Diagnostic and clinical value of F-18 FDG PET/CT in thoracic carcinoid tumors

Aim: To assess the correlation between standard uptake values ​​(SUVmax, SUVmean) and Ki-67 in typical lung carcinoid (TC) tumors. Methods: Thirty-eight patients with thoracic masses sent for diagnosis and staging were included in the study. F-18 FDG PET / CT was applied to all patients before the operation. The patients were operated by thoracic surgery clinic. By determining different cut-off values ​​(2.5 and 0.5), SUVmean and SUVmax values ​​of the lesions from the curves drawn to the area of ​​interest were calculated. Results: Thirty-eight patients were included in the study (18 women, 20 men). The average age of our patients was 45. Pathological diagnoses of all patients were determined as typical carcinoids. Eight of our patients had parenchymal lesions and twenty of them had endobronchial lesions. The average of the Ki-67 index was about 3-4% (range 1-10%). No recurrence or death was detected after resection in the 5-year follow-up period. SUVmean1 and SUVmean2 values ​​were statistically significant when compared with SUVmax1 and SUVmax2 values ​​(p <0.05). Conclusion: We think that the SUVmean and Ki-67 index may be an important prognostic indicator that identifies high-risk subgroups. It is thought that Ki-67 indices may correlate well with SUVmean values, and low cut-off values ​​may be more suitable for diagnosis and prognosis in typical carcinoid tumors. SUVmean values ​​can be used for lung carcinoid tumors and F-18 FDG PET/CT imaging is useful in the approach to carcinoid tumors of the lung before thoracic surgery. &nbsp

Elderly patients in emergency department: Dyspnea and chest pain

INTRODUCTION: As in all countries, the rate of geriatric group in the population is increasing rapidly in parallel with the improvement of life style.. Geriatric patients frequently refer to ED with cardiopulmonary complaints. The aim of study was to investigate the diagnosis distributions of geriatric patients with chest pain- respiratory distress. METHODS: This retrospective study was performed with 1343 patients over 65 years of age who were admitted to ED with respiratory distress- chest pain evaluated with computed tomography - cardiac enzyme levels. RESULTS: A total of 1343 patients with respiratory distress and chest pain from the geriatric age group were included in the study. 531 patients who were admitted due to trauma and more than one admission to hospital with the same complaints were excluded from the study. Respiratory distress and chest pain were observed in 343 of 812 patients (42.24%) cause of pulmonary, 247 (30.41%) patients cardiac, and 222 (27.33%) had due to other causes. In patients with pulmonary-related respiratory distress and chest pain, the most common cause was pneumonia (39.06%);and in 51.41% of patients with cardiac causes, acute myocardial infarction was detected. DISCUSSION AND CONCLUSION: We believe that to known the etiology of respiratory distress and chest pain will provide better patient evaluation. Considering that the number of geriatric patients who applied for emergency services increases day by day, the fact that emergency workers have more knowledge about geriatrics is an important factor that will increase the success rate of emergency department treatment

Morphological study of the perireticular nucleus in human fetal brains

The perireticular nucleus consists of scattered neurons that are located in the internal capsule. The presence of perireticular neurons in the rat, ferret, cat and human has been described previously. Evidence suggests that the perireticular neurons in various species decrease in number with increasing gestation, but in humans this finding has not been supported by quantitative data. This study aimed to investigate (1) the morphology of the human fetal perireticular neurons, (2) the average number of perireticular neurons within the anterior and posterior crus of the internal capsule per unit area, and (3) the magnitude and the stage of neuronal loss in the human perireticular nucleus subsequent to maturation. Nissl-stained sections of the internal capsule of human fetal brains of 24, 26.5, 32, 35, 37 and 39 weeks of gestation showed a number of clearly distinguishable large perireticular and small microglia cells. A regular increase of both perireticular and microglial cells was observed up to 32 weeks of gestation, after which a dramatic reduction in the number of both perireticular and microglia cells was observed. The average number of perireticular and the microglia cells per unit area, located within the posterior crus, was more than in the anterior crus of the internal capsule. In the adult, no perireticular neurons were detected within the internal capsule. The results show that perireticular neurons are not restricted to the region lateral to the thalamus and medial to the globus pallidus (posterior crus) but are also present at the region lateral to the caudate nucleus and medial to the globus pallidus (anterior crus)

Dysphagia in Alzheimer's disease

WOS: 000382713000003PubMed ID: 26924307Objective. - To investigate electrophysiological parameters of swallowing in all stages of Alzheimer's disease. Methods. - Forty Alzheimer's disease patients, 20 age-matched normal controls and 20 young normal controls were included. Dysphagia limit (DL) and sequential water swallowing (SWS) tests were performed. Cardiac rhythm, respiration and sympathetic skin responses were concomitantly recorded. Results. - Dysphagia was found in 30/40 (75%) of Alzheimer's disease patients. Mean volume at the DL test was significantly reduced (16.5 +/- 1.0 mL) in the Alzheimer's disease group. Swallowing and apnea times in the SWS test were significantly prolonged in elderly controls, but even longer in Alzheimer's disease patients. Conclusions. - Alzheimer's disease patients had electrophysiological features of dysphagia, even in the early period of disease. The cortical involvement and severity of cognitive disorder can increase swallowing problems, but subclinical signs of dysphagia may be observed even in patients with mild or moderate Alzheimer's disease. (C) 2016 Elsevier Masson SAS. All rights reserved

Electrophysiological Evaluation of Dysphagia in the Mild or Moderate Patients with Multiple Sclerosis: A Concept of Subclinical Dysphagia

WOS: 000356254900003PubMed ID: 25687968Swallowing mechanism and neurogenic dysphagia in MS have been rarely studied by electromyographical (EMG) methods. This study aims to evaluate the presence of subclinical dysphagia in patients with mild multiple sclerosis (MS) using electrophysiological methods. A prospective study of 51 patients with relapsing remitting multiple sclerosis and 18 age-matched healthy adults was investigated. We used electromyography to measure the activity of the submental muscles during swallowing. Electrophysiological recordings of patients were obtained during relapse, after relapse, and at any time in remission period. Clinical dysphagia was found in 12 % of MS patients, while electrophysiological swallowing abnormalities were encountered in 33 % of patients. Subclinical dysphagia was determined in 35 % of patients during an MS relapse, in 20 % of patients after a relapse, and in 25 % of all 51 patients in the remission period based on EMG findings. Duration of swallowing signal of submental muscles in all MS patients was found to be longer than in normal subjects (p = 0.001). During swallowing of 50 ml of sequential water, the compensatory respiratory cycles occurred more often in MS patients than normal subjects, especially during a relapse (p = 0.005). This is the first study investigating swallowing abnormalities and subclinical dysphagia from the electrophysiological aspect in MS patients with mild disability. The electrophysiological tests described in this study are useful to uncover subclinical dysphagia since they have the advantage of being rapid, easy to apply, non-invasive, and without risk for the patients

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