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IntroductionThere is no consensus about the standardized uptake value maximum (SUVmax) cut-off value to characterize pleural thickening worldwide. Sometimes, this causes unnecessary invasive diagnostic procedures. Our first aim is to determine a cut-off value for SUVmax. Secondly, we try to answer the following question: If we use this cut-off value together with morphological parameters, can we differentiate benign thickening from malignant pleural mesothelioma (MPM) more accurately?Material and methodsThirty-seven patients who underwent 2-deoxy-2-fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) before pleural biopsy were included the study. All of patients had histopathologically proven primary pleural disease. Their [18F]FDG-PET/CT imaging reports were re-assessed. If a patient’s SUVmax or size of the thickening was not mentioned in the report, we calculated it with their [18F]FDG-PET/CT.ResultsAge, pleural effusion, size, and SUVmax were found to have a relationship with MPM. We found the size > 14 mm, and SUVmax > 4.0 as cut-off values for MPM. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for size > 14 mm were found to be 86.4%, 85.2%, 82.6%, 88.5%, respectively. For SUVmax > 4.0, sensitivity, specificity, PPV, NPV were 90.9%, 87.0%, 85.1%, 92.2%, respectively.ConclusionsIf a patient has SUVmax > 4.0 and/or size > 14 mm, the risk of MPM is high. These patients should undergo biopsy. If a patient’s SUVmax < 4.0, size < 14 mm and does not have pleural effusion, he/she has low risk for MPM. These patients can undergo the follow-up. If a patient’s SUVmax < 4, size < 14, and has pleural effusion the MPM risk is approximately 4%. These patients can undergo biopsy/cytology/follow-up. Novel studies are needed for these patients.

The present study aims to evaluate the effect of lower or higher eggshell temperatures from days 7 to 21 on hatching performance, bone and blood parameters, and egg production along with the age of laying chickens. A total of 3150 eggs obtained from a white egg-type breeder were divided randomly into 3 groups of 1050 eggs. From 7 to 21 days, eggs were incubated at one of three eggshell temperatures: Control (IC) 37.5 degrees C, low (IL) 36.9 degrees C, and high (IH) 38.5 degrees C. At hatch, chicks were weighed, and blood was collected to measure total Ca, inorganic P, and ALP level weights, dimensions, and ash contents of femur, humerus, and tibia were obtained. A total of 240 chicks from each incubation temperature were reared up to 58 weeks. The results showed that hatchability was similar among the eggshell temperature groups. The IL chicks had the heaviest chick weight and yolk free chick weight. The IH group had reduced chick weight compared to IL and IC but increased lengths of tibia and humerus, ash contents of tibia and femur, and blood Ca levels at the day of the hatch. Laying hens from the IH group had impaired body weight during the laying cycle. At 58 weeks, there was no effect of eggshell temperature on egg production, bone length, and width. IH hens had lower tibia ash and serum Ca but higher P and ALP levels compared to IL and IC groups. However, bone mineral content and mineral density were similar for hens from different eggshell temperature groups. in conclusion, it appeared that although chicks from the IH group had reduced chick weight, they had improved bone morphology and ash content of bones compared to IC and IL at hatch. However, IH hens could not maintain the higher ash content during the grow-out and laying periods. The results indicate that the positive effect of IH incubation temperature on bone morphological measurements and ash content of tibia would not be long term., Ministry of AgricultureGida Tarim Ve Hayvancilik Bakanligi [TAGEM/HAYSUD/A/17/A06/P01/02], This study was supported by the Ministry of Agriculture, project number TAGEM/HAYSUD/A/17/A06/P01/02.

Resumen Introduccion Es dificil adoptar un enfoque cientifico basado en la evidencia con respecto al intervalo de aplicacion de la ablacion de restos con yodo radiactivo (RRA) en pacientes con carcinoma diferenciado de tiroides (DTC). El objetivo principal del estudio fue revelar si el intervalo de aplicacion de la RRA esta relacionado con la obtencion de una respuesta no estructuralmente incompleta (no SIR) en pacientes de bajo/intermedio y alto riesgo. Otro objetivo era revelar la correlacion entre el plazo de aplicacion y el estado no SIR en las mujeres en edad reproductiva. Materiales y metodos Se analizaron retrospectivamente los registros de 279 pacientes de bajo, intermedio y alto riesgo. El «intervalo de aplicacion» se refiere al numero de dias entre la cirugia y la RRA. Las pacientes de bajo/intermedio riesgo, las pacientes de alto riesgo y las mujeres en edad reproductiva de bajo/intermedio riesgo se dividieron en grupos SIR y no SIR, de acuerdo con las guias de 2015 de la Asociacion Americana de Tiroides para la respuesta terapeutica. Se analizo estadisticamente la relacion entre el intervalo de aplicacion y la respuesta terapeutica. Resultados No se observo ninguna relacion significativa en pacientes con riesgo bajo/intermedio entre el intervalo de aplicacion y la respuesta no SIR, incluidas las mujeres de 18 a 49 anos de edad (p > 0,1). Para los pacientes de alto riesgo, se encontro una relacion estadisticamente significativa entre el intervalo de aplicacion y la respuesta no SIR. Segun el analisis ROC, se encontro que el valor limite era RRA ≤ 58 dias. Se calcularon la sensibilidad, especificidad, cociente de probabilidad positivo y cociente de probabilidad negativo en 83,3%, 70,0%, 2,78 y 0,24, respectivamente. Conclusion La RRA debe comenzar dentro de los 58 dias despues de la cirugia en pacientes con DTC de alto riesgo. De este modo, se puede reducir el riesgo de SIR y el riesgo de mortalidad asociado. Para las mujeres en edad reproductiva con grupos de riesgo bajo/intermedio, se puede planificar el plazo de aplicacion de la RRA de acuerdo con los planes que tengan en cuanto al embarazo o la lactancia. Para otros grupos de riesgo bajo/intermedio, se puede proceder con seguridad de acuerdo con la capacidad de la instalacion medica y las consideraciones logisticas relacionadas.

Magnesium (Mg) deficiency may affect bone metabolism by increasing osteoclasts, decreasing osteoblasts, promoting inflammation/oxidative stress, and result in subsequent bone loss. The objective of the present study was to identify the molecular mechanism underlying the bone protective effect of different forms of Mg (inorganic magnesium oxide (MgO) versus organic magnesium picolinate (MgPic) compound) in rats fed with a high-fat diet (HFD). Forty-two Wistar albino male rats were divided into six group (n = 7): (i) control, (ii) MgO, (iii) MgPic, (iv) HFD, (v) HFD + MgO, and (vi) HFD + MgPic. Bone mineral density (BMD) increased in the Mg supplemented groups, especially MgPic, as compared with the HFD group (p &lt, 0.001). As compared with the HFD + MgO group, the HFD + MgPic group had higher bone P (p &lt, 0.05) and Mg levels (p &lt, 0.001). In addition, as compared to MgO, MgPic improved bone formation by increasing the levels of osteogenetic proteins (COL1A1 (p &lt, 0.001), BMP2 (p &lt, 0.001), Runx2 (p &lt, 0.001), OPG (p &lt, 0.05), and OCN (p &lt, 0.001), IGF-1 (p &lt, 0.001)), while prevented bone resorption by reducing the levels of RANK and RANKL (p &lt, 0.001). In conclusion, the present data showed that the MgPic could increase osteogenic protein levels in bone more effectively than MgO, prevent bone loss, and contribute to bone formation in HFD rats.

Objectives: In this study, we aimed to investigate the predictive value of pre-ablative stimulated thyroglobulin (Tg) and Tg/thyroid-stimulating hormone (TSH) to identify lymph node metastasis (LNM) or distant metastases (DM) prior to radioactive iodine (RAI) treatment. Methods: Patients without metastasis were included in group 1 (n=100), those with LNM were included in group 2 (n=83), and those with DM constituted group 3 (n=23). Tg and TSH values were measured approximately 4 hours prior to RAI ablation therapy. Results: There was a significant difference between group 3 and other groups (group 1 and group 2) in terms of Tg (p

In this study, we aimed to compare osteoporosis (OP)-related bone mineral density, and bone turnover (markers of formation, and resorption) between patients with Fibromyalgia Syndrome (FMS) and degenerative disc disease, and to determine the relationship of these parameters with clinical, functional and emotional evaluation outcomes in FMS. Fifty premenopausal women with FMS and 50 premenopausal female control patients with degenerative disc disease were enrolled. The patient and physicians global assessment of disease were assessed on a visual analog scale (VAS). Disease severity was determined with the Fibromyalgia Impact Questionnaire (FIQ). For the evaluation of fatigue The Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) were used. The quality of life of all patients was evaluated using Nottingham Health Profile (NHP), Oswestry Disability Index (ODI), and QUALEFFO-41. The emotional state of all patients with chronic pain was evaluated with Hospital Anxiety and Depression Scale (HADS). Bone turnover markers [serum bone-specific alkaline phosphatase (bALP) and serum osteocalcin as markers of bone formation, serum â-isomerized Carboxy-terminal telopeptide of collagen type I (â-CTX) and urine hydroxyproline (OH-Pro) as markers of bone resorption], serum parathyroid hormone (PTH) and 25-hydroxyvitamin D [25(OH)D] levels, lumbar spine and left proximal femur bone mineral density (BMD) and T scores were measured in both groups. The FIQ, MFIS, FSS, NHP, ODI, QUALEFFO-41, HADS-A and HADS-D scores were statistically significantly higher in the FMS group relative to the patient control group. A significant difference between FMS and patient control group as for bone formation (bALP and osteocalcin) and resorption (â-CTX ve OH-Pro) markers was not detected. In the FMS group lumbar spine and left proximal femur BMD and T score values were significantly lower when compared with the patient control group. In the FMS group significant correlations were found between serum 25(OH)D and â-CTX values and VAS scores evaluated by the patient and physician, SS scale, FIQ, MFIS, ODI, QUALEFFO-41 and NHP scores. In conclusion many factors including depression and anxiety attacks, the presence of widespread pain and a decline in physical activity level and quality of life in FMS patients make them more prone to osteoporosis. In patients with FMS, osteoporosis is a major cause of morbidity and should not be neglected. [Med-Science 2018; 7(1.000): 9-16]

14th Congress of the Balkan-Cities-Association-of-Nephroogy-Dialysis-Transplantation-and-Artificial-Organs -- SEP 20-23, 2018 -- Budva, MONTENEGRO WOS:000547335800002 Objective: We compared the glomerular filtration rate (GFR) values as measured by the gamma camera and eGFR methods, calculated by the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula in patients who underwent diethylenetriamine penta-acetic acid (DTPA) dynamic renal scintigraphy for suspected obstructive uropathy. Materials and Methods: A total of 59 patients were included in this retrospective study. On the basis of the eGFR results, patients were divided into three groups; eGFR >90 mL min-1 (Group 1), 60-90 mL min-1 (Group 2), and

Aim: Thyroidal incidentalomas (Tis) detected by F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18FDG PET/CT) may be associated with three different causes that include metastasis of another malignancy, primary thyroid gland malignancies and lastly benign thyroidal nodules, all require different clinical approaches. For appropriate treatment, quick characterization of the Ti is important, preferably with a lesser invasive method. Our aim was to determine whether the characterization of TIs can be performed with FDG-PET/CT, due to contribute faster diagnosis, and initiation of the therapy.Material and Methods: Forty-four patients with detected TIs in FDG-PET/CT were included in the study. The relationship between metabolically/morphological parameters and pathology results were evaluated statistically. If two subsequent cytology were negative, nodule accepted as benign. If cytology result was suspected or malignant, histopathological confirmation was made. For these patients, histopathological results were accepted as definite diagnosis. Results: Malignant thyroidal pathologies were detected in 29.5% of patients. We could not find any significant relationship between age, nodule size and SUVmax value and pathology results. According to ROC analysis, there were not any cut-off value for nodule size and SUVmax. Similar results were also obtained for papillary carcinoma as a special subgroup.Conclusion: Characterisation of TIs could not be performed by using age, nodule size and SUVmax. Therefore, TIs which detected by FDG-PET/CT should be examined pathologically due to high risk of malignancy.Keywords: Thyroidal incidentalomas; FDG-PET/CT; malignant; characterization.

Langerhans cell histiocytosis (LCH) is a benign disorder related to the histiocytes which can infiltrate bone tissue. The most effective method for demonstrating severity of this disease is PET/CT and bone scintigraphy might show bone lesions. We present a seventeen year old male patient with disseminated LCH presented with exophtalmos and having multiple vertebral lesions which were identified by F-18 FDG PET/CT scan and diagnostic CT but not in the bone scintigraphy.Langerhans hücreli histiositoz (LHH) histiyositlerle ilişkili kemiği infiltre edebilen iyi huylu bir hastalıktır. Bu hastalığın yaygınlığını gösteren en etkili metod PET/BT’dir ve kemik sintigrafisi de kemik lezyonlarını gösterir. Yaygın LHH tanısı ve egzoftalmus ile takip edilen, çoklu vertebral lezyonları F-18 FDG PET/BT ve tanısal BT tetkikleri ile saptanan ancak kemik sintigrafisinde tespit edilemeyen, on yedi yaşında erkek hastayı sunmaktayız.

Background: There are some problematic results in determination of differential renal function (DRF) by means of Tc-99m DMSA renal scintigraphy in hydronephrotic kidneys. In this study the classical method (CM) and unit area methods (UAM) in the estimation of DRF in unilateral hydronephrosis before and after intervention were compared. Methods: Twenty patients (12 M, 8 F; mean: 42.6±18.5 years old) who were candidates for surgery or intervention because of unilateral hydronephrosis were the subjects of this study. All the patients were evaluated by Tc-99m DMSA scintigraphy before and 3–6 months after the intervention. In order to estimate DRF both CM and UAM (obtained by division of the counts including the kidney ROI to pixel of the same ROI) were performed. Bland-Altman analyses were performed in order to compare the DRF values obtained from both methods. Results: The agreement between CM and UAM was poor in the preoperative estimation, however, the agreement was good after the operation or intervention. Conclusions: In this study it seems that DRF estimation with CM in unilateral hydronephrosis might be problematic in the determination of surgery thus UAM might be introduced as the method of choice in the determination of DRF in unilateral hyronephrosis.

Background: The most widely accepted approach nowadays in nodal staging of non–small cell lung cancer (NSCLC) is the combined use of 18-Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) and endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA). However, this approach may not be sufficient, especially for early stages. Aims: Our aim was to assess whether more satisfactory results can be obtained with standardized uptake value maximum lymph node/standardized uptake value mean mediastinal blood pool (SUVmax LN/SUVmean MBP), SUVmax LN/Primary tumor, or a novel cut-off value to SUVmax in this special group. Subjects and Methods: Patients with diagnosed NSCLC and underwent FDG-PET/CT were reviewed retrospectively. 168 LNs of 52 early stage NSCLC patients were evaluated. The LNs identified in surgery/pathology reports were found in the FDG-PET/CT images. Anatomic and metabolic parameters were measured. Statistical analysis was performed by using of MedCalc Statistical Software. Results: Regardless of LNs size; sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SUVmax >2.5 were 91.5%, 65.9%, 58.2%, and 95.1%, respectively. Optimum cut-off value of SUVmax was >4.0. Sensitivity, specificity, PPV, and NPV were found as 81.0%, 90.0%, 81.0%, and 90.0% respectively. Optimum cut-off value of SUVmax LN/SUVmean MBP was >1.71. Sensitivity, specificity, PPV, and NPV were found as 94.7%, 80.0%, 71.1%, and 96.7%, respectively. Optimum cut-off value of SUVmax LN/Primary tumor was >0.28. Sensitivity, specificity, PPV, and NPV were found as 81.1%, 85.1%, 72.9% and 90.1%, respectively. Conclusion: SUVmax LN/SUVmean MBP >1.71 has higher PPV than currently used, with similar NPV and sensitivity. This can provide increase in the accuracy of combined approach. In this way, faster nodal staging/treatment decisions, cost savings for healthcare system and time saving of medical professionals can be obtained.

Objective: Pulmonary thromboembolism (PTE) named due to migration of clots formed in systemic venous system to pulmonary vascular bed is a serious clinical table. After acute DVT, asymptomatic PTE is seen about 40-60% and this situation can not be discovered because of silent clinical course. In this study, we aimed to compare sensivity and spesifity of multi detector computerized tomography (MDCT), which is used extensively in recent years, with ventilation-perfusion (V/P) scintigraphy which is used formerly for diagnosis of asymptomatic PTE developed after acute lower extremity DVT. Methods: The study was carried out 25 patients who were admitted to our clinic and treated for lower extremity acute DVT. Pregnants, and cases with recurrent DVT, presence of symptomatic PTE during admission, thrombosis extending to vena cava, and history of passed PTE were excluded from the study. DVTs in patients were diagnosed by color doppler, and confirmed by D-dimer test. After patients\'s admission, V/P scintigraphy and MDCT were used to detects asymptomatic PTE at 1st and 8 th day of the admission. Results: D-dimer was measured as higher in 24 of 25 patients with asemptomatic PTE. Ten patients were diagnosed by MDCT. Development of asymptomatic PTE related to acute DVT was determined as 40%. Conclusion: In terms of diagnostic value, MDCT was found more useful than V/P scintigraphy., Amaç: Pulmoner tromboemboli (PTE) sistemik venöz sistemde oluşan pıhtıların pulmoner vasküler yatağa göçü ile ortaya çıkan klinik tabloya verilen isimdir. Akut derin ven trombozu (DVT) sonrası ortalama %40-60 oranında asemptomatik PTE görülmekte ve bu durum sessiz klinik seyir nedeniyle fark edilmemektedir. Bu çalışmamızda akut alt ekstremite DVT\'sine bağlı gelişen asemptomatik PTE tanısında hala günümüzde önemli bir yer tutan ventilasyon-perfüzyon (V/P) sintigrafisi ile son yıllarda kullanılmaya başlanan multi-detektor bilgisayarlı tomografinin (MDBT) sensitivite ve spesifitesini karşılaştırmayı amaçladık. Yöntemler: Çalışma alt ekstremite akut DVT nedeniyle kliniğimize yatırılarak tedavisi planlanan 25 hastada gerçekleştirildi. Gebeler, nüks DVT vakaları, müracaat esnasında semptomatik PTE tablosu olanlar, vena kavaya uzanım gösteren trombüsü olanlar, önceden geçirilmiş PTE öyküsü olanlar çalışmaya dahil edilmedi. Hastalarda DVT tanısı renkli doppler USG ile konulup, D-dimer testiyle teyit edildi. Hastalara yatışının 1.ve 8. günlerinde V/P sintigrafisi ve MDBT yapılarak asemptomatik PTE varlığı araştırıldı. Bulgular: Pulmoner tromboemboli açısından asemptomatik olan 25 DVT hastasının 24\'ünde D-dimer normalin üstünde ölçüldü. MDBT ile 10 hastaya PTE tanısı konuldu. Akut DVT\'ye bağlı %40 oranında asemptomatik PTE geliştiği tespit edildi. Sonuç: Multi-detektor bilgisayarlı tomografi tanı değeri açısından V/P sintigrafisinden daha faydalı bulundu.

Aim: The bone scintigraphy is indicated in patients with costochondral pain in order to identify the organic etiology. We aimed to investigate the local and projecting pain, or incidental findings in the three phase bone scintigraphy of the patients referred for costochondral pain. Methods: We included 50 patients (36F, 24M; mean: 41±18 years-old) referred to our department for three phase bone scintigraphy for costochondral pain between January 2009-July 2012. Results: Among the 50 patients 22 had normal scintigraphy. An increased activity accumulation in the sternoclavicular joint was observed in 12 patients (right in 4, left in 4 and bilateral in 4) only in late phase and in 9 patients (right in 2, left in 1 and bilateral in 6) with increased vascularity. Among projecting pain causes, activity was present on sternum in 4 patients, on humerus in 2 patients and on the first costae in 2 patients. For the characterization of inflammatory pathology, the three phase bone scintigraphy showed sensitivity, specificity, accuracy, positive and negative predictive values of 43%, 94%, 78%, 77% and 78% respectively. Conclusion: Bone scintigraphy is an effective diagnostic method for the identification of local or projecting pain, and additionally unexpected incidental pathologies ssociated with costochondral pain. However regarding the characterization of inflammatory process false negatives should be considered. Conflict of interest:None declared.

Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation-perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches. Conflict of interest:None declared.

Aim: Diagnosis of the hepatic hemangiomas is sometimes difficult by means of computed tomography (CT) or ultrasound (USG). This kind of lesions can be accurately identified by Tc-99m labeled erythrocyte -red blood cell (RBC) imaging. However there are controversial results about small lesions (

Coronary artery disease is one of the most common and important health problems in the world. Early diagnosis of this disease is very important to treat before severe myocardial damage occurred. Myocardial perfusion scintigraphy (MPS) and computed tomography coronary angiography (CTCA) which evaluates regional myocardial perfusion and coronary arteries, respectively, are reliable and non-invasive methods in terms of coronary artery disease. In this study we aimed to compare MPS and CTCA based on conventional coronary angiography (CCA). Totally 60 patients were included in the study. CCA and MPS were performed to 30 patients; CCA and CTCA were performed to the rest of the patients (30 patients). Lesions were classified as mild, moderate and severe in these imaging methods. MPS and CTCA were compared with CCA by using chi-square and Fisher’s exact test. MPS and CTCA’s p values were found for left anterior descending artery (LAD) p: 0, p: 0.271; for circumflex artery (Cx) p: 0.256, p: 0.08 and for right coronary artery (RCA) p: 0.033, p: 0.271, respectively. Furthermore MPS and CTCA’s sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated 81% to 87%; 70% to 49%; 73% to 72%; 54% to 72%; 90% to 71%, respectively. CCA results were found more concordant with MPS for LAD and RCA lesions and more concordant with CTCA for Cx lesions. It was also found that positive predictive value of MPS and negative predictive value of CTCA were significantly higher than the others. As a result, MPS and CTCA were suggested as complementary techniques for the diagnosis of coronary artery disease, not as alternatives to each other.

Objective To assess whether more accurate mediastinal lymph nodes radiotherapy can be performed with fluorode oxyglu cosepositron emission tomogaphy/computed tomography. METHODS The retrospective study was conducted at Inonu University Medical Faculty, Malatya, Turkey, and Afyon Kocatepe University Medical Faculty, Afyon, Turkey, and comprised record of patients histopathologically diagnosed with non-small cell lung carcinoma and who underwent fluorodeoxyglucose positron emission tomography / computed tomography between January 2013 and December 2016. Surgery and pathology reports of the patients were reviewed. Histopathologically proven malignant and benign lymph nodes were re-identified with fluorodeoxyglucose positron emission tomography / computed tomography imaging. Anatomical and metabolic parameters of lymph nodes were re-assessed by specialists and compared with histopathology reports. Maximum standardised uptake values were used to assess sensitivity, specificity, positive predictive value, and negative predictive values. SPSS 22 was used for data analysis. RESULTS The study included 144 mediastinal lymph nodes related to 42 patients who had a mean age of 62.4±9.8 years (range: 41-79 years). In terms of subtypes of the primary squamous cell carcinoma was found in 24(57.2%) patients, adenocarcinoma in 12(27.5%), and other subtypes in 6(15.3%) patients. Of the 144 lymph nodes, 48(33.3%) were metastatic. Sensitivity, specificity, positive predictive value, and negative predictive value were 92.8%, 64.3%, 56.9%, and 94.7%, respectively when maximum standardised uptake value >2.5 was used as the malignancy criterion. When lymph node maximum standardised uptake value / liver standardised uptake value-mean>1.69 was used as the criterion, the sensitivity, specificity, positive predictive value, and negative predictive value were 95.83%, 91.67%, 85.2%, and 97.8%, respectively. When the same values with lymph node >8mm was used as the criterion, the four resultant values were 89.6%, 93.8%, 87.8%, and 94.7%, respectively. When lymph node was replaced with mean attenuation >35 as the criterion, the consequent values were 79.2%, 93.8%, 86.4%, and 90.0%, respectively. CONCLUSIONS Lymph node maximum standardised uptake value / liver standardised uptake valuemean> 1.69 was associated with higher negative predictive value and more useful positive predictive value compared to maximum standardised uptake value >2.5. When this parameter was used along with short axis or mean attenuation value, there were no significant increase in positive predictive value, but there was a decrease in negative predictive value.

1. Soy isoflavones play a role in calcium and bone metabolism. Poor egg quality, skeletal abnormalities and architectural deterioration of bone tissue are common problems under hot climate conditions and with increased age in poultry. 2. In this study, we investigated the effects of soy isoflavone supplementation on egg production, egg quality, bone mineral density (BMD), levels of osteocalcin (OC), vitamin D, calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) activity in quail (Coturnix coturnix japonica) during the late laying period. 3. The birds (n = 180; 28 weeks old) were randomly assigned to 6 treatment groups consisting of 6 replicates of 5 birds each in a 2 x 3 factorial arrangement of treatments (temperatures, soy isoflavone concentration). Birds were kept in wire cages in a temperature-controlled room at either 22 degrees C (thermo-neutral, TN) or 34 degrees C (heat stress, HS) for 8 h/d (09:00 to 17:00 h; until the end of the study) and fed either on a basal (control) diet or on the basal diet supplemented with either 400 or 800 mg of soy isoflavones/kg of diet. 4. Heat exposure reduced feed intake, egg production, egg quality, BMD, OC, vitamin D, Ca, P and ALP when the basal diet was given. Feed intake, egg production and egg weight were not affected, while eggshell thickness and eggshell weight increased in soy isoflavone-supplemented quails reared under TN conditions. However, feed intake, egg production, egg weight, eggshell thickness, eggshell weight and Haugh units were positively influenced by soy isoflavone supplementation in HS groups for quail during the late laying period. Bone mineral density, serum OC, vitamin D, Ca, P levels and ALP activity were significantly improved by soy isoflavone supplementation in both the TN and HS groups in quail during the late laying period. 5. Soy isoflavone supplementation of basal diet significantly improved egg quality and bone mineralisation in quail during the late laying period.

The aim of this study was to investigate possible correlations of the cognitive impairment with abnormalities of regional cerebral blood flow and electroencephalogram in children with (Down's Syndrome) DS. Nine patients with DS were evaluated by single photon emission computed tomography (SPECT) in combination with clinical findings, electroencephalography (EEG), and magnetic resonance imaging (MRI). In cases with IQs below 40, there were one or more findings of abnormal EEG/MRI and brain perfusion SPECT. In 6 cases (66.7%) EEG findings were normal, but 3 (33.3%) had abnormal EEG findings. Perfusion abnormalities were most pronounced in the fronto-parieto-temporal region in the form of hypoperfusion (n = 5) and in the right hemisphere (n = 5) than the left hemisphere (n = 1). These findings suggest that the children with DS had varying levels of structural, perfusion, and electrophysiological abnormalities in the brain and these abnormalities were reflected by measurable alterations of the cognitive functions.

Fragile X syndrome is an inherited disorder caused by a defective gene on the X chromosome. It is associated with developmental or behavioral symptoms and various degrees of mental retardation. Morphologic abnormalities and altered perfusion of various brain areas can underlie these functional disturbances. The aim of this study was to investigate the cerebral perfusion state in patients with fragile X syndrome using single-photon emission computed tomography (SPECT). Structural and functional assessment was also performed by magnetic resonance imaging (MRI) and electroencephalography (EEG). Eight boys with cytogenetically confirmed fragile X syndrome (mean age 8.8 ± 4.4 years, range 5–18 years), were included. All patients had mental retardation, with a mean IQ of 58.9 ± 8.8 (range 40–68), and additional neurobehavioral symptoms. SPECT revealed cerebral perfusion abnormalities in six patients (75%), most commonly in the frontoparietotemporal area and prominent in the right hemisphere. The SPECT and EEG findings were concordant: hypoperfused areas in SPECT corresponded to regions of persistent slow-wave paroxysms on EEG. On the other hand, cranial MRI was abnormal qualitatively only in two patients (25%) showing cerebellar and vermal hypoplasia and cerebral hemispheric asymmetry. Our results indicate that cerebral perfusion abnormalities, which are correlated with electrophysiologic findings but not necessarily with anatomic abnormalities, can underlie the pathogenesis of the clinical findings observed in fragile X syndrome.

The aim of the present study was to determine the effect of a chlorhexidine chip on crevicular prostaglandin E2 (PGE2) levels and on the clinical and microbiological parameters of periodontitis when used as adjunctive therapy to scaling and root planing (SRP) in patients with chronic periodontitis.This randomized single-blind study was carried out in parallel design. The test group received SRP plus chlorhexidine chip, whereas the control group received SRP alone. Thirty-four subjects, aged 20 to 55 years, with chronic periodontitis were recruited. Clinical indices, microbiological samples, and gingival crevicular fluid (GCF) samples were evaluated at baseline and after 1, 3, and 6 months. Microbiological samples were evaluated under a light microscope. GCF PGE2 levels were determined using radioimmunoassay.Significant improvements could be found for all clinical variables in both groups over the study period. The mean changes in probing depth obtained by SRP plus chlorhexidine chip were greater than those obtained by the SRP alone group at 3 and 6 months. In the test group, there was also significant gain in clinical attachment level at 6 months. When data were combined from all groups, significant reductions in GCF PGE2 levels and number of microorganisms were noted at all time points. However, in the test group, reduction was greater at 6 months for crevicular PGE2 level and at 3 and 6 months for proportions of spirochetes.Based on the findings of this study, the chlorhexidine chip reduced GCF PGE2 levels and had positive effects on clinical parameters and subgingival flora when used as adjunctive therapy to SRP in patients with chronic periodontitis.

There is still much controversy regarding the optimal treatment for pulmonary contusion. Therefore, we examined the variables affecting patient outcomes over a 10-year period. We retrospectively reviewed 107 consecutive patients with a mean age of 28 years, who were treated for pulmonary contusion during a 10-year period. Pulmonary perfusion scans were obtained for 11 patients. We used a pulmonary contusion score (PCS) of one-third of a lung = 3 and the entire lung = 9. Overall mortality was 15%, which increased to 24.4% in patients with a PCS of 7–9. The time taken for contusions to resolve was longer based on scan results than chest X-rays (42.6 vs 15.5 days, respectively). Concomitant thoracic injures were present in 64.5% of patients, and 29% had a flail chest. The factors predictive of mortality were age ≥60 years, an injury severity score (ISS) ≥25, transfusion of ≥4 units of blood, a PaO2/FIO2 ratio of

Cortical visual impairment (CVI) most commonly occurs in children after hypoxic insults but may also occur as a sequel of meningitis, encephalitis, head trauma, and hydrocephalus. CVI secondary to hypoglycemia is rarely encountered. A 4-year-old girl was admitted to hospital with a history of bilateral visual impairment. She had several severe hypoglycemic attacks lasting a week in the neonatal period. Bilateral occipital gliotic lesions were defined on magnetic resonance imaging (MR). [99mTc]-hexamethyl propylene amine oxime (HMPAO) brain single-photon emission computerized tomography (SPECT) was performed to determine the cerebral blood flow (CBF). SPECT images showed an extended hypoperfusion area in the right parieto-temporal region with marked non-perfusion areas in bilateral occipital cortices. It should be noted that hypoglycemia has devastating effects on cerebral tissues including optical areas and thus resulting in CVI. We would like to emphasize the importance of early diagnosis and prompt trea...

UNLABELLED We present a 20 year-old male patient who had prominent positional proptosis of the right eye and admitted to the hospital for tonsillectomy operation. After conventional ophthalmological examination, magnetic resonance imaging (MRI) and Tc 99m labeled erythrocyte scintigraphy were performed to confirm the diagnosis. Although it is rare to perform scintigraphy for this pathology, the visualization of intraorbital hemangioma was very obvious and we would like to present the visualization of the intraorbital hemangioma both with scintigraphy and MRI. CONFLICT OF INTEREST None declared.

Limb-salvage operations such as vascularised or non-vascularised osseous grafts and allograft and callus distraction methods have replaced amputations because of the increase in the life expectancy of patients with malignant tumours. In this study we aimed to evaluate the effects of chemotherapeutic agents on distraction osteogenesis. For this purpose, 23 rabbits randomly divided into two groups were included in the study. The experimental group and the control group consisted of 12 rabbits and 11 rabbits, respectively. The experimental group were administered chemotherapeutic agents with the protocol identified in the osteogenic sarcoma regimen. All the subjects were corticotomised in the metaphyseal-diaphyseal region, and both groups underwent distraction with a circular ring fixator. X-ray films, bone scintigraphy and histopathological examination were performed three times during the study. No difference between the two groups was observed in radiological, scintigraphical and histopathological studies carried out before the distraction period and following the end of the distraction period. In this study, it was shown that the use of antineoplastic drugs has no significant negative effect on distraction osteogenesis applied for reconstruction in rabbits. We think that it can be an alternative treatment method in humans as well.

Purpose The aim of this study is to investigate the frequency and the spread of abdominal lymph node metastasis in patients with non-small-cell lung cancer (NSCLC) by (18)F-FDG PET/CT. Patients and methods Retrospective evaluation of the (18)F-FDG PET/CT examinations of 1191 patients diagnosed with NSCLC was performed. The metastatic abdominal lymph nodes of the patients were classified as inside the routine imaging field (covering the field of chest CT including adrenal glands) and outside the field. Results Seventy-four patients (6 F, 68 M; mean: 61 ± 11 years old) among 1191 patients (6%) were identified to have abdominal lymph node metastases. These abdominal lymph node metastasis changed management in 10 out of 74 patients (14%), and there were lymph node metastases outside the routine conventional imaging field in 43 (58%) patients. Conclusion (18)F-FDG PET/CT provided identification of the distant metastatic lymph nodes out of conventional imaging field in more than half of NSCLC patients with abdominal metastasis which changed patient management in 14% of the patients due to abdominal lymph node metastasis outside the routine imaging field. This study shows the necessity of imaging NSCLC patients with an imaging protocol with larger imaging field like PET/CT.

This study retrospectively evaluated the surgical indications and outcomes of 86 patients with bronchiectasis.Between 2000 and 2013, the clinical and surgical specifications as well as follow-up results of patients with bronchiectasis were reviewed. Cystic and cylindric morphologic features were determined by chest computed tomography and hemodynamics (perfused and nonperfused), by lung ventilation/perfusion scans. The main indication for surgical resection was localized areas of cystic, nonperfused bronchiectasis.Patients were a mean age of 37.8 ± 14.5 years. Symptom duration was 43.4 ± 36.9 months. Bronchiectasis was saccular in 66 patients (76.7%) and varicose in 20 (23.3%). Localized defects were limited in one region of the lung in 53 (61.6%), and 54 (62.8%) showed a mixed or an obstructive ventilatory pattern. Failure of medical therapy was the most common indication for pulmonary resection. The 86 patients underwent 98 operations. Ten underwent staged thoracotomies (contralateral lobectomy, 7; contralateral segmentectomy, 3). Complete resection of all bronchiectatic areas was done in 78 patients (90.7%). Complications developed in 14 patients (14.6%). The mortality rate was 1.1% (n = 1). After surgical treatment, 71 of 86 patients (82.5%) were free of symptoms (excellent), and the remaining 15 (17.5%) had a reduction in preoperative symptoms. The 53 patients with localized perfusion defects underwent complete resection and had symptom-free (excellent) postoperative results. Complete resection independently predicted symptom-free outcome (p0.05); a forced expiratory volume in 1 second of less than 60% of the predicted value, an incomplete resection, and a preoperative antibiotic therapy independently predicted postoperative complications (p0.05).Bronchiectasis can be improved with operation. In properly selected patients, pulmonary resection can be done with acceptable morbidity and mortality rates and can lead to lasting symptomatic improvements.

At present a large number of the renal transplantations are being performed from the deceased donors. The success of these transplantations depends on the viability of the deceased donor kidneys. The aim of this study was to investigate the reliability of scintigraphic estimation of function of deceased donor kidneys by comparing the histopathologic and scintigraphic findings. Ten rats were included in the study (2-3 months old, 250-300 g, all male). Control scintigraphy was performed to all the rats by injection of 37 MBq Tc-99m DTPA from the tail vein in a dynamic manner. Brain death of the rats was achieved by inflation of a Fogartys catheter in the cranial cavity. Immediately, after brain death confirmation, dynamic renal scintigraphy was performed with the same parameters of control scintigraphy. In the comparison of scintigraphies obtained in the before and just after brain death period, there was impairment of tubular functions, concentration and excretion functions in the postbrain death period. In the immediate postbrain death period, there was a significant elevation in the glomerular filtration rate and time to maximum concentration values. In the histopathological evaluation of the kidney samples in the postbrain death period, there were definitive findings of tubular impairment. Dynamic renal scintigraphy also demonstrated definite impairment of tubular system and tubular functions in the deceased donor kidneys. This could explain the reason of the increased frequency of acute tubular necrosis seen among deceased donor kidneys.

The role of positron emission tomography/CT (PET/CT) in diagnosis and follow-up of newborns with hypoxic ischaemic encephalopathy has been documented before; however, this is the first presentation of elder children with both diagnostic and follow-up PET/CT results as far as we know.

OBJECTIVE: Since twenty-four-hour imaging by Tl-201 myocardial perfusion scintigraphy has been introduced as an effective additional procedure, the aim of this study was to compare this method's result with only rest redistribution procedure in the diagnosis of myocardial viability. METHODS: Thirty patients (Seven female, 23 male; mean: 59.8 ± 10.7, 55.8-63.8 years old) with diagnosis of coronary artery disease were involved in this study. All patients had anamnesis of previous myocardial infarction and/or total occlusion of any main artery in the coronary angiography. Myocardial perfusion scintigraphy with Tl-201 with rest four hour (early) redistribution and 24 hour delayed redistribution protocol were performed to all of the patients. The images were evaluated according to 17 segment basis by an experienced nuclear medicine physician and improvement of a segment by visual interpretation was considered as viable myocardial tissue. RESULTS: Viability was found at 52 segments in the early redistribution images and additional 18 segments in the 24 hour delayed redistribution images on segment basis in the evaluation of 510 segments of 30 patients. On per patient basis, among the 26 patients who had viable tissue, 14 (54%) had additional improvement in 24 hour delayed images. Three (12%) patients had viable tissue in only 24 hour delayed images. CONCLUSION: Delayed imaging in Tl-201 MPS is a necessary application for the evaluation of viable tissue according to considerable number of patients with additional improvement in 24 hour images in our study, which is restricted to the patients with myocardial infarct.

The aim of this study was to evaluate gall bladder visualization in lymphoscintigraphy of extremities.Thirteen patients who had prediagnoses of lymphedema and were referred for lower extremity lymphoscintigraphy to our department were retrospectively evaluated. Lower extremity lymphoscintigraphy with Tc-99m sulfur colloid was performed on the patients, and planar images of the lower extremity and abdominal region were taken in early phase and late phase (at the 24th hour) routinely. Lymphoscintigraphy results of eight patients were normal regarding lymphatic flow or lymph nodes; however, additional pathologic tracer accumulations in gall bladder were observed, which disappeared at 24th hour images in three patients. Five patients had various pathologies regarding lymph flow or lymph nodes. However, there were no patients with gall bladder activity except those three patients who had casual anamnesis of fasting prior to the exam.The fasting state of the patients might be the cause of gall bladder visualization during the lymphoscintigraphy of the extremities with sulfur colloid.

We retrospectively evaluated patients with end-stage renal disease (ESRD) who were referred to our department for parathyroid scintigraphy. The aim of this study was to investigate the causes of bone marrow uptake observed on parathyroid scintigraphy.We included 18 ESRD patients (10 F, 8 M; mean, 52 ± 13 years old; range, 45-59) in the study. The disease duration of the patients was mean 7.7 ± 4.7 years. The patients' mean plasma calcium and parathormone (PTH) levels were 9.7 ± 1.4 mg/dL and 1,553.3 ± 691.7 pg/mL, respectively. Dual-phase technetium-99m 2-methoxyisobutyl-isonitrile (Tc-99m MIBI) parathyroid imaging and, if necessary, additional Tc-99m pertechnetate scintigraphy were performed. Quantification of the planar early phase parathyroid images was performed for various regions (sternum, humerus, ribs) with the same size rectangular region of interest (ROI, 176 × 176 pixels). Average counts were compared with paired samples Student's t tests, and P.05 was considered statistically significant.Tc-99m MIBI parathyroid imaging revealed parathyroid hyperplasia, adenoma, and ectopic adenoma in 7, 3, and 2 patients, respectively. The other 7 patients had normal scintigraphy results with regard to parathyroid pathologies. Bone marrow uptake in the sternum, ribs, and humerus was observed in 6 patients. The difference between the average quantitative value obtained from the ROIs drawn on the sternum and humerus was also statistically significant compared to patients without bone marrow uptake (P.05). All 6 patients' exhibited extremely high PTH levels (2,000 pg/mL; mean, 2,413.7 ± 150 pg/mL) compared to the other 12 patients (mean, 1,342.8 ± 249 pg/mL).Our results show that bone marrow uptake on parathyroid scintigraphy is a consequence of extremely high PTH levels in ESRD patients; no further analysis is required.

Haemophagocytic lymphohistiocytosis (HLH) is a rare immune disorder that predominantly affects macrophages and T lymphocytes and leads to multiple organ disease and death. The characteristic pathological finding in the bone marrow and the other affected tissues is haemophagocytosis of macrophages (macrophages digesting erythrocyte). Primary (hereditary) and secondary (acquired) forms of the disease are present. A patient with documented HLH disease revealed by positron emission tomography/CT is reported in this paper.

17-days-old baby girl with continuous crying and persistent icterus attended to our hospital. Hepatobiliary scintigraphy was performed in order to diagnose aetiology of icterus and polianomaly of patient was incidentally found with scintigraphic imaging.

Objective: The effect of Celiac Disease (CD) on children’s bone is the decrease in bone mineral density (BMD). Osteoporosis is a consequence of this decrease and usually manifests in adult ages. Studies in CD patients generally show that bone density of these patients can be different at the same ages for the same duration of disease. The aim of this study is to investigate the relationship between age and bone mineral density of CD patients at first diagnosis. Material and Methods: Ninety one patients (M/F: 36/55; age range: 3-16; mean age: 9.6±3.5) with diagnosis of CD were included in the study. BMD survey from L1-L4 lumbar spine and total hip of the patients was evaluated at presentation. We evaluated the patients in 3 groups according to their ages: Group 1: pre-school (3-7 years old), Group 2: elementary school (8-11 years old) and Group 3: adolescent (12-16 years old). Results were compared using Student’s t test and correlation analysis. Results: The mean disease duration of the patients was 16.4±16.3 months. Mean height and weight of the patients were 124.8±17.9 cm and 27±9.3 kg, respectively and height and weight of 37 patients were in ≤ 3. percentile according to age. The BMD values of both lumbar spine and total hip and Z-scores of lumbar region were in mild correlation with age (r>0.5). There was significant difference between mean ages of patients with low bone mass for chronological age and normal bone densitometry values (p

1. The effects of 25-hydroxycholecalciferol (25-OH-D(3)) and soy isoflavones supplementation on performance, carcase recovery, bone mineral density, and tibia ash, Ca, P, and serum vitamin D concentrations and alkaline phosphatase activity in the Japanese quail (Coturnix coturnix japonica) exposed to high ambient temperature were evaluated. 2. A total of 270 ten-d-old Japanese quail were randomly assigned to 9 treatment groups, 6 replicates of 5 birds each in a 2 x 3 x 3 factorial arrangement of treatments. Birds were kept in a temperature-controlled room at either 22 degrees C (thermo-neutral) or 34 degrees C (heat stress) for 8 h/d (09:00-17:00 h) and given a basal (control) diet or the basal diet supplemented with one of three levels of 25-OH-D(3) (0, 250 and 500 IU/kg of diet) combined with one of three levels of soy isoflavones (0, 400 and 800 mg/kg of diet). 3. Birds kept at 34 degrees C consumed less feed and gained less weight than control birds. An increase in body weight, feed intake (and improvement in feed efficiency and carcase recovery were found in soy isoflavones and 25-OH-D(3)-supplemented quail reared under heat stress conditions. Bone mineral density, tibia ash, Ca, and P were linearly improved by 25-OH-D(3) and soy isoflavones supplementation in both thermoneutral and heat stress groups. Serum vitamin D levels and alkaline phosphatase activity were improved by 25-OH-D(3) and soy isoflavones supplementation in both thermoneutral and heat stress groups in quail. 4. In conclusion, a combination of 25-OH-D(3) and soy isoflavones supplementation to basal diet significantly improved bone mineralisation in quail.

Objectives To define a novel technique in the diagnosis of partial and complete ejaculatory duct obstruction (EDO). Methods Twenty men with suspected EDO were initially evaluated by transrectal ultrasound (TRUS). Subsequently, all patients underwent TRUS-guided seminal vesicle (SV) scintigraphy. Technetium Tc 99m sulphur colloid solution was injected into each SV under TRUS guidance and patients were immediately evaluated by scintigraphy. After patients ejaculated scintigraphy was repeated. The difference between 2 measurements in respect to technetium Tc 99m count was used to measure the percentage of emptying. Results In the first group, TRUS revealed 11 patients with findings suggestive of EDO, whereas no abnormality was found in 9. Scintigraphic measurement in first group of patients showed a mean emptying ratio for the right and left SVs of 16.6% ± 2.22 (2.2 to 30.6) and 17.1% ± 2.34 (1.4 to 32.5), respectively. The mean percent of emptied technetium Tc 99m from right and left SVs in patients with no pathologic findings on TRUS was 30.9% ± 4.3 (10.1 to 44.2) and 33.9% ± 5.81 (13.6 to 68.1), respectively. Statistically significant difference was determined between 2 groups ( P = 0.037). Initially, TRUS examination revealed no pathologic findings in 3 patients; however, SV scintigraphy showed less than 30% emptying and revealed an additional 33% of patients to be obstructed in our series. Conclusions TRUS, the static anatomic imaging modality, may not be sufficient to distinguish functional from complete obstruction. Seminal vesicle scintigraphy is unique that incorporates physiologic aspect of ejaculation into a diagnostic intervention, of which we believe that is especially important in diagnosis of functional EDO.

Fragile X syndrome (FXS) is known as the most common form of inherited mental retardation. In our study, brain perfusion single photon emission computed tomography (SPECT) was performed in a 6 year-old boy diagnosed with FXS. Diffuse bilateral uptake of Technetium-99m hexamethyl propylene amine oxime (99mTc-HMPAO) was noted in his orbits, as well as cortical perfusion defects (hypoperfusion in the right parietal and the left temporal lobe). Ophthalmologic examination showed no pathological findings. Magnetic resonance imaging (MRI) revealed no abnormality in the orbital structures, although hypoplasia of cerebellum and vermis was visualized. Since the patient was crying during the injection, the increased blood flow or the increased metabolism of the eyes and/or ocular muscles may be responsible for this orbital finding. Alternatively, the enhanced uptake of HMPAO in the orbits may reflect the pathology associated with FXS, because patients with FXS might have visual-motor abnormalities. To the best of our knowledge, there has been no report documenting such an orbital uptake of HMPAO. Moreover, the visualization of decreased cerebral perfusion, with the normal findings of MRI, indicates that brain SPECT imaging with HMPAO is helpful for detecting brain abnormalities in children with FXS.

We report a patient with DTPA and DMSA uptake on unsuspected bone metastases. He had severe pain due to grade 3 hydronephrosis of his left kidney. When Tc-99m DTPA and DMSA renal scanning were performed for preoperative evaluation, abnormal radiopharmaceutical uptake on the iliac area was noted. Pancreatic adenocarcinoma metastases to bone were subsequently defined. This patient is a very demonstrative case in respect of having all DTPA, DMSA and HDP uptakes in bone metastases. The type of the tumor has to be added to the list of extrarenal uptake of DTPA and DMSA as a rare cause.

Arginine silicate inositol complex (ASIdagger; arginine 49.5%, silicon 8.2%, inositol 25%) is a novel material which is a bioavailable source of silicon and arginine. ASI offers potential benefits for vascular and bone health. Poor eggshell quality has been a major economic concern to commercial egg producers. Poor egg quality, skeletal abnormalities and architectural deterioration of bone tissue are common problems under hot conditions and in older birds. The effects of ASI supplementation on egg production, egg quality, levels of osteocalcin (OC) and bone mineral content were investigated in heat-stressed Japanese quail during the later part of the laying period. The birds were randomly assigned to six treatment groups consisting of six replicates of five birds each in a 2 x 3 factorial arrangement of treatments (temperatures, ASI levels). The birds were kept in wire cages in a temperature-controlled room at either 22 degrees C (TN) or 34 degrees C (HS) for 8 h/d and fed either a basal (control) diet or the basal diet supplemented with either 500 or 1000 g of ASI/kg. Heat exposure reduced egg production, egg quality and bone mineralisation when the basal diet was fed. ASI supplementation had no effect on feed intake or egg production under TN or HS conditions. However, ASI supplementation increased egg weight, shell thickness, shell weight and Haugh unit in both TN and HS groups during the late laying period. Bone mineral density (BMD) was significantly improved by ASI supplementation in both TN and HS groups. Serum osteocalcin (OC) concentrations and alkaline phosphatase (ALP) activity increased linearly with dietary ASI supplementation during the late laying period. The amount of calcium and phosphorus in the excreta decreased, while ash, mineral content, calcium and phosphorus concentrations in tibia increased in ASI-supplemented quail in both TN and HS groups during the late laying period. ASI supplementation significantly improved egg quality and bone mineralisation in quail during the late laying period and did not affect feed consumption or egg production.

Functional imaging studies in patients with Sydenhams chorea have suggested brain perfusional abnormalities. In this study, we aimed to investigate the cerebral perfusion patterns of the cortical/subcortical structures by using Tc-99m hexamethylpropylenamine oxime single photon emission computed tomography in children with Sydenhams chorea, accompanied with magnetic resonance imaging and cranial Doppler studies. Brain MRI and Doppler studies of the all cases were normal. In the brain SPECT study, six patients were determined to have cerebral perfusion abnormalities. Although six patients responded well to the therapy, two girls who had hypoperfusion in the right frontal region as well as hypo- / hyperperfusion in the basal ganglia did not respond to therapy. While the chorea form of the patients who have cerebral perfusional abnormality was generalized, the clinical picture of the patients with normal cerebral perfusion was in the form of hemichorea.

Skeletal abnormalities, low bone mass, bone deformities, and bone fractures increase the risk of osteoporosis and osteoarthritis, which are of concern from both a public standpoint and a cost-of-care burden standpoint. Arginine silicate inositol complex (ASI; Arg = 49.47%, silicone = 8.2%, inositol = 25%) is a novel, bioavailable source of Si and Arg and one that offers potential benefits for vascular and bone health. Skeletal abnormalities and architectural deterioration of bone tissue are common under hot climate conditions in the poultry industry. In this study, we evaluated the effects of ASI supplementation on performance and bone mineral density (BMD) in Japanese quail (Coturnix coturnix japonica) exposed to the high ambient temperature of 34 degrees C. The birds (n = 180; 10 d old) were randomly assigned to 6 treatment groups consisting of 10 replicates of 3 birds. Birds were kept in wire cages in a temperature-controlled room at either 22 degrees C (thermoneutral; TN) or 34 degrees C (heat stress; HS) for 8 h/d (0900 to 1700 h until the end of study) and were fed a basal (control) diet or the basal diet supplemented with either 500 or 1,000 mg of ASI/kg of diet. Heat exposure decreased performance and bone mineralization when the basal diet was fed (P = 0.001). The ASI supplement had no effect on feed intake, BW, feed efficiency, and carcass traits (P > 0.05) in quails reared under TN or HS conditions. The BMD was significantly improved by ASI supplementation in both TN and HS groups [0.72 (TN) vs. 0.60 (HS); P < or = 0.05]. Serum osteocalcin, dehydroepiandrosterone concentrations, and alkaline phosphatase activity increased, whereas tumor necrosis factor-alpha and Creactive protein concentrations decreased, as dietary ASI supplementation increased in quail reared under HS. This improvement was linear with increased doses of supplement (P = 0.001). In the ASI group, the amount of Ca, P, Mg, and Mn in the excreta decreased (P < or = 0.05), and the concentrations of these minerals in tibia ash increased in quail reared under HS conditions (P < or = 0.05). In conclusion, ASI supplementation to the basal diet significantly improved bone mineralization in quail and did not impact feed consumption, BW gain, or feed efficiency.

Because of the difficulty in diagnosis and different treatment options, debate on thoracic outlet syndrome (TOS) has continued. Our aim is to report our surgical experience.Forty-seven patients with thoracic outlet syndrome were operated on between 1985 and 2000. Mean age was 37.9 years (range, 17 to 58 years); female/male ratio was 41/6. The most frequent symptom was paresthesia (72.3%). Seventeen patients (36%) had bilateral symptoms. Of all, 89.3% (42 cases) were neurologic thoracic outlet syndrome, and 10.7% (five cases) were vascular. Lower plexus (C8-T1/ulnar nerve) compression was present in 36 patients and upper plexus (C5-C7/median nerve) compression in 6 patients. Doppler ultrasonography in 11 patients, angiography in 8, and lymph node scintigraphy in 1 patient were also performed. Main operative indications were persistence of symptoms after conservative therapy and reduced (60 m/s) ulnar nerve conduction velocity.Fifty-five operations were performed on the 47 patients. First (59.6%) and cervical costae (21.3%) resections were the most frequent operations. Mean ulnar nerve conduction velocity was 54.8 m/s (range, 43 to 68 m/s) preoperatively and 69.4 m/s (range, 47 to 70 m/s) postoperatively (p0.05). The morbidity rate was 17% (8 of 47). No difference was observed between transaxillary and supraclavicular incisions. No brachial plexus injuries occurred. The most frequent cause of morbidity was incisional pain. Two reoperations were performed for recurrences. Follow-up was 4.6 years, and 75% of lower plexus and 50% of upper plexus compressions remained asymptomatic. Severe and long-term pain occurred in 1 patient.Surgical decompression for thoracic outlet syndrome is efficient and dependable, but results deteriorate over time.