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1.
Br J Neurosurg ; 34(4): 397-401, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32297525

RESUMO

Objective: The aim of this study was to evaluate histopathological, functional and bone densitometry examinations of the beneficial effects of dexpanthenol (DEX) on nerve regeneration in a rat model of peripheral nerve crush injury.Methods: Thirty adult Sprague-Dawley rats were divided equally into three groups. A crush injury was simulated in all rats by clamping the right sciatic nerve for one minute. In group 1, one day before the surgical procedure, 500 mg/kg DEX administered via intraperitoneally (ip) was initiated and continued three times in a week during the experiment period as 28 days. In group 2, rats received a dose of 10 mg/kg DEX to investigate possible effects of DEX alone. Group 3 served as the control (sciatic nerve injury) and was not given any drugs.Results: Performance was significantly lower in group 3 compared to the drug treatment groups during the rotarod test (30 rpm and 40 rpm) (p < 0.05). After a while, the rats which were able to remain on the rod was significantly lower in group 3 during the acceleration test (p < 0.05). Hot plate latency test results in group 3 were significantly lower when compared to the other groups (p < 0.05).Conclusion: DEX appears to be useful as a supportive clinical agent for the treatment of pain and nerve damage.


Assuntos
Traumatismos dos Nervos Periféricos , Neuropatia Ciática , Animais , Ácido Pantotênico/análogos & derivados , Ratos , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Nervo Isquiático , Neuropatia Ciática/tratamento farmacológico
2.
J Pak Med Assoc ; 70(1): 29-34, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31954019

RESUMO

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.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Mediastino/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Linfonodos/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos
3.
J BUON ; 21(4): 958-963, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27685920

RESUMO

PURPOSE: The purpose of this study was to evaluate the clinical status, prognostic factors and treatment modalities affecting survival in patients with brain metastasis. We aimed to evaluate the whole brain radiation therapy (WBRT) outcomes of patients with brain metastasis in our center. METHODS: Clinical data of 315 patients referred to our center between 2004 and 2014 with metastatic brain cancers were collected and analysed for possible relationships between survival time, age, gender, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary tumor, number of brain lesions, surgery, radiation therapy scheme, extracranial metastatic status and primary disease control status. RESULTS: The average patient age of onset was 58 years. The primary tumor site was lung (68%), breast (12%), melanoma (4%), colorectal (1.6%), sarcoma (1.3%) and unknown primary disease (4.4%). The rest of the patients had other primary sites. Eighty four (26.6%) patients had single brain metastasis, 71 (22.5%) had 2 or 3 lesions, and 159 (50.4%) patients had more than 3 lesions. Leptomeningeal involvement was seen in combination of paranchymal involvement in 11 (3.5%) patients. Fifty patients had undergone surgical resection. WBRT was delivered to all of the patients. Median overall survival was 6.7 months (95% CI, 5.80-7.74). Median overall survival of patients treated with combination of surgery and WBRT was significantly better compared with those treated with WBRT alone (13.5 vs 5.5 months, p=0.0001). One- and 2- year survival was 17 and 4.7%, respectively. CONCLUSIONS: The present study concludes that brain metastasis is common in cancer patients. The best overall survival was obtained by surgery+NBRT in good-condition patients. Treatment should be tailored on an individual basis to all these patients.


Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/secundário , Encéfalo/patologia , Metástase Neoplásica/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Avaliação de Estado de Karnofsky , Pessoa de Meia-Idade , Prognóstico , Resultado do Tratamento , Adulto Jovem
4.
Am J Cardiol ; 99(2): 159-62, 2007 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-17223411

RESUMO

Prevalences of mitral annular calcium (MAC), osteoporosis, and coronary artery disease (CAD) increase with aging and often usually coexist. Correlates of MAC including cardiovascular risk factors and bone mineral density (BMD) have never been evaluated in men and women undergoing coronary angiography. Accordingly, we assessed the association between cardiovascular risk factors, BMD, and MAC in patients undergoing coronary angiography. The study population consisted of 484 consecutive patients (180 women, mean 60 +/- 10 years of age; 304 men, mean 60 +/- 10 years of age) who underwent coronary angiography. Complete transthoracic echocardiographic studies were performed in all patients. Diagnosis of MAC was made by M-mode and cross-sectional transthoracic echocardiography. All patients were referred to the nuclear medicine department to measure BMD (T score) using dual-energy x-ray absorptiometry. The following clinical and demographic parameters were recorded: age, gender, body mass index, hypertension, diabetes mellitus, CAD, hypercholesterolemia, and smoking status. Prevalence of MAC in our study population was 20%. There were no statistically significant differences between groups with respect to body mass index, diabetes mellitus, hypercholesterolemia, and presence of CAD (p >0.05 for all comparisons). Prevalence of hypertension and mean age were significantly higher in patients with MAC than in those without MAC (hypertension 74% vs 52%, p <0.001; age 68 +/- 9 vs 58 +/- 10 years, p <0.001, respectively). Age and hypertension were found to be independent positive risk factors for MAC, whereas T score and age-gender adjusted T score were found to be negatively and independently associated with MAC. In conclusion, we found that MAC in patients undergoing coronary angiography is independently and positively associated with age and hypertension and negatively associated with T-score measurement of BMD.


Assuntos
Densidade Óssea/fisiologia , Calcinose/epidemiologia , Cardiomiopatias/epidemiologia , Angiografia Coronária , Valva Mitral , Absorciometria de Fóton , Idoso , Calcinose/diagnóstico por imagem , Cardiomiopatias/diagnóstico por imagem , Ecocardiografia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Fatores de Risco
5.
Ulus Travma Acil Cerrahi Derg ; 13(3): 186-91, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17978892

RESUMO

BACKGROUND: We investigated the changes of bone mineral density at distal radius and ulna in patients with volar wrist clean-cut tendon(s) injuries that were treated by early primary repair and passive mobilization. METHODS: Fifteen patients with non-dominant hand injury (group I), 12 patients with dominant hand injury (group II) and 15 healthy volunteers serving as the control group (group III) were enrolled into this study. Side to side bone mineral component differences (SSD) of the proximal, middle and ultradistal radius that were obtained at 6th week and 4th month after operation were statistically compared. RESULTS: In comparison with the control group, SSD measurements of the middle and proximal subregions of group II at the 6th week were significantly decreased (p<0.01 and p<0.001). The decreases were 8.9 and 8.6% respectively. Similarly, the 4th month SSD measurements of the middle and proximal subregions of group II were also significantly decreased compared to group III (p<0.001). The decreases were 10.2% and 7.7%, respectively. In group I, except a 7.4% decrease at the middle subregion of the radius at 4th month, there was no significant difference in SSD measurements as compared with the control group. CONCLUSION: Results of our study indicate that there is a considerable bone loss of distal radius in patients who are surgically treated for acute clean-cut tendon(s) injuries at the volar wrist level.


Assuntos
Osteoporose/fisiopatologia , Rádio (Anatomia)/fisiopatologia , Traumatismos dos Tendões/fisiopatologia , Traumatismos do Punho/fisiopatologia , Adolescente , Adulto , Densidade Óssea , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Traumatismos dos Tendões/cirurgia , Traumatismos do Punho/cirurgia
6.
Gulf J Oncolog ; 1(23): 26-32, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28271999

RESUMO

BACKGROUND: Salivary gland carcinoma are rare tumors and the main treatment is surgical. The addition of radiotherapy to surgery decreases locoregional relapses in high risk patients. Aim of our study is to retrospectively evaluate local control and survival and the factors affecting them in patients who received postoperative radiotherapy. MATERIALS AND METHODS: The medical records of 30 patients with salivary gland tumors operated on and referred to our clinic for adjuvant RT between January 2004 and June 2015 were retrospectively evaluated. RT was applied to the primary tumor or its lymphatics in a median dose of 60 Gy (48-66 Gy) in 1.8-2 Gy/fraction. The number of patients receiving concomitant chemotherapy was 8 (27%) and 22 (73%), respectively. RESULTS: The mean duration of follow-up was 47 months (range: 3-132 months). The mean duration between surgery and RT was 51 days and mean duration of RT was 43 days. Tumors were located in the parotid gland in 25 patients (83%), in the submandibular gland in four patients (14%), and in the sublingual gland in one patient (3%). Histopathologically, the most common tumor was adenoid cystic carcinoma (27%), followed by mucoepidermoid carcinoma (20%), and skin SCC metastatic to the parotid gland. Five-year overall survival (OS), five-year disease specific survival (DSS), and five-year disease free survival (DFS) were 50%, 50%, and 54%, respectively. Regional recurrence and distant organ metastasis developed in 5 (17%) and 9 (30%) patients, respectively. OS, DSS, and DFS were significantly decreased in patients with lymph node metastasis compared to the patients with no metastasis (p=0.002). DFS was better in Stage 1-2 patients compared to Stage 3-4 patients (p=0.019). OS and DFS were significantly in radiotherapy time in less than 45 days (p=0.01). A duration between surgery and radiotherapy of more than 42 days was associated with low DFS (p=0.042). No prognostic significance of age, gender, type of the salivary gland, T stage, tumor diameter, surgical margin, PNI, LVI, and extracapsular involvement was found among the other variables. CONCLUSION: Adjuvant RT is an efficacious and safe method of treatment in high risk patients operated on for salivary gland tumor.


Assuntos
Cuidados Pós-Operatórios , Radioterapia Adjuvante , Neoplasias das Glândulas Salivares/radioterapia , Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Humanos , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Estudos Retrospectivos
7.
World J Nucl Med ; 16(4): 275-280, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29033675

RESUMO

It was aimed to investigate the correlation between maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and retention index (RI), which represents the quantitative evaluation of the uptake of 18F-fluoro-2-deoxy-D-glucose (18F-FDG) used in positron emission tomography (PET) and clinicopathologic as well as biologic prognostic factors. Forty-one women with breast cancer who were histopathologically diagnosed were included in this study. Neoadjuvant chemotherapy was applied to all patients before PET/computed tomography (CT). After FDG injection, PET/CT screening was applied within the 1st h (PET-1) and in the 2nd h (PET-2). SUVmax, SUVmean, SUVmax RI, and SUVmean RI of every image were calculated qualitatively and semiquantitatively. The correlation between quantitative and semiquantitative PET parameters and biologic as well as clinicopathologic prognosis factors was evaluated. Statistically, significant positive correlation was found between lymph nodes (LNs), which were evaluated by clinical picture, clinical stage as well as histopathologically and quantitative PET parameters (SUVmax1, SUVmax2,, RImax, SUVmean1, SUVmean2, RImean) (P < 0.05). While statistically significant correlation with RImax was detected only by LN (histopathological), correlations with RImean were detected by clinical picture, clinical stage, metabolic stage, and LN (histopathological). Statistically, significant correlation was found between RImax and estrogen receptor in patients who were histopathologically diagnosed with invasive ductal carcinoma (n = 34) (P < 0.05). We detected correlations between biologic and clinicopathologic prognostic factors and SUVmax as well as SUVmean values in breast carcinoma. SUVmean values may provide important knowledge when the correlation between prognostic factors and PET parameters is investigated even if they are not used routinely.

8.
J Child Neurol ; 21(12): 1040-6, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17156695

RESUMO

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.


Assuntos
Encéfalo/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico por imagem , Síndrome do Cromossomo X Frágil/diagnóstico por imagem , Deficiência Intelectual/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único , Adolescente , Encéfalo/anormalidades , Encéfalo/fisiopatologia , Artérias Cerebrais/fisiopatologia , Circulação Cerebrovascular/fisiologia , Transtornos Cerebrovasculares/fisiopatologia , Criança , Pré-Escolar , Eletroencefalografia , Síndrome do Cromossomo X Frágil/fisiopatologia , Lateralidade Funcional/fisiologia , Humanos , Deficiência Intelectual/genética , Deficiência Intelectual/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Valor Preditivo dos Testes
9.
J Clin Densitom ; 9(2): 198-201, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16785081

RESUMO

Tendon lacerations at the distal forearm are a common clinical problem. The aim of this study is to investigate whether there is any significant bone loss of the dominant and nondominant forearm due to early passive mobilization in surgically treated patients for acute tendon-artery-nerve clean-cut injuries at the wrist level. Fifty-eight dominant right-handed patients who underwent such an operation were enrolled in this study. Patients were divided into two groups. Patients in group 1 (n=26) were operated on for dominant forearm clean-cut injuries; patients in group 2 (n=29) were operated on for nondominant forearm clean-cut injuries. Bone mineral density (BMD) measurements of ulna and radius were obtained at weeks 1 and 6, and at months 3 and 12 after the operation. Bone mineral density (BMD) of the radius and ulna did not change significantly with time in group 1 (p>0.05). In group 2, BMD measurements were reduced significantly more with time in the mid-diaphysis and distal regions of the ulna and in the ultra-distal region of the radius. Most BMD decreases were observed at month 3 of the study. Eventually, these bone losses were found to be recovered at month 12.


Assuntos
Densidade Óssea , Rádio (Anatomia)/fisiopatologia , Traumatismos dos Tendões/fisiopatologia , Ulna/fisiopatologia , Traumatismos do Punho/fisiopatologia , Adolescente , Adulto , Idoso , Feminino , Traumatismos do Antebraço/fisiopatologia , Traumatismos do Antebraço/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos dos Tendões/cirurgia , Traumatismos dos Tendões/terapia , Cicatrização/fisiologia , Traumatismos do Punho/cirurgia , Traumatismos do Punho/terapia
10.
North Clin Istanb ; 3(3): 201-208, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28275752

RESUMO

OBJECTIVE: Osteoporosis is progressive metabolic bone disease that decreases bone density and features deterioration of bone structure. Dual-energy X-ray absorptiometry (DXA) is commonly used and reliable method to measure bone mineral density (BMD). Aim of this study was to determine normal ranges of BMD in left proximal tibia. METHODS: Fifty-five females were included in this study. BMD was measured at the lumbar spine and the left proximal tibia using DXA. BMD value of subregions in the left proximal tibia was significantly correlated with BMD value of the total lumbar spine (r=0.111-0.766). New average BMD values of the left proximal tibia were calculated according to age using linear regression formula, leading to average BMD value for the total lumbar spine (L1-L4) in normal population. New simulated T-scores for proximal subregions of the tibia were then calculated. RESULTS: T-scores for proximal subregions were not different from T-scores of total lumbar spine (p>0.05). CONCLUSION: It was concluded that proximal tibia is an ideal region for measurement of BMD in osteoporosis.

11.
World J Nucl Med ; 15(1): 68-70, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26912985

RESUMO

Major vascular invasion is one of the worst prognostic factors of hepatocellular carcinoma (HCC). Fludeoxyglucose F 18 ((18) F-FDG) positron emission tomography/computed tomography (PET/CT) method is succesfully being used in HCC patients for the detection of particularly long-distance metastasis. Major vascular invasion is shown by radiological methods [particularly dynamic CT and/or magnetic resonance imaging (MRI)]. A male patient aged 60 years was diagnosed with HCC, according to biopsy after the detection of a mass in the liver. His medical examinations that were performed for the evaluation in terms of liver transplantation were dynamic CT and dynamic MRI; invasion in the intrahepatic branches of the portal vein and in main portal vein was also detected. PET/CT was performed to investigate the distant metastases. Moreover, diffuse (18) F-FDG uptake in the intrahepatic branches of the portal vein and in the main portal vein was observed.

12.
Balkan Med J ; 33(2): 204-11, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27403391

RESUMO

BACKGROUND: Severe functional and anatomical defects can be detected after the peripheral nerve injury. Pharmacological approaches are preferred rather than surgical treatment in the treatment of nerve injuries. AIMS: The aim of this study is to perform histopathological, functional and bone densitometry examinations of the effects of sildenafil on nerve regeneration in a rat model of peripheral nerve crush injury. STUDY DESIGN: Animal experiment. METHODS: The study included a total of thirty adult Sprague-Dawley rats that were divided into three groups of ten rats each. In all rats, a crush injury was created by clamping the right sciatic nerve for one minute. One day before the procedure, rats in group 1 were started on a 28-day treatment consisting of a daily dose of 20 mg/kg body weight sildenafil citrate given orally via a nasogastric tube, while the rats in group 2 were started on an every-other-day dose of 10 mg/kg body weight sildenafil citrate. Rats from group 3 were not administered any drugs. Forty-two days after the nerve damage was created, functional and histopathological examination of both sciatic nerves and bone densitometric evaluation of the extremities were conducted. RESULTS: During the rotarod test, rats from group 3 spent the least amount of time on the rod compared to the drug treatment groups at speeds of 20 rpm, 30 rpm and 40 rpm. In addition, the duration for which each animal could stay on the rod throughout the accelerod test significantly reduced in rats from group 3 compared to rats from groups 1 and 2 in the 4-min test. For the hot-plate latency time, there were no differences among the groups in either the basal level or after sciatic nerve injury. Moreover, there was no significant difference between the groups in terms of the static sciatic index (SSI) on the 42(nd) day (p=0.147). The amplitude was better evaluated in group 1 compared to the other two groups (p<0.05). Under microscopic evaluation, we observed the greatest amount of nerve regeneration in group 1 and the lowest in group 3. However, this difference was not statistically significant. Moreover, there was no significant difference in the bone mineral density (BMD) levels among the groups. CONCLUSION: We believe that a daily single dose of sildenafil plays an important role in the treatment of sciatic nerve damage and bone healing and thus can be used as supportive clinical treatment.

13.
Coron Artery Dis ; 16(6): 379-83, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16118543

RESUMO

BACKGROUND: Cardiovascular risk factors are reported to increase the incidence of aortic valve calcification. Among older women, low bone mineral density appears to be associated with increased prevalence of aortic calcification. We aimed to assess and compare cardiovascular risk factors and bone mineral density of patients with and without aortic valve calcification. MATERIALS AND METHODS: Cardiovascular risk factors and bone mineral density measurements have been assessed in 49 patients with aortic valve calcification and in 65 patients without aortic valve calcification. All patients were subsequently referred to the nuclear medicine department to measure bone mineral density after echocardiographic evaluation. RESULTS: No statistically significant differences were observed between the two groups with respect to sex, body mass index, history of coronary artery disease, diabetes mellitus, hypercholesterolemia, and smoking status. Although height and weight of the patients with aortic valve calcification were significantly lower than those of patients without aortic valve calcification, they were not independent risk factors. Age and hypertension were found to be independent positive risk factors for aortic valve calcification, whereas T score was found to be negatively associated with aortic valve calcification. CONCLUSION: We have shown that aortic valve calcification is positively associated with age and hypertension, whereas bone mineral density is negatively associated with aortic valve calcification. The mechanism underlying the association between decreased bone mineral density and aortic valve calcification remains to be clarified in further studies.


Assuntos
Densidade Óssea/fisiologia , Calcinose/fisiopatologia , Doenças das Valvas Cardíacas/fisiopatologia , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Valva Aórtica/fisiopatologia , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/fisiopatologia , Ecocardiografia , Feminino , Humanos , Hipertensão/diagnóstico por imagem , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico por imagem , Osteoporose/fisiopatologia , Fatores de Risco , Fatores Sexuais
14.
Ann Nucl Med ; 18(7): 627-30, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15586638

RESUMO

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


Assuntos
Displasia Fibrosa Poliostótica/diagnóstico por imagem , Displasia Fibrosa Poliostótica/metabolismo , Fígado/diagnóstico por imagem , Fígado/metabolismo , Medronato de Tecnécio Tc 99m/farmacocinética , Adulto , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Humanos , Achados Incidentais , Masculino , Cintilografia , Compostos Radiofarmacêuticos/farmacocinética
15.
Tex Heart Inst J ; 31(4): 363-7, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15745286

RESUMO

We induced angiogenesis in the tibial medulla and cortex of rabbits by electrical and mechanical stimulation, with the aim of future application to ischemic disease. Sixteen New Zealand rabbits were divided into 4 groups: in Group 1, a K wire was inserted into the medullary channel; in Group 2 a hole was drilled into the tibia; in Group 3, electrical stimulation was applied to the medullary channel; and in Group 4 (the control group), nothing was done. The interventions were applied during a 21-day period, after which all animals were evaluated scintigraphically and histopathologically. All 3 interventional groups were significantly superior to the control group in regard to medullary and cortical vascularity: the P values were 0.021 in all comparisons to control. However, the most fibrotic changes in the medulla occurred in the group that had been treated with electricity (P = 0.008). Slight fibrotic changes occurred in the hole group (P = 0.040), and none occurred in the K-wire group. In sum, all 3 interventions are capable of inducing medullary angiogenesis, but electricity is inferior in regard to fibrotic change. We believe that this present study can establish a baseline for further work that explores clinical applications to problematic ischemic conditions, including delayed sternal wound healing after cardiac surgery.


Assuntos
Medula Óssea/irrigação sanguínea , Estimulação Elétrica , Neovascularização Fisiológica , Osteotomia , Tíbia/irrigação sanguínea , Cicatrização , Animais , Medula Óssea/fisiopatologia , Medula Óssea/cirurgia , Fios Ortopédicos , Modelos Animais , Coelhos , Esterno/cirurgia , Tíbia/fisiopatologia , Tíbia/cirurgia
17.
Ann Hematol ; 87(5): 391-5, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-17992530

RESUMO

Circulating homocysteine is a risk factor of cardiovascular and cerebrovascular events. Hyperhomocysteinemia may be an early indicator for vitamin B12 disorders because cobalamin is a cofactor in the remethylation process of homocysteine. Serum holotranscobalamin (holoTC II) becomes decreased before the development of metabolic dysfunction. In this study, we assessed circulating holoTC II to estimate the diagnosis of vitamin B12 deficiency in the first ischemic cerebrovascular attack. We also compared the efficacy of the measurement of plasma holoTC II with the other standard biochemical and hematological markers used to reach the diagnosis of cobalamin deficiency. Forty-five patients (age 71 years (range 35-90), 16 men/29 women) within the first ischemic cerebrovascular event were included in this prospective study. All the enrolled patients have been administered vitamin B12 1 mg intramuscular injection once a day for 10 days. At the baseline and on the tenth day of treatment, plasma levels of holoTC II and the proper biochemical and hematological markers in diagnosing cobalamin deficiency were measured. After admission, anemia and diminished serum vitamin B12 levels were determined to be only 20% (9/45) and 44% (20/45), respectively; 78% (35/45) of the patients had low serum holoTC II (<37 pmol/l). Serum homocysteine was higher in patients (49% of them) who had previously suffered a stroke. Thrombocytopenia, hypersegmentated neutrophils, and indirect hyperbilirubinemia were observed in 20% of the patients. Leukopenia and macrocytosis were not evident in any of them. In 18 of 27 patients (67%) that had low holoTC II levels after joining the study and who remained in the study until the end of cobalamin treatment, serum holoTC II levels returned to normal values. Cobalamin deficiency should be considered in patients with cerebrovascular diseases, even if anemia, elevated mean cell volume, depression of the serum cobalamin, or other classic hematological and/or biochemical abnormalities are lacking. Furthermore, measurement of serum holoTC II looks promising as a first-line of tests for diagnosing early vitamin B12 deficiency.


Assuntos
Isquemia Encefálica/sangue , Hiper-Homocisteinemia/sangue , Transcobalaminas/análise , Deficiência de Vitamina B 12/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Isquemia Encefálica/etiologia , Feminino , Humanos , Hiper-Homocisteinemia/complicações , Hiper-Homocisteinemia/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radioimunoensaio , Transcobalaminas/metabolismo , Vitamina B 12/administração & dosagem , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/tratamento farmacológico , Complexo Vitamínico B/administração & dosagem
18.
Int J Cardiol ; 131(1): 66-9, 2008 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-18222554

RESUMO

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


Assuntos
Densidade Óssea/fisiologia , Angiografia Coronária/normas , Doença das Coronárias/diagnóstico por imagem , Pós-Menopausa/fisiologia , Fatores Etários , Idoso , Índice de Massa Corporal , Doença das Coronárias/etiologia , Doença das Coronárias/fisiopatologia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco
20.
J Bone Miner Metab ; 24(5): 401-4, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16937273

RESUMO

The aim of this study was to investigate whether there is any significant difference in bone loss between female and male patients as a result of early passive mobilization after surgery for acute tendon-artery-nerve clean-cut injuries at the wrist level. A total of 51 patients who underwent such operations were enrolled in this study. Group I consisted of 40 male patients (mean age 30.2 +/- 9.1 years, age range 15-44 years) and group II consisted of 11 female patients (mean age 24.1 +/- 9.9 years, age range 14-43 years); postmenopausal women were not included in this group. Twenty-one patients in group I and six patients in group II were operated on for clean-cut tendon injury combined with nerve injury, artery injuries, or both. Bone mineral density (BMD) measurements of injuired forearms were obtained at 1 week, 6 weeks, 3 months, and 12 months after operation. The BMD of the radius and ulna did not change significantly throughout the follow-up period in group II (P > 0.05). In group I, BMD values were reduced significantly in the distal regions of the ulna and in the ultradistal region of the radius at the follow-up measurements when compared to the values at week 1 and the reduction was higher in month 3 than at other times. On the other hand, after 12 months, the BMD values of the ultra-distal region of the ulna and radius were higher than those after 3 months. In conclusion, our results showed that there is considerable bone loss of the radius and ulna in patients operated on for acute clean-cut tendon injuries on the volar side of the wrist at postoperative month 3 in male patients. These bone losses were recovered after 12 months. Additionally, female patients are less likely to experience immobilization-induced bone loss than male patients.


Assuntos
Traumatismos do Antebraço/fisiopatologia , Osteoporose/fisiopatologia , Traumatismos dos Tendões/fisiopatologia , Adolescente , Adulto , Densidade Óssea/fisiologia , Feminino , Traumatismos do Antebraço/cirurgia , Humanos , Masculino , Terapia Passiva Contínua de Movimento , Fatores Sexuais , Traumatismos dos Tendões/cirurgia
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