Cengiz Yagmur

Aortic valve calcification: association with bone mineral density and cardiovascular risk factors

BackgroundCardiovascular risk factors are reported to increase the incidence of aortic valve calcification. Among older women, low bone mineral density appears to be associated with increased prevalence of aortic calcification. We aimed to assess and compare cardiovascular risk factors and bone mineral density of patients with and without aortic valve calcification. Materials and methodsCardiovascular risk factors and bone mineral density measurements have been assessed in 49 patients with aortic valve calcification and in 65 patients without aortic valve calcification. All patients were subsequently referred to the nuclear medicine department to measure bone mineral density after echocardiographic evaluation. ResultsNo statistically significant differences were observed between the two groups with respect to sex, body mass index, history of coronary artery disease, diabetes mellitus, hypercholesterolemia, and smoking status. Although height and weight of the patients with aortic valve calcification were significantly lower than those of patients without aortic valve calcification, they were not independent risk factors. Age and hypertension were found to be independent positive risk factors for aortic valve calcification, whereas T score was found to be negatively associated with aortic valve calcification. ConclusionWe have shown that aortic valve calcification is positively associated with age and hypertension, whereas bone mineral density is negatively associated with aortic valve calcification. The mechanism underlying the association between decreased bone mineral density and aortic valve calcification remains to be clarified in further studies.

Evaluation of cardiovascular risk factors and bone mineral density in post menopausal women undergoing coronary angiography

BACKGROUND The underlying mechanism by which osteoporosis and cardiovascular disease may be linked is not fully understood. However studies mainly focused on the association between bone mineral density (BMD) and cardiovascular risk factors or atherosclerosis itself by only assessing the presence of vascular calcification. In this study we aimed to evaluate both cardiovascular risk factors, and presence of coronary artery disease (CAD) in post-menopausal women patients with and without low BMD. MATERIALS AND METHODS Study population consisted of post menopausal women who were scheduled to coronary angiography. Two hundred and twenty seven consecutive female patients were included in the study and evaluated for the presence of cardiovascular risk factors and CAD. Bone mineral density was measured in all patients either the day before or the day after coronary angiography. Low BMD was defined as T score<-1 and normal BMD was defined as T score > or = -1. For statistical analysis patients were divided into two groups: patients with low BMD and patients with normal BMD. RESULTS There were not statistically significant differences between two groups in respect to body mass index, presence of diabetes mellitus, hypercholesterolemia, and smoking status. Age and presence of CAD was found to be statistically different between two groups being higher in patients with low BMD. Logistic regression analysis revealed that age was positively and independently associated with low BMD in post menopausal female patients (Odds ratio=1.072 CI: 1.036-1.11, p=0.001). CONCLUSION Age is found to be an independent predictor of decreased BMD in our study population recruited from the coronary angiography laboratory. However, neither cardiovascular risk factors, nor coronary artery disease itself has been found to be associated with low BMD.

Calculating colon transit time withradionuclide-filled capsules in constipated patients: a new method for colon transit study

BackgroundColon motility disorders require reliable methods for calculating segmental colonic transit time. This study evaluated bowel transit time by means of a safe, easy, cheap, nondigestive, and nondisintegrating radionuclide-filled capsule that provided accurate and clear images.MethodsRadionuclide-filled minicontainers (MCs) were prepared from infusion sets by an apparatus used for sealing blood bags or plasmapheresis sets. In vitro stability studies were performed by immersing 5% methylene blue dye-filled MCs in buffers of variable pH and enzymes simulating the conditions in the stomach and the small bowel. Colon transit scintigraphy was performed with MCs filled with iodine 131 (n = 5) and thallium 201 (n = 8) that were placed in a commercially available capsule.ResultsBy in vitro acid, base, and intestinal enzyme resistance tests, no methylene blue leakage was determined visually and by spectrophotometric analysis. Accurate and clear images were obtained for colon transit study in constipated patients. After excretion of MCs in the feces, abdominal, myocardial, thyroid, and urinary bladder region counts were found to show the same activity as the background. Radionuclide leakage from MCs was not determined in vivo by gamma camera.ConclusionsThis is a suitable, safe, easy, and cheap method to provide accurate and clear images for colon transit study in constipated patients.

Cervical involvement in juvenile-onset ankylosing spondylitis with bone scintigraphy

Juvenile-onset ankylosing spondylitis is an unusual disorder which can present with either peripheral arthritis or more classic hip girdle and back symptoms. A 12-year-old child with this disease was admitted with walking disorder, cervical pain, restricted cervical motion, and right ankle swelling. Diffusely increased accumulation of radioactivity in the cervical spine, focally increased accumulation in bilateral sacroiliac joints, and diminished irregular uptake in thoracal spine were detected on technetium 99m methylene diphosphonate bone scintigraphy. As a result, this imaging technique may give important information for diagnosis and differential diagnosis in juvenile chronic arthritis.

Pathologic hepatic Tc-99m-MDP uptake in polyostotic fibrous dysplasia

Fibrous dysplasia of bone is a congenital, sporadic developmental disorder characterized by immature fibrous connective tissue and bone deformities. Hepatic Tc-99m-MDP uptake is a rare, serendipitous finding during bone scanning studies. The present patient was a 25-year-old male who had severe polyostotic fibrous dysplasia. On Tc-99m-MDP (methylene diphosphonate) bone scintigraphy, increased activity accumulations were seen on multiple ribs, vertebrae and base of the cranium. In addition, diffuse increased pathologic uptake of Tc-99m-MDP in the liver was shown. Intravenous pamidronate was administered monthly for two months. In the third week of the last administration Tc-99m-MDP bone scintigraphy was performed again, but despite sustained bone involvement, pathologic hepatic uptake was not seen on the scan. We thought that pathologic hepatic Tc-99m-MDP accumulation, may be related to the formation and aggregation of calcium oxalate and phosphate crystals which improved with pamidromat treatment.