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Öğe Acute-phase response after radioiodine treatment in hyperthyroidism(LIPPINCOTT WILLIAMS & WILKINS, 2007) Sari, Oktay; Tunc, Recep; Kisakol, Gurcan; Dostbil, Zeki; Serdengecti, MustafaPurpose: Acute-phase response is an innate body defense seen during acute illnesses and involving the increased production of certain blood proteins termed acute-phase proteins. There are limited data about acute-phase response after radioiodine therapy. This study is designed to determine whether acute-phase response changes after radioiodine therapy. Materials and Methods: Twenty-six hyperthyroid patients were included in this study, aged between 25 and 69 years (mean, 47.7 +/- 10.5, 18 females and 8 males). All patients were given radioiodine therapy (8-15 mCi). Leukocyte, hemoglobin, platelet, erythrocyte sedimentation rate, and C-reactive protein (CRP) were measured before radioiodine therapy and after 24 hours, 72 hours, 1 week, 1 month, and 3 months. Free T3, free T4, TSH, thyroglobulin (Tg), antithyroid antibody, and antimicrosomal antibody (AMA) were measured before radioiodine therapy and after 1 and 3 months. Results: Mean CRP levels were 3.74, 3.90, 4.29, 5.71, 3.85, and 5.41 mg/L, respectively. There was a significant difference between the initial and the first-week results. Mean Tg levels were 68.15, 143.90, and 77.00 ng/mL, respectively, with a significant difference between the initial and the first-month and third-month results. Mean AMA levels were 158.80, 178.85, and 636.25 IU/mL, respectively, demonstrating a significant difference between the initial and the third-month and first- and third-month results. Conclusion: We have shown that radioiodine therapy causes an increase in CRP, Tg, and AMA levels. We conclude that radioiodine treatment is a cause of the increase in the CRP, Tg, and AMA levels in hyperthyroid patients.Öğe Differential diagnosis between secondary and tertiary hyperparathyroidism in a case of a giant-cell and brown tumor containing mass. Findings by Tc-99m-MDP, F-18-FDG PET/CT and (99)mTc-MIBI scans(HELLENIC SOC NUCLEAR MEDICINE, 2014) Gedik, Gonca Kara; Ata, Ozlem; Karabagli, Pinar; Sari, OktayBrown tumor is one of the skeletal manifegtations of hyperparathyroidism. It is a benign but locally aggressive bone lesion and its differential diagnosis with giant cell containing skeletal tumors or metastases may be complicated. We present a male patient with chronic renal failure who was initially misdiagnosed as having a giant-cell rich neoplasm of bone in his right thumb. Diffusely increased fluorine-18 fluorodeoxyglucose (F-18-FDG) uptake in the axial and appendicular skeleton and multiple F-18-FDG avid lytic lesions suggesting multiple metastases were observed on the F-18-FDG positron emission tomography/computed tomography (PET/CT) scan. On the usual technetium-99m methylene diphosphonate (Tc-99m-MDP) bone scan we noticed diffusely increased uptake in the skeleton and two focuses with very much increased uptake, which suggested a metabolic bone disease rather than a multiple metastatic giant cell tumor or bone metastases. Additional investigation documentated increased levels of parathyroid hormone. Parathyroid hyperplasia was finally diagnosed with Tc-99m-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy. Fluorine-18-FDG avid lytic lesions were attributed to hyerparathyroidism associated brown tumors instead of multiple metastases. In conclusion, we present a patient with chronic renal insufficiency, who suffered from secondary and later from tertiary HPT with polyostotic brown tumors, which were best shown by the F-18-FDG PET/CT than by the Tc-99m-MDP or the Tc-99m-MIBI scans.Öğe Evaluation of the effects of nasal septal deviation and its surgery on nasal mucociliary clearance in both nasal cavities(OCEAN SIDE PUBLICATIONS INC, 2007) Ulusoy, Bulent; Arbag, Hamdi; Sari, Oktay; Yoendemli, FuatBackground: In this study the effects of nasal septal deviation (NSD) and its surgery on nasal mucociliary clearance velocity (NMCV) in both nasal cavities were evaluated. Methods: This study included 20 patients with NSD and 20 healthy subjects as a control group who had no complaint related to the nose. NMCV was measured with rhinoscintigraphy using technetium-99m-macroaggregated albumin (Tc-99m-MAA). Results: Before the septal surgery, the NMCV of concave (10.24 +/- 3.96 mm/minute) and convex sides (10.78 +/- 3.53 mm/minute) of the patients were significantly lower than the control group (17.94 +/- 2.89 mm/minute). There is no statistically significant difference between the NMCV of the concave and convex sides. After septal surgery, the NMCVs of the concave (16.34 +/- 4.40 mm/minute) and convex sides (17.21 +/- 3.43 mm/minute) were not significantly different from control groups (17.94 +/- 2.89 mm/minute). Postoperative NMCVs of the concave and convex sides was significantly better than preoperative NMCVs. Conclusion: The results of this study showed that NSD significantly impaired NMCVs in both sides and that septoplasty significantly improved NMCVs in both sides.Öğe F-18 fdg pet/ct imaging in a patient presenting with mediastinal lymphadenopathies: a case of sarcoidosis(DRUNPP-SARAJEVO, 2012) Dostbil, Zeki; Kaya, Bugra; Sari, Oktay; Varoglu, ErhanF-18 FDG PET/CT has been used increasingly in evaluation of pulmonary and mediastinal lesions. However, inflammatory and granulomatous disorders may show increased F-18 FDG uptake on PET scanning. So, some benign conditions may cause false-positive results in cancer investigation. In this case, F-18 FDG PET/CT findings were presented in a patient with sarcoidosis who was investigated for primarily suspected malignancy.Öğe Fibrous dysplasia mimicking vertebral bone metastasis on 18F-FDG PET/computed tomography in a patient with tongue cancer(ELSEVIER SCIENCE INC, 2015) Guler, Ibrahim; Nayman, Alaaddin; Gedik, Gonca Kara; Koplay, Mustafa; Sari, Oktay[Abstract not Available]Öğe Influence of single photon emission computed tomography (SPECT) reconstruction algorithm on diagnostic accuracy of parathyroid scintigraphy: Comparison of iterative reconstruction with filtered backprojection(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2017) Gedik, Gonca Kara; Sari, OktayBackground & objectives: Preoperative localization of parathyroid lesions is essential for improving the results in patients with primary hyperparathyroidism. The purpose of this study was to evaluate retrospectively the value of technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) and to compare the diagnostic accuracy of iterative reconstruction (IR) and filtered backprojection (FBP) reconstruction algorithms about localization of parathyroid lesions. Methods: Forty four patients with primary hyperparathyroidism, in whom histopathological correlation could be performed, were included in the study. Dual-phase Tc-99m parathyroid scintigraphy was performed 20 and 120 min after injection of 740 MBq Tc-99m MIBI in all patients. Tomographic images were acquired 120 min after the administration of radiopharmaceutical. The SPECT data were evaluated using an IR as well as a FBP algorithm. In 23 of 44 patients, SPECT acquisitions were performed in 64x64 matrix; in the remaining 21 patients, tomographic data were collected in 128x128 matrix. The imaging results were compared with pathological findings and sensitivities of both reconstruction algorithms, and planar views were calculated. Results: Using planar MIBI scans, abnormal parathyroid glands were correctly localized in 75 per cent of the cases. Sensitivity increased to 77 per cent using SPECT with FBP and to 84 per cent with IR. When the sensitivities were calculated according to the acquisition matrix, these were 95 per cent (20/21) and 85 per cent (18/21) for IR and FBP, respectively in patients in whom 128x128 matrix was used. The sensitivities were lower in patients who were imaged with 64x64 matrix; these were calculated as 74 per cent (17/23) and 70 per cent (16/23) with IR and FBP, respectively. Interpretation & conclusions: Our findings showed that compared to planar scintigraphy, Tc-99m MIBI SPECT was more sensitive diagnostic modality in the detection of abnormal parathyroid tissues. Image quality and sensitivity may be improved further when larger matrices with IR are used instead of FBP algorithm.Öğe Marine-Lenhart syndrome in a young girl(WALTER DE GRUYTER GMBH, 2014) Sen, Yasar; Cimbek, Emine Ayca; Yuca, Sevil Ari; Gedik, Gonca Kara; Sari, OktayGraves' disease is the most common reason of hyperthyroidism in children. Graves' disease with accompanying functioning nodules is defined as Marine-Lenhart syndrome. This syndrome has not been described in children before. Here, a 15-year-old girl with Graves' disease and a coexisting cold nodule is presented. A thyroid scan showed diffuse uptake of Tc-99m pertechnatate in both lobes and decreased uptake in accordance with the left lobe nodule. The nodule was histologically diagnosed as benign. The patient was diagnosed with type 1 diabetes mellitus and polyglandular autoimmune syndrome during clinical follow-up. The differential diagnoses of Graves' disease with coexisting nodules should include the Marine-Lenhart syndrome. Treatment options should be determined taking this rare condition into account.Öğe Obstructive Sleep Apnea Syndrome May Be a Risk Factor for the Development of Osteoporosis in Men at an Early Age?(AVES, 2015) Aslan, Saadet Han; Yosunkaya, Sebnem; Kiyici, Aysel; Sari, OktayObjective: Chronic intermittent hypoxia due to respiratory events occurring during sleep and sleep fragmentation due to arousals in obstructive sleep apnea syndrome (OSAS) may affect bone mineral density (BMD) directly or may be by causing a change in BMD through effects on hormones. We aimed to investigate whether any BMD change or any change in the level of hormones [growth hormone (GH), insulinlike growth factor-1 (IGF-1), free testosterone, total testosterone, and sex hormone-binding globulin (SHBG)], which may be related to BMD, occurs in middle-aged male patients with OSAS and compare the same with normal individuals. Material and Methods: Blood samples were collected from the participants in the morning (07.00-08.00 AM) after applying polysornnography for diagnosis. CH, IGF-1, total testosterone, and SHBG levels were measured using the enzyme-linked imrnunosorbent assay method, whereas the free testosterone level was measured using the radioimmunoassay method. BMD was measured at the femoral neck and lumbar vertebra using the Dual energy X-ray absorptiornetry (DEXA) method. Results: Between the two groups of hormones levels and T-score values statistically significant difference was not obtained. There was a statistically significant positive relationship between age and T-score femur (p<0.001) and T-score vertebra (p=0.017) and between rapid eye movement sleep time and T-score femur (p=0.032) in the OSAS group. Although patients who have BMD <-2.5 in the OSAS group (5/24) was detected to be higher than the control group (0/22), the difference was not statistically significant (p=0.05). Conclusion: In this study, we demonstrated that OSAS may not be a risk factor in the development of osteoporosis in middle-aged male patients. In addition, there was no direct relation between BMD and chronic intermittent hypoxia, apnea hypopnea index, or excessive sleepiness. Furthermore, we could not obtain any distinct relationship between OSAS and hormonal parameters that affects BMD.Öğe The outcome of I-131 therapy with fixed doses for Graves disease and toxic nodular/multinodular goiter in endemic region(SOC NUCLEAR MEDICINE INC, 2011) Serdengecti, Mustafa; Sari, Oktay[Abstract not Available]Öğe The role of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating between benign and malignant adrenal lesions(LIPPINCOTT WILLIAMS & WILKINS, 2011) Kara, Pelin Ozcan; Kara, Taylan; Gedik, Gonca Kara; Kara, Fatih; Sahin, Ozlem; Gunay, Emel Ceylan; Sari, OktayObjectives This retrospective study was designed to investigate the clinical role of whole-body positron emission tomography/computed tomography (PET/CT) by using 2[(18)F]fluoro-2-deoxy-D-glucose (FDG), for the evaluation of adrenal lesions and to find the best index to distinguish benign from malignant lesions in various cancer patients. Materials and methods A total of 81 patients (55 male and 26 female, age range: 31-81 years, mean: 61.5) who had confirmed primary malignancies (lung cancer in 47 patients, gastrointestinal malignancies in 13 patients, malignant melanoma in one patient, renal cell cancer in three patients, mesothelioma in two patients, breast carcinoma in nine patients, cervical cancer in one patient, ovarian cancer in two patients, pheochromocytoma in one patient, unknown primary in two patients) underwent PET/CT examinations for cancer screening, staging, restaging, and detection of suspected recurrence. Of the 81 patients, 104 adrenal lesions (34 benign and 70 malignant adrenal lesions) were shown by CT. On visual analysis of PET/CT imaging, adrenal uptake was based on a three-scale grading system. For final assessment standards of references for adrenal malignant lesions was based on biopsy (n=2), interval growth, or reduction after chemotherapy. An adrenal lesion, which remained unchanged on clinical and imaging follow-up of at least 7 months (mean follow-up time 19.31 months +/- 6.46, range 7-30 months), was decided as a benign lesion. Results In adrenal malignant lesions maximum standardized uptake value (SUV(max)) (8.82 +/- 4.47) was higher than that of adrenal benign lesions (3.02 +/- 1.15, P<0.0001). In the differentiation of adrenal benign and malignant lesions, a CT threshold of 10 Hounsfield units corresponded to a sensitivity of 64.7%, specificity of 98.6%, and accuracy of 87.5%. An SUV(max) cut-off value of 2.5 corresponded to a sensitivity of 100%, specificity of 38.2%, and accuracy of 80%. An SUV(max) cut-off value of 4.2 corresponded to a sensitivity of 88.6%, specificity of 88.2%, and accuracy of 88.5%. The ratio of tumor SUV(max) to liver SUV(mean) was 3.61 +/- 1.77 for adrenal malignant lesions whereas it was 1.20 +/- 0.38 for adrenal benign lesions (P<0.0001). T/L SUV ratio cut-off value of 1.8 corresponded to a sensitivity of 87%, specificity of 91%, and accuracy of 88.5%. T/L SUV ratio cut-off value of 1.68 corresponded to a sensitivity of 90%, specificity of 91.1%, and accuracy of 90.4%. Conclusion 2-[(18)F]fluoro-2-deoxy-D-glucose-PET/CT improves the diagnostic accuracy in the differentiation of benign from malignant adrenal lesions in various cancer patients. Combined information obtained from PET/CT (SUV(max) T/L SUV ratio, visual analysis) and unenhanced CT (size, Hounsfield units measurement) is recommended for better differentiation. Nucl Med Commun 32:106-112 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Nuclear Medicine Communications 2011, 32:106-112Öğe Thyroid Hemiagenesis and Graves' Disease in a Child(LIPPINCOTT WILLIAMS & WILKINS, 2009) Serdengecti, Mustafa; Ayan, Asli; Sari, OktayHemiagenesis of the thyroid is a rare malformation and Graves' disease with ophthalmopathy is reported quite rarely in adult patients but is not seen in children, This is a report of an 8-year-old girl with congenital absence of the left thyroid lobe, or hemiagenesis.
