Mustafa Kibar | Cukurova University (original) (raw)

Papers by Mustafa Kibar

Journal of Clinical Gastroenterology, Feb 1, 2003

Goals: To investigate the relationships between gastric emptying and autonomic dysfunction in hep... more Goals: To investigate the relationships between gastric emptying and autonomic dysfunction in hepatic cirrhosis and to assess the effects of cisapride on gastric emptying in cirrhotic patients. Study: Twenty-four cirrhotic patients (8 patients in each Child-Pugh classification) and 25 healthy controls were enrolled. All the patients had viral (B or C) hepatitis. Patients with DM, alcoholic cirrhosis, active peptic ulcer, gastric malignancy and pyloric obstruction were excluded by esophagogastroduodenoscopy. Parasympathetic and sympathetic functions were assessed by the criteria set forth by Ewing and Clark. Drugs affecting GI motility and smoking were discontinued 48 hours and 12 hours prior to the study respectively. A solid-phase of gastric emptying study was conducted by scintigraphic method for the calculation of gastric half-emptying time (GET 1/2). Results: The study revealed that 9 patients with Child-Pugh B and C cirrhosis had autonomic neuropathy and none of Child-Pugh A cirrhosis had autonomic neuropathy. Prolonged GET 1/2 was noted in cirrhotics compared with the control group (p < 0.05). However, there was significant difference between 9 patients (Child B-C) with autonomic neuropathy compared with patients 15 patients without autonomic neuropathy. Again there was a significant difference in GET 1/2 between Child A cirrhotic and Child B-C cirrhotic whether they had autonomic neuropathy or not. Cisapride decreased GET 1/2 significantly in cirrhotic patients (Child B-C cirrhotic). Clearly, patients with autonomic neuropathy in Child B-C cirrhosis had significantly reduced GET 1/2 after cisapride administration. Even though cisapride decreased GET 1/2 in patients with Child B-C cirrhosis without autonomic neuropathy, this was not significant. Conclusion: Autonomic neuropathy in advanced cirrhosis from viral hepatitis may cause prolonged gastric emptying. Cisapride can shorten gastric emptying time in such patients.

Radiotherapy and Oncology, May 1, 2017

Annals of Nuclear Medicine, Oct 1, 2003

Purpose: The aim of this study is to compare the results of direct radionuclide cystography (DRNC... more Purpose: The aim of this study is to compare the results of direct radionuclide cystography (DRNC) and voiding cystourethrography (VCUG) in a group of children with a high suspicion of vesicoureteral reflux (VUR).Methods: For this purpose, 25 children were studied with both VCUG and DRNC. Among 50 ureter units able to be compared 39 ureter units did not show any VUR on either study. Eleven ureter units (10 children) had VUR either on one study or on both (VCUG and DRNC). In the children who had VUR on either study, a dimercaptosuccinic acid scintigraphy (DMSA) was performed to determine their cortical function.Results: We identified the following four patterns: 1) Five ureter units (five children) read positive on DRNC who were negative on VCUG and four of these children had positive findings on DMSA; 2) Four ureter units (four children) read positive on VCUG who were negative on DRNC, and two of them had positive findings on DMSA; 3) Two ureters (one child) read positive in both studies and also had abnormal DMSA findings; 4) Thirtynine ureter units read as negative on both studies.Conclusion: Although the results of these two methods did not show a significant difference, DRNC offers a high sensitivity in the younger age group whereas VCUG seems to be more sensitive in the older age group. DRNC also offers continuous recording during the study, ease of assessment and lower radiation dose to the gonads, which makes it a preferable method for the initial diagnosis and follow-up of VUR.

Dementia due to ischemic cerebrovascular causes are referred as vascular cognitive disorder in cl... more Dementia due to ischemic cerebrovascular causes are referred as vascular cognitive disorder in clinical practice. However, based on limited cases in the literature, it is known that intracranial hemorrhage can also lead to dementia. In this presentation, two cases considered as "strategic hemorrhage dementia" due to bleeding at strategic locations will be discussed. Two patients with blurred consciousness and stroke were admitted to our department. Hemorrhagic lesions in thalamus in one patient and in head of caudate nucleus and internal capsule in the other were detected in the right hemispheres of the patients. After the acute stage, dementia with executive dysfunction in addition to memory disturbance developed in both patients. Dementias due to strategic area infarcts are the interesting subgroup of vascular dementias. Lesions in dorsolateral frontal subcortical areas and lesions interrupting hippocampal-hypothalamic-thalamic circle may cause dementia. It should also be kept in mind that strategic area hemorrhages lead to dementia

Asian Pacific Journal of Cancer Prevention, Nov 30, 2013

Background: Some epidemiological studies reported that sunlight exposure and highvitamin D levels... more Background: Some epidemiological studies reported that sunlight exposure and highvitamin D levels may decrease the morbidity and mortality related to cancer. We aimed to evaluate whether sunlight exposure has an impact on survival in patients with non small cell lung cancer. Materials and Methods: A total of 546 patients with NSCLC from two different regions (Kayseri and Adana) differing according to sunlight exposure were analysed retrospectively. Results: The median overall survival (OS) rates were 11. 6 (CI: 9.50-13.6) and 15.6 months (CI: 12.4-18.8) for Kayseri and Adana, respectively, in all patients (p=0.880). Conclusions: There were no differences between groups in terms of OS. While there is strong evidence regarding inverse relationship between cancer incidence and sunlight exposure, it is still controversial whether sunlight exposure is a good prognostic factor for survival in patients with lung cancer.

Nuclear Medicine Communications, Oct 1, 2002

The aims of this study were to assess the role of 99m Tc-tetrofosmin scintigraphy in the diagnosi... more The aims of this study were to assess the role of 99m Tc-tetrofosmin scintigraphy in the diagnosis of maligniant vs. benign musculoskeletal tumours and to determine the relationship between P-glycoprotein expression and tetrofosmin uptake in malignant lesions. Forty-six patients (32 malignant, 14 benign) with various musculoskeletal lesions were studied. Each patient underwent 99m Tc-methylene diphosphonate three-phase bone scanning initially. At least 2 days later, dynamic and static 99m Tc-tetrofosmin scans were obtained. The tetrofosmin scans were evaluated by visual and quantitative analysis. The count ratio of the lesion to the contralateral normal area (uptake ratio, UR) was calculated from the region of interest drawn on the tetrofosmin scan. The lesions were then resected by open biopsy to obtain a histopathological diagnosis. P-glycoprotein levels were determined immunohistochemically in 22 of 32 malignant lesions. A significant difference between the mean UR values of benign and malignant lesions was found (1.36+0.47 vs. 3.35+2.08, P = 0.000). Visual analysis showed an accuracy of 85%, and the accuracy of the quantitative analysis was 87% with the threshold level of UR as 1.76. When perfusion findings were added to the evaluation criteria, the accuracies of visual and quantitative analysis were increased to 87% and 89%, respectively. The relationship between the levels of P-glycoprotein and the UR values of tetrofosmin was not statistically significant (r = 70.235, P = 0.2). In addition, the mean UR value of the patients with Pglycoprotein expression was not statistically different from that of the patients without P-glycoprotein expression (3.01+1.48 vs. 4.27+2.90, P = 0.297). In conclusion, visually significant tetrofosmin uptake and increased perfusion in a musculoskeletal lesion strongly suggest that the lesion is malignant (positive predictive value, 96%). P-glycoprotein expression was not found to be a major factor interfering with 30 min tetrofosmin uptake in a malignant musculoskeletal lesion. However, the relatively high falsenegative rate among negative results (28%) limits the value of 99m Tc-tetrofosmin scintigraphy as a single diagnostic tool in differentiating between benign and malignant musculoskeletal tumours.

Clinical Nuclear Medicine, Dec 1, 2000

A 44-year-old woman who had tuberculosis treatment 6 years earlier and a pleural decortication op... more A 44-year-old woman who had tuberculosis treatment 6 years earlier and a pleural decortication operation of the right lung 2 years earlier was referred for perfusion lung imaging. This revealed decreased right lung volume with faint irregular perfusion and herniation of the left lung into the right hemithorax. To the authors' knowledge, perfusion lung imaging showing herniation of one lung into the other hemithorax has not yet been described.

Journal of Women's Imaging, Jun 1, 2005

Clinical Nuclear Medicine, Feb 1, 1998

A 7-year-old child who had previously undergone a left pyeloplasty because of vesicoureteral refl... more A 7-year-old child who had previously undergone a left pyeloplasty because of vesicoureteral reflux (VUR) underwent dynamic Tc-99m-DTPA imaging for an evaluation of renal function. Dynamic images showed a nonfunctioning left kidney and a normally functioning right kidney with pelvicaliceal stasis. Following furosemide injection, the right pelvicaliceal stasis disappeared in a few minutes, while the left ureteral and subsequently left pelvicaliceal system was filling with the activity that came from the right kidney that had passed through the bladder. This drainage demonstrated a high degree VUR (Grade III) on the side of the nonfunctioning kidney. Extensive parenchymal damage was thought to be due to a high degree VUR in the left kidney. A static Tc-99m DMSA study and ultrasonography revealed the presence of left VUR nephropathy.

$Research paper thumbnail of Tc-99m MIBI uptake in traumatic vertebral fractures and metastatic vertebral lesions: Comparison with Tc-99m MDP$

Advances in Therapy, 2006

This study compared technetium-99m-hexakis-2-methoxyisobutyl-isonitrile (Tc-99m MIBI) with techne... more This study compared technetium-99m-hexakis-2-methoxyisobutyl-isonitrile (Tc-99m MIBI) with technetium-99m methylene iphosphonate (Tc-99m MDP) to determine whether Tc-99m MIBI could distinguish vertebral metastases from traumatic vertebral fractures. Twenty patients with traumatic vertebral fracture (and no malignant disease) and 14 patients with metastatic vertebral lesions were evaluated. Three to 4 hours after intravenous injection of Tc-99m MDP, images of the vertebrae in all patients were obtained. Corresponding Tc-99m MIBI images were acquired within 4 days after the Tc-99m MDP bone images were obtained. Computed tomography and magnetic resonance imaging demonstrated 24 vertebral traumatic fractures and 44 vertebral metastases. On conventional bone scans, Tc-99m MDP activity was increased in 92% of vertebral fractures and in 100% of vertebral metastases. However, on MIBI scans, no abnormal findings were observed in the vertebrae with fracture, although increased activity was seen in 73% of vertebral metastases. In this study, traumatic vertebral fractures tended to display no pathologic increases in Tc-99m MIBI uptake, whereas bone metastases usually appeared with high uptake. In light of the excellent specificity of Tc-99m MIBI scans compared with Tc-99m MDP bone scans, imaging studies that use Tc-99m MIBI scans may play an important complementary role in differentiating vertebral metastases from traumatic vertebral fractures.

Annals of Nuclear Medicine, Feb 1, 2005

The aim of this study was to evaluate the washout rate of Tc-99m tetrofosmin in asymmetric septal... more The aim of this study was to evaluate the washout rate of Tc-99m tetrofosmin in asymmetric septal hypertrophy (ASH). As Tc-99m tetrofosmin accumulation and retention depend on sarcolemmal and/or mitochondrial function, the presence or absence of abnormalities in the washout rate of Tc-99m tetrofosmin could provide information about sarcolemmal and/or mitochondrial damage noninvasively. The study group consisted of 18 patients with ASH and 10 healthy subjects. After intravenous injection of 1,110 MBq (30 mCi) Tc-99m tetrofosmin, tomographic images were obtained 1 hour later (early image) and again 4 hours later (delayed image). Using tomographic images, the distribution and washout of tetrofosmin in the left ventricle was examined quantitatively. Short-axis SPECT images were divided into 5 segments (anterior, septal, lateral, inferior wall and apex) in early and delayed images, and the mean radioactivity counts were measured in each segment by drawing regions of interest. Washout rates of apex, anterior, septal, lateral and inferior walls were 0.34 ± 0.06, 0.37 ± 0.07, 0.36 ± 0.07, 0.33 ± 0.08, 0.33 ± 0.07 in ASH and 0.20 ± 0.05, 0.23 ± 0.05, 0.22 ± 0.03, 0.21 ± 0.03, 0.22 ± 0.03 in the normal group, respectively. In ASH, the washout rates of all myocardial segments were significantly increased as compared to those of the normal controls (p < 0.05). The findings of the present study suggest that there could be dysfunction of sarcolemma and/or mitochondria in the entire left ventricle which would be important in the pathophysiology of this disease. Also our study revealed that Tc-99m tetrofosmin washout was higher in NYHA II-III patients compared to NYHA I patients and the degree of Tc-99m tetrofosmin washout corresponded well with the thickness of the interventricular septum and posterior walls.

European Journal of Nuclear Medicine and Molecular Imaging, Jun 10, 1998

Abstract. We have not encountered any brain single-photon emission tomography (SPET) study perfor... more Abstract. We have not encountered any brain single-photon emission tomography (SPET) study performed in adolescent depressed patients in the literature. Therefore, we used technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) brain SPET in adolescent patients with major depressive disorder (MDD) to examine the possible changes in cerebral perfusion and the possible association between perfusion indices and clinical variables. Fourteen adolescent out-patients (nine females, five males; mean±SD age: 13.11±1.43 years; range: 11–15 years) fulfilling the DSM-IV criteria for MDD and 11 age-matched healthy control subjects (six females, five males; mean±SD age: 13.80±1.60 years; range: 12–15 years) were included in the study. 99Tc-HMPAO brain SPET was performed twice in the patient group and once in the control group. The first SPET investigation was performed under non-medicated conditions and the second was performed after depressive symptoms had subsided. A relative perfusion index (PI) was calculated as the ratio of regional cortical activity to the whole brain activity. We found significant differences between the PI values of the untreated depressed patients and those of the controls, indicating relatively reduced perfusion in the left anterofrontal and left temporal cortical areas. No significant differences in regional PI values were found between the remitted depressed patients and the controls. Our study suggests that adolescent patients with MDD may have regional cerebral blood flow deficits in frontal regions and a greater anterofrontal right-left perfusion asymmetry compared with normal subjects. The fact that these abnormalities in perfusion indices have a trend toward normal values with symptomatic improvement suggests that they may be state-dependent markers for adolescent MDD.

International Urology and Nephrology, Sep 1, 1997

In the present study we investigated the role of endothelin and AT II in radiocontrast nephropath... more In the present study we investigated the role of endothelin and AT II in radiocontrast nephropathy induced in rats with reduced renal mass (70-75%). Thirty-five male Wistar albino rats weighing between 280 and 400 g were anaesthetized with ketamine (130 mg/kg b.w.) and right total, left 50% nephrectomy were performed. After this operation, the rats were kept under observation for six to eight weeks and then they were randomly separated into three groups. Group I rats were infused with 8.9 ml/kg (or 2.9 g of iodine/kg body weight) Na diatrizoate (Urovision, 1,500 mosm/kg). Group II rats were infused with 0.9% NaCl in an equal volume with the radiocontrast material. Group III rats were given 4.5% NaCl that had the same volume and osmolality as the radiocontrast material. Two hours after the drug infusions, blood and accumulated urine samples were collected from all the rats and tested for endothelin, AT II, BUN, creatinine, uric acid, electrolytes, calcium and phosphorus. We found that the plasma endothelin levels in Group I (77.64 +/- 29.62 pg/ml) were significantly higher than in Group II (20.52 +/- 5.83 pg/ml) and Group III (15.04 +/- 5.15 pg/ml) (t = 8.34 and t = 9.14, respectively, p < 0.001). Therefore elevation in circulating endothelin might have been an additional factor leading to the radiocontrast-induced nephrotoxicity.

23rd Annual Congress of the European-Association-of-Nuclear-Medicine (EANM) -- OCT 09-13, 2010 --... more 23rd Annual Congress of the European-Association-of-Nuclear-Medicine (EANM) -- OCT 09-13, 2010 -- Vienna, AUSTRIAWOS: 000283023801728…European Assoc Nuclear Me

Annals of Nuclear Medicine, May 1, 2003

Technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) as a static renal agent is currently the mos... more Technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) as a static renal agent is currently the most frequently used agent in the detection of renal scarring, and allows accurate calculation of differential renal function (DRF). But this agent has some disadvantages such as relatively higher radiation dose and time consumption. Methods: The purpose of this study was to evaluate the potential of summed image that obtained from parenchymal phase of the dynamic technetium-99m-N,N-ethylenedicysteine (Tc-99m EC) scintigraphy in the detection of renal parenchymal defects and in the estimation of DRF, and to compare the results of this method with those of Tc-99m DMSA scintigraphy. The uptake ratios of the kidney to body background were also calculated for these two methods. Twenty-nine children with various renal disorders underwent both static Tc-99m DMSA and dynamic Tc-99m EC scintigraphy. The cortical analysis of Tc-99m EC scintigraphy was performed on the summed image obtained from dynamic images using the time interval between the first 45-120 sec. Results: There was a very close correlation between these two methods with respect to DRF (r = 0.99). In the detection of renal parenchymal lesions, scintigraphy with Tc-99m DMSA detected more lesions, and the sensitivity and specificity of the summed Tc-99m EC images were calculated as 92.6% and 100%, respectively. In addition, the ratios of mean uptake values for Tc-99m DMSA and Tc-99m EC images were 7.59 ± 2.17 and 2.95 ± 0.91, respectively. This ratio of Tc-99m EC seems to be acceptable and allows good delineation of the kidneys. But, the main disadvantages of the summed Tc-99m EC images in comparison with static Tc-99m DMSA images are the use of only posterior projection that may be an important drawback in patients with abnormal kidney positions, lower image counts and higher pixel size because of dynamic acquisition. Conclusion: These results show that summed Tc-99m EC images with an acceptable high image contrast provide an accurate DRF calculation in patients without abnormal kidney positions and allow the detection of most renal parenchymal abnormalities. However, Tc-99m DMSA scintigraphy remains the gold standard method because of its well known advantages.

Türk Beyin Damar Hastalıkları Dergisi, Aug 1, 2007