Ummuhan Abdulrezzak

Serum ghrelin and leptin levels in patients with depression and the effects of treatment.

Objective Ghrelin and leptin, appetite-regulating hormones, play a role in mood regulation. Current data about the relation between leptin/ghrelin and depression are still controversial. This study aimed to investigate serum leptin and ghrelin levels in patients with depression and the effects of treatment on these levels. Methods Serum ghrelin and leptin levels were measured before and after treatment with antidepressant drugs and/or electroconvulsive therapy in 28 patients with depression and once in 21 healthy controls. Results Serum ghrelin levels of the patients were high in the pre-treatment. After the treatment, ghrelin levels were not different from those of the controls. We found no difference in serum levels of leptin between the patients and controls and no change with treatment. body mass index of the patients increased after the treatment especially in the drug-treated group. Conclusion The present study found increased serum ghrelin levels in depressive patients and normalization with improving of depression but no alteration in leptin levels.

The Effects of Antidepressants on Neuropeptide Y in Patients with Depression and Anxiety.

INTRODUCTION This study aimed to investigate the neuropeptide Y (NPY) levels in patients with anxiety and depression and also the effects of antidepressants on this neuropeptide. MATERIALS AND METHODS The study included 40 outpatients who presented with depressive and anxiety symptoms, and 32 healthy controls. The patients received antidepressant treatment for 6 months. Serum levels of neuropeptide Y were measured before treatment in 40 patients, after 8 weeks of treatment in 32 patients, after 6 months in 10 patients, and once in the controls. RESULTS Serum NPY levels were lower in the patients than in the controls. NPY levels were increased and normalized by antidepressant treatment. While there was no change in NPY levels in the patients using fluoxetine and sertraline for 8 weeks, an increase was found in patients using escitalopram and venlafaxine. Serum NPY levels were increased by treatment for 8 weeks in the patients with depression, but not in the patients with anxiety. DISCUSSION The findings suggest that NPY may be related to pathophysiology in depression and anxiety, and antidepressants influence NPY levels.

Association of Gingival Crevicular Fluid Cortisol/Dehydroepiandrosterone Levels With Periodontal Status

BACKGROUND The aim of the present study is to examine whether anxiety and depression scale scores change with regard to clinical periodontal status and to investigate the association between the levels of stress-related hormones in gingival crevicular fluid (GCF) and extent/severity of periodontal disease. METHODS One hundred twenty participants who fulfilled the study inclusion criteria were chosen. Patients with chronic periodontitis (CP) and those with healthy periodontal tissues/mild gingivitis were included. The clinical examinations were performed on the day after the psychologic evaluations which included anxiety and depression measurements. GCF sampling was undertaken the following day. Commercially available enzyme-linked immunosorbent assay kits were used to determine GCF cortisol and dehydroepiandrosterone (DHEA) levels. Study groups were assigned as follows: group 1, non-periodontitis; group 2, localized CP; and group 3, generalized CP. RESULTS There were no significant differences with respect to age, sex, education, income level, occupation, or smoking history among the groups (P >0.05). There were no significant differences between the non-periodontitis and CP groups for any of the psychosocial scales (P >0.05). Group 3 had significantly higher mean DHEA scores compared with group 1 (P <0.05); however, the median cortisol scores showed no statistically significant differences among the three groups (P >0.05). CONCLUSIONS Anxiety/depression scores and GCF cortisol levels did not show any difference with regard to clinical periodontal status. However, a significant association was found between elevated levels of GCF DHEA and the severity of periodontitis.

Hepatobiliary function assessed by 99mTc-mebrofenin cholescintigraphy in the evaluation of fibrosis in chronic hepatitis: histopathological correlation.

PurposeAlthough liver biopsy remains the gold standard in the staging of liver fibrosis in chronic hepatitis C virus (HCV) infection, several noninvasive methods are under evaluation for clinical use. The aim of this study was to evaluate the utility of hepatobiliary function through technetium-99m-N-(-3-bromo-2,4,6-trimethylacetanilide) iminodiacetic acid (99mTc-mebrofenin) scintigraphy in evaluating liver fibrosis in patients with chronic HCV infection. MethodsWe studied 62 patients with HCV (18 men, 44 women). The patients were allocated into three groups according to histopathological score: group 1: portal/periportal fibrosis (21 patients; eight men, 13 women); group 2: bridging fibrosis (23 patients; seven men, 16 women); and group 3: incomplete/complete cirrhosis (18 patients; three men, 15 women). As a control group, 20 healthy volunteers (six men and 14 women) were studied. Hepatocyte mebrofenin uptake rate, the time required for maximal hepatic activity (Tmax), and the time required for peak activity to decrease by 50% (T1/2max) were calculated using 99mTc-mebrofenin cholescintigraphy. Scintigraphic parameters were correlated with biochemical parameters and liver histopathology. ResultsThe uptake rates were significantly decreased in all groups with fibrosis compared with the controls (P<0.05). The correlation between the severity of fibrosis and 99mTc-mebrofenin uptake rate was strongly significant (r2=−0.81, P<0.0001). Tmax and T1/2max were significantly prolonged in groups 2 and 3 compared with the controls. Histopathology score was correlated moderately with Tmax and T1/2max (r2=0.61, P<0.0001 and r2=0.52, P<0.0001, respectively). ConclusionThe assessment of hepatobiliary function by 99mTc-mebrofenin scintigraphy may be a good choice for assessing the severity of liver fibrosis in patients with HCV.

The association between depression, weight loss and leptin/ghrelin levels in male patients with head and neck cancer undergoing radiotherapy

OBJECTIVE This study investigated the relationship between weight loss, depression and anxiety, and appetite hormones, leptin and ghrelin levels in patients with head and neck cancer (HNC), as well as the effect of radiotherapy and antidepressant treatment on weight and these hormones. METHODS Forty male patients with HNC and twenty physically and mentally healthy male controls were recruited for the study. Psychiatric status was evaluated with clinical interview and psychometric tests. All patients received radiotherapy and antidepressant treatment with mirtazapine that was given to patients with psychiatric disorders. Serum leptin and ghrelin levels were measured pre- and post-treatment in the patients and once in the controls. RESULTS There was no significant difference between the serum leptin and ghrelin levels of patients and controls. The leptin levels of the patients were decreased by radiotherapy. Eleven patients were diagnosed with major depressive disorder and adjustment disorder and were classed as depressive patients. Depressive patients were affected more by radiotherapy with respect to weight loss. The basal leptin levels of depressive patients were also lower than non-depressive patients and controls. CONCLUSION It seems that depression aggravated weight loss and, in addition, decreased leptin levels in cancer patients. Detection and treatment of psychiatric disorders may improve prognosis by preventing weight loss as well as by providing psychiatric treatment in cancer patients.

Combined imaging with 68Ga-DOTA-TATE and 18F-FDG PET/CT on the basis of volumetric parameters in neuroendocrine tumors.

AimTo assess the additional contribution of the combined imaging approach with 68Ga-DOTA-TATE and fluorine-18 fluorodeoxyglucose (18F-FDG) on the basis of volumetric parameters in neuroendocrine tumors (NETs). Materials and methodsForty-one patients with NET (19 women, 22 men; age range: 30–79 years; mean age: 56.7±12.3 years) underwent 68Ga DOTA-TATE and 18F-FDG PET/computed tomography (CT) imaging. Within the drawn regions of interest, in addition to evaluating the maximum and mean standardized uptake values (SUVmax and SUVmean), the metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in 18F-FDG PET/CT imaging, and the somatostatin receptor density and total lesion somatostatin receptor expression (TLSRE) in 68Ga somatostatin receptor imaging (SRI) were measured. The patients were graded on the basis of the proliferation index: well (G1; Ki-67 ⩽2), moderately (G2; Ki-67=3–20), and poorly (G3; Ki-67>20) differentiated groups. ResultsOf the 41 NET patients, 22, 14, and five were in the G1 (53.7%), G2 (34.1%), and G3 (12.2%) groups, respectively. Liver metastases had significantly higher TLSRE values than the TLG values. Ki-67 levels showed a positive correlation with the primary tumor MTV and TLG values. Cg-A levels had a positive correlation with the volumetric parameters of the whole-body tumor burden (P<0.001). Conclusion68Ga SRI and 18F-FDG PET/CT provide complementary information on treatment protocol and response assessment. While assessing the prognosis and tumor aggressiveness, lesions and whole-body tumor burdens can be calculated on the basis of volumetric parameters by 18F-FDG PET/CT using MTV and TLG, and by 68Ga SRI using somatostatin receptor density and TLSRE.

Relationship between orexin A and childhood maltreatment in female patients with depression and anxiety

ABSTRACT Objective: Childhood maltreatment leads to neuroendocrine changes, which may be associated with an increased vulnerability for psychopathology, such as depression and anxiety in later life. This study aimed to investigate the relationship between childhood maltreatment and orexin A levels in patients with depression and anxiety. The study consisted of 27 female outpatients who presented with depressive and/or anxiety symptoms, and 27 healthy female controls. Childhood trauma history was assessed using the childhood trauma questionnaire (CTQ-28) in patients and controls. Serum levels of orexin and cortisol were measured in all subjects. There were positive correlations between serum orexin levels and CTQ total score and between orexin levels and some CTQ subscale scores, such as physical and emotional neglect, in patients. Orexin levels in patients with a positive history of physical and emotional neglect were higher than those in patients with a negative history of them. In the controls, there was a positive correlation between emotional neglect score and serum orexin level. There were no differences in serum levels of orexin and cortisol between patients and controls. Orexin levels may be associated with childhood maltreatment per se, rather than psychopathology, such as depression or anxiety.

PET/CT and Bremsstrahlung Imaging After 90Y DOTANOC Therapy for Rectal Net With Liver Metastases

Peptide receptor radionuclide therapy with Lu or Y is promising with successful results in somatostatin receptor-positive tumors. In all radiation therapies, knowledge of the radiation dose received by the target, and other organs in the body is essential to evaluate the risks and benefits of any procedure. We report a case of liver metastases from a rectal neuroendocrine tumor, which was treated with Y DOTANOC. Posttreatment whole-body planar images were acquired through Bremsstrahlung radiations of Y on a γ-camera, and thoracolumbar PET/CT images were acquired on PET.

Imaging of Primary Liver Carcinosarcoma Scintigraphically; A Case Report

Primary liver carcinosarcoma is a very rare disease. There have been only a few cases described to date, none of which has been imaged by bone scintigraphy. A 69-year-old man who developed right back pain and weight loss was admitted to our hospital. Tenderness of the right upper abdomen, hepatomegaly, and a giant mass were the main physical examination signs. Abdominal ultrasonography showed a large lobulated heterogeneous echogenic solid mass with multiple cystic areas of varying size and a highly echogenic region that had posterior acoustic shadowing within the mass in the right lobe of the liver. Labeled erythrocyte imaging and 99mTc-nanocolloid liver-spleen scan were performed to exclude hemangioma, showing a large intrahepatic photon deficient area. 99mTc-methylene diphosphonate (MDP) bone scintigraphy revealed heterogeneous, irregular and dense activity accumulation thought to be osteoblastic activity in the liver mass. Postsurgical pathological diagnosis revealed “carcinosarcoma”. Conflict of interest:None declared.

Comparison of Dynamic Contrast-Enhanced MRI and PET/CT in the Evaluation of Laryngeal Cancer After Inadequate CT Results.

Summary Background To investigate the diagnostic value of dynamic magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for laryngeal cancers after inadequate CT results. Material/Methods The study comprised 45 patients investigated for primary laryngeal cancer or recurrence-residue in which CT was considered inadequate. A mass was found in 20 patients. Dynamic MRI and PET/CT were compared for diagnosis of mass, lymph node involvement, recurrence and residue. The dynamic curves formed in dynamic MRI were investigated for diagnostic contributions. Results The sensitivity and specificity of the dynamic MRI, for supraglottic, glottic and subglottic location, was 100%, 80%, and 92%; 100%, 85%, and 100%, respectively. In PET/CT the sensitivity and specificity were 100% for all of those localizations. For lymph node involvement, the sensitivity of dynamic MRI and PET/CT was 100%, the specificity was 100% and 93%, respectively. For recurrence-residue, the sensitivity and specificity of dynamic MRI were 86% and 67%, respectively, with 100% sensitivity and specificity in PET/CT. The sensitivity of type A curve for detection of malignancy was 40%, and specificity was 100%. When type A and B curves were included, the sensitivity was 100%. Conclusions For patients investigated for laryngeal cancer in which CT is considered inadequate, dynamic MRI or PET/CT is useful.