Orhan Ozkan - Academia.edu (original) (raw)
Papers by Orhan Ozkan
Turkiye Klinikleri Genel Cerrahi Ozel Dergisi, 2014
Ulusal Cerrahi Dergisi, 2008
World journal of gastroenterology, Jan 21, 2015
Intrahepatic cholestasis of pregnancy (ICP) is a reversible pregnancy-specific cholestatic condit... more Intrahepatic cholestasis of pregnancy (ICP) is a reversible pregnancy-specific cholestatic condition characterized by pruritus, elevated liver enzymes, and increased serum bile acids. It commences usually in the late second or third trimester, and quickly resolves after delivery. The incidence is higher in South American and Scandinavian countries (9.2%-15.6% and 1.5%, respectively) than in Europe (0.1%-0.2%). The etiology is multifactorial where genetic, endocrine, and environmental factors interact. Maternal outcome is usually benign, whereas fetal complications such as preterm labor, meconium staining, fetal distress, and sudden intrauterine fetal demise not infrequently lead to considerable perinatal morbidity and mortality. Ursodeoxycholic acid is shown to be the most efficient therapeutic agent with proven safety and efficacy. Management of ICP consists of careful monitoring of maternal hepatic function tests and serum bile acid levels in addition to the assessment of fetal we...
Journal of vascular and interventional radiology : JVIR, 2016
In 2005, a 48-year-old man with a spinal cord injury had an inferior vena cava filter placed for ... more In 2005, a 48-year-old man with a spinal cord injury had an inferior vena cava filter placed for recurrent deep vein thrombosis and pulmonary embolism. He was referred for filter retrieval after a computed tomography scan demonstrated caval stenosis and 2 fractured filter arms, 1 in a pulmonary artery and 1 penetrating into the retroperitoneum and impinging on the aorta. During retrieval, 1 arm was inadvertently advanced into the aorta, and embolization of the arm occurred to the left profunda femoris artery. It was subsequently retrieved. This is the first reported case to the authors' knowledge of migration and embolization of a filter fragment into the systemic arterial system.
Diagnostic and Interventional Radiology, 2008
To evaluate the safety and efficacy of image-guided drainage of infected pleural effusions. The c... more To evaluate the safety and efficacy of image-guided drainage of infected pleural effusions. The clinical outcomes of 93 patients who underwent image-guided drainage of infected pleural effusions between 1998 and 2003 were retrospectively analyzed. Among the 93 patients, 31 (33.3%) were younger than 16 years of age. In all, 129 catheters (8F-14F pigtail catheters) were placed under ultrasonography (US) or computed tomography guidance. In 27 patients (29.0%) intracavitary fibrinolytic therapy with streptokinase was employed to improve drainage. The patients were followed up during daily rounds and, when drainage problems occurred, catheters were exchanged or repositioned. New catheters were placed for undrained loculations. The success, failure, and recurrence rates were 92.5% (86/93), 7.5% (7/93), and 6.4% (6/93), respectively. In the pediatric age group the success rate was significantly higher. Intracavitary fibrinolytic therapy significantly improved daily output, but did not significantly reduce drainage duration or hospital stay. There was no significant difference between the successful and failed treatment cases in terms of US findings, gross appearance, or culture positivity. The only major complication was anaphylactic reaction due to intracavitary instillation of streptokinase (n = 1, 1.1%). The 30-day mortality rate was 2%. Image-guided catheter drainage of infected pleural collections is a safe and effective method. Addition of intracavitary fibrinolytic instillation improves drainage, but early intervention prior to collections becoming more complicated remains an important factor in determining prognosis. Non-loculated anechoic collections without septa have a high probability of favorable outcome.
Diagnostic and Interventional Radiology, Mar 1, 2009
PURPOSE: The aim of this study was to assess the safety and efficacy of fluoroscopy-guided retrog... more PURPOSE: The aim of this study was to assess the safety and efficacy of fluoroscopy-guided retrograde double-J stent exchange.MATERIALS AND METHODS: Between March 2003 and June 2005, 39 retrograde ureteral stent exchange procedures on 19 patients and 24 ureters were performed under fluoroscopic guidance. Seventeen of the patients were female and 2 were male. All procedures were done on an outpatient basis unless the patient was already an inpatient. All exchanges were performed through 10 F introducer sheaths. Once the stent was grasped, the sheath, the snare and/or the wire holding the stent were pulled out as a unit. For retrieving the stents, several different techniques (guide wire lasso and wire snaring) were used in addition to simple snare technique. Two parallel stents were placed for each ureter in 2 patients (3 ureters) after a history of stent occlusion in less than 3 months.RESULTS: Technical success rate was 100%. Procedure time ranged from 16 to 38 minutes (average, 21 min). There were no major complications. All patients had minor hematuria after the procedure which resolved within one day.CONCLUSION: Fluoroscopy-guided retrograde double-J stent exchange is a safe and effective procedure and can easily be performed with equipment and techniques used in daily interventional practice.
Cardiovascular and Interventional Radiology, Jun 10, 2008
American Journal of Roentgenology, Nov 23, 2012
We describe CT, MR, and sonography findings of diaphragmatic mesothelial cysts and the results of... more We describe CT, MR, and sonography findings of diaphragmatic mesothelial cysts and the results of percutaneous treatment with ethanol. All cysts were bilobulate and showed extrahepatic location between the right liver lobe and diaphragm. Radiologic findings are helpful in diagnosing diaphragmatic mesothelial cysts, which should be managed conservatively. Percutaneous ethanol sclerotherapy should be the first choice of treatment if necessary.
Radiology, Jan 12, 2016
Purpose To demonstrate the feasibility of four-dimensional (4D)-flow magnetic resonance (MR) imag... more Purpose To demonstrate the feasibility of four-dimensional (4D)-flow magnetic resonance (MR) imaging for noninvasive longitudinal hemodynamic monitoring of hepatic blood flow before and after transjugular intrahepatic portosystemic shunt (TIPS) placement. Materials and Methods The institutional review board approved this prospective Health Insurance Portability and Accountability Act compliant study with written informed consent. Four-dimensional-flow MR imaging was performed in seven patients with portal hypertension and refractory ascites before and 2 and 12 weeks after TIPS placement by using a time-resolved three-dimensional radial phase-contrast acquisition. Flow and peak velocity measurements were obtained in the superior mesenteric vein (SMV), splenic vein (SV), portal vein (PV), and the TIPS. Flow volumes and peak velocities in each vessel, as well as the ratio of in-stent to PV flow, were compared before and after TIPS placement by using analysis of variance. Results Flow v...
Journal Belge De Radiologie, 2004
We describe a case of an oncocytoma occurring in the adrenal gland, a rare location, and describe... more We describe a case of an oncocytoma occurring in the adrenal gland, a rare location, and describe US and CT findings of this tumor in our patient. The mass was well marginated but heterogeneous on both CT and US and unfortunately the imaging findings of the tumor are non-specific.
Diagnostic and Interventional Radiology, 2007
The Annals of Thoracic Surgery, Apr 1, 2003
A n 18-month-old boy had a Swan-Ganz catheter inserted through the right femoral vein. A chest ro... more A n 18-month-old boy had a Swan-Ganz catheter inserted through the right femoral vein. A chest roentgenogram after placement showed that the catheter was advanced too far and was curled with multiple loops in the right atrium. Under fluoroscopy, the catheter was pulled back into the inferior vena cava (IVC) where the multiple loops formed a knot that prevented passage beyond the IVC bifurcation . A forceps catheter (BIOPAL 7 formable biopsy forceps; Cordis Corporation, Miami, FL) (arrows) was inserted through the contralateral femoral vein to unknot and remove ( the Swan-Ganz catheter. The procedure was uncomplicated, and the patient demonstrated no sequelae on follow-up.
Turkiye Klinikleri Journal of General Surgery Special Topics, 2012
Turkiye Klinikleri Journal of General Surgery Special Topics, 2014
Tanısal ve girişimsel radyoloji: Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı
To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of o... more To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of our patients. We retrospectively evaluated the medical records of 37 patients who underwent percutaneous cholecystostomy. Eighteen female and 19 male patients were included into this study between the ages of 7 and 88 years. All of our patients had acute cholecystitis or eventually developed acute cholecystitis except one. Seven year old male patient with Non-Hodgkin lymphoma underwent percutaneous cholecystostomy due to elevation of liver function tests and direct bilirubin. Since he had dilated intrahepatic biliary ducts due to a lymphadenopathy compression at portal hilus, percutaneous cholecystostomy was performed to decompress the biliary system to decrease the bilirubin and liver function tests to normal levels for initiating appropriate chemotherapy protocol. All the procedures were carried under fluoroscopic and sonographic guidance through transhepatic or transperitoneal approach...
Case Reports in Surgery, 2015
Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as in... more Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as intestinal perforation and bleeding usually occur with sharp, thin, stiff, long, and pointed objects. This case describes the management of three lead pellets within the appendix vermiformis. A 45-year-old male visited our clinic complaining of a 4-month history of abdominal pain. The patient inquiry revealed that he had eaten hunted rabbit meat on numerous occasions and had unintentionally ingested three lead pellets. Plain abdominal films and a barium enema showed foreign bodies in the right lower abdominal quadrant. Since the lead pellets were thought to have migrated extraluminally, they were removed through laparotomy under fluoroscopic guidance. An appendectomy was performed. Pathologically, three lead pellets were embedded in the appendix, which showed signs of intramucosal inflammation. Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects enter the appendicular lumen, there is a high risk of appendicitis, perforation, or abdominal pain. An appendectomy was required to remove the ingested lead pellets in the appendix.
European Journal of Plastic Surgery, 2002
. A 44-year-old woman undergoing abdominoplasty, laparoscopic cholecystectomy, and incisional her... more . A 44-year-old woman undergoing abdominoplasty, laparoscopic cholecystectomy, and incisional hernia repair is presented. Abdominal wall lipodystrophy and incisional hernia, both pathologies leading to esthetic deformity, and cholelithiasis causing biliary symptoms were treated at the same operation without any complications. Combining two or multiple abdominal procedures may reduce the potential risks of multiple anesthesia for each procedure, shorten total hospital
Medical Imaging 2013: Physics of Medical Imaging, 2013
ABSTRACT
Emergency radiology, 2002
Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an... more Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an acute life-threatening emergency. The following case describes one such patient with an emphasis on the CT findings in these cases.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of o... more To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of our patients. We retrospectively evaluated the medical records of 37 patients who underwent percutaneous cholecystostomy. Eighteen female and 19 male patients were included into this study between the ages of 7 and 88 years. All of our patients had acute cholecystitis or eventually developed acute cholecystitis except one. Seven year old male patient with Non-Hodgkin lymphoma underwent percutaneous cholecystostomy due to elevation of liver function tests and direct bilirubin. Since he had dilated intrahepatic biliary ducts due to a lymphadenopathy compression at portal hilus, percutaneous cholecystostomy was performed to decompress the biliary system to decrease the bilirubin and liver function tests to normal levels for initiating appropriate chemotherapy protocol. All the procedures were carried under fluoroscopic and sonographic guidance through transhepatic or transperitoneal approach...
Turkiye Klinikleri Genel Cerrahi Ozel Dergisi, 2014
Ulusal Cerrahi Dergisi, 2008
World journal of gastroenterology, Jan 21, 2015
Intrahepatic cholestasis of pregnancy (ICP) is a reversible pregnancy-specific cholestatic condit... more Intrahepatic cholestasis of pregnancy (ICP) is a reversible pregnancy-specific cholestatic condition characterized by pruritus, elevated liver enzymes, and increased serum bile acids. It commences usually in the late second or third trimester, and quickly resolves after delivery. The incidence is higher in South American and Scandinavian countries (9.2%-15.6% and 1.5%, respectively) than in Europe (0.1%-0.2%). The etiology is multifactorial where genetic, endocrine, and environmental factors interact. Maternal outcome is usually benign, whereas fetal complications such as preterm labor, meconium staining, fetal distress, and sudden intrauterine fetal demise not infrequently lead to considerable perinatal morbidity and mortality. Ursodeoxycholic acid is shown to be the most efficient therapeutic agent with proven safety and efficacy. Management of ICP consists of careful monitoring of maternal hepatic function tests and serum bile acid levels in addition to the assessment of fetal we...
Journal of vascular and interventional radiology : JVIR, 2016
In 2005, a 48-year-old man with a spinal cord injury had an inferior vena cava filter placed for ... more In 2005, a 48-year-old man with a spinal cord injury had an inferior vena cava filter placed for recurrent deep vein thrombosis and pulmonary embolism. He was referred for filter retrieval after a computed tomography scan demonstrated caval stenosis and 2 fractured filter arms, 1 in a pulmonary artery and 1 penetrating into the retroperitoneum and impinging on the aorta. During retrieval, 1 arm was inadvertently advanced into the aorta, and embolization of the arm occurred to the left profunda femoris artery. It was subsequently retrieved. This is the first reported case to the authors' knowledge of migration and embolization of a filter fragment into the systemic arterial system.
Diagnostic and Interventional Radiology, 2008
To evaluate the safety and efficacy of image-guided drainage of infected pleural effusions. The c... more To evaluate the safety and efficacy of image-guided drainage of infected pleural effusions. The clinical outcomes of 93 patients who underwent image-guided drainage of infected pleural effusions between 1998 and 2003 were retrospectively analyzed. Among the 93 patients, 31 (33.3%) were younger than 16 years of age. In all, 129 catheters (8F-14F pigtail catheters) were placed under ultrasonography (US) or computed tomography guidance. In 27 patients (29.0%) intracavitary fibrinolytic therapy with streptokinase was employed to improve drainage. The patients were followed up during daily rounds and, when drainage problems occurred, catheters were exchanged or repositioned. New catheters were placed for undrained loculations. The success, failure, and recurrence rates were 92.5% (86/93), 7.5% (7/93), and 6.4% (6/93), respectively. In the pediatric age group the success rate was significantly higher. Intracavitary fibrinolytic therapy significantly improved daily output, but did not significantly reduce drainage duration or hospital stay. There was no significant difference between the successful and failed treatment cases in terms of US findings, gross appearance, or culture positivity. The only major complication was anaphylactic reaction due to intracavitary instillation of streptokinase (n = 1, 1.1%). The 30-day mortality rate was 2%. Image-guided catheter drainage of infected pleural collections is a safe and effective method. Addition of intracavitary fibrinolytic instillation improves drainage, but early intervention prior to collections becoming more complicated remains an important factor in determining prognosis. Non-loculated anechoic collections without septa have a high probability of favorable outcome.
Diagnostic and Interventional Radiology, Mar 1, 2009
PURPOSE: The aim of this study was to assess the safety and efficacy of fluoroscopy-guided retrog... more PURPOSE: The aim of this study was to assess the safety and efficacy of fluoroscopy-guided retrograde double-J stent exchange.MATERIALS AND METHODS: Between March 2003 and June 2005, 39 retrograde ureteral stent exchange procedures on 19 patients and 24 ureters were performed under fluoroscopic guidance. Seventeen of the patients were female and 2 were male. All procedures were done on an outpatient basis unless the patient was already an inpatient. All exchanges were performed through 10 F introducer sheaths. Once the stent was grasped, the sheath, the snare and/or the wire holding the stent were pulled out as a unit. For retrieving the stents, several different techniques (guide wire lasso and wire snaring) were used in addition to simple snare technique. Two parallel stents were placed for each ureter in 2 patients (3 ureters) after a history of stent occlusion in less than 3 months.RESULTS: Technical success rate was 100%. Procedure time ranged from 16 to 38 minutes (average, 21 min). There were no major complications. All patients had minor hematuria after the procedure which resolved within one day.CONCLUSION: Fluoroscopy-guided retrograde double-J stent exchange is a safe and effective procedure and can easily be performed with equipment and techniques used in daily interventional practice.
Cardiovascular and Interventional Radiology, Jun 10, 2008
American Journal of Roentgenology, Nov 23, 2012
We describe CT, MR, and sonography findings of diaphragmatic mesothelial cysts and the results of... more We describe CT, MR, and sonography findings of diaphragmatic mesothelial cysts and the results of percutaneous treatment with ethanol. All cysts were bilobulate and showed extrahepatic location between the right liver lobe and diaphragm. Radiologic findings are helpful in diagnosing diaphragmatic mesothelial cysts, which should be managed conservatively. Percutaneous ethanol sclerotherapy should be the first choice of treatment if necessary.
Radiology, Jan 12, 2016
Purpose To demonstrate the feasibility of four-dimensional (4D)-flow magnetic resonance (MR) imag... more Purpose To demonstrate the feasibility of four-dimensional (4D)-flow magnetic resonance (MR) imaging for noninvasive longitudinal hemodynamic monitoring of hepatic blood flow before and after transjugular intrahepatic portosystemic shunt (TIPS) placement. Materials and Methods The institutional review board approved this prospective Health Insurance Portability and Accountability Act compliant study with written informed consent. Four-dimensional-flow MR imaging was performed in seven patients with portal hypertension and refractory ascites before and 2 and 12 weeks after TIPS placement by using a time-resolved three-dimensional radial phase-contrast acquisition. Flow and peak velocity measurements were obtained in the superior mesenteric vein (SMV), splenic vein (SV), portal vein (PV), and the TIPS. Flow volumes and peak velocities in each vessel, as well as the ratio of in-stent to PV flow, were compared before and after TIPS placement by using analysis of variance. Results Flow v...
Journal Belge De Radiologie, 2004
We describe a case of an oncocytoma occurring in the adrenal gland, a rare location, and describe... more We describe a case of an oncocytoma occurring in the adrenal gland, a rare location, and describe US and CT findings of this tumor in our patient. The mass was well marginated but heterogeneous on both CT and US and unfortunately the imaging findings of the tumor are non-specific.
Diagnostic and Interventional Radiology, 2007
The Annals of Thoracic Surgery, Apr 1, 2003
A n 18-month-old boy had a Swan-Ganz catheter inserted through the right femoral vein. A chest ro... more A n 18-month-old boy had a Swan-Ganz catheter inserted through the right femoral vein. A chest roentgenogram after placement showed that the catheter was advanced too far and was curled with multiple loops in the right atrium. Under fluoroscopy, the catheter was pulled back into the inferior vena cava (IVC) where the multiple loops formed a knot that prevented passage beyond the IVC bifurcation . A forceps catheter (BIOPAL 7 formable biopsy forceps; Cordis Corporation, Miami, FL) (arrows) was inserted through the contralateral femoral vein to unknot and remove ( the Swan-Ganz catheter. The procedure was uncomplicated, and the patient demonstrated no sequelae on follow-up.
Turkiye Klinikleri Journal of General Surgery Special Topics, 2012
Turkiye Klinikleri Journal of General Surgery Special Topics, 2014
Tanısal ve girişimsel radyoloji: Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı
To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of o... more To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of our patients. We retrospectively evaluated the medical records of 37 patients who underwent percutaneous cholecystostomy. Eighteen female and 19 male patients were included into this study between the ages of 7 and 88 years. All of our patients had acute cholecystitis or eventually developed acute cholecystitis except one. Seven year old male patient with Non-Hodgkin lymphoma underwent percutaneous cholecystostomy due to elevation of liver function tests and direct bilirubin. Since he had dilated intrahepatic biliary ducts due to a lymphadenopathy compression at portal hilus, percutaneous cholecystostomy was performed to decompress the biliary system to decrease the bilirubin and liver function tests to normal levels for initiating appropriate chemotherapy protocol. All the procedures were carried under fluoroscopic and sonographic guidance through transhepatic or transperitoneal approach...
Case Reports in Surgery, 2015
Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as in... more Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as intestinal perforation and bleeding usually occur with sharp, thin, stiff, long, and pointed objects. This case describes the management of three lead pellets within the appendix vermiformis. A 45-year-old male visited our clinic complaining of a 4-month history of abdominal pain. The patient inquiry revealed that he had eaten hunted rabbit meat on numerous occasions and had unintentionally ingested three lead pellets. Plain abdominal films and a barium enema showed foreign bodies in the right lower abdominal quadrant. Since the lead pellets were thought to have migrated extraluminally, they were removed through laparotomy under fluoroscopic guidance. An appendectomy was performed. Pathologically, three lead pellets were embedded in the appendix, which showed signs of intramucosal inflammation. Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects enter the appendicular lumen, there is a high risk of appendicitis, perforation, or abdominal pain. An appendectomy was required to remove the ingested lead pellets in the appendix.
European Journal of Plastic Surgery, 2002
. A 44-year-old woman undergoing abdominoplasty, laparoscopic cholecystectomy, and incisional her... more . A 44-year-old woman undergoing abdominoplasty, laparoscopic cholecystectomy, and incisional hernia repair is presented. Abdominal wall lipodystrophy and incisional hernia, both pathologies leading to esthetic deformity, and cholelithiasis causing biliary symptoms were treated at the same operation without any complications. Combining two or multiple abdominal procedures may reduce the potential risks of multiple anesthesia for each procedure, shorten total hospital
Medical Imaging 2013: Physics of Medical Imaging, 2013
ABSTRACT
Emergency radiology, 2002
Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an... more Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an acute life-threatening emergency. The following case describes one such patient with an emphasis on the CT findings in these cases.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2004
To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of o... more To evaluate the effectiveness of the percutaneous cholecystostomy with the follow up results of our patients. We retrospectively evaluated the medical records of 37 patients who underwent percutaneous cholecystostomy. Eighteen female and 19 male patients were included into this study between the ages of 7 and 88 years. All of our patients had acute cholecystitis or eventually developed acute cholecystitis except one. Seven year old male patient with Non-Hodgkin lymphoma underwent percutaneous cholecystostomy due to elevation of liver function tests and direct bilirubin. Since he had dilated intrahepatic biliary ducts due to a lymphadenopathy compression at portal hilus, percutaneous cholecystostomy was performed to decompress the biliary system to decrease the bilirubin and liver function tests to normal levels for initiating appropriate chemotherapy protocol. All the procedures were carried under fluoroscopic and sonographic guidance through transhepatic or transperitoneal approach...