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Öğe Ankylosing Spondylitis With Mycetoma Case Treated With Oral Itraconazole(Springer Heidelberg, 2010) Bekçi, Taha; Kelsi, Recep; Maden, Emin; Özbek, OrhanPleuropulmonary involvement is an uncommon event in the course of ankylosing spondylitis (AS). Apical fibrosis, interstitial infiltrates, and pleural thickening were considered to be the main patterns. However, the presence of cavity is very rare in AS. Here, we report an AS case with aspergilloma, which has been successfully treated with itraconazole.Öğe Anterior Spinal Artery Aneurysm Presenting With Spinal Cord Compression: MRI and MRI Angiographic Findings(B M J Publishing Group, 2010) Koç, Osman; Özbek, Orhan; Paksoy, Yahya; Kocaoğulları, YalçınA 30-year-old woman presented with progressive paraparesis and urinary incontinence for 1 month. Physical examination revealed weakness at the plantar and dorsal flexors of the ankle and toes. Routine blood tests were normal. MRI showed spinal cord compression.Öğe The association between myocardial iron load and ventricular repolarization parameters in asymptomatic beta-thalassemia patients(2012) Kayrak, Mehmet; Acar, Kadir; Gül, Enes Elvin; Özbek, Orhan; Abdulhalikov, Turyan; Sönmez, Osman; Alibaşiç, HayruddinPrevious studies have demonstrated impaired ventricular repolarization in patients with ?-TM. However, the effect of iron overload with cardiac T 2 * magnetic resonance imaging (MRI) on cardiac repolarization remains unclear yet. We aimed to examine relationship between repolarization parameters and iron loading using cardiac T 2 * MRI in asymptomatic ?-TM patients. Twenty-two ?-TM patients and 22 age- and gender-matched healthy controls were enrolled to the study. From the 12-lead surface electrocardiography, regional and transmyocardial repolarization parameters were evaluated manually by two experienced cardiologists. All patients were also undergone MRI for cardiac T 2 * evaluation. Cardiac T 2 * score <20msec was considered as iron overload status. Of the QT parameters, QT duration, corrected QT interval, and QT peak duration were significantly longer in the ?-TM group compared to the healthy controls. T p - T e and T p - T e dispersions were also significantly prolonged in ?-TM group compared to healthy controls. (T p - T e) / QT was similar between groups. There was no correlation between repolarization parameters and cardiac T 2 * MRI values. In conclusion, although repolarization parameters were prolonged in asymptomatic ?-TM patients compared with control, we could not find any relation between ECG findings and cardiac iron load. Copyright © 2012 Mehmet Kayrak et al.Öğe Behçet hastalığında iyatrojenik sağ internal mamaryan arter çalma sendromu(2014) Erol, Cengiz; Paksoy, Yahya; Kanat, Fikret; Özbek, Seda; Kıvrak, A.Sami; Koplay, Mustafa; Özbek, OrhanSubklaviyan arter anevrizması nedeniyle opere edilen bir Behcet olgusunda anevrizmaya açılan vertebral arter ve sağ internal mamaryan arterin, anevrizma kesesi içerisinde bırakılması sonucu, post operatif dönemde iatrojenik olarak ortaya çıkan sağ internal mamaryan arter çalma sendromunun görüntüleme bulgularını sunmak istedik. Bizim bilgilerimize göre bugüne kadar, sağ internal mamaryan arterin sorumlu olduğu çalma sendromu literatürde tariflenmemiştir. Kesitsel noninvaziv radyolojik görüntüleme yöntemleri, bu olguda anatomik detayın gösterilmesi, cerrahi sonrası değişen ve yeni ortaya çıkan anatominin ortaya konmasında oldukça başarılı olmuştur.Öğe Çok dedektörlü bilgisayarlı tomografi ile kardiyak değerlendirme(2009) Koç, Osman; Özbek, OrhanAmaç: Bu derleme son yıllarda hızla gelişen ve her geçen gün klinik kullanımı yaygınlaşan ÇDBT koroner anjiyografinin teknik özelliklerini, uygulama yöntemini ve tanıdaki başarısını göstermek üzere hazırlandı. Ana bulgular: Koroner arter hastalığı gelişmiş ülkelerde en önemli ölüm sebebidir. İnvaziv koroner anjiyografi koroner arterlerin anatomi ve patolojisini değerlendirmede, koroner arter hastalığında koroner lümen daralmalarının büyüklük ve şiddetini göstermede halen standart teknik olarak kullanılmaktadır. Çok dedektörlü BT (ÇDBT) primer olarak obstrüktiv koroner hastalıkları değerlendirmede kullanılmasına rağmen, konjenital defektler ve koroner arter anomalilerinin saptanmasında, torasik girişimlerin planlanmasında, bypass greftlerin ve koroner stentlerin değerlendirilmesinde ve kardiyak fonksiyonların gösterilmesinde giderek artan bir şekilde kullanılmaktadır. Çeşitli BT teknikleri ile yapılan koroner arter kalsiyum skorlama koroner arter hastalığı riskini saptamada kullanılmaktadır. Sonuç: Bilgisayarlı tomografi (BT) tekniğindeki yeni gelişmeler aterosklerotik koroner hastalığın ve diğer kardiyak patolojilerin noninvaziv bir şekilde değerlendirilmesine olanak sağlamıştır.Öğe Compartmentalization of Inoperable High-Flow Vascular Malformation(2009) Keskin, Mustafa; Toksoz, Rasid; Özbek, Orhan; Tosun, Zekeriya; Savacı, NedimA high-flow vascular malformation of the face is a rare entity, and it can cause severe disfigurement and can even be potentially fatal as a result of massive hemorrhage. The authors describe a high-flow vascular malformation case that was successfully treated by compartmentalization and sclerotherapy with polidocanol. Two weeks later, the necrotic tissues were debrided and the resulting defect was covered with a skin graft. The resulting aesthetic outcome was more than anticipated by the patient. With this technique, it was possible to treat what was considered an untreatable vascular malformation using a standard technique.Öğe Congenital Aortopulmonary Fistule: Multislice CT Angiography Findings(2009) Özbek, Orhan; Koç, Osman; Paksoy, Yahya; Gümüş, Serter; Karaaslan, SevimAortopulmonary fistulas are most commonly reported as a complication of thoracic surgery or aortic dissection. Formation of congenital fistula between aorta and main pulmonary artery without an accompanying congenital malformation has not been reported yet. A patient who had a milimetric tortuous vascular structure between descending aorta and main pulmonary artery on CT angiography and diagnosed as congenital aortopulmonary fistula and attempted to our hospital with dyspnea, is reported. The aim of this report is to demonstrate aortopulmonary fistula in the multislice CT images and to emphasize considering the aortopulmonary fistula in the differential diagnosis of left to right shunt. © 2009 Elsevier Ireland Ltd. All rights reserved.Öğe Congenital hydrocephalus as a rare cause of severe type 1 plasminogene deficiency(Kare Publishing, 2013) Annagür, Ali; Altunhan, Hüseyin; Özbek, Orhan; Öztürk, Banu Turgut; Örs, RahmiSevere type I plasminogen deficiency is a rarely seen autosomal recessive disease that causes chronic inflammation in mucous membranes, primarily eye membranes. The most commonly encountered clinical manifestation is ligneous conjunctivitis. In these patients, congenital occlusive hydrocephaly may rarely be observed. In this report, we presented a newborn who had hydrocephaly in the prenatal period and presence of severe plasminogen deficiency was detected after birth. We found that the same disease was present in two children of the family and in the aunt of the newborn and discussed this situation. It should be kept in mind that plasminogen deficiency may also be present in cases with occlusive hydrocephaly and especially in newborns with the diagnosis of ligneous conjunctivitis and with familial history of ligneous conjunctivitis.Öğe Constrictive Calcific Pericarditis Masked by Haemodialysis(2009) Solak, Yalçın; Selçuk, Nedim; Tekinalp, Mehmet; Özbek, Orhan; Atalay, HüseyinWe admitted a maintenance haemodialysis patient with hypotension and weakness. He had undergone cadaveric renal transplantation 19 years earlier. He had lost his kidney due to chronic allograft nephropathy 1 year after transplantation and returned to haemodialysis. He had hypotension, especially remarkable during haemodialysis. He also had hepatitis C but no cirrhosis. The patient denied a previous pulmonary tuberculosis. On physical examination, he was hypotensive (80/60 mmHg) but without peripheral oedema, neck vein distention or hepatomegaly. Heart sounds were weakly heard and there was no audible murmur or friction rub. Pericardial calcification was noticed on chest x-ray (Figure 1). Echocardiography could not visualize the pericardium or heart. Only coarse calcification of the pericardium from the subphrenic angle, but no further detail, was visible. Subsequently, we performed computerized tomography of the pericardium (Figure 2), which revealed a crescent-like calcification of the pericardium. There were calcific plaques on the right lower lobe of the pulmonary pleura as well.Öğe Doğuştan hidrosefalinin nadir bir nedeni olarak tip-1 plazminojen eksikliği(2013) Annagür, Ali; Altunhan, Hüseyin; Özbek, Orhan; Turgut, Banu Öztürk; Örs, RahmiCiddi tip 1 plazminojen eksikliği otozomal çekinik geçen ve başta göz olmak üzere müköz membranlarda kronik enflamasyona neden olan nadir bir hastalıktır. En sık görülen klinik tablosu linyöz konjonktivittir. Bu hastalarda nadiren doğuştan tıkayıcı hidrosefali de görülebilir. Biz burada doğum öncesi hidrosefali tanısı konan ve doğumdan sonra ciddi plazminojen eksikliği olduğu gösterilen yenidoğan bir bebeği sunduk. Ailenin ilk çocuğunda ve iki teyzesinde de aynı hastalığın bulunduğunu saptayıp tartıştık. Tıkayıcı hidrosefali olgularında ve özellikle linyöz konjonktivit tanısı konan veya aile öyküsünde linyöz konjonktivit olduğu bilinen bebeklerde plazminojen eksikliğinin de olabileceği akılda bulundurulmalıdır.Öğe A FRONTONASAL DYSPLASIA CASE WITH ABSENCE OF FALX CEREBRI(NOBEL ILAC, 2013) Altunhan, Hüseyin; Annagür, Ali; Özbek, Orhan; Örs, RahmiFrontonasal dysplasia which is also called median cleft face syndrome, is a disease that presents with signs like hypertelorism, broad nasal base, formation defect of nasal edge, anterior cranium, bifidum ocultum, microphtalmia in the face and head but with possible anomalies in any organ or system. Central nervous system anomalies like corpus callosum agenesis, lipomas of corpus callosum and encephalosel may also be seen in these cases. We presented a frontonasal dysplasia case without falx cerebri. According to our investigation, this is the first case of frontonasal dysplasia without falx cerebri.Öğe A frontonasal dysplasia case with Absence of falx cerebri(2013) Altunhan, Hüseyin; Annagür, Ali; Özbek, Orhan; Örs, RahmiFrontonasal dysplasia which is also called median cleft face syndrome, is a disease that presents with signs like hypertelorism, broad nasal base, formation defect of nasal edge, anterior cranium, bifidum occultum, microphtalmia in the face and head but with possible anomalies in any organ or system. Central nervous system anomalies like corpus callosum agenesis, lipomas of corpus callosum and encephalosel may also be seen in these cases. We presented a frontonasal dysplasia case without falx cerebri. According to our investigation, this is the first case of frontonasal dysplasia without falx cerebri.Öğe Influenza A/H1N1 infection in a renal transplant recipient: Early recognition prevented unfavorable results(2011) Solak, Yalçın; Selçuk, Nedim Yılmaz; Atalay, Hüseyin; Özbek, Orhan; Genç, NejdetInfluenza A/H1N1 2009, 2009 yılında ilk olguların görülmesinden sonra hızlı şekilde bir pandemi meydana getirmiştir. Bu virüs bulaşma hızı ve özellikle genç sağlıklı erişkinlerde yol açtığı ölümler gibi özellikleri nedeniyle dünya çapında bir panik havasına neden olmuştur. Pandemi binlerce laboratuvar tanılı olgu ve yüzlerce ölüme neden olmuştur. Yüksek prevalansına rağmen literatürde böbrek transplant hastalarında bu enfeksiyon ve klinik sonuçlarına ilişkin az sayıda bildirim mevcuttur. Erken tanı ve hızlı şekilde oseltamivir uygulaması şiddetli respiratuvar hastalığı önleyebilir. Biz burada H1N1/influenza A enfeksiyonu semptomlarının başlamasından kısa süre sonra başvuran oseltamivir ve geniş spektrumlu antibiyotiklerle tedavisi sonucu çabuk iyileşme gösteren bir böbrek transplant alıcısını sunmaktayız.Öğe Karaciğerden köken alan mezenkimal hamartom: Radyolojik bulgular(2010) Özbek, Seda; Özbek, OrhanAmaç: Karaciğerden köken alan mezenkimal hamartom nadir görülen benign bir tümör olup iki yaş altı çocuklarda izlenir. Mezenkimal hamartomun kistik, solid, ve mikst olmak üzere üç farklı tipi vardır. Nadir görülen bu tümörün tanısında ve tiplendirilmesinde ultrasonografi ve çok kesitli bilgisayarlı tomografi değerli bulgular vermektedir. Olgu sunumu: Bu makalede karında şişlik ve nefes almakta güçlük yakınması ile pediatri bölümüne başvuran 7 aylık erkek olguda saptanan geniş boyutlu kistik hepatik mezenkimal hamartomun ultrasonografi, çok kesitli bilgisayarlı tomografi bulguları sunulmuştur.Öğe Magnetic resonance cholangiopancreatography evaluation of intrahepatic bile duct variations with updated classification(2016) Nayman, Alaaddin; Özbek, Orhan; Erol, Seyit; Karakuş, Hayrettin; Kaya, Hasan EminPURPOSE Preoperative detection of intrahepatic bile duct (IHBD) variations is essential to reduce surgical mor-bidity and mortality rates. Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive and reliable method for demonstrating the normal IHBD anatomy and its variations. This retrospec-tive study aimed to identify and classify novel variations, except those already reported in the liter-ature, using MRCP.METHODSMRCP examinations, which were conducted in two different centers in the last five years, were ret-rospectively evaluated. IHBD variations were recorded with respect to the Yoshida classification. In addition, newly detected variations that were not included in this classification were identified and classified.RESULTSMRCP examinations of 2624 patients were screened, and 2143 were determined to be eligible for evaluation. Of 2143 patients, 987 were males (average age, 54±18 years) and 1156 were females (mean age, 57±17 years). In this study, 10 novel variations that were not included in the Yoshida classification were identified in 14 patients.CONCLUSIONMRCP is an effective, reliable, and noninvasive imaging method for evaluating the IHBD anatomy and its variations. Novel variations described in this study may help to better understand the biliary anatomÖğe Massive Haematuria Successfully Managed by Intravesical Ankaferd in a Haemodialysis Patient Complicated With Disseminated Intravascular Coagulation(BMJ Publishing Group, 2012) Solak, Yalçın; Gaipov, Abduzhappar; Özbek, Orhan; Hassan, Mustafa Aziz; Yeksan, MehdiMassive haematuria is a life-threatening condition, demanding immediate management of bleeding. The mortality is very high in the case of delayed management of bleeding, especially in elderly patients with concomitant comorbidity. The treatment options of haematuria are wide, and depend on underlying conditions. However, therapeutic choices are limited in the presence of massive and intractable haematuria caused by disseminated intravascular coagulation (DIC). Ankaferd blood stopper (ABS) is a novel, commercially available, haemostatic agent, which has been approved by the Ministry of Health for local use in Turkey. Here, for the first time in the literature, we report a case of diffuse intravesical bleeding stopped by intravesical use of ABS in a 72-year-old man, haemodialysis patient complicated with sepsis and DIC.Öğe Non-steroidal anti-inflammatory drug (NSAID)-related colopathy mimicking neoplasia: CT findings [Steroid olmayan anti-inflamatuar ilaç kullanimi ile ilişkili neoplaziyi taklit eden kolopati: BT bulgulari](2013) Altunhan, Hüseyin; Annagür, Ali; Özbek, Orhan; Örs, Rahmi; Engin, GülgünA 67-year-old female patient who had lower quadrant pain for a week was assessed with abdominal CT and colonoscopy. Computed tomography revealed diffuse tumoral wall thickness in 10 cm segment of distal ascending colon. There was 13x9 mm in size a necrotic space in the central of lesion. Mesenteric adipose tissue was seen as heterogeneous. CT findings were evaluated as T3 colon tumor. Neither lymph node or liver metastases or mesenteric vascular pathology were seen. Colonoscopy demonstrated bloody, vegetan mass which did not let the endoscope pass. Laparoscopic right hemicolectomy was performed. After surgery, there was no tumor in histopathologic examination. Microscopy revealed chronic inflammation and findings of closed perforation. There was no lymph node involvement. The patient had history of using NSAID for two months. This pathology was diagnostically challenging because of its similar endoscopic and CT findings with ischemic, inflammatory/ infectious bowel disease or neoplasia. Hence this pathology should be kept in mind in order to differentiate the diagnosis, especially in patients with a history of NSAID use.Öğe Periton diyaliz hastalarında kemik mineral dansitometresi ile damar kireçlenmesi (Vasküler kalsifi kasyon) arasındaki ilişki(2012) Türkmen, Kültigin; Erdur, Fatih Mehmet; Özbek, Orhan; Kayıkçıoğlu, Hatice; Sağlam, Mustafa; Tombul, Halil ZekiAMAÇ: Son dönem böbrek yetersizliği (SDBY) gelişen hastalarda damar kireçlenmesi (DK) ve kemik mineral metabolizma (KMM) bozukluğu yaygın olarak gözlenmektedir. SDBY hastalarında fetuin-A düzeyinin ileri derecede düşük olduğu saptanmıştır. Çalışmamızın amacı periton diyaliz (PD) hastalarında koroner arter kireçlenmesi (KAKS), KMM ve fetuin-A arasındaki ilişkiyi incelemektir. GEREÇ ve YÖNTEMLER: Çalışmamıza 46 PD (E/K28/18) hastası alınmıştır. Hastalara çok kesitli bilgisayarlı tomografi ile koroner arter kalsiyum skorlaması (KAKS) yapıldı. KAKS değerlerine göre hastalar Grup 1 (KAKS 0), Grup 2 (KAKS: 1-99), Grup 3 (KAKS: 100-399) ve Grup 4 (KAKS: 400) olmak üzere 4 gruba ayrıldı. Serumda fetuin-A düzeyi çalışıldı. DEXA ile kemik mineral dansitometresi ölçüldü. BULGULAR: Periton diyaliz hastalarının KAKS ile femur T skorları arasında istatistiksel olarak anlamlı ilişki saptanmıştır. Hastalarının KAKS'ı arttıkça femur T skoru azalmaktaydı. Buna ek olarak T skoru -2'nin altında ve üstünde olan hastalar karşılaştırıldığında KAKS değerleri bakımından anlamlı bir farklılık saptanmamıştır. İstatistiksel açıdan anlamlı olmamakla birlikte osteopenik olan PD hastaları daha yaşlıydı ve bu hastaların fetuin-A değerleri daha düşüktü. SONUÇ: Periton diyaliz hastalarında KAKS ile kemik mineralizasyonu arasındaki anlamlı bir ilişki saptadık.Öğe Periton Diyaliz Hastalarında Kemik Mineral Dansitometresi ile Damar Kireçlenmesi (Vasküler Kalsifikasyon) Arasındaki İlişki(2012) Türkmen, Kültigin; Erdur, Fatih Mehmet; Özbek, Orhan; Kayıkçıoğlu, Hatice; Sağlam, Mustafa; Tonbul, Halil ZekiOBJECTIVE: Vascular calcifi cation (VC) and disturbed bone mineral metabolism (BMM) are commonly seen in patients with end-stage renal disease (ESRD). Fetuin-A has been found to be signifi cantly low in ESRD patients. The aim of our study was to investigate the relation between coronary artery calcifi cation, BMM and fetuin-A in peritoneal dialysis (PD) patients. MATERIAL and METHODS: 46 PD (M/F=28/18) patients were included in the study. Coronary artery calcifi cation scoring (CACS) was performed by multi slice computed tomography. The patients were divided into 4 groups according to their CACS values as Group 1 (CACS: 0), Group 2 (CACS:1- 99), Group 3 (CACS:100-399) and Group 4 (CACS: ?400). Serum levels of fetuin-A were measured. Bone mineral densitometry was measured by dual energy X-ray absorptiometer (DEXA). RESULTS: There was a statistically signifi cant difference difference between CACS and femur T scores in PD patients. Femur T scores were found to be decreased while CACS values are increased. We could not fi nd any differences in terms of CACS when we separated patients according to T scores greater or lower than -2. Osteopenic patients were found to be older and they also had low fetuin-A levels. CONCLUSION: We found an important relationship between CACS and bone mineralization in PD patients.Öğe Priapism as presenting manifestation of germ cell tumor in a child(2011) Özbek, Orhan; Köksal, Yavuz; Koç, Osman; Karagöl, Cüneyt; Özbek, Seda; Kılıç, MehmetSeksüel uyarı olmaksızın peniste ereksiyon halinin olması durumu olarak tanımlanan priapizm, çocuklarda nadir görülür. Perineal travma öyküsü olan 2 yaşında erkek hasta priapizm yakınması ile başvurdu. Dopler ultrasonografisinde yüksek akımlı priapizm tanısı konuldu. Manyetik rezonans görüntüleme yönteminde penis köküne uzanım gösteren intrapelvik kitle saptandı. Alfa fötoprotein düzeyi 54.600 ng/ml (Normal aralık: 0-9 ng/ml) idi. Tru-cut biyopsi uygulanan hastaya endodermal sinüs tümörü tanısı konuldu. Kemoterapinin 4. günü penisteki sertlik yumuşamaya başladı ve birinci kütr kemoterapi sonrasında tamamen kayboldu.
