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N C Gülaldi

Publications and source records attributed to N C Gülaldi.

6 recordsLinked to original sources

Impact of radiotherapy on normal brain tissue: semi-automated quantification of decrease in perfusion.

PURPOSE: We attempted to ascertain the impact of Co-60 conventional external radiotherapy (cRT) on the perfusion of normal brain tissue in relation to the radiation doses delivered to the tumors in patients with primary brain tumors. MATERIALS AND METHODS: After surgery 18 patients (pts) were due to undergo cRT with a total dose of 5400- 6400 cGy. All the patients had a Tc-99m-HMPAO SPECT study prior to cRT (basal), 15th and 30th days of cRT as well as 1 (in 6 pts), 3 (in 9 pts), and 6 (in 3 pts) months after cRT. For quantitative evaluation, the entire set of transverse slices were divided into 4 regions as frontal, parietal, occipital and temporal regions by means of a computer software program. Semi-automated quantification was performed on a total of 1392 regions in 87 studies to determine left to right ratios. An interregional difference of at least 10% was considered abnormal. RESULTS: After elimination of tumor sites, 80 normal brain regions showed decreased perfusion after cRT. The percent decrease in perfusion was (mean 22.5+/-9.9) significantly higher in areas irradiated with doses > 3000 cGy (p < 0.05). CONCLUSION: cRT has adverse effects on the perfusion of normal brain tissue for doses > 500 cGy. Our findings justify treating patients with small and limited lesions with stereotactic radiotherapy in order to minimize the adverse effects of cRT on normal tissues.

Adolescent↗

Scintigraphic evaluation of healing response after heterograft usage for alveolar extraction cavity.

OBJECTIVE: Reconstruction of bone defects remains an important problem in oral and maxillofacial surgery. Restoration of defect sites with various grafting materials is a valuable approach to the solution of this problem. The aim of this study was to evaluate the effects of the use of heterografts on osteoblastic activity by means of a radionuclide technique. STUDY DESIGN: The postextraction alveolar cavities of impacted mandibular third molars on 22 patients were used as a healing model for this study. Granulated freeze-dried heterograft material of bovine origin was used on 11 patients; the other 11 patients constituted a control group. On each patient, three-phase bone scans were performed on postoperative days 7 and 28. RESULTS: Although dynamic and blood pool studies showed similar patterns with respect to the mean values of asymmetry ratios of operation sites to the contralateral sides for the 7th- and 28th-day scans, static-phase bone scans revealed that healing response through osteoinduction was more prominent in the study group than in the control group. A significant increase in the mean value of the ratio from the first scan to the second was observed on static images in the study group (first scan, 1.6 +/- 0.2; second scan, 2.0 +/- 0.5; p < 0.05). However, the same ratio failed to show any significant change in the control group (first scan, 1.5 +/- 0.2; second scan, 1.5 +/- 0.3; p > 0.05). CONCLUSION: Static-phase bone scintigraphy showed that when freeze-dried heterograft material is used to fill alveolar extraction cavities, it stimulates osteoblastic activity, which in turn leads to acceleration of the healing process and helps to maintain the linearity of bony structure. Moreover, radionuclide study can be used to evaluate the viability of freeze-dried heterografts in the 4th postoperative week, at which time no additional increase in perfusion resulting from surgical trauma was found in our series.

Alveolar Process↗

Evaluation of Tc-99m(V) DMSA for imaging inflammatory lesions: an experimental study.

The present study evaluated 99mTc(V) DMSA as an agent for the visualization of inflammatory lesions in comparison to 99mTc(III) DMSA and 99mTC-HIG. All three radiopharmaceuticals were prepared with commercial kits. 99mTc(V) DMSA was prepared at neutral pH by the addition of first bicarbonate and then pertechnetate to the kit contents. The labeling efficiency was 99% as determined by ITLC. Abscesses were induced by i.m. injection of 50 microliters turpentine into the right thighs of 36 Swiss albino mice. Six days later 3.7 MBq of each radiopharmaceutical was i.v. administered to 12 mice. The mice were sacrificed at 1, 3, 6 and 24 h later. Scintigrams were obtained with a gamma camera. The abscesses were better visualized on scintigrams with 99mTc(V) DMSA compared to 99mTc(III) DMSA, starting at 1 h. The animals were dissected and the organs were removed, weighed and the radioactivity determined with a gamma counter. The abscess to other tissue ratios were higher with 99mTc(V) DMSA than the other radiopharmaceuticals. The max. abscess/muscle ratios were 9.46 +/- 3.20 (24 h), 4.19 +/- 1.39 (6 h) and 5.98 +/- 1.17 (24 h) and max. abscess/blood ratios were 6.22 +/- 1.41, 4.09 +/- 0.84 and 0.914 +/- 0.351 all at 24 h for 99mTc(V) DMSA, 99mTc(III) DMSA and 99mTc-HIG, respectively. Experimental arthritis was produced in New Zealand white rabbits by intra-articular injection of ovalbumin. Four days later 37 MBq of 99mTc(V) DMSA and 99mTc-HIG were each i.v. administered to 3 rabbits. Scintigrams obtained at 1, 3, 6, and 24 h clearly demonstrated arthritic joints. ROI's over arthritic joints were compared to contralateral normal joints (A/C). The max. A/C ratios were 2.10 +/- 0.31 (3 h) and 2.92 +/- 0.99 (24 h) for 99mTc(V) DMSA and 99mTc-HIG, respectively. Our results indicated the feasibility of imaging inflammatory lesions with 99mTc(V) DMSA.

Abscess↗

Comparison of 201Tl, 99Tcm-MIBI and 131I imaging in the follow-up of patients with well-differentiated thyroid carcinoma.

Problems stemming from the withdrawal of TSH suppressing doses of T4 or T3 and false-negative studies associated with 131I scintigraphy have justified the search for other radionuclides in the follow-up of patients with well-differentiated thyroid carcinoma. Although 201Tl and 99Tcm-MIBI (MIBI) have been suggested as alternatives, their role in the detection of residual and recurrent disease has yet to be established. We therefore studied 36 patients who had undergone total or near total thyroidectomy for well-differentiated thyroid carcinoma to determine the imaging potential of 201Tl, MIBI and 131I in the detection of residual or recurrent disease. Eighteen of the 36 patients had undergone 131I ablation. Imaging was performed 20 min following the intravenous injection of 111 MBq 201Tl or 555 MBq MIBI, or 48 h after the oral ingestion of 185 MBq 131I. The overall concordance between the 201Tl, MIBI and 131I scans was 70%. The concordance between thyroglobulin (TG) levels and the 131I scans was 78%; that between the 201Tl and MIBI scans and TG levels was 83%. Among the group of pre-ablative patients, there were six false-negative results with 201Tl and three false-negative results with MIBI. Among the post-ablation group, the 201Tl and MIBI scans were falsely negative in five patients. The 131I scans revealed all known residual or recurrent diseases. In conclusion, 201Tl, MIBI or TG levels should not be used in the place of 131I for the detection of residual or recurrent thyroid cancer. However, in patients who have not had their TSH suppressing doses of T4 or T3 withdrawn, the role of 201Tl and MIBI is debatable.

Adenocarcinoma, Follicular↗