The Effects of Mineral Water Drinking and Extra-abdominal Pressure in Elimination of Attenuation Artifacts on Myocardial Perfusion SPECT

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. [Med-Science 2015; 4(4.000): 2869-83

Lumbar spine and proximal femur BMD values in Turkish girls and the effect of precocious puberty on BMD.

Previous studies have shown no impairment in bone mineral density in girls with precocious and early puberty. The aim of this study was to evaluate the effect of precocious puberty on BMD and to measure average bone mineral density in Turkish girls. Fourteen girls between the ages of 5-10 (7.57 ± 1.83 year) who had new diagnosed precocious and early puberty were included in this study. BMD was measured in the posterior-anterior projection at the lumbar spine and at the right hip using DEXA. Correlation analysis was performed among BMD in all sub-regions. According to age, new average BMD values of sub-regionals in lumbar spine and proximal femur were calculated by linear regression formula leading to an average value of the lumbar spine total BMD in normal population. According to new average ± SD BMD of all sub-regions, simulated new Z-scores of each girl in proximal femur and lumbar spine were calculated and statistically compared. We found significant Z-score correlation between proximal femur and lumbar spine (r=0.70 0.99). According to age, new average values of sub-regional BMD in lumbar vertebrae and proximal femoral sub-regions in Turkish girls were presented. Average spinal BMD values in Turkish girls were similar with western countries. We though that DEXA scan at lumbar spine, with the exception of some patients, may be enough for an accurate measurement in children. [Med-Science 2012; 1(3.000): 188-199

The Value of Tc-99m Mibi for Differential Diagnosis of Biliary Atresia and Hepatitis in Rats

Cholestatic diseases in neonates which characterized by deterioration of bile passage to intestine. We investigated the usability of Tc-99m MIBI as a hepatobiliary scintigraphy radiopharmaceutical for diferential diagnosis of biliary atresia and hepatitis in experimental model. A total of 20 males Wistar albino rats who had weights ranging from 200-350 g were included in this study. Rats were randomly divided into 4 groups. Control group, sham operated group, biliary atresia group and chemical hepatitis group (with carbon tetrachloride) were created, respectively. Blood flow phases, consantration and early excreation phases was performed after an intravenous injection through the internal jugular vein of 37 MBq Tc-99m MIBI using a gamma camera. Dual late static images were obtained at the same position at 15, 30, 60, 90 and 120 min after injection. In control group, radiopharmaceutical passage into the small intestine was seen between 45 and 60 min and evidently seen between 120 and 150 min as large hyperactive focus on midline or non-linear (snaky) radiopharmaceutical accumulation at the level of kidney. In biliary atresia group, radiopharmaceutical concentration was seen normal in liver but passage into the small intestine was not seen all rats. In carbon tetrachloride group, blood flow, concentration and early excretion scintigraphic images did not differ from control group and radiopharmaceutical passage into the small intestine was seen between 45 and 60 min. Although radiopharmaceuticals passage into the intestine was not shown in all rats of biliary atresia group. We suggest that Tc-99m MIBI as a radiopharmaceutical of hepatobiliary scintigraphy would be the contribution of the differential diagnosis of biliary atresia and hepatitis in humans. [Med-Science 2016; 5(1.000): 134-46

Influence of Resveratrol Against Ovariectomy Induced Bone Loss in Rats: Comparison With Conjugated Equine Estrogen Tibolone and Raloxifene

OBJECTIVE: We examined the effect of resveratrol, a phenolic compound found in the skins of most grapes, on bone loss in ovariectomized rats. STUDY DESIGN: A total of 42 young Wistar-albino rats, of which 35 animals were submitted to bilateral oophorectomy, and 7 rats were submitted to the same surgical incision but without oophorectomy were studied. The rats were assigned to six groups of 7 animals each. For 35 consecutive days the following treatments were given: Group 1, sham; group 2, ovariectomized (OVX); group 3, OVX plus resveratrol; group 4, OVX plus conjugated equine estrogen; group 5 OVX plus tibolone; group 6, OVX plus raloxifene. Immediately 40 days after the ovariectomy bone mineral density (BMD) of the lumbar spine and femur by using dual-energy X-ray absorptiometry. The BMD of lumbar region (R1), total femur region (R2) and three neighbor subregions of femur (R3, R4, R5) were drawn. RESULTS: There were no significant difference between OVX and resveratrol groups for R2, R3 and R4 values. Compared with the OVX group, CEE group had lower values for R3 but similar values for R2 and R4. Raloxifene group had significantly higher value than the OVX, resveratrol, CEE and tibolone groups for R2. For R3, raloxifene had significantly higher values than in the ones in resveratrol, CEE and tibolone. For R4 region, raloxifene had significantly higher values than CEE group. CONCLUSION: Resveratrol administered to ovariectomized rats for 35 days had not a beneficial effect on the development of osteopenic skeletal changes

The Effect of Sildenafil on Recuperation from Sciatic Nerve Injury in Rats

Background: 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

Outcomes of radiotherapy in early stage glottic laryngeal carcinoma: a single center experience

Our aim was to determine the treatment outcomes and the prognostic factors affecting local control in early stage glottic carcinoma (ESGC) treated with definitive radiotherapy (RT). Between April 2003 and May 2015, 76 patients with ESGC were treated at Inonu University Hospital. There were 58 patients with T1a, 7 T1b and 11 with T2 tumors. Twenty-two patients were treated with conformal radiotherapy, 31 patients were treated with conventional RT and 23 patients were treated with intensity modulated radiotherapy as initial treatment. During a median follow-up of 51 months (range 6-136), 11 patients had failures. Five year overall survival rates were 73.7% in T1 and 81.8% T2. Local control rate was 85.5% in our patients. Patients who were over 61 years had significantly lower local control (p = 0.042). One patient treatment was interrupted because of grade 3 edema. One patient had grade 3 dermatitis, 2 patients grade 3 mucositis and 4 patients grade 3 edema, respectively. Our results suggest that curative radiotherapy is an effective treatment modality in ESGC without increasing toxicity. Age proved to be the only independent prognostic factor affecting local control after primary radiotherapy according to the results of this study. [Med-Science 2016; 5(4.000): 928-32