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    Akut Koroner Sendromda Eş Zamanlı İki Koroner Damarda Trombüs Görülmesi: Üç Olgu Sunumu
    (Düzce Üniversitesi, 2011) S, Bulur; Bulur, Serkan; Erkan, Melih Engin; Aydın, Mesut; Çağlar, Sabri Onur; Alemdar, Recai; Yalçın, Sübhan
    [Abstract Not Available]
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    Anemia, celiac disease and low bone mass
    (Elsevier Science Bv, 2013) Korkmaz, Uğur; Korkmaz, Ayşe Nurdan; Erkan, Melih Engin
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    Asymmetric dimethylarginine is not a good predictor of ischemia using myocardial perfusion scintigraphy
    (Tubitak Scientific & Technical Research Council Turkey, 2015) Erkan, Melih Engin; Aşık, Muhammet; Uçgun, Taner; Yıldız, Nilgün; Yılmaz, Ayşe; Aslantaş, Yusuf; Doğan, Ahmet Semih
    Background/aim: Asymmetric dimethylarginine (ADMA) plays role in the pathogenesis of coronary artery disease and related mortality and morbidity through a number of mechanisms. We hypothesized that plasma ADMA levels would be increased in the presence of reversible ischemia as measured by GATED single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy (MPS). Materials and methods: Fasting i.v. blood samples were drawn before testing. All patients underwent 99mTc-sestamibi GATED SPECT MPS with a one-day stress-rest protocol; the images were visually analyzed. Post-stress GATED parameters, including ejection fraction, end systolic and end diastolic volumes, and automatic stress defect scores, were recorded. Results: The plasma ADMA levels were higher in the ischemic group than in the non-ischemic group (0.46 +/- 0.19 vs. 0.40 +/- 0.15; P = 0.016). Plasma ADMA levels (odds ratio [OR] = 13.5; 95% confidence interval [CI] = 1.7-109.01; P = 0.015) and sex (OR = 2.49, 95% CI = 1.18-5.26; P = 0.017) were independent predictors of ischemia. There was no linear correlation between plasma ADMA levels and both the GATED SPECT and stress test parameters. Conclusion: Our data support the hypothesis that increased baseline ADMA levels are independently related with the presence of reversible ischemia.
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    A case of a gigantic urine Madder due to prostate cancer obstruction on a technetium-99m methyl diphosphonate bone scan
    (Hellenic Soc Nuclear Medicine, 2007) Erkan, Melih Engin; İlçe, Huri Tilla; Korkmaz, Nurdan; Büyükkaya, Ramazan; Yıldırım, Mustafa
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    Comparison of Conventional Bone Scintigraphy and Whole-Body Magnetic Resonance Imaging for the Detection of Musculoskeletal System Metastases
    (Düzce Üniversitesi, 2014) Topaloğlu, Meral; Erkan, Melih Engin; Büyükkaya, Ramazan; Beşir, Halit; Yazıcı, Burhan; Özşahin, Mustafa; Erdoğmuş, Beşir
    Purpose: In this study, the aim is to compare the findings of conventional bone scintigraphyand whole-body magnetic resonance imaging for the known primary malignancy in patientswith bone metastases.Methods: 34 patients were studied with retrospectively and prospectively. The detectionsensitivity, specificity and adaptation of bone metastases were examined whit whole-bodymagnetic resonance imaging and bone scintigraphy.Results: Whole-body magnetic resonance imaging has a higher sensitivity than bonescintigraphy for the detection of metastases.Conclusion: Whole-body magnetic resonance imaging can be used for bone metastases forscreening as an alternative imaging modality
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    Comparison of the effects of N-acetyl cysteine and erdosteine in rats with renal injury caused by paracetamol intoxication
    (Sage Publications Ltd, 2011) Kandiş, Hayati; Erkan, Melih Engin; Yıldırım, Ümran; Güneş, Harun; Erbaş, Mesut; Yıldırım, Hayriye A.K.; Kara, İsmail Hamdi
    Aim: The aim of the present study was to investigate the therapeutic and preventive effects of N-acetyl cysteine and erdosteine on renal injury associated with paracetamol (acetaminophen) intoxication. Materials and methods: Female albino Wistar rats were divided into six groups: control; paracetamol (1 g/kg, oral); paracetamol (1 g/kg, oral) + erdosteine (150 mg/kg/day, oral); paracetamol (1 g/kg, oral) + N-acetyl cysteine (140 mg/kg bolus, followed by 70 mg/kg, oral); N-acetyl cysteine control (140 mg/kg bolus, followed by 70 mg/kg, oral); and erdosteine control (150 mg/kg/day, oral). Potential renal injury was assessed using biochemical analyses, radionuclide imaging, and histopathological parameters. Results: In the paracetamol group, blood urea nitrogen and creatinine levels were significantly increased compared with controls. Histopathological examination showed tubular vacuolization, tubular necrosis, and remarkable interstitial inflammation. The excretion function was observed to be insufficient on radionuclide imaging. However, in the groups treated with erdosteine or N-acetyl cysteine after paracetamol, biochemical analyses, radionuclide imaging, and histopathological parameters showed significantly less evidence of renal toxicity than that observed in the group receiving paracetamol alone. Less renal toxicity was detected in rats receiving N-acetyl cysteine than in those receiving erdosteine. Conclusion: Renal injury may develop after paracetamol overdose. Erdosteine and N-acetyl cysteine are both effective in the prevention of renal injury when given in the early phase of paracetamol nephrotoxicity. N-acetyl cysteine is more protective than erdosteine.
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    Correlation between 18F FDG Uptake with Pathological Prognostic Factors in Breast Carcinoma
    (Springer, 2012) Ekmekçioğlu, Özgül; Aliyev, Anar; Erkan, Melih Engin; Döner, Zübeyde Rana Kaya; Çalışkan, Fatma; Başkır, B.; Sönmezoğlu, Kerim
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    The effect of osteoporosis on self-report sleep quality in postmenopausal women
    (Wiley-Blackwell, 2011) Yazıcı, Selma; Canan, Fatih; Baki, Ali Erdem; Erkan, Melih Engin; Ataoğlu, Safinaz; Ataoğlu, Ahmet
    We aimed to show the effect of osteoporosis on sleep quality in 59 postmenopausal women. The participants' bone-mineral density levels were measured by dual-energy X-ray absorptiometry (DEXA). According to their DEXA results, participants were divided into two groups as osteoporotics and controls. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Fourteen osteoporotic women (43.8%) and four controls (14.8%) were "poor" sleepers (p < 0.05). Postmenopausal women with osteoporosis scored greater on the "sleep latency" and "sleep duration" components of PSQI than controls. According to the findings of our study, osteoporosis is a risk factor for poor sleep quality in postmenopausal women.
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    Efficiency of radioactive I-131 therapy in geriatric patients with toxic nodular goiter
    (Springer, 2012) Erkan, Melih Engin; Demirin, Hilmi; Aşık, Muhammed; Celbek, Gökhan; Yıldırım, Mustafa; Aydın, Yusuf; Doğan, Ahmet Semih
    Background and aims: The success of I-131 therapy in geriatric patients who were referred to an endocrinology clinic with toxic nodular goiter and who lived in iodine-deficiency regions was studied. Materials and methods: Patients older than 60 years who received I-131 therapy were included via retrospective data analyses. Fifty-nine patients between 60 and 82 years of age were enrolled in the study. The patients received an oral capsular form of I-131 (10-25 mCi) and were followed up for 1 year with clinical and laboratory results. Euthyroid or hypothyroid status at the end of the year after treatment was deemed to be a response to treatment. Results: Of the 21 (36%) male and 38 (64%) female patients, 29 (49%) had a solitary toxic nodule and 30 (5 1%) had toxic multinodular goiter. Twenty-nine (49%) of the patients received propylthiouracil therapy. At the end of the year, 38 (64%) patients were euthyroid, 11 (19%) were hypothyroid, and 10 (17%) were thyrotoxic. Forty-nine (83%) patients who were euthyroid and hypothyroid were considered responders. Conclusion: Geriatric patients with toxic nodular goiter were shown to have a high response rate to I-131 therapy. Thus, we suggest that radioactive iodine treatment should be the first-line treatment in these patients. (C) 2012, Editrice Kurtis
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    Egzersiz sonrası kalp hızındaki düzelme ile gated miyokard perfüzyon SPECT bulguları ve prognostik göstergelerinin ilişkisi
    (Düzce Üniversitesi, 2009) Erkan, Melih Engin; Yıldırım, Mustafa
    Amaç: Efor testi sonlandırıldıktan sonra kalp hızındaki düzelmede meydana gelen anormallik otonom sinir sistemi bozukluğunu yansıtan basit ve kolayca elde edilebilir bir parametredir. GATED miyokard perfüzyon SPECT sintigrafisi de koroner arter hastalığı tanısı koymada ve prognozu belirlemede kullanılan bir tekniktir. Bu çalışmada kalp hızındaki düzelme ile miyokard perfüzyon sintigrafisi sonuçlarını karşılaştırdık. Bu şekilde koroner arter hastalığı tanısı koymada ve prognozu belirlemede kalp hızındaki düzelmenin rolünü araştırdık.Yöntem: Bu kesitsel çalışmaya egzersiz GATED miyokard perfüzyon SPECT sintigrafisi uygulanan hastalar dahil edildi. (n = 50, 27 bayan, 23 erkek). Egzersiz testi semptom sınırlı Bruce protokolüne göre yapıldı. Kalp hızındaki düzelme, egzersiz de ulaşılan maksimal kalp hızından, egzersiz sonlandırıldıktan sonra birinci dakikadaki kalp hızı çıkarılarak elde edildi. Miyokardiyal perfüzyon, duvar hareketi ve kalınlığı 20 segment skorlamasına göre yarı kantitatif görsel analiz yöntemiyle değerlendirildi. Sol ventriküle ait sayısal parametreler kantitatif GATED SPECT yazılımı ile otomatik olarak elde edildi.Bulgular: Çoklu lineer regresyon analizi sonucunda kalp hızındaki düzelme ile stress sırasındaki miyokard defektinin büyüklüğü arasında çok kuvvetli negatif bağımsız doğrusal ilişki olduğu ortaya çıktı (ß= -0,957; SE= 0,650; p= 0,043). Yaşın da kalp hızındaki düzelme için negatif bağımsız bir prediktör olduğu bulundu (ß= -0,473; SE= 0,250; p= 0,022). Modelin korelasyon sabiti (R) 0,604, uyum iyiliği değeri (R2) de 0,365 bulundu.Sonuçlar: Kalp hızındaki düzelme miktarı düşük olan hastalarda stress sonrası myokardiyal defektin daha şiddetli olduğu izlenmektedir. Stress sırasındaki miyokardiyal defektin büyüklğü ileri kardiyak olay ve prognoz ile ilişkili olduğu için kalp hızındaki düzelme de kardiyak olay gelişimi ve hastalığın pronozuyla ilişkilidir.
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    Evaluation of carotis intima media thickness in COPD patients
    (European Respiratory Soc Journals Ltd, 2012) Beşir, Fahri Halit; Aydın, Leyla Yılmaz; Yazgan, Ömer; Dumlu, Talha; Erkan, Melih Engin; Önder, Elif; Coşkun, Hülya
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    Evaluation of the effects of desflurane and sevoflurane anesthesia on alveolar epithelial permeability by Tc-99m DTPA inhalation scintigraphy
    (Tubitak Scientific & Technical Research Council Turkey, 2013) İskender, Abdülkadir; Erkan, Melih Engin; Erbaş, Mesut; Güven, Damla Güçlü; Sezen, Gülbin; Aşık, Muhammet; Yıldırım, Mustafa
    Aim: Recently studies showed that volatile anesthetics affect the ciliary beat frequency in vitro. We know that impairment of ciliary beat frequency is related to a risk of pulmonary complications with general anesthesia. Other studies have also shown that exposure to a volatile anesthetic can increase the permeability of the alveolar-capillary barrier. The present study aimed to determine the effects of desflurane and sevoflurane anesthesia on the technetium-labeled diethylene triamine penta-acetic acid (Tc-99m DTPA) clearance rate of the alveolar epithelium. Materials and methods: A total of 40 patients who underwent elective tympanoplasty with general anesthesia were included in this study. Patients having any systemic disease or infection, or with any property that affected lung functions, were excluded from the study. Patients were randomized into 2 groups (20 patients in each) as receiving sevoflurane and desflurane. A Tc-99m DTPA aerosol inhalation lung imaging method was used to assess lung functions. Results: Demographic properties were similar in both groups. There were no significant differences between basal and postoperative lung clearance of inhaled Tc-99m DTPA in either group. Conclusion: We propose that neither sevoflurane nor desflurane induces pulmonary alveolar capillary injury in the acute period of general anesthesia based on Tc-99m DTPA scan results.
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    FDG and FDG-labelled leucocyte PET/CT in the imaging of prosthetic joint infection
    (Springer, 2014) Aksoy, Sabire Yılmaz; Asa, Sertaç; Özhan, Meftune; Ocak, Meltem; Sağer, M. Sait; Erkan, Melih Engin; Kanmaz, Bedii
    Purpose The demand for arthroplasty is rapidly growing as a result of the ageing of the population. Although complications such as heterotrophic ossification, fracture and dislocation are relatively rare, differentiating aseptic loosening, the most common complication of arthroplasty from infection, is a major challenge for clinicians. Radionuclide imaging is currently the imaging modality of choice since it is not affected by orthopaedic hardware. Whereas FDG PET/CT imaging has been widely used in periprosthetic infection, it cannot discriminate aseptic from septic inflammation. In this study we aimed to evaluate the role of FDG PET/CT and FDG-labelled leucocyte PET/CT in the diagnosis of periprosthetic infection. Methods Of 54 patients with painful joint arthroplasty who were imaged by FDG PET/CT for diagnosis of periprosthetic infection examined, 46 (36 women, 10 men; mean age 61.04 +/- 12.2 years, range 32 - 89 years) with 54 painful joint prostheses (19 hip, 35 knee) with grade 2 (above liver uptake) FDG accumulation on FDG PET/CT were included in the study and these 46 patients also underwent FDG-labelled leucocyte PET/CT. Final diagnoses were made by histopathological-microbiological culture or clinical follow-up. Results The final diagnosis showed infection in 15 (28 %) and aseptic loosening in 39 (72 %) of the 54 prostheses. FDG PET/CT was found to have a positive predictive value of 28 % (15/54). Since patients with no FDG uptake on FDG PET/CT were excluded from the study, the sensitivity, specificity, negative predictive value and accuracy could not be calculated. The sensitivity, specificity, and positive and negative predictive values of FDG-labelled leucocyte PET/CT were 93.3 % (14/15), 97.4 % (38/39), 93.3 % and 97.4 %, respectively. Conclusion Since FDG is not specific to infection, the specificity of FDG PET/CT was very low. FDG-labelled leucocyte PET/CT with its high specificity may be a useful method and better than labelled leucocyte scintigraphy in periprosthetic infection imaging.
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    High Levels of High Sensitivity C-Reactive Protein and Uric Acid can Predict Disease Severity in Patients with Mitral Regurgitation
    (Elsevier Science Inc, 2013) Türker, Yasin; Ekinözü, İsmail; Aslantaş, Yusuf; Türker, Yasemin; Akkaya, Mehmet; Erkan, Melih Engin
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    The importance of coronary angiography for ischemic sign confirmation detected by myocardial perfusion scintigraphy Reply
    (Tubitak Scientific & Technical Research Council Turkey, 2016) Erkan, Melih Engin; Aşık, Muhammet; Uçgun, Taner; Yıldız, Nilgün; Yılmaz, Ayşe; Aslantaş, Yusuf; Doğan, Ahmet Semih
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    Kronik obstrüktif akciğer hastalığında karotis intima mediya kalınlığının değerlendirilmesi
    (Ankara University, 2012) Beşir, Fahri Halit; Aydın, Leyla Yılmaz; Yazgan, Ömer; Dumlu, Talha; Erkan, Melih Engin; Önder, Elif; Coşkun, Hülya
    Giriş: Kronik obstrüktif akciğer hastalığı (KOAH) ve ateroskleroz benzer risk faktörlerine bağlı olarak meydana gelebilmekte olup, önemli oranda morbidite ve mortaliteye neden olmaktadır. Bu çalışmada KOAH ve ateroskleroz arasındaki ilişkinin değerlendirilmesi için KOAH’lı ve aterosklerotik risk faktörü olmayan, normal beden kitle indeksi ve metabolik parametrelere sahip erişkin sağlıklı bireylerin karotis intima mediya kalınlıkları (KİMK)’nın karşılaştırılması amaçlanmıştır. Materyal ve Metod: Yaşları 18-92 arasında değişen 2298 katılımcıyla yapılan çalışmamızda, solunum fonksiyon testi ve klinik özelliklerine göre KOAH tanısı konulan 46 hasta ile dışlama kriterini taşımayan 47 sağlıklı birey değerlendirildi. Katılımcılara KİMK değerlendirmesi için doppler ultrasonografi incelemesi yapıldı. İstatistiksel olarak p< 0.05 anlamlı kabul edildi. Bulgular: Ortalama KİMK KOAH grubunda 0.79 ± 0.16 mm; kontrol grubunda 0.616 ± 0.1 mm olarak ölçüldü (p< 0.001). KİMK’yi etkileyen aterosklerotik parametrenin tayini için yapılan çoklu lineer regresyon analizinde KİMK’nin yaş ile anlamlı bir şekilde doğru orantılı (p= 0.002), FEV1% ile de anlamlı bir şekilde ters orantılı (p= 0.04) olduğu saptandı. KİMK değerine göre ateroskleroz tanısı konulan hastalarımızda ateroskleroza hangi parametrenin en fazla katkı sağladığını bulmak için yapılan multivaryant lojistik regresyon analizinde ateroskleroz ile ilişkili parametre bulamadık. Sonuç: KOAH ve aterosklerotik hastalıklarda bulunan kalıcı düşük dereceli sistemik inflamasyon varlığının, muhtemelen her iki patolojiyi de yürüten faktör olabileceği bildirilmiştir. KOAH tanılı erişkinlerde erken dönem ateroskleroz ve kardiyovasküler riski, diğer risk faktörlerinden bağımsız olarak artmakta olup girişimsel olmayan, kolay uygulanabilir ve ucuz bir tanı yöntemi olarak risk tayininde kullanılabilen KİMK yaş ile doğru FEV1% ile ters orantılı olarak artış göstermektedir.
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    Kronik obstrüktif akciğer hastalığında karotis intima mediya kalınlığının değerlendirilmesi
    (2012) Beşir, Fahri Halit; Yılmaz, Leyla Aydın; Yazgan, Ömer; Dumlu, Talha; Erkan, Melih Engin; Önder, Elif; Coşkun, Hülya
    Giriş: Kronik obstrüktif akciğer hastalığı (KOAH) ve ateroskleroz benzer risk faktörlerine bağlı olarak meydana gelebilmek- te olup, önemli oranda morbidite ve mortaliteye neden olmaktadır. Bu çalışmada KOAH ve ateroskleroz arasındaki ilişkinin değerlendirilmesi için KOAH’lı ve aterosklerotik risk faktörü olmayan, normal beden kitle indeksi ve metabolik parametrele- re sahip erişkin sağlıklı bireylerin karotis intima mediya kalınlıkları (KİMK)’nın karşılaştırılması amaçlanmıştır. Materyal ve Metod: Yaşları 18-92 arasında değişen 2298 katılımcıyla yapılan çalışmamızda, solunum fonksiyon testi ve kli- nik özelliklerine göre KOAH tanısı konulan 46 hasta ile dışlama kriterini taşımayan 47 sağlıklı birey değerlendirildi. Katı- lımcılara KİMK değerlendirmesi için doppler ultrasonografi incelemesi yapıldı. İstatistiksel olarak p 0.05 anlamlı kabul edil- di. Bulgular: Ortalama KİMK KOAH grubunda 0.79 0.16 mm; kontrol grubunda 0.616 0.1 mm olarak ölçüldü (p 0.001). KİMK’yi etkileyen aterosklerotik parametrenin tayini için yapılan çoklu lineer regresyon analizinde KİMK’nin yaş ile anlam- lı bir şekilde doğru orantılı (p 0.002), FEV1% ile de anlamlı bir şekilde ters orantılı (p 0.04) olduğu saptandı. KİMK değe- rine göre ateroskleroz tanısı konulan hastalarımızda ateroskleroza hangi parametrenin en fazla katkı sağladığını bulmak için yapılan multivaryant lojistik regresyon analizinde ateroskleroz ile ilişkili parametre bulamadık. Sonuç: KOAH ve aterosklerotik hastalıklarda bulunan kalıcı düşük dereceli sistemik inflamasyon varlığının, muhtemelen her iki patolojiyi de yürüten faktör olabileceği bildirilmiştir. KOAH tanılı erişkinlerde erken dönem ateroskleroz ve kardiyo- vasküler riski, diğer risk faktörlerinden bağımsız olarak artmakta olup girişimsel olmayan, kolay uygulanabilir ve ucuz bir tanı yöntemi olarak risk tayininde kullanılabilen KİMK yaş ile doğru FEV1% ile ters orantılı olarak artış göstermektedir.
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    Left ventricular remodeling assessment in patients with anterior acute myocardial infarction treated with successful primary percutaneous coronary intervention: an observational study
    (Aves Yayincilik, 2013) Uslu, Hatice; Çakmak, Nazmiye; Erkan, Melih Engin; Hacımahmutoğlu, Sevim; Yılmaz, Sabire; Özkan, Sevil; Sayar, Nurten
    Objective: We aimed to analyze the left ventricular (LV) remodeling in patients treated with coronary intervention (PCI) in the acute phase of anterior myocardial infarction (MI) and to analyze the relationship between LV functional remodeling and residual viability in the infarct zone detected by thallium-201 (TI-201) imaging and echocardiography. Methods: We designed an observational prospective cohort study including 30 patients (26 men, 4 women, mean age; 52 +/- 12 years old) with acute anterior MI. Echocardiography and Tl-201 imaging were performed in all patients three days and two months after PCI and left ventricular end-systolic volume (ESV), left ventricular end-diastolic volume (EDV), ejection fraction (EF) and summed redistribution score (SRS) were calculated. Paired samples t- test or Wilcoxon rank sign test for comparing continuous variables in dependent groups, Pearson correlation for testing relationship between continuous variables were used. Results: Left ventricular function baseline values just after PCI and two months after PCI obtained by echocardiography and scintigraphy were statistically significant. Among patients 76.7% had an EF >= 0.50 after the event. EDV and ESV values are significantly low when compared to values two months before. There was not any marked change in SRS in five patients. Polar maps were correlated with heart rate (r=0.438; p=0.023), peak creatine kinase MB (r=0.440; p=0.015) and troponin (r=0.471; p=0.009) during acute MI. Conclusion: Significant recovery in EDV, ESV and SRS values, and increase in EF two months after the infarction shows us substantial part of the remodeling process is completed in two months and Tl-201 imaging is extremely effective in determining of salvaged myocardium.
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    Non-Ischemic Finding on Gated SPECT Myocardial Perfussion Imaging to Explain Symptoms: Case Report
    (Ortadogu Ad Pres & Publ Co, 2010) Erkan, Melih Engin; Korkmaz, Ayşe Nurdan; İlçe, Huri Tilla; Aydın, Mesut; Yıldırım, Mustafa; Doğan, Ahmet Semih
    On myocardial perfusion scintigraphy, planar projection images allow detection of both cardiac and noncardiac abnormalities, which may affect interpretation of the myocardial perfusion images, and can explain patient's symptoms so, increased and reduced extracardiac uptakes should be considered. We present such a case demonstrating the importance of systematic inspection of planar projections. A 63-year-old male with progressive exertional dyspnea and fatigue was referred for myocardial perfusion single photon emission computed tomography (SPECT) imaging for evaluating ischemic heart disease. In our case planar projection images demonstrated a large photopenic area around the heart and, mild increased lung uptake. After we performed CT pleural, pericardial effusions, and pulmonary capillary enlargement were realized. After all this findings, patient had medical theraphy for heart failure and symptoms were subsided. We suggest that physicians should be careful about inspection of planar projection, tomographic, images on GATED cardiac SPECT study. Evalution perfusion defects only may not be enough, to explain patient's symptoms.
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    A Novel Indicator for Assessment of Mitral Regurgitation Severity: Pro-Adrenomedullin
    (Elsevier Science Inc, 2013) Türker, Yasin; Aslantaş, Yusuf; Türker, Yasemin; Uçgun, Taner; Akkaya, Mehmet; Erkan, Melih Engin
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