Evaluation of Nasal Mucociliary Transport Rate by99mTc-Macroaggregated Albumin Rhinoscintigraphy in Woodworkers

Woodworkers in the furniture industry are exposed to wood dust in their workplaces. The aim of this study is to investigate the effect of occupational wood dust exposure on the nasal mucociliary transport rates (NMTRs) in woodworkers. Twenty five woodworkers and 30 healthy controls were included in this study. Wood dust concentration in workplaces was measured using the sampling device. 99m Tc-macroaggregated albumin (99mTc-MAA) rhinoscintigraphy was performed, and NMTR was calculated in all cases. In statistical analysis, an independent samples t-test was used to compare NMTR of woodworkers and control subjects. We found that the mean NMTR of the woodworkers was lower than that of the healthy controls. However, there was not a statistically significant difference between them (P = 0.066). In conclusion, our findings suggested that wood dust exposure may not impair nasal mucociliary transport rate in woodworkers employed in joinery workshops

FDG-PET/BT ile tespit edilen küçük hücreli akciğer kanserinin kemik iliği metastazı

Öksürük, hemoptizi, kilo kaybı, yaygın kemik ağrısı şikayetleri ile başvuran elli dokuz yaşında erkek hastanın kontrastlı toraks BT’sin- de sağ akciğerde kitle tespit edildi. Kitlenin biopsi sonucu küçük hücreli akciğer kanseri KHAK olarak rapor edildi. Yaygın kemik ağrısı şikayeti olan hastanın kemik sintigrafisi normal olarak değerlendirildi. Evreleme amacıyla yapılan FDG-PET/BT’de kemik ili- ğinde heterojen artmış FDG florodeoksi glukoz tutulumu saptandı. Kemik iliği biyopsisinin patolojik değerlendirme sonucu KHAK metastazı olarak raporlandı. Klinik olarak kemik metastazı şüphesi bulunan ve kemik sintigrafisi normal olan hastalarda kemik ve kemik iliği metastazlarını göstermek için FDG-PET/BT görüntüleme akılda tutulmalıdı

Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy before and after surgery in patients with deviated nasal septum

In this study, we have investigated the effect of nasal septal deviation (NSD) on nasal mucociliary activity and how does a septoplasty operation affecs the nasal mucociliary transport rate in the first and third months during the post-operative period. Twenty-two patients who were diagnosed with NSD and 22 healthy controls were studied using rhinoscintigraphy with Tc-99m-macroaggregated albumin (Tc-99m-MAA). On each case, the nasal mucociliary transport rate (NMTR) was measured pre-operatively only on five cases, on the first and third months of post-operative period. The NMTRs of patients with a deviated septum were significantly lower than the NMTRs of the healthy controls on both the convex and concave sides. Significant improvement was observed in the first post-operative month. On the concave and convex sides, the average postop third month post-operative NMTR value was higher than the first month post-operative NMTR values. It was concluded that the septoplasty operation improves reduced NMTRs after surgery. The effect of nasal surgery on nasal mucociliary activity may be more accurately evaluated in the third month than the first month of post-operative period

Evaluation of relationship between pelvicaliceal stasis and renal functions in children who are under suspicion of ureteropelvic junction obstruction by using 99mtc-mag3 scintigraphy

Üreteropelvik bileşke darlığı, çocukluk döneminde üriner sistemde görülen en sıkobstrüksiyon nedenidir. Hafif derecedeki üreteropelvik bileşke obstrüksiyonları ömürboyu renal fonksiyonlarda herhangi bir gerilemeye neden olmazken, şiddetliobstrüksiyonlar cerrahi yöntemlerle tedavi edilmedikleri takdirde böbrek fonksiyonlarınınkalıcı olarak yitirilmesine neden olur. Cerrahi kararının alınmasında en önemli nokta iseobstrüksiyon şiddetinin renal fonksiyonları geriletecek düzeyde olduğunun güvenilirşekilde tesbit edilmesidir. Zamanında güvenilir teşhis ve doğru zamanda cerrahi tedaviuygulanarak irreversible böbrek fonksiyon kaybı önlenmelidir. Bu amaçla günümüzdeobstrüksiyon karakteristiğinin değerlendirilmesinde öncelikle diüretikli dinamik böbreksintigrafileri; yapısal anatomik incelemede ise USG, IVP ve VSÜG gibi radyolojikgörüntüleme yöntemleri kullanılmaktadır.99mÇalışmamızda, diüretikli Tc-MAG3 dinamik böbrek sintigrafisi ile UP darlık tanısıalan çocuklarda görsel olarak pelvikalisiyel sistemlerinde staz değerlendirmesi ile renalfonksiyonlarındaki gerileme arasındaki ilişkiyi araştırmak ve bu sayede hastanın kliniktakibi ve tedavi uygulamasında kolaylık sağlanması amaçlanmıştır. UP darlık ön tanısıyla99mgönderilen 1-84 ay (13,8 ± 20,4 ay) arasında 42 çocukluk yaş grubundaki hastaya Tc-MAG3 böbrek sintigrafisi uygulandı. Çalışma sonunda ve geç görüntülerde pelvikalisiyelstazı devam eden böbrekler incomplete obstrüksiyon ile uyumlu kabul edilerek fonksiyonelstazlı diğer böbreklerle renal fonksiyon parametreleri istatistiksel olarak karşılaştırıldı.Obstrüktif grubun Tmax, T1/2 ve Tmax+1/2 değerleri, normal böbrek grubuna oranla anlamlıolarak artmış bulundu. PI ve ERPF ve split fonksiyon değerlerinde farklılık bulunmadı.Unilateral obstrüktif grubun diferansiye fonksiyonları, normal gruba oranla anlamlıderecede azalmış, Tmax, T1/2 ve Tmax+1/2 değerleri anlamlı derecede artmış bulundu; PI veERPF'de anlamlı değişiklik izlenmedi. Ayrıca 5 hastada afonksiyone atrofik böbrekizlendi. Görsel ve kantitatif bulgularımız obsrüktif böbrek grubunda ekskresyonfonksiyonunun belirgin olarak gerilediğini, split fonksiyonun hafif düzeyde azaldığınıkanlanma fonksiyonunun ise etkilenmediğini göstermiştir. Bulgularımız obstrüktif böbreğesahip çocuklarda renal fonksiyonların az da olsa olumsuz etkilenme gösterdiğinidüşündürmektedir. Ayrıca bulgularımız literatürde yapılan çalışmalarla benzerlikgöstermektedir. Split fonksiyonu %40'ın altına inen veya diüretiğe dirençli pelvikalisiyelstazı olanların ve takiplerde split renal fonksiyon %10 ve üzerinde azalma gösteren58hastalarda gecikmeden cerrahi tedavi kararı verilmesi ve hafif stazı olan obstrüktifhastaların renal fonksiyon parametreleri ile iyi takip edilmesi gerektiğini düşünüyoruz.99mTc-MAG3 böbrek sintigrafisi UP darlık tanısı alan çocuklarda renal fonksiyon takibiile cerrahi tedavi kararının doğru zamanda verilmesine ve irreversible renal fonksiyonkaybının önlenmesine katkı sağlayabilir.Evaluation of relationship between pelvicaliceal stasis and renal functions in children99mwho are under suspicion of ureteropelvic juntion obstruction by using Tc-MAG3scintigraphyUreteropelvic junction stenosis is one of the main causes of urinary system obstructionseen during the childhood. Although mild degrees of ureteropelvic junction obstructionmay persist throughout life without any decrease in renal function, severe obstructioneventually leads to permanent loss of renal functions if surgical correction isn?t done. Mostimportant factor in decision making for surgical intervention is the determination thatdegree of ureteropelvic junction obstruction is severe enough to impair renal functions.Reliable diagnosis at correct time and surgical therapy at the right time are necessary toprevent irreversible renal function loss. Today, for determination of the obstructioncharacteristics, diuretic dynamic renal scintigraphies are used mainly and for anatomicparameters radiologic methods like USG, IVP and VCUG are used.In this study, we have aimed to investigate the correlation between degree of99mpelvicaliceal stasis interpreted visually on Tc-MAG3 diuretic dynamic renalscintigraphy and deterioration of renal functions making follow-up of patients clinicallyand therapeutically easier. 42 children who were reffered because of suspicion ofureteropelvic junction obstruction were included in the study. Ages ranged between 1-8499mmonths (13,8 ± 20,4 months). Tc-MAG3 diuretic dynamic renal scintigraphy wasperformed in all cases. Renal units in which pelvicaliceal stasis persisted on 30 minuteimages of dynamic study were accepted as incomplete obstructed and comparedstatistically with the contralateral normal kidneys even with functional stasis. Differentialrenal function of unilateral obstructed group was found significantly lower; T max, T1/2and Tmax+1/2 values were found significantly higher than that of contralateral normal unitsand there was no significant difference between PI and ERPF values of obstructed andnormal units. In 5 patients, non-functioning atrophic kidneys were observed. Visual andquantitative findings indicated that excretion functions in obstructed renal group decreasedevidently, split renal functions decreased slightly and perfusion functions were notaffected. Findings in our study have implicated that renal functions of children havingobstructed kidneys are negatively affected even in small amounts. Our findings are similarto that in literature. In our opinion, in patients whose split function reduced below 40% or60diuretic resistant pelvicaliceal stasis and split renal function decreased 10% or more onfollow-up, decision for surgical intervention should be made and patients with obstructedkidneys at mild degrees should be followed strictly in the aspect of renal functionparameters.99mTc-MAG3 diuretic dynamic renal scintigraphy contributes to follow-up of renalfunctions, decision making for surgical therapy at the right time and prevent irreversiblerenal function loss in children who have been diagnosed with ureteropelvic junctionstenosis

The importance of background correction during calculation of the major salivary gland function in salivary gland scintigraphy

Objective: The aim of this study was to compare the parotid (P) and submandibular (SM) glands uptake and excretion ratios of 99mTc-pertechnetate, which were calculated by using the backgrounds drawn on five different areas. Methods: Ninety-eight P and 98 SM glands of totally 48 patients were included in the study. 99mTc-pertechnetate salivary gland scintigraphy was performed in all patients. Oral stimulation with lemon juice was made at 15th minute of the imaging. The 99mTc-pertechnetate uptake and excretion ratios of the P and SM glands were calculated separately without using any background, and by using the backgrounds drawn on wide frontal, narrow frontal, temporal, cervical and shoulder regions. These values were statistically compared with each other in pairwise manner. Results: The radioactivity uptake and excretion ratios of the P and SM glands calculated without using any background correction were statistically different from that calculated by using any background correction. In addition, the radioactivity uptake and excretion ratios of the P and SM glands calculated by using the backgrounds drawn on five different areas were mostly found statistically different from each other (p<0.05). Conclusion: Background correction is important during the calculation of the uptake and excretion ratios of P and SM glands. This study demonstrates that calculated uptake and excretion ratios of P and SM glands may differ according to the used background area

Investigation of diagnostic value of stool antigen test by comparing with urea breath test in dyspeptic patients

Amaç: H. pylori, gastrit, peptik ülser, gastrik kansere sebep olabilen ve midede sık rastlanan bir bakteridir. Bu çalışmanın amacı dispeptik hastalarda yeni kullanıma giren H. pylori gaita antijen (HpSA) testinin tanı değerini üre soluk testi ile kıyaslamaktır. Yöntem: Bu çalışmada hastanemizin çeşitli polikliniklerine dispeptik şikayetlerle başvuran 57 hasta çalışmaya alındı. Bu hastalardan son 1 hafta içinde proton pompa inhibitörleri, antiasit, bizmut içeren bileşikler ve 1 ay antibiyotik almayan hastalarda üre soluk testi (Heliprobe) ve gaita antijen testi rapid HpSA (Meridian Bioscience Europe, Milano, İtalya) çalışıldı. Bulgular: Çalışmaya alınan 57 hastanın 39’unda üre soluk testi pozitifken (%68.4), 18 inde (%31.6) üre soluk testi negatifti. 32 hastada gaita antijen testi pozitifken (%56.1), 25 hastada negatifti (%43.9).Gaita antijen testinin sensivitesi %82.0, spesifitesi %100, pozitif prediktif değeri %100, negatif prediktif değeri %72.0 idi. Sonuç: Üre soluk testi tek başına H. pylori tanısında kullanılabilmektedir. Gaita antijen testi dispepsisi olan kişilerde tanı ve tedavi takibinde kullanılabilir. Tek başına dispeptik şikayetleri olmayan hastalarda tanı koydurucu değildir ve diğer testlerle beraber kullanılması faydalıdır.Objective: Helicobacter pylori (H. pylori) is the most common pathogen found in gastric mucosa and can cause gastritis, peptic ulcus and gastric cancer. The aim of this study was to compare and evaluate the effect of the urea breath test which has a high sensitivity and specifity with a new test; stool antigen test. Method: Fifty-seven patients with dispepsia who had admitted gastroenterology department were included in this study. Patients who received acid supressing drugs, antibiotics, proton pump inhibitors and drugs containing bizmut due to any reason for one month before undergoing urea breath test were excluded from the study. Hp stool antigen rapid HpSA (Meridian Bioscience Europe, Mila¬no, Italy) and Urea breath test (Heliprobe) were investigated in all patients. Results: The urea breath test was positive in thirty-nine patients (%68.4) and was negative in eighteen patients (%31.6). The stool antigen test was positive in thirty-two patients (%56.1) and was negative in twenty-five patients (%43.9). The sensitivity, specificity, positive and negative predictive values of HpSA were 82.0%, 100%, 100% and 72.0%, respectively. Conclusion: The urea breath test can be used for the diagnosis of H. pylori infection. Rapid HpSA can be used for dyspeptic patient for diagnosing H. pylori infection but in nondyspeptic patient isn’t sufficient test alone and can be useful in combination with the other tests

Bone marrow metastasis of small cell lung cancer detected by FDG-PET/CT scan: a case report

Öksürük, hemoptizi, kilo kaybı, yaygın kemik ağrısı şikayetleri ile başvuran elli dokuz yaşında erkek hastanın kontrastlı toraks BT'sin- de sağ akciğerde kitle tespit edildi. Kitlenin biopsi sonucu küçük hücreli akciğer kanseri (KHAK) olarak rapor edildi. Yaygın kemik ağrısı şikayeti olan hastanın kemik sintigrafisi normal olarak değerlendirildi. Evreleme amacıyla yapılan FDG-PET/BT'de kemik ili- ğinde heterojen artmış FDG (florodeoksi glukoz) tutulumu saptandı. Kemik iliği biyopsisinin patolojik değerlendirme sonucu KHAK metastazı olarak raporlandı. Klinik olarak kemik metastazı şüphesi bulunan ve kemik sintigrafisi normal olan hastalarda kemik ve kemik iliği metastazlarını göstermek için FDG-PET/BT görüntüleme akılda tutulmalıdırA mass in the right lung was detected with the contrast enhanced tomography of a fifty-nine year-old male patient presented with cough, hemoptysis, weight loss and common bone pain complaints. The result of the biopsy of the mass was reported as small cell lung cancer (SCLC). Bone scintigraphy of the patient with common bone pain was evaluated as normal. FDG-PET/CT performed for staging revealed heterogeneously increased FDG involvement in the bone marrow. The pathological evaluation result of the bone marrow biopsy was reported as SCLC metastasis. FDG-PET/CT imaging should be kept in mind to show bone and bone marrow metastases in the patients clinically suspected of having bone metastasis and with normal bone scintigraph

Clinical Study Assessment of Technetium-99m Labeled Macroaggregated Albumin Rhinoscintigraphy for the Measurement of Nasal Mucociliary Transport Rate: Intratest, Interobserver, and Intraobserver Reproducibility

Objectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin ( 99m Tc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine interand intraobserver reproducibility. Rhinoscintigraphy with 99m Tc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using 99m Tc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability