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Öğe Application of first-pass contrast bolus tracking sequence for the assessment of morphology and flow dynamics in cardiac MRI(AVES, 2013) Paksoy, Yahya; Ozbek, Orhan; Gumus, Serter; Koc, Osman; Nayman, Alaaddin; Kerimoglu, UlkuPURPOSE There are two well-known indications for first-pass perfusion in the literature. First is the evaluation of Myocardial ischemia, and the other is the evaluation of tumor vascularity. Our aim was to assess the value of a first-pass Contrast bolus tracking sequence (FPCBTS) for cases unrelated to these pathologies. MATERIALS AND METHODS A total of 35 patients (age range, 1 day to 66 years; mean age, 10.4 +/- 19.2 years; median age, 4.5 months) with suspected congenital (n=31) and acquired (n=4) heart and great vessel disease Were included in the study. All the patients underwent cardiac magnetic resonance imaging (MRI) and FPCBTS, and 20 patients underwent contrast enhanced magnetic resonance angiography (CE-MRA). We used cardiac MRI and CE-MRA for anatomic evaluation and FPCBTS for dynamic flow evaluation. RESULTS Truncus arteriosus, double outlet right ventricle, tetralogy of Fallot; corrected transposition of great arteries, atrial and ventricular septal defect, aortic rupture, cardiac hydatid cyst, tricuspid atresia, anomalous pulmonary venous return; and interrupted aorta were detected using the technique described here. Septal defects in six patients arid atrial aneurysm in two patients were excluded. The shunt gap and flow direction of the septal defects, a ruptured Wall in a dissected aorta, a hydatid cyst, and the atrial relationship in two cases with paracardiac masses Were diagnosed easily using this dynamic evaluation technique. CONCLUSION FPCBTS Can be performed in addition to cardiac MRI and CE-MRA to reveal flow dynamics and morphology.Öğe Blue Rubber Bleb Nevus Syndrome: Successful Treatment With Sirolimus(AMER ACAD PEDIATRICS, 2012) Yuksekkaya, Hasan; Ozbek, Orhan; Keser, Melike; Toy, HaticeBlue rubber bleb nevus syndrome (BRBNS) is a rare disorder with characteristic vascular malformations of the skin, gastrointestinal system, and, less often, other organ systems. The characteristic cutaneous lesions consist of deep-blue, soft, rubbery blebs, which are easily compressible. The most serious complication is abundant gastrointestinal bleeding. We describe the case of an 8-year-old girl with diagnosed BRBNS who had multiple venous malformations all over her body, importantly, throughout the gastrointestinal tract, mouth, esophagus, stomach, small bowel, and colon. She presented with recurrent massive gastrointestinal bleeding and soft tissue hematoma despite prednisolone and a-interferon therapy. We started low-dose sirolimus as an antiangiogenic agent. The vascular masses were reduced rapidly and there was no gastrointestinal bleeding and muscular hematoma after sirolimus therapy. There was no drug adverse reaction at 20-month follow-up. To the best of our knowledge, this is the first report related to the use of sirolimus in a patient with BRBNS. Pediatrics 2012;129:e1080-e1084Öğe Bronchocele: Demonstration By 3D Volume Rendering Imaging with Multidetector Computed Tomography: Case Report(ORTADOGU AD PRES & PUBL CO, 2011) Sakarya, Mehmet Emin; Ceran, Sami; Koc, Osman; Ozbek, Orhan; Karabekmez, Leman G.; Odev, KemalCongenital bronchial atresia (CBA) is a rare congenital abnormality of the lung. It results from a congenital focal obliteration of a proximal segmental or sub-segmental bronchus with normal development of distal structures. Because of proksimal bronchial stenosis, the distal bronchi became filled with mucus and form a bronchocele. Three dimensional (3D) volume rendering (VR) imaging was performed with 64-slice multidetector computed tomography (MDCT) equipment in a patient with CBA and bronchocele. 3D VR images clearly revealed branching nonenhancing tubular structure and the adjacent lung with features of air trapping. A diagnosis of bronchocele was made radiologically. We report a case of bronchocele documented by 3D image reconstruction and VR images using 64-slice MDCT. In this article we report that, the radiologic findings of the broncocele can be shown more clearly with 3D VR technique than standan CT imaging.Öğe Complementary Use of NBCA with the Amplatzer Vascular Plug for Embolization of a High-Flow Traumatic Hepatic Arteriovenous Fistula(SPRINGER, 2009) Koc, Osman; Cil, Barbaros Erhan; Peynircioglu, Bora; Emlik, Dilek; Ozbek, Orhan[Abstract not Available]Öğe Displacement of the heart by diaphragm: is this heart alternating?(CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2011) Gul, Enes Elvin; Can, Ilknur; Ozbek, OrhanA-64-year-old man was admitted to the emergency department because of dyspnea. Twelve-lead ECG revealed alternating QRS complexes. In consequence of diagnostic tests, i.e., chest tomography showed eventration of the left diaphragm. In this case, we present an unusual case of electrical alternans due to diaphragmatic eventration. (C) 2011 Elsevier Inc. All rights reserved.Öğe Dural Carotico-Cavernous Fistula: Pre and Postembolization Appearances of Bone-Subtracted CT Angiography(TURKISH NEUROSURGICAL SOC, 2013) Koc, Osman; Genc, Emine; Ozturk, Banu; Genc, Bulent Oguz; Keskin, Fatih; Ozbek, OrhanDigital subtraction angiography (DSA) is the best method of evaluating carotid cavernous fistulas (CCF). DSA, however, has the disadvantage of being an invasive procedure. Computerized tomography (CT) angiography which is noninvasive, have been shown to provide more information about the size and location of fistulas. As a new method, Bone-Subtraction CT Angiography (BSCTA), than conventional CT angiography, is a method that improves the detection and interpretation of vascular lesions near to the cavernous segment of carotid artery. In this case report, we report a case of a dural carotico-cavernous fistula (CCF), appearances of pre and postembolization BSCTA images, confirmed by on DSA. As far as we know, CCF demonstrated by BSCTA has not been reported yet.Öğe Dural Carotico-Cavernous Fistula: Pre and Postembolization Appearances of Bone-Subtracted CT Angiography(2013) Koc, Osman; Genc, Emine; Ozturk, Banu; Genc, Bulent Oguz; Keskın, Fatıh; Ozbek, OrhanDij ital subtraksiyon anj iyografi (DSA) karotiko-kavernöz fistülü (KKF) değerlendirmede en iyi metodtur. Ancak DSA invaziv bir yöntemdir. Noninvaziv bir yöntem olan Bilgisayarlı tomografi (BT) anj iyografi fistül lokalizasyonu ve büyüklüğünü gösterebilir. Yeni bir yöntem olan Kemik baskılı BT anj iyografi (KBBTA) özellikle karotid arterin kavernöz segment lezyonlarının saptanmasında ve yorumlanmasında konvansiyonel BT anj iyografiye göre daha değerli bilgiler vermektedir. Bu olgu sunumunda, tanısı DSA ile doğrulanmış KKF olgusunun pre ve postembolizasyon görüntülerini sunduk. Bizim bilgilerimize göre KBBTA ile tanısı konulan KKF olgusu bildirilmemiştir.Öğe Ectopic, Polycystic and Stoned: Pelvic Kidney in a Patient With Autosomal Dominant Polycystic Kidney Disease(LIPPINCOTT WILLIAMS & WILKINS, 2012) Solak, Yalcin; Biyik, Zeynep; Gaipov, Abduzhappar; Ozbek, Orhan; Tonbul, Halil Zeki[Abstract not Available]Öğe Effects of secondary amyloidosis on arteriovenous hemodialysis fistula outcomes and intradialytic hypotension: A case-control study(WILEY-BLACKWELL, 2012) Solak, Yalcin; Caymaz, Memduh; Tonbul, Halil Zeki; Ozbek, Orhan; Turkmen, Kultigin; Gormus, NiyaziAmyloid fibrils can affect vascular structure through deposition and by causing nitric oxide depletion and increase of asymmetric dimethyl arginine. Patients with amyloidosis are prone to development of hypotension. Hypotension may also affect the maturation of arteriovenous fistula (AVF) and may set the stage for formation of thrombosis and fistula failure. Thus, we aimed to evaluate effects of secondary amyloidosis on AVF outcomes and intradialytic hypotension. This is a case-control study which included 20 hemodialysis patients with amyloidosis and 20 hemodialysis patients without amyloidosis as control group. All patients underwent Doppler ultrasound of AVF. A thorough fistula history and baseline laboratory values along with episodes of intradialytic hypotension and blood pressure measurements were recorded. There was no difference between the groups regarding age, gender, body mass index, presence of comorbidities, hypertension, and drug use. Systolic and diastolic blood pressures were similar (119 +/- 28/75 +/- 17 and 120 +/- 14/75 +/- 10?mmHg for patients with and without amyloidosis, respectively). Intradialytic hypotension episodes were also similar. Patients with amyloidosis had significantly lower serum albumin and higher C-reactive protein values compared to control hemodialysis patients. AVF sites and total number of created fistulas were similar in both groups. Flow rates of current functional AVFs were not different between the groups (1084 +/- 875 and 845 +/- 466?mL/minute for patients with and without amyloidosis, respectively, p:0.67). Patency duration of first AVF was not different between the groups. Clinical fistula outcomes and rate of intradialytic hypotension episodes were not significantly different between patients with and without secondary systemic amyloidosis.Öğe Endovascular Management of Massive Gastrointestinal Bleeding Associated with Polyarteritis Nodosa(ELSEVIER SCIENCE INC, 2009) Koc, Osman; Ozbek, Orhan; Gumus, Serter; Demir, Ali[Abstract not Available]Öğe Epicardial Adipose Tissue and Coronary Artery Calcification in Diabetic and Nondiabetic End-Stage Renal Disease Patients(TAYLOR & FRANCIS LTD, 2011) Tonbul, Halil Zeki; Turkmen, Kultigin; Kayikcioglu, Hatice; Ozbek, Orhan; Kayrak, Mehmet; Biyik, ZeynepBackground/aims: Atherosclerosis, coronary artery calcification, diabetes mellitus, inflammation, endothelial dysfunction, and left ventricular hypertrophy are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in end-stage renal disease (ESRD) patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between coronary artery disease (CAD) and EAT was shown in healthy subjects and patients with high risk of CAD. To date, there is not enough data about EAT in diabetic and nondiabetic ESRD patients. Therefore, we aimed to investigate the EAT and coronary artery calcification score (CACS) in diabetic and nondiabetic ESRD patients and healthy subjects. Methods: Sixty ESRD patients (17 diabetic, 43 nondiabetic ESRD patients) and 20 healthy subjects were enrolled in the study. EAT and CACS were performed by a 64-slice multidetector computed tomography scanner. Results: There were no differences in age, gender, body mass index, pre-dialysis systolic and diastolic blood pressure levels, biochemical parameters including serum low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, and C-reactive protein between healthy subjects, diabetic, and nondiabetic ESRD patients. Total CACSs and EAT measurements were significantly higher in diabetic ESRD patients when compared with nondiabetic ESRD patients and healthy subjects. There was statistically significant relationship between EAT and CACS in ESRD patients (p < 0.0001, r = 0.48). Conclusion: In conclusion, we found a significant increase in terms of EAT and CACS in diabetic ESRD patients when compared with nondiabetic ESRD patients and healthy subjects.Öğe Epstein-Barr virus encephalitis: findings of MRI, MRS, diffusion and perfusion(TURKISH J PEDIATRICS, 2011) Ozbek, Orhan; Koc, Osman; Paksoy, Yahya; Aydin, Kursad; Nayman, AlaaddinOzbek O, Koc O, Paksoy Y, Aydin K, Nayman A. Epstein-Barr virus encephalitis: findings of MRI, MRS, diffusion and perfusion. Turk j Pediatr 2011; 53: 680-683 Epstein-Barr virus is an infection that is known as infectious mononucleosis. Even though the central nervous system is not a primary region of involvement of this disease, neurological complications are reported rarely. In this case report, we evaluated a 15-month-old male who presented to the pediatric neurology clinic due to high fever and a neurologic attack. His serological tests and radiological examinations (magnetic resonance imaging (MRI), MR spectroscopy (MRS), diffusion-weighted imaging (DWI) and MR perfusion) were consistent with Epstein-Barr virus encephalitis, which is a very rare complication of infectious mononucleosis. Additionally, we discuss the MRI, MRS, DWI and MR perfusion findings of our case, which were different from other cases reported in the literature.Öğe Magnetic resonance cholangio pancreatography evaluation of intrahepatic bile duct variations with updated classification(AVES, 2016) Nayman, Alaaddin; Ozbek, Orhan; Erol, Seyit; Karakus, Hayrettin; Kaya, Hasan EminPURPOSE Preoperative detection of intrahepatic bile duct (IHBD) variations is essential to reduce surgical morbidity and mortality rates. Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive and reliable method for demonstrating the normal IHBD anatomy and its variations. This retrospective study aimed to identify and classify novel variations, except those already reported in the literature, using MRCP. METHODS MRCP examinations, which were conducted in two different centers in the last five years, were retrospectively 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. RESULTS MRCP 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. CONCLUSION MRCP 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 anatomy.Öğe Morphometric Analysis of Suprarenal Glands (Adrenal Glands) with Multislice Computerized Tomography(SOC CHILENA ANATOMIA, 2017) Akin, Duygu; Yilmaz, Mehmet Tugrul; Ozbek, Orhan; Ozbiner, Huseyin; Cicekcibasi, Aynur Emine; Buyukmumcu, Mustafa; Kabakci, Anil DidemThe aim of our study are to determine the shape, vertebrae level, height, volume, corpus medial and lateral branch thicknesses of AG and the distance from some neighboring structures on multidetector computed tomography (MDCT) images and also to determine the relationship between these data and gender, age, height, weight and body mass index (BMI). The study was conducted on a total of 420 MDCT images consisted of 220 male (mean age 63.44 +/- 8.00, 50-81 years), 200 female (mean age 61.23 +/- 7.95, 50-84 years) healthy individuals. Vertebrae level of AG (VLAG), height of AG (HAG), adrenal gland volume (VAG), corpus thickness of AG (CTAG), medial section thickness of AG (MTAG) and lateral section thickness of AG (LTAG) were investigated. In our study, RAG were observed on T12 vertebrae level in 38.19 % of males and 42.5 % of females and LAG were also observed at that level in 39.55 % of the male and 51 % of the female individuals. RAG were observed in all males and 98.5 % of the females and LAG were observed 88.63 % of the males and 94 % of the females "Y" shaped. VAG were observed lower in males compared to females in age groups and VAG was observed increasing with age in males; decreased in 60-69 age group of females and increased again in 70 and plus age group. The aim of this study is to determine normal ranges of AG sizes and the relationship of each one with sex, age, height, weight and BMI.Öğe PERI-AORTIC FAT TISSUE THICKNESS IN PERITONEAL DIALYSIS PATIENTS(MULTIMED INC, 2013) Turkmen, Kultigin; Ozbek, Orhan; Kayrak, Mehmet; Samur, Cigdem; Guler, Ibrahim; Tonbul, Halil ZekiBackground: Thoracic peri-aortic fat tissue (PFT) and epicardial adipose tissue (EAT) are metabolically active visceral fat deposits surrounding the thoracic aorta and the heart, respectively. Various studies have demonstrated a positive predictive value of both PFT and EAT for coronary artery disease in the general population. In the present study, we aimed to investigate PFT thickness and the independent predictors of PFT in peritoneal dialysis (PD) patients. Methods: Our cross-sectional study enrolled 35 PD patients (10 women, 25 men) and 30 age-and-sex-matched healthy subjects (15 women, 15 men). We measured PFT, thoracic artery calcification (TAC), EAT, and coronary artery calcification (CAC) by electrocardiogram-gated 64-multi-detector computed tomography. Results: The measured PFT, EAT, CAC, and TAC were significantly higher in the PD group than in the healthy subjects (p < 0.05 each). In the PD group, PFT and TAC were significantly correlated (r = 0.33, p = 0.007). Also, PFT measurements were positively correlated with EAT and total CAC in the PD and the control group alike (r = 0.58, p = 0.001 and r = 0.54, p = 0.01 respectively). A stepwise linear regression analysis revealed that age, duration of hypertension, and being a PD patient were independent predictors of PFT. Conclusions: Measured PFT was higher in PD patients than in healthy subjects and, in the PD population, was also shown to be related to calcification scores and EAT.Öğe Predictors of Kidney Dimensions Measured by Multi-detector Computed Tomography (MDCT) in 930 Middle-Aged and Elderly Patients(INFORMA HEALTHCARE, 2012) Ozbek, Orhan; Solak, Yalcin; Guler, Ibrahim; Ozbiner, Huseyin; Ozbek, Seda; Turkmen, Kultigin; Nayman, AlaaddinPurpose: A few studies investigated renal size using computed tomography (CT) in middle-aged and elderly patients while taking renal function into account. Thus, we aimed to assess kidney dimensions and their predictors in patients without known renal disease by multi-detector computed tomography (MDCT). Methods: This is a 6-month-long prospective observational study. Estimated glomerular filtration rate (eGFR) was calculated with Cockcroft-Gault (CG) and modification of diet in renal disease (MDRD) formulas. Pole-to-pole kidney length (R1) was determined from coronal and sagittal oblique images. Kidney length (R2), width (R3), and parenchymal thickness were measured in axial slices. Results: The data of the 930 patients were included in this study. CG-eGFR was more closely correlated with R1, R2, and R3 than MDRD-eGFR. CG-eGFR, female gender, and presence of diabetes mellitus were independent predictors of R1 size in logistic regression analyses. Conclusion: Kidney sizes diminish with advancing age. CG-eGFR shows a better correlation with kidney dimensions compared with MDRD. Overall, age was a stronger determinant of eGFR than renal dimensions.Öğe Priapism as Presenting Manifestation of Germ Cell Tumor in a Child(AKAD DOKTORLAR YAYINEVI, 2011) Ozbek, Orhan; Koksal, Yavuz; Koc, Osman; Karagol, Cuneyt; Ozbek, Seda; Kilic, MehmetPriapism, defined as prolonged and persistent erection of the penis without sexual stimulation, is rarely seen in children. We report a 2-year-old boy who was admitted with priapism with a history of the perineal trauma. Doppler ultrasonography revealed signs of high-flow priapism. Magnetic resonance imaging revealed an intrapelvic mass beside the root of the penis. The serum alpha-fetoProtein level was 54.600 ng/ml (Normal range: 0-9 ng/ml). Tru-cut biopsy was performed and endo-dermal sinus tumor was diagnosed. At the fourth day of chemotherapy, the penis became progressively less turgid and soft. After the first cycle chemotherapy, priapism had completely resolved.Öğe Radiofrequency ablation of a rare pathology: vertebral intraosseous lipoma(ELSEVIER SCIENCE INC, 2016) Ozbek, Orhan; Keskin, Fatih; Kaya, Hasan Emin; Guler, Ibrahim; Nayman, Alaaddin; Koc, Osman[Abstract not Available]Öğe Radiofrequency ablation of phalangeal osteoid osteoma: technical challenges encountered in small bones(TURKISH JOINT DISEASES FOUNDATION, 2011) Ozbek, Orhan; Nayman, Alaaddin; Koc, Osman; Kucukapan, Ahmet; Ozbek, Seda; Kerimoglu, UlkuOsteoid osteoma, a benign bone tumor, is characterized by a generally less than 1 cm nidus surrounded by a zone of reactive sclerosis. It is frequently located in the femur and tibia; on the other hand in up to 5% of cases it may be presented in upper extremities. In previous years, its treatment was usually open surgery with en-bloc resection or curettage of the tumor. Various minimal invasive percutaneous treatments including radiofrequency ablation became popular in last years. In this report, the difficulties encountered during radiofrequency ablation treatment in small bones is described in a 19-year-old female case of osteoid osteoma.Öğe Radiologic findings of a traumatic urethral diverticulum with stones in an infertile male patient(TURKISH SOC RADIOLOGY, 2011) Ozbek, Orhan; Piskin, Mesut; Koc, Osman; Kadiyoran, Cengiz; Ozbek, Seda; Odev, KemalUrethral diverticulum is rarely encountered in male patients. Although postmicturition dribble, pain and infection are usually present, infertility is rarely reported in urethral diverticulum. We present a case with urethral diverticulum associated with infertility, which was diagnosed radiologically.
