada bu konunun aydınlanması için ileri çalışmalara ihtiyaç vardır.Öğe Aortic valve calcification: Assessment of cardiovascular risk factors and bone mineral density in patients undergoing coronary angiography(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2008) Özgün Tekin, Gülaçan; Yağmur, Jülide; Kekilli, Ersoy; Yağmur, Cengiz; Uçkan, Ahmet; Aksoy, Yüksel; Turhan, Hasan; Yetkin, Ertan; Özdemir, Ramazan; Koşar, FeridunÖz: ÖZET: Amaç: Aort kapak kalsifikasyonu (AKK) yüksek kardiyovasküler risk insidansına sahip görünmekte olup, aterosklerozun bir sonucu olarak kabul edilebilir. Düşük kemik mineral dansitesi ve artmış aort kalsifikasyon prevalensi arasındaki ilişki esas olarak toplum tabanlı çalışmalarda yaşlı bayanlarda gösterilmiştir. Ancak bazı çalışmalar kemik mineral dansitesi ile aort kalsifikasyonu arasında ilişki olmadığını bildirmiştir. Bu yüzden. biz koroner angiografi yapılan hastalarda AKK’nu değerlendirmeyi ve AKK olan ve olmayan hastaların kardiyovasküler risk faktörlerini ve kemik mineral dansitelerini karşılaştırmayı amaçladık. Materyal ve metod: Çalışma populasyonu koroner angiografi yapılan 585 ardışık hasta (372 erkek, 213 kadın, ortalama yaş=59±10 yıl) içeriyordu. Bütün hastalara transtorasik ekokardiyografik inceleme yapıldı. AKK bir yada daha fazla küspis üzerinde birden fazla parlak yoğun ekoların izlenmesi ve tutulan küspisin azalmış hareketi olarak tanımlandı. Bütün hastalar dual energy x-ray absorpsiyometri (DEXA) yöntemi ile kemik mineral dansitesi (T scor) ölçümü için Nükleer Tıp bölümüne yönlendirildi. Tüm hastalarda yaş, cinsiyet, vücut kitle indeksi, hipertansiyon, diyabetes mellitus, koroner arter hastalığı, hiperkolesterolemi ve sigara içiciliği kaydedildi. Bulgular: Çalışmamızda AKK prevalensı %27 (160/585) bulundu. Her iki grup arasında diyabetes mellitus, hiperkolesterolemi ve sigara içiciliği yönünden istatistiksel olarak anlamlı fark yoktu (p>0.05 hepsi için). Yaş ve hipertansiyon AKK için bağımsız risk faktörü olmasına karşılık vücut kitle indeksi AKK için bağımsız ve negatif risk faktörü olarak saptandı. AKK ile ilişkili bulunmasada AKK olan grupta koroner arter hastalığı anlamlı oranda yüksek saptandı. Ne T skoru, ne de yaş ve cinsiyete uyarlanmış T skoru AKK ile ilişkili bulunmadı. Sonuç: Biz bu çalışmada yaş, hipertansiyon ve vücut kitle indeksi ile AKK arasında bağımsız ilişki olduğunu gösterdik. Kemik mineral dansite ölçümünde yaş-cinsiyet uyarlanmış T skoru AKK ile ilişkisiz bulundu. Her ne kadar çalışmamızda koroner arter hastalığı ile AKK arasında ilişki olmadığı gösterilmiş olsada bu konunun aydınlanması için ileri çalışmalara ihtiyaç vardır.Öğe Calculating colon transit time with radionuclide filled capsules in constipated patients a new method for colon transit study(Abdominal Imaging, 2005) Kekilli, Ersoy; Işık, Burak; Aydın, O. M.; Yağmur, C.Background: 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 Calculating colon transit time with radionuclide filled capsules in constipated patients a new method for colon transit study(Abdominal Imaging, 2005) Kekilli, Ersoy; Işık, BurakBackground: 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 Can diffusion weighted magnetic resonance imaging (DW-MRI) be an alternative to 18f-FDG PET/CT (18f fluorodeoxyglucose positron emission tomography) in nasopharyngeal cancers?(Scientific Publishers India, 2017) Yildirim, Ismail Okan; Ekici, Kemal; Dogan, Metin; Temelli, Oztun; Kekilli, Ersoy; Saglik, Semih; Erbay, FatihObjective: This study aimed to evaluate correlations, if any, between the ADC (Apparent Diffusion Coefficient) measurements in MRI (Magnetic Resonance Imaging) and SUV max (Standardized Uptake Value) in F-18-FDG PET/CT in patients with nasopharyngeal cancers and to investigate whether DW-MRI (Diffusion Weighted MRI) can be an alternative to F-18-FDG PET/CT in the evaluation of the response to treatment and prognosis in those patients. Methods: This study was performed between January 2015 and February 2016 at Inonu University Medical Faculty, Department of Radiology on 22 patients who were diagnosed with nasopharyngeal cancer by histopathological evaluation at Department of Pathology of the same faculty. Diffusion weighted images were obtained using 1.5 T MRI in all patients. F-18-FDG PET/CT images were obtained approximately 1-2 weeks after the diffusion-weighted images. Results: Two groups were created according to the histological subtypes as keratinized (n: 8) and non-keratinized (n: 14) among the 22 cases with a definitive histopathological diagnosis of nasopharyngeal cancer. No statistical difference was found between the groups in terms of SUVmax, SUVmean and ADC mean values (p> 0.05). ADC mean values measured in patients with nasopharyngeal cancer were statistically significantly and negatively correlated with SUV max (r=-0.619, p< 0.001) and SUV mean values (r=-0.677, p< 0.001). Conclusion: Even though there are anatomic and patient-related limitations of the DW-MRI in nasopharyngeal cancers, we suggest that it may be a complementary and alternative method of F-18-FDG PET/CT in the evaluation of treatment response and prognosis detection in nasopharyngeal cancers.Öğe The changes in bone mineral density of the forearm and distal radius-ulna subcortical bone due to ulnar variance(Springer, 2009) Ertem, Kadir; Kekilli, Ersoy; Karakoc, Yunus; Yologlu, SaimThe aim of this study was to evaluate the changes in subcortical bone mineralization of the distal radius and ulna in the presence of negative ulnar variance. A total of 77 healthy right hand-dominant volunteers [34 women and 43 men of mean age 38 +/- A 14.8 years (range 14-71)] were enrolled in this study. Bilateral bone mineral density (BMD) and bone mineral density ratio (BMDR) measurements of the distal radius and ulna were performed by using dual energy X-ray absorptiometry. We found a significant decrease of ulnar subcortical BMD and BMDR subcortical in the dominant forearms of the subjects with negative ulnar variance when compared to that of subjects with neutral ulnar variance (P < 0.02). But this difference was not seen on the non-dominant side. There was no significant difference in BMDRs between the dominant and non-dominant forearms for all subjects. Radial and ulnar subcortical BMD values were significantly different between dominant and non-dominant forearms in subjects with bilateral neutral ulnar variance, whereas not significantly different in subjects with bilateral negative ulnar variance. The increase found in the BMD value of radial subcortical bone in subjects with negative ulnar variance may be due to the indirect shift of axial forces through the ulna to radius.Öğe Comparison of different quantitative methods and visual evaluation on the Tc-99m-HMPAO brain perfusion SPET(Fırat Tıp Dergisi, 2006) Kekilli, Ersoy; Yağmur, Cengiz; Ertem, Kadir; Turgut, Songül; Aydın, Ömer MuratÖz: Amaç: Beyin perfüzyon sintigrafisi beyin perfüzyonu ve metabolik durumunu değerlendirmek için yaygın olarak kullanılmaktadır. Biz görsel değerlendirmeye dayanarak Tc-99m-HMPAO SPET'deki farklı ölçüm metodlarını karşılaştırmayı amaçladık. Gereç ve Yöntem: Kıyaslamalı çalışmamıza 47 hasta dahil edildi. Tc-99m-HMPAO beyin perfüzyon SPET uygulandı. Yarı-kantitatif analiz için iki orbitomeatal (OM) compozit kesit oluşturuldu. Bölgesel serebral perfüzyon bilgileri semi-kantitatif olarak her bir serebral ROI ortalama sayımı ve referans bölge ortalama sayımı arası oran olarak hesaplandı. Serebellum sayım ortalaması, alt OM kesit sayım ortalaması ve karşı hemisfer ilgi alanı sayım ortalaması referans bölgeler olarak kullanıldı. İki nükleer tıp uzmanı bütün görüntüleri değerlendirdi. Görsel değerlendirmede ilgi alanlarını 0 (=hipoperfüze alan); 1 (=normal alan) ve 2 (=hiperperfüze alan) olarak tanımladı. SPET kesiti ilgi alanları bilgileri farklı ölçüm metotlarının ideal karar eşiğini temin metodu olan ROC analizle değerlendirildi. Bulgular: Bizim bulgularımız küçük ilgi alanları almanın büyük ilgi alanlarından daha iyi olduğunu gösterdi. Alt OM kesit sayım ortalaması serebellum sayım ortalaması ile pozitif korelasyona sahipti. Ek olarak, referans alan olarak, alt OM kesit sayım ortalaması kullanımı serebellumunkinden hafif; karşı hemisfer simetrik alanınınkinden ise belirgin daha iyiydi. Sonuç: Biz görsel değerlendirme ile bu ölçüm metotları arasında beklediğimiz yüksek uyumluluğu bulamadık. Beyin perfüzyon Tc-99m-HMPAO SPET te yeni ölçüm metotlarına ihtiyaç olduğunu düşünmekteyiz.Öğe The Effect of Sildenafil on Recuperation from Sciatic Nerve Injury in Rats(Galenos Publ House, 2016) Korkmaz, Mehmet Fatih; Parlakpinar, Hakan; Ceylan, Mehmet Fethi; Ediz, Levent; Samdanci, Emine; Kekilli, Ersoy; Sagir, MustafaBackground: Severe functional and anatomical defects can be detected after the peripheral nerve injury. Pharmacological approaches are preferred rather than surgical treatment in the treatment of nerve injuries. Aims: The aim of this study is to perform histopathological, functional and bone densitometry examinations of the effects of sildenafil on nerve regeneration in a rat model of peripheral nerve crush injury. Study Design: Animal experiment. Methods: The study included a total of thirty adult Sprague-Dawley rats that were divided into three groups of ten rats each. In all rats, a crush injury was created by clamping the right sciatic nerve for one minute. One day before the procedure, rats in group 1 were started on a 28-day treatment consisting of a daily dose of 20 mg/kg body weight sildenafil citrate given orally via a nasogastric tube, while the rats in group 2 were started on an every-other-day dose of 10 mg/kg body weight sildenafil citrate. Rats from group 3 were not administered any drugs. Forty-two days after the nerve damage was created, functional and histopathological examination of both sciatic nerves and bone densitometric evaluation of the extremities were conducted. Results: During the rotarod test, rats from group 3 spent the least amount of time on the rod compared to the drug treatment groups at speeds of 20 rpm, 30 rpm and 40 rpm. In addition, the duration for which each animal could stay on the rod throughout the accelerod test significantly reduced in rats from group 3 compared to rats from groups 1 and 2 in the 4-min test. For the hot-plate latency time, there were no differences among the groups in either the basal level or after sciatic nerve injury. Moreover, there was no significant difference between the groups in terms of the static sciatic index ( SSI) on the 42nd day ( p=0.147). The amplitude was better evaluated in group 1 compared to the other two groups ( p<0.05). Under microscopic evaluation, we observed the greatest amount of nerve regeneration in group 1 and the lowest in group 3. However, this difference was not statistically significant. Moreover, there was no significant difference in the bone mineral density (BMD) levels among the groups. Conclusion: We believe that a daily single dose of sildenafil plays an important role in the treatment of sciatic nerve damage and bone healing and thus can be used as supportive clinical treatment.Öğe The effects of immobilization subsequent to the repair of clean-cut tendon injuries on distal radius bone mineral content(Ulusal Travma ve Acil Cerrahi Dergisi, 2007) Ertem, Kadir; Kekilli, ErsoyÖz: AMAÇ Önkol voler yüzde düzgün tendon yaralanması olan olgularda erken primer tamir ve pasif hareket sonrası distal radiusta meydana gelen kemik mineral yoğunluğundaki değişimin araştırılması. GEREÇ VE YÖNTEM On beş dominant olmayan el yaralanması olan hasta (grup I), 12 dominant el yaralanması olan hasta (grup II) ve sağlıklı gönüllülerden oluşan 15 kişilik kontrol grubu (grup III) çalışmaya alındı. Ameliyattan sonra 6. haftada ve 4. ayda elde edilen önkol proksimal, orta ve ultradistal bölgelerin yan-yana kemik mineral içeriğindeki değişimler (SSD) istatistiksel yöntemlerle karşılaştırıldı. BULGULAR Kontrol grubu ile kıyaslandığında, grup II olgularda altıncı haftada radiusun proksimal ve orta bölgelerindeki SSD ölçümleri anlamlı derecede azaldı (p<0,01 ve p<0,001). Bu azalma sırayla %8,9 ve %8,6 oranındaydı. Benzer şekilde, kontrol grubu ile kıyaslandığında, grup II olgularda dördüncü ay radiusun proksimal ve orta bölgelerindeki SSD ölçümleri anlamlı derecede azaldı (p<0,001). Bu azalma sırayla %10,2 ve %7,7 olduğu kaydedildi. Grup I’de 4. aydaki radius orta kısım SSD ölçümündeki %7,4 azalma hariç tutulursa, kontrol grubuna kıyaslandığında SSD ölçümlerinin anlamlı farklılığı yoktu. SONUÇ Önkol voler yüzde düzgün tendon yaralanması olan olgularda erken primer tamir ve pasif hareket sonrası distal radiusta meydana gelen kemik mineral yoğunluğunda anlamlı derecede azalma olabilmektedir. Başlık (İngilizce): Tendon tamiri sonrası immobilizasyonun distal radius kemik mineral içeriğine etkisi Öz (İngilizce): BACKGROUND We investigated the changes of bone mineral density at distal radius and ulna in patients with volar wrist clean-cut tendon(s) injuries that were treated by early primary repair and passive mobilization. METHODS Fifteen patients with non-dominant hand injury (group I), 12 patients with dominant hand injury (group II) and 15 healthy volunteers serving as the control group (group III) were enrolled into this study. Side to side bone mineral component differences (SSD) of the proximal, middle and ultradistal radius that were obtained at 6th week and 4th month after operation were statistically compared. RESULTS In comparison with the control group, SSD measurements of the middle and proximal subregions of group II at the 6th week were significantly decreased (p<0.01 and p<0.001). The decreases were 8.9 and 8.6% respectively. Similarly, the 4th month SSD measurements of the middle and proximal subregions of group II were also significantly decreased compared to group III (p<0.001). The decreases were 10.2% and 7.7%, respectively. In group I, except a 7.4% decrease at the middle subregion of the radius at 4th month, there was no significant difference in SSD measurements as compared with the control group. CONCLUSION Results of our study indicate that there is a considerable bone loss of distal radius in patients who are surgically treated for acute clean-cut tendon(s) injuries at the volar wrist level.Öğe The effects of mineral water drinking and extra-abdominal pressure in elimination of attenuation artifacts on myocardial perfusion SPECT(2015) Bati, Fatih; Kekilli, Ersoy; Koksal, İsmail; Subasi, VedatAbstract: Myocardial perfusion scintigraphy is often used non-invasive diagnostic test for detection of coronary artery disease, myocardial viability, risk assessment and prediction of prognosis. The aim of this study was to evaluate of mineral water drinking and extra-abdominal pressure for elimination of attenuation artifacts on myocardial perfusion SPECT. A total of 27 patients (20 males, 7 females) who have suspicious findings on stress image were included in this study. If patients were reported ischemia or infracted on myocardial perfusion SPECT, they were excluded from the study. Stress SPECT imaging was repeated continuously three times following basal imaging, application of extra-abdominal pressure and after mineral water drinking. SPECT slices were obtained and "Summed Stress Scores" were calculated from three SPECT imaging. Double-blinded two clinicians visually evaluated these slices and have rated based on ease of evaluation as "best image", "Medium" and "Low". Additionally four groups were created from 4 rating areas which had Summed Stress Scores of 3 or above on Polar Map. Mineral water drinking and application of extra-abdominal may be better than basal imaging. Although a method selecting was difficult in theassessment of inferior and inferoseptal wall. Among the three applications for "Summed Stress Scores" were statistically significant differences with Friedman's test in the 1st, 2nd, 3rd and 4th groups (p=0.03, p=0.008, p=0.005 and p=0.0001, respectively). For evaluation of suspicious lesions in the anterior and anteroseptal region, basal imaging did not significantly differ from application of extra-abdominal pressure. Mineral water drinking (and close to the pressure) was found better than basal imaging in Group 2 and 3. In Group 4, there was not significant difference between the application of extra-abdominal pressure and mineral water drinking. On static images, we did not found any significant change for intrathorasic localization and axis of left ventricul among three SPECT. The most remarkable finding among three SPECT was gradually decreasing of hepatic uptake. We though that change in "Summed Stress Score" in both application of extra-abdominal pressure and mineral water drinking may only be due to decreases in hepatic activity associated with time.Öğe Endometrium kanserinde postoperatif radyoterapi: tedavi sonuçları ve prognostik faktörler(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Temelli, Öztun; Gürocak, Şimay; Kekilli, Ersoy; Ekici, KemalAmaç: Bu çalışmayla postoperatif radyoterapi uygulanan hastalarda, tümöre ve tedaviye bağlı prognostik faktörlerin, lokal ve bölgesel kontrol, genel sağkalım ve hastalıksız sağkalım üzerindeki etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Adjuvan eksternal radyoterapi ve brakiterapi uygulanan 61 endometrium kanserli hasta retrospektif olarak değerlendirilmiştir. Hastaların yaşı, tümör diferansiasyonu, tümör evresi, lenfovasküler invazyon, seroza invazyonu, myometrial invazyon, endoservikal tutulum, adneks tutulumu, lenf nodu tutulumu, sigara kullanımı, hipertansiyon ve diyabet hastalığı, hormon replasman tedavisi alıp almaması, doğum sayısı, menopoz yaşı, kemoterapi durumu, vajinal brakiterapi, radyoterapi şekli ve dozları, lokal nüks değerlendirilmiştir. Bulgular: Altmış bir hastanın 53’ü (%87) endometrioid adenokarsinom, 8’i (%13) ise diğer adenokarsinom (seröz, müsinöz, clear cell, mikst tip) histolojisine sahipti. Hastaların 53’üne (%87) Total abdominal histerektomi+ bilateral salfingooferektomi + bilateral pelvik lenf nodu diseksiyonu (TAH+BSO+BPLND), 8 hastaya (%13) sadece TAH+BSO yapılmış. Otuz hastaya konvansiyonel, 23 hastaya ise konformal radyoterapi uygulanmıştır. Sekiz hastaya ise eksternal radyoterapi uygulanmamış sadece brakiterapi uygulaması yapılmıştır. İki yıllık genel sağkalım %93.4; 5 yıllık genel sağkalım %80.3 olarak bulunmuştur. Ortalama sağkalım 51 aydır. Hastalıksız sağkalım 2 yıllık ve 5 yıllık sırasıyla %85.2 ve %77 olarak tespit edildi. Genel sağkalım üzerine, serozal invazyon olması (p=0.034) anlamlı bulundu. Sonuç: Endometrium kanserinde postoperatif radyoterapi efektif ve güvenli bir yöntemdir.Öğe Evaluation of cardiovascular risk factors and bone mineral density in post menopausal women undergoing coronary angiography(Elsevier Ireland Ltd, 2008) Tekin, Gulacan Ozgun; Kekilli, Ersoy; Yagmur, Julide; Uckan, Ahmet; Yagmur, Cengiz; Aksoy, Yuksel; Turhan, HasanBackground: The underlying mechanism by which osteoporosis and cardiovascular disease may be linked is not fully understood. However studies mainly focused on the association between bone mineral density (BMD) and cardiovascular risk factors or atherosclerosis itself by only assessing the presence of vascular calcification. In this study we aimed to evaluate both cardiovascular risk factors, and presence of coronary artery disease (CAD) in post-menopausal women patients with and without low BMD. Materials and methods: Study population consisted of post menopausal women who were scheduled to coronary angiography. Two hundred and twenty seven consecutive female patients were included in the study and evaluated for the presence of cardiovascular risk factors and CAD. Bone mineral density was measured in all patients either the day before or the day after coronary angiography. Low BMD was defined as T score<-1 and normal BMD was defined as T score >=-1. For statistical analysis patients were divided into two groups: patients with low BMD and patients with normal BMD. Results: There were not statistically significant differences between two groups in respect to body mass index, presence of diabetes mellitus, hypercholesterolemia, and smoking status. Age and presence of CAD was found to be statistically different between two groups being higher in patients with low BMD. Logistic regression analysis revealed that age was positively and independently associated with low BMD in post menopausal female patients (Odds ratio=1.072 CI: 1.036-1.11, p=0.001). Conclusion: Age is found to be an independent predictor of decreased BMD in our study population recruited from the coronary angiography laboratory. However, neither cardiovascular risk factors, nor coronary artery disease itself has been found to be associated with low BMD. (C) 2007 Published by Elsevier Ireland Ltd.Öğe Kemik greftlerinde nükleer tıp uygulamaları(Ersoy K., Cengiz Y., Kadir E., Türk Bilge B. (2005). Kemik greftlerinde nükleer tıp uygulamaları, İnönü Üniversitesi, Malatya., 2005) Kekilli, Ersoy; Yağmur, Cengiz; Ertem, Kadir; Bilen, Türk BilgeÖz: Kemik greftleri eklem füzyonunda, eklem rekonstrüksiyonunda, kraniomaksillofasiyal rekonstrüksiyonda, travmatik yaralanmalarda, kemik rezeksiyonunda ve enfeksiyonlarında, protez komplikasyonlarında, kırık ve kaynama problemlerinde, konjenital malformasyonlar ve kozmetik problemlerin tedavisinde kullanılırlar. Kemik greftleri sıklıkla kemik doku iskelesi, köprü, alan kaplayıcı, defekti doldurucu ve kemik kaybını yerine koyucu rollere sahiptirler. Günümüzde kemik grefti kullanımı gittikçe artmaktadır. Ülkemizde de otolog kemik greftleri kullanımı oldukça yaygındır. Kemik greftlerinde greft canlılığının ve komplikasyonlarının değerlendirilmesinde ve hastanın takibinde nükleer tıp değerli bilgiler vermektedir. Özellikle vasküler kortikal kemik greftlerinde ve vasküler pediküllü kemik greftlerinde operasyondan kısa süre sonra greft canlılığı ve vasküler anastomozun başarısı kemik sintigrafisi ile gösterilebilmektedir. İşlemin patofizyolojisini öğrenmekle, sintigrafik bulguların yorumu kolayca verilebilecektir. Vasküler olmayan kemik greftlerinde iyileşme revaskülarizasyon ve remineralizasyon ile olur. Kansellöz otogreftlerde vasküler cevap kortikal greftlerinkinden daha büyüktür. Kansellöz yatağın tamamı yaklaşık 1-2 hafta içinde tamamen revaskülarize olabilir: Vasküler kemik greftlerinde ve kas pediküllü kemik greftlerinde iyileşme kırık iyileşmesi ile benzerdir. Allogreft kemik basitçe bir kalsiyum iskelesini sağlar, herhangi bir kemikleşme hücresi ve proteinlerine sahip değildir. Kemik sintigrafisi ile allogreft iyileşmesinin otogreftlere benzediği ancak revaskülarizasyonun ve remineralizasyonun daha uzun sürdüğü gösterilmiştir. Bu nedenle, bu derlemede patofizyolojik bilgiler genişce verilmiştir. Son dönem literatürleri ışığında yazarlar, kemik greftleme işlemleri hakkında genel bilgileri vermeyi ve bu hastalarda kullanılabilecek nükleer tıp uygulamalarını tartışmayı amaçlamışlardır. Başlık (İngilizce): Bone grafts and nuclear medicine: Review Öz (İngilizce): Bone grafts find application in multiple settings: joint fusion and reconstruction, bone infection and resection, prothesis complications, congenital malformation and cosmetic adjustments, cranio-maxillofacial reconstruction, as well as the treatment of various trauma injuries such as fractures resulting in delayed unions and non-unions. Bone grafts have often played the roles of scaffolds, bridges, spacers, defect fillers, and bone-loss replacements. There is a growing trend in bone graft usage today. The use of autolog bone grafts is widespread in Turkey. Nuclear medicine has proven to be a helpful adjunct in the determination of graft viability. In particular, the status of vascular anastomoses can be shown on bone scintigraphy short periods after cortical and pedicle bone grafts. With added knowledge of individual pathophysiology, the interpretation of scintigraphic results is greatly facilitated. Non-vascularized bone grafts improve with revascularisation and remineralisation. In cancellous autografts, the vascular response is much greater than in cortical grafts. The entire cancellous bed may be completely revascularized within approximately l to 2 weeks. Healing of vascularized bone grafts and pedicles is similar to the process manifested in fractures. Allograft bone simply provides calcium scaffolding and does not possess bone-growing cells or proteins. Previous studies utilizing bone scintigraphy have shown that allograft healing proceeds not unlike that of autografts, with the exception that revascularisation and remineralisation are delayed. The authors review the current literature on bone grafting procedures and discuss the possible applications of nuclear medicine in this setting.Öğe Measuring holotranscobalamin II, an early indicator of negative vitamin B12 balance, by radioimmunoassay in patients with ischemic cerebrovascular disease(Springer, 2008) Serefhanoglu, Songul; Aydogdu, Ismet; Kekilli, Ersoy; Ilhan, Atilla; Kuku, IrfanCirculating homocysteine is a risk factor of cardiovascular and cerebrovascular events. Hyperhomocysteinemia may be an early indicator for vitamin B-12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B-12 deficiency in the first ischemic cerebrovascular attack. We also compared the efficacy of the measurement of plasma holoTC II with the other standard biochemical and hematological markers used to reach the diagnosis of cobalamin deficiency. Forty-five patients (age 71 years (range 35-90), 16 men/29 women) within the first ischemic cerebrovascular event were included in this prospective study. All the enrolled patients have been administered vitamin B-12 1 mg intramuscular injection once a day for 10 days. At the baseline and on the tenth day of treatment, plasma levels of holoTC II and the proper biochemical and hematological markers in diagnosing cobalamin deficiency were measured. After admission, anemia and diminished serum vitamin B-12 levels were determined to be only 20% (9/45) and 44% (20/45), respectively; 78% (35/45) of the patients had low serum holoTC II (< 37 pmol/l). Serum homocysteine was higher in patients (49% of them) who had previously suffered a stroke. Thrombocytopenia, hypersegmentated neutrophils, and indirect hyperbilirubinemia were observed in 20% of the patients. Leukopenia and macrocytosis were not evident in any of them. In 18 of 27 patients (67%) that had low holoTC II levels after joining the study and who remained in the study until the end of cobalamin treatment, serum holoTC II levels returned to normal values. Cobalamin deficiency should be considered in patients with cerebrovascular diseases, even if anemia, elevated mean cell volume, depression of the serum cobalamin, or other classic hematological and/or biochemical abnormalities are lacking. Furthermore, measurement of serum holoTC II looks promising as a first-line of tests for diagnosing early vitamin B-12 deficiency.Öğe The mechanical or electrical induction of medullary angiogenesis will it improve sternal wound healing(Tex Heart Inst J, 2004) Alat, İlker; İnan, Muharrem; Gürses, İclal; Kekilli, Ersoy; Germen, Burak; Harma, Ahmet; Eskin, Ahmet; Ayın, Ömer MuratWe 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 K 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 The mechanical or electrical induction of medullary angiogenesis will it improve sternal wound healing(Tex Heart Inst J, 2004) Alat, İlker; İnan, Muharrem; Gürses, İclal; Kekilli, Ersoy; Germen, Burak; Harma, Ahmet; Eskin, Ahmet; Aydın, Ömer MuratWe 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 K 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. (Tex Heart Inst J 2004;31:363-7)Öğe Melorheostosis of the left upper limp(Open Journal of Medical Imaging, 2012) Evren, Bahri; Çıkım Sertkaya, Ayşe; Köksal, İsmail; Kekilli, ErsoyMelorheostosis, also known as Leri disease or flowing periosteal hyperostosis, is a rare, non-hereditary, benign, sklerosing bone dysplasia which radiologically characterized by the appearance of “melting wax flowing down a candle”. We report on a 43-year-old woman with melorheostosis who had pain in the upper limp for 10 years, limitation of joint movement and a deformity in the left third finger. Radiographies and bone scintigraphy were evaluated. All lesions of melorheostosis in radiography were seen in bone scintigraphy. More than half of increased uptakes on bone scintigraphy are due to degenerative process.Öğe Normal range of BMD in proximal tibia as a different skeletal site at women(Kare publ, kare yayıncılık, sogutlucesme cad, no 76-103, ıstanbul, 34000, turkey, 2016) Aluclu, Mustafa Arif; Bati, Fatih; Kekilli, ErsoyOBJECTIVE: Osteoporosis is progressive metabolic bone disease that decreases bone density and features deterioration of bone structure. Dual-energy X-ray absorptiometry (DXA) is commonly used and reliable method to measure bone mineral density (BMD). Aim of this study was to determine normal ranges of BMD in left proximal tibia. METHODS: Fifty-five females were included in this study. BMD was measured at the lumbar spine and the left proximal tibia using DXA. BMD value of subregions in the left proximal tibia was significantly correlated with BMD value of the total lumbar spine (r=0.111-0.766). New average BMD values of the left proximal tibia were calculated according to age using linear regression formula, leading to average BMD value for the total lumbar spine (L1-L4) in normal population. New simulated T-scores for proximal subregions of the tibia were then calculated. RESULTS: T-scores for proximal subregions were not different from T-scores of total lumbar spine (p>0.05). CONCLUSION: It was concluded that proximal tibia is an ideal region for measurement of BMD in osteoporosis.Öğe Novel noninvasive detection method for endometriosis: research and development of scintigraphic survey on endometrial implants in rats(Elsevier Science Inc, 2008) Hascalik, Seyma; Celik, Onder; Kekilli, Ersoy; Elter, Koray; Karakas, Hakki Muammer; Aydin, Nasuhi EnginIn this experimental study on endometriosis, the majority of the implants were successfully detected with technetium-(Tc-99m) labeled red blood cell scintigraphy.Öğe Outcomes of radiotherapy in early stage glottic laryngeal carcinoma: a single center experience(Medicine Science, 2016) Ekici, Kemal; Temelli, Oztun; Eraslan, Ayse Fatma; Gurocak, Simay; Kaplan Bozdag, Nihal; Elkiran, Emin Tamer; Kekilli, Ersoy; Kizilay, Ahmet[Abstract Not Acailable]
