Introduction: The purpose of this study was to evaluate possible preventive role of quercetin on doxorubicin (DOX) induced kidney toxicity using Tc-99m Dimercaptosuccinic Acid ([99mTc]Tc-DMSA) renal cortical scintigraphy and biochemical approaches. Methods: 28 Male wistar rats were separated into four groups. First group was intraperitoneally (i.p.) injected saline and regarded as the control group; second one was received 18 mg/kg/i.p doxorubicin for three days at a 24 h interval; the third and last group received 10 mg/kg and 100 mg/kg quercetin for 21 days and for the last 3 days doxorubicin and quercetin were administrated together at the same time. On the 22nd day of the experiment, [99mTc]Tc-DMSA renal cortical scintigraphy and biochemical parameters were measured. Results: DOX administration significantly increased blood urea nitrogen (845%) and creatinine (702%) levels in serum; nitric oxide (158%), plasma tumor necrosis factor-alpha (233%) and interleukin-6 (191%) levels in kidney tissue, and also reduced [99mTc]Tc-DMSA uptake by 29% in the kidneys as well. Pre-treatment with quercetin mitigated such alterations in all mentioned parameters. Conclusion: All data indicate that oxidative stress and inflammatory processes are involved in DOX-induced nephrotoxicity, which might be decreased by quercetin. In addition, [99mTc]Tc-DMSA scintigraphic may be a good method for demonstrating doxorobucin-induced renal injury.

Background and Objectives: The HUG-HEART Trial (ClinicalTrials.gov Identifier: NCT02323477) was a controlled, prospective, phase VII, multicenter, single-blind, three-arm randomized study of intramyocardial deliver of human umbilical cord-derived mesenchymal stromal cells (HUC-MSCs) combined with coronary artery bypass-grafting (CABG) n patients with chronic ischemic cardiomyopathy (CIC). The trial aimed to assess (i) the safety and the efficacy of cell transplantation during one-year follow-up, (ii) to compare the efficacy of HUC-MSCs with autologous bone-marrow-derived mononuclear cells (BM-MNCs) in the same clinical settings. Methods and Results: Fifty-four patients who were randomized to receive HUC-MSCs (23x10(6)) (n=26) or BM-MNCs (70x10(7)) (n=12) in combination with CABG surgery. The control patients (n=16) received no cells/vehicles but CABG intervention. All patients were screened at baseline and 1, 3, 6, 12 months after transplantation. Forty-six (85%) patients completed 12 months follow-up. No short/mid-term adverse events were encountered. Decline in NT-proBNP (baseline similar to 6 months) in both cell-treated groups; an increase in left ventricular ejection fraction (LVEF) (5.4%) and stroke volume (19.7%) were noted (baseline similar to 6 or 12 months) only in the HUC-MSC group. Decreases were also detected in necrotic myocardium as 23% in the control, 4.5% in BM-MNC, and 7.7% in the HUC-MSC groups. The 6-min walking test revealed an increase in the control (14.4%) and HUC-MSC (23.1%) groups. Conclusions: Significant findings directly related to the intramyocardial delivery of HUC-MSCs justified their efficacy in CIC. Stricter patient selection criteria with precisely aligned cell dose and delivery intervals, rigorous follow-up by detailed diagnostic approaches would further help to clarify the responsiveness to the therapy.

Taking an overdose of AMT, a commonly prescribed tricyclic antidepressant drug, has an increased risk of sudden cardiac death. The cardiotoxicity of amitriptyline (AMT) is a commonly observed toxicity with high morbidity and mortality rates in emergency departments (ED). Nevertheless, there are still no effective treatment options for AMT-induced cardiotoxicity. The aim of the present study was to evaluate the effects of paricalcitol (PRC), a Vitamin D receptor agonist, using electrocardiographic (ECG), biochemical, and scintigraphic methods. Twenty-eight male Wistar rats were randomly divided into four groups: untreated control (CON), amitriptyline-induced cardiotoxicity (AMT), paricalcitol (PRC), and amitriptyline + paricalcitol (AMT + PRC). Cardiotoxicity was induced by intraperitoneal (i.p) injection of a single-dose AMT (100 mg/kg). PRC was administered as 10 μg/kg (i.p.) after the injection of AMT. We examined ECG, biochemical, and scintigraphic results of PRC administration on AMT-induced changes. Cardiotoxicity of AMT was characterized by conduction abnormalities (increased QRS complex, T wave, and QT interval duration and elevation of ST segment amplitude), elevated 99m Technetium Pyrophosphate ([ 99m Tc]PYP) uptake, and increased cardiac troponin T (cTnT) levels. Treatment with PRC significantly decreased all AMT-associated conduction abnormalities in ECG (p < 0.001), and decreased [ 99m Tc]PYP uptake ( p < 0.001) and serum cTnT level ( p < 0.001). The present study indicated that the vitamin D receptor agonist paricalcitol could decrease the AMT-induced cardiotoxicity. This suggests [ 99m Tc]PYP as a non-invasive method for the evaluation of myocardial injury induced by AMT. According to the results of the present study, PRC has beneficial effects on AMT-induced cardiotoxicity.

AIM:The present study aimed to determine the protective effect of melatonin and agomelatine on DOX-induced cardiotoxicity in rats by electrocardiographic, scintigraphic and biochemical methods.MATERIALS AND METHODS:Forty-nine male Wistar rats were randomly separated into seven groups; control (CON), doxorubicin (DOX), melatonin (MEL), agomelatine (AGO), melatonin+doxorubicin (MEL+DOX), agomelatine+doxorubicin (AGO+DOX) and melatonin+ agomelatine+ doxorubicin (MEL+AGO+DOX) groups. Cardiotoxicity was induced by intraperitoneal (i.p.) injection of DOX (18 mg/kg daily for three days). Rats receiving MEL and AGO treatment in the DOX-induced cardiotoxicity group received MEL and AGO (40 mg/kg/day, i.p., for seven days). They were injected with doxorubicin (18 mg/kg, i.p.) on days 5, 6, and 7. The rats were given MEL and AGO as substance control (40 mg/kg/day, i.p., for 7 days). On day 8 of the experiment, animals were evaluated by means of electrocardiography (ECG) and 99mtechnetium pyrophosphate (99mTc PYP) scintigraphy and their biochemical parameters [blood urea nitrogen (BUN), creatine kinase (CK), cardiac troponin T (cTnT)] were examined.RESULTS:DOX-induced acute cardiotoxicity in rats is characterized by conduction abnormalities in the ECG pattern (including decreased P wave and QRS complex duration, increased QT and RR intervals, and ST-segment elevation), increased serum BUN, CK, and cTnT parameters and increased 99mTc PYP uptake (p < 0.001). Pretreatment with MEL, AGO, or MEL+AGO effectively alleviated DOX-induced ECG abnormalities close to normal (p < 0.001). Moreover, serum biochemical evidence and 99mTc PYP uptake values demonstrated that pretreatment with MEL, AGO, or MEL+AGO has the same protective effect against the abnormalities produced in the heart by DOX (p < 0.001).CONCLUSIONS:MEL and AGO have a potential protective effect on DOX-induced cardiotoxicity. At the same time, this study suggests that 99mTc PYP is a non-invasive method suitable for early determination of DOX-induced cardiotoxicity (Tab. 3, Fig. 5, Ref. 41).

Amac : Adriamisin (ADR), kemoterapide yaygin olarak kullanilan antineoplastik bir ilactir, ancak kardiyotoksisitesi, bu ilacin klinik kullanimini sinirlayan en onemli yan etkidir. Bu calismada, ratlarda adriamisin ile olusturulan kardiyotoksisite modelinde guclu bir antioksidan olan edaravonun (EDO) etkisini elektrokardiyografik (EKG), biyokimyasal ve sintigrafik yontemlerle arastirdik. Yontem: Yirmi sekiz eriskin erkek Wistar-Albino rat rastgele dort gruba ayrildi; kontrol (CON); Adriamisin (ADR); edaravon (EDO), edaravon + adriamisin (EDO + ADR). Ratlarda kardiyotoksisite, 5., 6. ve 7. gunlerde 24 saatlik (h) araliklarla ADR enjeksiyonu (kumulatif doz: 18 mg / kg, intraperitoneal-i.p.-) ile induklenmistir. EDO + ADR grubu uygulamasinda ratlara 7 gun boyunca EDO (30 mg / kg / gun, i.p.) uyguladi ve 5., 6. ve 7. gunlerde ADR (18 mg / kg, i.p.) enjekte edildi. 8. gunde elektrokardiyografi (EKG), biyokimyasal ve teknesyum-99m pirofosfat ( 99m Tc-PYP) sintigrafik parametreleri degerlendirildi. Bulgular: ADR induksiyonu EKG paterninde degisikliklere neden oldu; kalp atisi, P dalgasi ve QRS kompleks suresi azaldi, hem ST-segment genligini hem de QT suresini arttirdi (p u003c 0,001), ayrica biyokimyasal belirteclerde artis izlendi [kan ure azotu (BUN), kreatin kinaz (CK), kardiyak troponin T (cTnT)] ve yuksek 99mTc-PYP uptakei seviyesi (p u003c 0,001). EDO tedavisi, ratlarda ADR’nin neden oldugu kardiyotoksisite parametrelerinin tumunu engelledi, EKG’deki tum ADR’e bagli anormallikler, 99m Tc-PYP uptakei ve serum BUN, CK ve cTnT seviyeleri onemli olcude azaldi ( p u003c0.001). Sonuc: Verilerimiz, EDO’nun ADR kaynakli kardiyotoksisite uzerinde kardiyoprotektif etkilere sahip oldugunu gostermektedir. Ayni zamanda, bu calisma 99m Tc-PYP’nin ADR’nin neden oldugu kardiyotoksisitenin erken teshisi icin non-invaziv bir yontem olarak kullanabilecegini dusundurmektedir.

Amitriptyline (AMT) cardiotoxicity is commonly seen with high morbidity and mortality rates in emergency departments. Nevertheless, there are still no effective treatment options for amitriptyline-induced cardiotoxicity. The aim of the present study was to evaluate the effects of edaravone, a potent antioxidant and free radical scavenger, in rats by electrocardiographic (ECG), biochemical, and scintigraphic methods. Twenty-eight male Wistar rats were randomly divided into four groups as untreated control (CON), amitriptyline-induced cardiotoxicity (AMT), edaravone treatment (EDO), and amitriptyline + edaravone treatment (AMT+EDO). Cardiotoxicity was induced by intraperitoneal (i.p.) injection of a single-dose amitriptyline (100 mg/kg). Edaravone was administered at a dose of 30 mg/kg (i.p.) after amitriptyline injection. ECG, biochemical, and scintigraphic changes due to edaravone were analyzed. AMT cardiotoxicity was characterized with conduction abnormalities (increased QRS complex, T wave, and duration of QT interval and elevation of ST segment amplitude), elevated 99mTechnetium Pyrophosphate (99mTc-PYP) uptake level, and increased cardiac troponin T level (cTnT). Edaravone treatment significantly decreased all amitriptyline-associated conduction abnormalities in ECG (p < 0.001), 99mTc-PYP uptake (p < 0.001), and serum cTnT level (p < 0.001). 99mTc-PYP scintigraphy can show amitriptyline cardiotoxicity as well as ECG abnormalities and increased values of cTnT. According to the results of the present study, edaravone has strong beneficial effects on amitriptyline-induced cardiotoxicity.

Aim: Diffuse homogen hepatic uptake in whole-body scan (WBS) after radioiodine remnant ablation (RRA) suggests that there is occult or visible remnant thyroid tissue and/or tumor tissue. It is thought that the reason is hepatic metabolization of radioiodine (1311) marked thyroglobulin fragments which are secreted by remnant/tumor tissue. The aims of this study were to investigate whether the hepatic visualisation after radioiodine remnant ablation showed the presence of metastatic or residual disease in patients with differentiated thyroid cancer and also to investigate whether early or late WBS after RRA (RxWBS) had an effect on the physiological hepatic uptake. Material and Method: 201 DTC patients were evaluated (F/M: 152/49; mean age: 49.61 +/- 13 years (range: 18-85 years)) who referred for RRA. The therapeutic 1311 dose ranged from 100mCi to 200mCi. RxWBS was performed earlier (in 1-4th-day after RRA) in 106 patients (Group 1) and was performed later (in 5-9th-day after RRA) in 95 patients (Group 2). Results: Diffuse hepatic uptake were seen only in three patients (2.8%) and was not seen in 103 patients (97.2%) in Group 1. However, in Group 2 diffuse hepatic uptake was seen in 93 patients (97.9%) (p<0.05) and not seen only in 2 patients (2.1%). There is not a statistically significant relationship between the hepatic uptake and serum Tg. LT4 and TSH level. There is a statistically significant relationship between anti-Tg level and hepatic uptake. Discussion: Physiological diffuse hepatic uptake of radioiodine in WBS after RRA may not be seen during the early WBS. Thus, metastatic foci may be missed with early scanning. We conclude that RxWBS after RRA should be done in late period.

Aim: Adriamycin (ADR) is an antineoplastic drug that is widely used in chemotherapy but its cardiotoxicity is the most important side effect that limits the clinical use of this drug. In this study, we investigated of edaravone (EDO), which is a potent antioxidant, ADR-induced cardiotoxicity model in rats by electrocardiographic (ECG), biochemical and scintigraphic methods. Methods: Twenty-eight adult male Wistar-Albino rats were randomly separated into four groups; namely control (CON); Adriamycin (ADR); substance control of edaravone (EDO), edaravone + adriamycin (EDO+ADR) groups. Cardiotoxicity in rats was induced by adriamycin injection (cumulative dose:18 mg/kg, intraperitoneal-i.p.-) at an interval of 24 hours (h) on the 5 th , 6 th and 7 th days. Rats receiving edaravone treatment in the adriamycin group administration edaravone (30 mg/kg/day, i.p.) for 7 days and were injected with adriamycin (18 mg/kg, i.p.) on 5 th , 6 th and 7 th days. On the 8 th day electrocardiography (ECG), biochemical and technetium-99m pyrophosphate ( 99m Tc-PYP) scintigraphic parameters were assessed. Results: ADR induction caused changes in the ECG pattern, decreased heartbeat, P wave and QRS complex duration, increased both ST-segment amplitude and QT interval duration (p < 0,001), increase in the biochemical markers [blood urea nitrogen (BUN), creatine kinase (CK), cardiac troponin T (cTnT)], and elevated 99m Tc-PYP uptake level (p < 0,001). EDO treatment prevented all the parameters of ADR-induced cardiotoxicity in rats, by significantly decreased all ADR-associated conduction abnormalities in ECG (p < 0.001), decreased 99m Tc-PYP uptake (p < 0.001) and serum BUN, CK and cTnT, (p < 0.001). Conclusions: Our data demonstrate that EDO has cardioprotective effects on DOX-induced cardiotoxicity. At the same time, this study suggested that 99m Tc-PYP may be using as a non-invasive method for the early diagnosis of ADR-induced cardiotoxicity.

OBJECTIVE:We aimed to determine the possible protective effects of melatonin and agomelatine on an animal model of adriamycin nephrotoxicity by 99mTc DMSA renal scintigraphy and biochemical methods.METHODS:Ten weeks old 49 male Wistar rats were randomly separated into seven groups; namely control (CON), adriamycin (ADR), melatonin (MEL), agomelatine (AGO), melatonin + adriamycin (MEL+ADR), agomelatine + adriamycin (AGO+ADR) and melatonin + agomelatine + adriamycin (MEL+AGO+ADR) groups. Nephrotoxicity was induced by a three-dose of 18 mg/kg adriamycin, i.p. at a 24 h interval on the 5th, 6th and 7th days. A dose of melatonin and agomelatine (40 mg/kg/i.p, the same doses) were injected for 7 days before and after the injected of ADR (18 mg/kg, i.p.), respectively. On the 8th day of the experiment, all animals were evaluated and scintigraphic and biochemical parameters were assessed, respectively.RESULTS:ADR significantly increased blood urea nitrogen (1040 %) and plasma creatinine (1020 %), and decreased 99mTc DMSA uptake levels (59 %) compared to the control (p < 0.001). Pretreatment with MEL, AGO, MEL+AGO mitigated these abnormalities produced by ADR in the kidney (p < 0.001).CONCLUSION:99mTc DMSA for the early determination of ADR-induced nephrotoxicity had an important role. Also, a significant correlation was found between biochemical and scintigraphy parameters. Adriamycin caused significant damages to kidneys that were reduced with MEL and AGO (Tab. 2, Fig. 3, Ref. 39).

Objective: The aim of the present study was to determine the methods to reduce the radiation dose during imaging carried out for patients with bone or other organ metastases who were treated with palliative radiotherapy. In planning stages of treatment for these patients, tomographic imaging with computed tomography (CT) is performed on affected area using three-dimensional (3D) conformal radiotherapy. To what level the radiation dose could be lowered in imaging was investigated via changing the parameters used in CT scanning. Method: Twenty seven patients with metastases treated in the Radiation Oncology department (16M, 11F, mean age 65.2 ± 11.9 years) were included in the study. These patients underwent a total of 30 palliative radiotherapy treatments. Standard CT dose of 72 milli-ampere-second (mAs) and 130 peak kilo voltage (kVp) in CT 1 scanning carried out for radiotherapy planning was lowered to 30mAs and 130kVp in CT 2 scanning. Results: Radiation dose was reduced by 62.68% ± 0.02 percent as a result of changes made in planning CT scan (p<0.0001). Analysis of the images obtained revealed that despite the minimal reduction in image quality, results had no effect on treatment planning. Conclusions: It was concluded that the radiation dose could be reduced via making changes in the parameters of CT scanning during palliative radiotherapy planning stage.

Objective: Doxorubicin (DOX) is a chemotherapeutic agent used to treat several cancer types; however, it exhibits severe side effects in the nervous system which DOX treatment evoked neurobehavioral alterations such as anxiety and depressive-like behavior. We investigated the use of melatonin and agomelatine to prevent neurobehavioral alterations caused by DOX. Material and Methods: Forty-nine Wistar albino rats were randomly divided into 7 groups, namely control (CON, n=7), doxorubicin (DOX, n=7), melatonin (MEL, n=7), agomelatine (AGO, n=7), melatonin + doxorubicin (MEL + DOX, n=7), agomelatine + doxorubicin (AGO + DOX, n=7) melatonin + agomelatine + doxorubicin (MEL + AGO + DOX, n=7) groups. Doxorubicin (18 mg/kg) was injected intraperitoneally (i.p) on the 5th, 6th, 7th day of the study. Animals were treated with melatonin (40 mg/kg/i.p), agomelatine (40 mg/kg/i.p), melatonin (40 mg/kg/i.p) + agomelatine (40 mg/kg/i.p), for 7 days and then doxorubicin (18 mg/kg/i.p) was injected on the 5th, 6th, 7th day. On the 8th day of the experiment, all animal evaluated open field test (OFT) and forced swim test (FST) respectively. Results: The only DOX-treated rats exhibited the reduced exploration, grooming, and locomotor activity in the open field test and increased immobility time, reduced swimming time. Our data showed that the rats treated with DOX exhibited anxiety and depressive-like behavior. Melatonin and agomelatine treatment reduced all the parameters of DOX-induced anxiety and depressive-like behavior in rats. Conclusions: Melatonin and agomelatine have a protective effect of against DOX-induced neurobehavioral alterations in rats.

OBJECTIVE: Quality control testing of a SPECT gamma camera is crucial in assessing the suitability of the camera for use in nuclear medicine department. The aim of the present study was to investigate the effect of gamma camera acquisition parameters on image quality. METHODS: Camera scanning was carried out using a double-headed gamma cameraon a total of 48 patients (29 female and 19 male, mean age: 47.4±11.1) referred to our department for myocardial perfusion scintigraphy and thyroid scintigraphy. Then, camera acquisition parameters were changed (for myocardial perfusion scintigraphy from 64x64 to 128x128 matrix change and for thyroid scintigraphy from 5 cm to 10 cm distance change), and scanning was repeated and images were analyzed. RESULTS: Left ventricle ejection fraction (EF) value in 64x64 matrix was calculated to be 62.7±8.8%. Smaller EF value of 48.9±10.3% was obtained in 128x128 matrix for the same patients. 99m Tc-pertechnetate uptake percentage was 3.8±2.3% in measurements carried out at a distance of 10 cm. On the other hand, a higher uptake percentage of 6.2±3.6% was found for the same patients measured at a distance of 5 cm. CONCLUSION: In order to obtain proper imaging in SPECT gamma camera system, correct acquisition parameters should be used along with quality control tests for intrinsic flood-field uniformity and relative sensitivity.

Objective: The aim of our study was to investigate clinical importance of neutrophil to lymphocyte ratio (NLR) and plateled to lymphocyte ratio (PLR) in patients with acute pulmonary embolism (PE). Methods: 50 patients with a diagnosis of acute PE included into the study between January 2016 and December 2017. NLR level was measured by dividing neutrophil count to lymphocyte count. PLR level was measured by dividing plateled count to lymphocyte count. Pre-treatment and post-treatment groups of NLR and PLR values were compared. Results: It has been NLR and PLR ratio have a significantly higher value in admission and patients with pre-treatment groups were found statistically significant variable to predict the treatment effects. Also, correlation analysis showed a significant correlation between NLR and PLR. Conclusion: NLR and PLR values may be a useful biomarker for risk stratification and also prognosis for PE.

Purpose: The aim of the present study was to show the protective effect of pulsed magnetic field (PMF) application and melatonin administration on damage in testis in a one-sided torsion detorsion induced rat model using testicular scintigraphy with Tc-99m pertechnetate, PET/CT with F-18-FDG and histopathological methods. Materials and Methods: Sixty male rats were used in the study; 30 rats were randomly divided into five groups for one day applications of sham control, torsion, melatonin, pulsed magnetic field (PMF) and melatonin plus PMF. Similarly, the other 30 rats were divided into the same five groups (n = 6) for one week treatment, and the animals were sacrificed after one week. Rats were exposed to 50 Hz, 1 mT PMF for two hours. PET/CT with 37 MBq F-18-FDG and testicular scintigraphy with and 37 MBq Tc-99m pertechnetate examinations were carried out, and testicular tissue was examined using histopathological methods. Results: In one day treatment, melatonin administration significantly increased perfusion and glucose metabolism compared to torsion group (P < 0.01). Perfusion and glucose metabolism was also higher in the PMF and melatonin plus PMF groups than torsion group (P < 0.01). In one week treatment, melatonin administration resulted in a significantly higher perfusion and glucose metabolism rates compared to torsion group (P < 0.01 and P < 0.001, respectively). In addition, perfusion and glucose metabolism significantly increased in PMF and melatonin plus PMF groups compared to torsion group (P < 0.01 and P < 0.001, respectively). Furthermore, caspase-3 immunoreactivity and pathological changes increased in the torsion group (P < 0.05). Melatonin and melatonin plus PMF treatment reduced the rate of immunoreactivity and pathological findings compared to the torsion group (P < 0.05). Conclusion: According to these results it can be concluded that PMF application has a therapeutic benefit as effective as melatonin administering. In addition, it was indicated that PET/CT with F-18-FDG and testicular scintigraphy with Tc-99m pertechnetate could be efficiently used in determining the treatment efficiency in testicular torsion.

AIMTo evaluate the usefulness of bone scintigraphy in spinal fusion surgery.MATERIAL AND METHODSThis retrospective study included 21 patients who had undergone previous anterior or posterior spinal fusion procedures, or both. Implant failure, fusion failure and adjacent segment disease were the evaluated pathological parameters. Scintigraphic data from all patients were evaluated with intraoperative observational data, radiological data and clinical data.RESULTSRadiological evaluation revealed adjacent segment disease in 5 patients (23.8%), implant failure in 2 (9.5%), and fusion failure in 1 (4.8%). Scintigraphic evaluation of operating segments revealed pseudo-fusion in 3 patients (14.3%) and fusions in 18 (85.7%). Reoperations were performed in 9 patients (42.9%): in 5 (23.8%) because of adjacent segment disease, and in 4 (19.0%) because they requested removal of the implants. Two patients (9.5%) with implant failure did not undergo reoperation because their scintigraphic data were consistent with fusion and they were almost symptom free, with lower Visual Analogue Scale (VAS) scores. The VAS scores of the rest of the patients were significantly reduced after the reoperations (p < 0.001).CONCLUSIONBone scintigraphy may be helpful for surgeons in planning appropriate surgical revision strategy by giving proper data about spinal fusion at least one year after the initial surgery.

Epilepsi tekrarlayan nobetlerle karakterize olan en yaygin norolojik hastaliklardan biridir. Kanabinoidlerin epilepside onemli rolu oldugu yapilan deneysel calismalarda gosterilmistir. Kanabinoidlerin bircok fizyolojik surecte duzenleyici rol oynadigi bilinmektedir ve son yillarda, hastaliklarin tedavisinde kullanilmasi konusunda artan bir ilgi soz konusudur. Kanabinoid sistemde CB1 ve CB2 olmak uzere iki tip reseptor bulunur. Esrarin psikoaktif bileseni olan Δ9-Tetrahydrocannabinol (THC), kimyasal olarak uretilen sentetik kanabinoidler ve insan ve hayvanlarda dogal olarak uretilen dokanabinoidler, kanabinoid reseptorlerine baglanarak etki gosterirler. Kanabinoidler, beyinde ayni anda birden fazla kanal ve reseptor sistemi uzerinde etkili maddeler oldugundan, epilepsi uzerine olan etkisinin hangi sistem uzerinden gerceklestiginin ortaya konulmasi zordur. Bu yazida kanabinoid sistem ve epilepsiyle olan iliskisi ozetlenmistir.

Aim: The aim of the study is to evaluate a quantitative method in comparison with a visual method based on 99mTc-DMSA renal planar scintigraphy performed during pyelonephritis (PN). Material and Method: A total of 21 children (6,6 +/- 3,2 y old (mean +/- SD)) were examined by 99mTc-DMSA scintigraphy during (DMSA1) and 12,4 +/- 6,8 month (mean +/- SD) after (DMSA2) PN. Two levels of interpretation were performed independently: first, a visual analysis to classify the kidneys by considering the evolution between DMSA1 and DMSA2, and second, a semiquantitative analysis of DMSA1 and DMSA2. A visual method of kidney evaluation, 9-point visual analysis of each kidney was performed. A kidney was considered normal when the score was >= 7. Renal scarring was defined as a score of < 7 on DMSA1 and DMSA2, and 2 groups were obtained normal(N) and defective(DF). Semiquantitative analysis of kidney evolution; was performed to an automatic threshold (% 20-80) for the kidney and then calculating ratios of the count density and number of pixels (nC%=C in a given isocount/C in a 20% isocount, nS%=S in a given isocount/S in a 20% isocount). Results: For the semiquantitative analysis, the nC70 ve nS70 ratio was considered the best index to classify the kidneys by considering the evolution between DMSA1 (to determine which kidneys N or DF group) (table1). When this nC70 ratio was used a cutoff value of 0,34, it was able to differentiate between N and DF groups with a sensitivity of % 55, a specificity of % 100. According to the semiquantitative analysis of DMSA-2, when the cutoff value of C70% (0.36) was taken into consideration, 12 of 15 kidneys were in the N group, and 14 of 27 were in the DF group. As a result, a group change occurred in 16/42 (% 38) kidneys. Discussion: We concluded that the assessment of DMSA scintigraphy might show significant interobserver variation and that there was a need for quantitative parameters to make more objective evaluations.

Amaç: Bu çalışmanın amacı, pediatrik üriner sistem hastalıklarının tanısında dinamik manyetik rezonans ürografi (MRÜ)'nin fonksiyonel olarak tanı değerini araştırmak ve obstrüktif patolojilerde obstrüksiyonun derecesinin belirlenmesinde dinamik MRÜ'nin doğruluğunu ortaya koymaktır. Materyal ve Metod: Çalışmaya diüretik renal sintigrafi (DRS)'den önce veya sonra dinamik MRÜ ile değerlendirilen toplam 33 hasta dahil edildi. Hastaların yaşları 1 ay ile 18 yıl (ortalama yaş=7.03 yıl) arasında değişmekteydi. Obstrüksiyonun tanısında standart test olarak DRS kabul edilerek, dinamik MRÜ'nin sensitivite, spesifite, pozitif prediktif değeri ve negatif prediktif değeri hesaplandı. Bulgular: Dinamik MRÜ ve DRS sonuçları arasında fonksiyonel olarak farklılık bulunup bulunmadığını araştırmak için bağımlı gruplarda t testi yapıldı. Split renal fonksiyon açısından dinamik MRÜ ve DRS sonuçları arasında istatistiksel olarak anlamlı farklılık saptanmadı (p=0.978). Sonuç: Çalışmamızda dinamik MRÜ ve DRS sonuçları arasında renal fonksiyonların değerlendirilmesi bakımından çok güçlü ve yüksek bir tutarlılık ve uyum saptadık. Dinamik MRÜ'nin eksresyon açısından normal ve anormal böbrekleri ayırtetmedeki etkinliğini %100 olarak saptadık.