Gulhane Military Medical Academy and Medical Faculty

Ankara, Turkey

Gulhane Military Medical Academy and Medical Faculty

Ankara, Turkey
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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.


PubMed | Ufuk University, Etimesgut Military Hospital and Gulhane Military Medical Academy and Medical Faculty
Type: | Journal: Pediatric neurology | Year: 2016

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.We enrolled 59 individuals with afebrile and febrile seizures (mean age, 6.094.46years) and 28 age-, sex-, and weight-matched healthy children. Melatonin levels were measured near the time of a seizure (0 to 1hour) and at 12 and 24hours post-seizure, and control melatonin levels were measured from a single venous blood sample.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.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.


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.


Altun D.,Gulhane Military Medical Academy and Medical Faculty | Kurekci A.E.,Gulhane Military Medical Academy and Medical Faculty | Gursel O.,Gulhane Military Medical Academy and Medical Faculty | Hachamdioglu D.O.,Gulhane Military Medical Academy and Medical Faculty | And 3 more authors.
Biological Trace Element Research | Year: 2014

We aimed to investigate the effects of iron deficiency (ID) or iron-deficiency anemia (IDA) on oxidative stress and renal tubular functions before and after treatment of children. A total of 30 children with a diagnosis of IDA constituted the IDA group and 32 children with a diagnosis of ID constituted the ID group. Control group consisted 38 age-matched children. Serum ferritin, soluble transferrin receptor (sTfR), serum, and urinary sodium (Na), potassium (K), calcium (Ca), phosphorus (P), creatinine (Cr), uric acid (UA), urinary N-acetyl-β-d-glucosaminidase (NAG) levels, and intra-erythrocyte malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) levels were measured before and after iron therapy in the IDA and ID groups, whereas it was studied once in the control group. We have divided the study group in groups according to age (infants <2 years, children 3–9 years, and adolescents 10–15 years). Patients with IDA (infant, adolescent) and ID (infant, children, and adolescent) had a significantly high level of MDA in post-treatment period in comparison to those of healthy control. Patients with IDA (children, adolescent) and ID (infant, children) had a significantly high level of pre-treatment GSH-Px than controls. Post-treatment SOD was lower in IDA (children and adolescent) groups than control and post-treatment CAT was lower in IDA and ID (adolescent) groups than control. These findings show that ferrous sulfate used in the treatment of ID or IDA could lead to oxidative stress; however, a marked deterioration of in proximal renal tubular functions was not seen. © 2014, Springer Science+Business Media New York.


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.


PubMed | Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital and Gulhane Military Medical Academy and Medical Faculty
Type: Journal Article | Journal: Annals of thoracic medicine | Year: 2014

The purpose of this study was to assess the contribution of (18)F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) in detection and staging of pulmonary carcinoid tumors.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).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.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.


PubMed | Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital and Gulhane Military Medical Academy and Medical Faculty
Type: Journal Article | Journal: Cancer biotherapy & radiopharmaceuticals | Year: 2015

To evaluate any potential value of 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography/computerized tomography (FDG PET/CT) in staging of patients with Pancoast tumors and to investigate the relationship between volume-based quantitative PET parameters and prognosis.The authors retrospectively reviewed data of the 47 patients with Pancoast tumors who underwent initial staging by conventional imaging methods and FDG PET/CT. FDG-PET images were visually and quantitatively evaluated, and metabolic tumor volume (MTV), total lesion glycolysis, and maximum standardized uptake values of primary tumors were calculated. The correlations between quantitative PET parameters and tumor stages, as well as overall survival, were analyzed.By detecting unknown distant metastasis, PET/CT upstaged 21% of patients. The sensitivity and specificity for detection of lymphatic involvement were 100% and 83.75%, respectively. Having surgery (p = 0.01) and being at an early stage (p = 0.004) were the most predictive factors for overall survival. Although there was no significant correlation between quantitative PET parameters and overall survival, MTV was the most powerful discriminator for operability and preoperative staging (p < 0.05).FDG-PET imaging was found to be a valuable method for an accurate staging in the management of patients with Pancoast tumor. Having surgery and being at an early stage at presentation were found to be significant predictors for survival. Quantitative metabolic parameters may contribute to clarification of operable patient subgroups having an early disease stage with low MTV.


PubMed | Gulhane Military Medical Academy and Medical Faculty
Type: Journal Article | Journal: Hellenic journal of nuclear medicine | Year: 2016

In nearly 20%-30% of patients with differentiated thyroid carcinoma (DTC) relapse and 7% of them die during the next 10 years after initial diagnosis. In 10%-30% of patients with DTC after ablation therapy during the follow-up show a negative iodine-131 (We studied retrospectively 165 DTC patients with elevated Tg levels and a negative The sensitivity and specificity of The most important factors affecting a true positive


Arslan N.,Gulhane Military Medical Academy and Medical Faculty | Tuncel M.,Gulhane Military Medical Academy and Medical Faculty | Kuzhan O.,Gulhane Military Medical Academy and Medical Faculty | Alagoz E.,Gulhane Military Medical Academy and Medical Faculty | And 3 more authors.
Annals of Nuclear Medicine | Year: 2011

Objective The objective of this study is to determine whether 2-deoxy-2-[ 18F] fluoro-D-glucose with positron emission tomography (FDG-PET) imaging and quantitative PET parameters can predict outcome and differentiate patients with limited disease (LD) from extensive disease (ED) in patients with small cell lung cancer (SCLC). Methods We retrospectively evaluated data from 25 patients who underwent either initial staging (Group A, n 12) or restaging (Group B, n 13) by conventional imaging methods and FDG-PET according to the simplified staging scheme developed by the Veterans Administration Lung Cancer Study Group-2. FDG-PET images were both visually and quantitatively evaluated with SUV max, SUVave, total metabolic tumor volume (with SUV max>%50 and SUV max>2.5), total lesion glycolysis (Tlg) (with SUV max>%50 and SUV max>2.5). The correlation between quantitative PET parameters, disease stages and survival were analyzed. Results By conventional methods 14 of 25 (56%) patients were reported to have LD and 11 of 25 (44%) had ED. FDG-PET scan upstaged 9 out of 25 (36%) and downstaged 2 out of 25 (%8) patients. Among the quantitative PET parameters, Tlgs were the only PET parameters that differentiated between Group A and Group B patients. FDG-PET staging (p = 0.019) could predict significant survival difference between stages on contrary to conventional staging (p = 0.055). Moreover, Tlg [SUV max [%50] was the only quantitative PET parameter that could predict survival (p = 0.027). Conclusion FDG-PET imaging is a valuable tool in the management of patients with SCLC for a more accurate staging. The use of quantitative PET parameters may have a role in prediction of stage and survival. © The Japanese Society of Nuclear Medicine 2011.


PubMed | Gulhane Military Medical Academy and Medical Faculty
Type: Journal Article | Journal: Helicobacter | Year: 2016

Anticardiolipin (aCL) antibodies are associated with thrombosis and have an important role in the etiology of diseases such as stroke and myocardial infarction whose etiologies were based on thrombosis. H. pylori has been proposed to be responsible for the pathophysiology of some diseases including stroke, myocardial infarction, thrombosis, and autoimmune diseases. From this point of view, we hypothesized a possible relationship between H. pylori infection and aCL antibodies and initially aimed to determine the prevalence of aCL antibody positivity in children with H. pylori infection.Anticardiolipin antibodies were studied in 84 patients before and after eradication therapy and in a control group including 40 children.The pretreatment aCL IgA (median 12.78 APL/mL), aCL IgM (median 21.60 MPL/mL), and aCL IgG antibody levels (median 14.22 GPL/mL) were significantly higher than those of post-treatment results (median 5.38 APL/mL, 7.02 MPL/mL, and 6.64 GPL/mL, respectively) and controls (median 5.90 APL/mL, 4.80 MPL/mL, and 4.81 GPL/mL, respectively). Anticardiolipin antibodies revealed no significant differences between the study group after therapy and the control group.In our particular experience, H. pylori can cause aCL antibody positivity in children and eradication of H. pylori provides the disappearance of these antibodies.

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