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Ozmen O.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Tatci E.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Gokcek A.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Koksal D.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | And 3 more authors.
Annals of Nuclear Medicine | Year: 2013

Objective: Wegener's granulomatosis (WG) is a rare disorder characterized by granulomatous necrotizing vasculitis which mainly affects small- and medium-sized vessels. While the classical triad of involvement is upper and lower respiratory system and glomerulonephritis, WG may involve any organ or system in the body. The aim of our study was to investigate the role of positron emission tomography/computerized tomography (PET/CT) both in the initial evaluation and follow-up of patients with WG. Methods: We retrospectively evaluated PET/CT data from 13 patients (6 males; 7 females) with a mean age of 45 ± 12.4 years (range 28-63) who underwent either initial evaluation (n = 12) or response evaluation (n = 2) by conventional imaging methods and FDG with PET/CT. PET/CT images were both visually and quantitatively evaluated. The demographic data, clinical and laboratory findings of each patient were also recorded from the hospital files. Results: Lung (n = 13), parapharyngeal space (n = 8), nose (n = 8), and ear (n = 3) were the most common disease sites detected on PET/CT. The entire initial evaluation patients had either solitary or multiple pulmonary nodular/mass lesions with marked increased FDG uptake (mean SUVmax 12 ± 4, range 3.53-19.51) on PET/CT. There was no significant pathological FDG uptake in patients consistent with complete treatment response after appropriate immunosuppressive therapy. PET/CT clearly demonstrated unexpected disease sites besides the respiratory system, with WG involvement except kidneys. Possibly due to physiological urinary excretion of FDG, urine analysis, BUN and creatinine levels were accepted still the best way for diagnosis of renal involvement. Conclusion: FDG with PET/CT is a valuable tool in the management of patients with WG for a more accurate clinical evaluation regarding disease extension and treatment response. © 2013 The Japanese Society of Nuclear Medicine. Source


Tatci E.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Ozmen O.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Biner I.U.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Kaya S.,Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital | Arslan N.,Gulhane Military Medical Academy and Medical Faculty
Annals of Thoracic Medicine | Year: 2014

Aim: The purpose of this study was to assess the contribution of 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) in detection and staging of pulmonary carcinoid tumors.Methods: A total of 22 patients with pulmonary carcinoid tumors (14 typical, 8 atypical) were reviewed in this retrospective study. PET/CT images of all patients were evaluated for primary tumor as well as metastatic regional lymph nodes, bone and other distant metastases. PET/CT positivity of primary tumors was determined by visual interpretation. Tumor size, SUVmax and Hounsfield Unit (HU) values of the tumors were used to test for differences between tumor groups (typical carcinoids and atypical carcinoids).Conclusion: Although FDG PET/CT can be a useful tool for the detection of pulmonary carcinoid tumors and distant metastasis, it cannot discriminate typical carcinoids from atypical ones and absence of an FDG avid lesion cannot exclude pulmonary carcinoid tumors. Moreover, PET/CT is not a reliable tool in the staging of mediastinal and hilar lymph nodes especially for those patients with typical carcinoids. Copyright © 2014 by The Saudi Thoracic Society.Results: SUVmax of carcinoids ranged from 1.24 to 11.1 (mean, 5.0; median, 2.67). The mean largest diameter of primary tumors was 2.7 ± 1.3 cm, ranging from 1 to 5.5 cm. The overall sensitivity of FDG PET/CT for detection of pulmonary carcinoid tumors was 81.8%. Tumor size, SUVmax and Hounsfield Unit (HU) values of the atypical carcinoids were higher than those for typical carcinoids. However, the results were not statistically meaningful (P > 0.05). The sensitivity and specificity of FDG PET/CT in the detection of mediastinal and hilar lymph nodes metastases were 25% and 83% respectively. One patient had bone metastasis. Source


Dabak O.,Etimesgut Military Hospital | Altun D.,Ufuk University | Arslan M.,Gulhane Military Medical Academy and Medical Faculty | Yaman H.,Gulhane Military Medical Academy and Medical Faculty | And 3 more authors.
Pediatric Neurology | Year: 2016

Background Melatonin modulates central nervous system neuronal activity. We compared the melatonin levels of patients with febrile and afebrile seizures during and after seizure with those of healthy controls. Methods We enrolled 59 individuals with afebrile and febrile seizures (mean age, 6.09 ± 4.46 years) and 28 age-, sex-, and weight-matched healthy children. Melatonin levels were measured near the time of a seizure (0 to 1 hour) and at 12 and 24 hours post-seizure, and control melatonin levels were measured from a single venous blood sample. Results Plasma melatonin levels increased during seizures in the study group (P < 0.001). Post-seizure plasma melatonin levels were significantly lower in the study group than in the control group (P < 0.05). Plasma melatonin levels did not differ between patients with afebrile seizures who had and had not used antiepileptic drugs. Daytime (8 AM to 8 PM) and nighttime (8 PM to 8 AM) post-seizure melatonin levels were not significantly different. Conclusions Melatonin levels were lower in pediatric patients prone to seizures than in healthy children and increased during seizures. Further research is needed to test the role of melatonin in the pathophysiology and treatment of epilepsy. © 2016 Elsevier Inc. All rights reserved. Source


Gursel O.,Gulhane Military Medical Academy and Medical Faculty | Kurekci A.E.,Gulhane Military Medical Academy and Medical Faculty | Tascilar E.,Gulhane Military Medical Academy and Medical Faculty | Ileri T.,Ankara University | And 7 more authors.
Journal of Pediatric Hematology/Oncology | Year: 2012

OBJECTIVES:: In this study, we aimed to investigate the relationship between chronic hemolysis and increased body iron burden with development of premature atherosclerosis by carotid intima-media thickness (IMT), ferritin, serum lipid profile, homocysteine, nitrate/nitrite, and chitotriosidase enzyme activity in children with β-thalassemia major. MATERIALS AND METHODS:: A total of 31 children with a diagnosis of β-thalassemia major between the ages of 4 to 16 years constituted the study group. Control group was consisted of 36 age-matched healthy children. Complete blood count, serum glucose, lipid profile, ferritin, homocysteine, calcium, chitotriosidase, and nitrate/nitrite levels were measured and electrocardiographic and echocardiographic investigation and carotid IMT measurement were performed. RESULTS:: In study group serum total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were found to be significantly reduced, and very-low-density lipoprotein cholesterol levels were found to be significantly elevated. Plasma nitrate/nitrite levels were significantly reduced; chitotroisidase enzyme activity was significantly increased and carotid IMT was significantly increased in study group. Nitrate/nitrite was found to be the only variable that was statistically significantly related to carotid IMT. CONCLUSIONS:: Subclinical atherosclerosis in children with β-thalassemia major begins early in life, and these children are at risk for development of premature atherosclerosis. Copyright © 2012 by Lippincott Williams & Wilkins. Source


Hacihamdioglu B.,Gulhane Military Medical Academy and Medical Faculty | Okutan V.,Gulhane Military Medical Academy and Medical Faculty | Yozgat Y.,Gulhane Military Medical Academy and Medical Faculty | Yildirim D.,Gulhane Military Medical Academy and Medical Faculty | And 3 more authors.
Turkish Journal of Pediatrics | Year: 2011

We aimed in this study to investigate carotid intima-media thickness (IMT) inobese children and evaluate the relationship of IMT to various cardiovascularrisk factors. One-hundred four obese children (9.3 ± 2.5 years) and 30 healthyage-matched control subjects were enrolled in the study. All children wereassessed for fasting levels of glucose, insulin, lipid profile, skinfold thickness(SFT), waist circumference (WC), and blood pressure (BP). Insulin resistancewas estimated by the homeostasis model assessment (HOMA) index. CarotidIMT measurements and non-alcoholic fatty liver disease (NAFLD) werediagnosed with ultrasonographic findings. IMT was significantly higher in obese children compared to controls (0.49 ± 0.05 vs. 0.40 ± 0.02 mm, p<0.001).Significant positive correlations were found between increased carotid IMTand body fat percentage (BFP), body mass index (BMI), age, height, systolicBP, WC, SFT, triglyceride and insulin levels, and insulin resistance index. Ina linear logistic regression analysis, the only parameter affecting the increase in carotid IMT was WC (β: 0.589, p<0.001). Furthermore, IMT was increasedsignificantly in obese children with NAFLD when compared to obese children without NAFLD (0.54 ± 0.04 vs. 0.48 ± 0.05 mm, p<0.001). Children with abdominal obesity are at increased risk for atherosclerosis, and WC can beused to determine the atherosclerosis risk in obese children. Source

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