Mehmet Aydin

Scintigraphic evaluation of impaction grafting for total hip arthroplasty revision

Abstract To determine the fate of an impacted allograft after a minimum follow-up of 1 year, we examined 9 of 40 patients who underwent revision arthroplasty with the impaction grafting technique. The allograft used in this study was morselized cancellous freeze-dried allograft. We examined these 9 patients with technetium-99 m methylene diphosphonate bone scintigraphy at an average of 14 (range 12–20) months after surgery. All of them had a good clinical outcome, with an average postoperative Hip Society Score of 89 (range 65–98) and no evidence of radiolucency or subsidence on direct radiography. Scintigraphic examination demonstrated that the area corresponding to the allograft had a remarkable radioactivity accumulation suggesting new bone formation. The allograft in total hip revision using the impaction grafting technique undergoes a significant neovascularization and new bone formation. This study suggests than when vigorous impaction is used, freeze-dried cancellous allograft can be used for impaction grafting.

Evaluation of Tc-99m(V) DMSA for imaging inflammatory lesions: An experimental study

The present study evaluated99mTc(V) DMSA as an agent for the visualization of inflammatory lesions in comparison to99mTc(HI) DMSA and99mTc-HIG. All three radiopharmaceuticals were prepared with commercial kits.99mTc(V) DMSA was prepared at neutral pH by the addition of first bicarbonate and then pertechnetate to the kit contents. The labeling efficiency was 99% as determined by ITLC. Abscesses were induced by i.m. injection of 50 μl turpentine into the right thighs of 36 Swiss albino mice. Six days later 3.7 MBq of each radiopharmaceutical was i.v. administered to 12 mice. The mice were sacrificed at 1,3,6 and 24 h later. Scintigrams were obtained with a gamma camera. The abscesses were better visualized on scintigrams with99mTc(V) DMSA compared to99mTc(III) DMSA, starting at 1 h. The animals were dissected and the organs were removed, weighed and the radioactivity determined with a gamma counter. The abscess to other tissue ratios were higher with99mTc(V) DMSA than the other radiopharmaceuticals. The max. abscess/muscle ratios were 9.46 ± 3.20 (24 h), 4.19 ± 1.39 (6 h) and 5.98 ± 1.17 (24 h) and max. abscess/blood ratios were 6.22 ± 1.41, 4.09 ± 0.84 and 0.914 ± 0.351 all at 24 h for99mTc(V) DMSA,99mTc(III) DMSA and99mTc-HIG, respectively.Experimental arthritis was produced in 6 New Zealand white rabbits by intra-articular injection of ovalbumin. Four days later 37 MBq of99mTc(V) DMSA and99mTc-HIG were each i.v. administered to 3 rabbits. Scintigrams obtained at 1, 3, 6, and 24 h clearly demonstrated arthritic joints. ROFs over arthritic joints were compared to contralateral normal joints (A/C). The max. A/C ratios were 2.10 ± 0.31 (3 h) and 2.92 ± 0.99 (24 h) for99mTc(V) DMSA and99mTc-HIG, respectively.Our results indicated the feasibility of imaging inflammatory lesions with99mTc(V) DMSA.

Prospective Evaluation of 140 Patients With Brucellosis in the Southern Region of Turkey

The aim of this study was to asses the epidemiological, clinical, and laboratory characteristics of brucellosis in Adana region, Turkey. In this prospective study, a total of 140 patients with brucellosis were investigated in terms of spread of infection; seasonal, age, and sex distribution; clinical and laboratory characteristics; depression and anxiety rates; relapse rates; and response to different treatment combinations. One hundred two patients (72.9%) were female, and 38 patients (27.1%) were male; mean age was 45.81 ± 15.62 years, ranging from 2 to 77 years. Twenty-five patients (17.8%) had history of contact with animals, and 31 patients (22.1%) had history of consumption of raw milk and/or its products. The highest seasonal distribution was observed during summer. Malaise (95.0%), sweating (85.7%), and arthralgia (85.0%) were the major presenting symptoms. The most common physical examination findings were fever (52.9%), hepatomegaly (20.7%), and splenomegaly (12.1%). Osteoarticular involvement, orchitis, and iridocyclitis were observed in 64.9%, 38.0% (of male patients), and 0.7% of the patients, respectively. Scintigraphy was performed for 114 patients who have focal joint and bone complaints and findings. Beck Depression Inventory and State-Trait Anxiety Inventory testing were applied to 98 patients with brucellosis, and depression was observed in 37.8% of these patients. The total point of State Anxiety Inventory testing was 46.21 ± 12.87, and the total point of Trait Anxiety Inventory testing was 46.98 ± 10.11. Either the depression rates or points of State Anxiety Inventory testing and Trait Anxiety Inventory testing in patients with brucellosis were statistically higher than in the control group. In 134 patients, initial standard tube agglutination testing titer was 1/160 or more. Brucella melitensis was found positive in 22 patients. Relapse rate was 3.5%. Brucellosis continues to be a health problem in countries where consumption of unpasteurized dairy products and stockbreeding are common.

The impact of IQ and EQ on pre-eminent achievement in organizations: implications for the hiring decisions of HRM specialists

In this study, IQ and EQ determinants of pre-eminent achievement in organizations were explored to help HRM specialists in selecting more appropriate job applicants, having potential for outstanding performance in their career paths. Several EQ elements were proved the most important in the achievement. However, IQ elements still play a very important role in superior performance. Results also exhibit that correlation of IQ and EQ levels of superior performers is significant and strong. In conclusion, HRM specialists have to test both IQ and EQ in the hiring process, to create a high-performing workforce in their organizations.

Effect of silicone breast implants on myocardial imaging.

The authors investigated the effect of silicone breast implants (SBIs) on thallium-201 myocardial perfusion scintigraphy. Twenty-nine patients with SBIs and 14 control subjects were included in the study. All of the participants underwent a resting thallium-201 myocardial perfusion study. Comparison of the thallium images between patients with SBI and control subjects was done both visually and semiquantitatively. On visual analysis, neither image distortion nor image artifact attributable to the SBIs was noted. Semiquantitative analysis revealed that in patients with SBIs, the uptake values of the anteroseptal, anterolateral, lateroanterior, and lateroinferior myocardial walls was slightly, but significantly, lower than those of control subjects: anteroseptal, 87.7+/-6.0% vs. 92.8+/-5.1%; anterolateral, 88.0+/-5% vs. 92.6+/-4.5%; lateroanterior, 87.4+/-5% vs. 91.4+/-4.7%; and lateroinferior, 86.0+/-6.0% vs. 91.7+/-7.0%. The uptake value of the remaining walls in patients with SBIs were not significantly different than the control subjects. In conclusion, SBIs did cause a significant decrease in uptake values of the myocardial walls, which should be considered during interpretation of the images.

Intense FDG Uptake around the Inguinal Surgical Mesh 5 Years after Operation: Case Report and Review of the Literature

We present the case of a 40-year-old man who underwent a FDG PET/CT study for restaging of renal cell carcinoma treated with left nephrectomy, for suspected metastasis in lung and retroperitoneal lymph nodes. The patient had a history of left inguinal hernia repair with implantation of mesh prosthesis 5 years ago. PET/CT image revealed linear intense FDG uptake in left inguinal region most likely corresponding to a persistent foreign body reaction. In this article, a case with an intense FDG uptake around mesh prosthesis after many years was reported, and a summary of the literature about surgical mesh and foreign body reaction causing FDG uptake was reviewed. Conflict of interest:None declared.

The conditions for which the geometric mean method revealed a more accurate calculation of relative renal function in 99mTc-DMSA scintigraphy

Aims(1) To compare the results of calculating relative renal function (RRF) by using only posterior images (POST) with the geometric mean (GM) through both anterior and posterior imaging on dimercaptosuccinic acid (DMSA) scintigraphy. (2) To determine whether there was an age-related difference between them and whether some renal pathologies or asymmetrical renal function cause an error in the RRF calculation by using posterior images only. MethodsEight hundred and ninety-one DMSA scans were studied retrospectively. The patients were divided into five age groups: group I, ≤2 years; group II, >2 to ≤5 years; group III, >5 to ≤10 years; group IV, >10 to ≤18 years; and group V, >18 years. The RRF of the right kidney (RKF) was calculated from the POST and GM counts. The differences between RKFGM and RKFPOST were calculated in all the patients. ResultsAmong the 891 patients, nine had malrotated or malpositioned kidneys, 373 had renal pathologies of pyelonephritis, hydronephrosis, cortical scarring and atrophy, 247 had asymmetrically functioning kidneys and 509 had normal kidneys. When the patients were analysed according to different age groups, significant differences were found between all groups (P<0.05) except groups I–II and IV–V (P>0.05) with the F-test. The clinically meaningful RRF variance (≥5% difference between two methods) rate differed significantly between groups I, II and III, and groups IV and V (chi-squared test, P<0.05). In patients aged ≤10 years, a clinically meaningful RRF variance (≥5%) rate was significantly higher in the groups with pathological or asymmetrically low (≤40% RRF) functioning kidneys than in the groups without pathological or asymmetrically low functioning kidneys, respectively (P<0.05). ConclusionsAccording to our findings, the calculation of RRF using the GM method differs significantly from that using posterior images. Calculation of the GM can effectively correct the RRF measurement not in only adults, but also in the patient population ♯10 years of age. In addition, a significant correction can be made in patients aged ♯10 years who have a renal pathology or an asymmetrically low functioning kidney.

Tc-99m pertechnetate scintigraphy before and after potassium perchlorate administration for the diagnosis of retrosternal goiter.

A 52-year-old woman was hospitalized because of dyspnea and dysphagia. Thoracic computed tomography revealed a retrotracheal mass. Tc-99m pertechnetate scintigraphy showed intense accumulation of radioactivity corresponding to the mediastinal mass detected by computed tomography. Repeated Tc-99m pertechnetate scintigraphy performed after oral administration of potassium perchlorate (KCLO4) revealed complete disappearance of the radioactive accumulation in the mediastinum, suggesting that the retrotracheal mass was a retrosternal goiter. Subsequent surgical removal and analysis of the mass showed it was indeed a retrosternal goiter. This case highlights the importance of Tc-99m pertechnetate thyroid scintigraphy with and without KCLO4 administration as a simple, accurate, and cost-effective imaging method to diagnose retrosternal goiter.

Scintigraphic visualization of ocular melanoma with Tc-99m glutathione

In a patient with ocular melanoma scintigraphy obtained with99mTc-GSH clearly demonstrated the histologically proven ocular lesion both in planar and SPECT images.99mTc-sestamibi study obtained in the same patient three days later was negative.99mTc-GSH is a potential alternative to the currently used radiopharmaceuticals for imaging both cutaneous and ocular melanomas and their metastases.

Diffuse splenic F-18 FDG uptake in visceral leishmaniasis.

A 51-year-old woman had splenomegaly and enlarged multiple splenic hilar lymph nodes. The patient was referred to our department for F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) evaluation to determine the metabolic activity of lymph nodes and define a biopsy site. PET/CT images showed diffuse increased FDG uptake in an enlarged spleen and hypermetabolic splenic hilar lymph nodes. The metabolic activity in bone marrow also seemed diffusely increased. After splenectomy, histopathologic analysis showed the growth of Leishmania amastigotes in splenic tissue, and bone marrow biopsy did not reveal any significant pathology but only mild hypercellularity.