Burhan Yazici

Comparison of the three age estimation methods: Which is more reliable for Turkish children?

BACKGROUND Three atlases-the GOK, the Greulich-Pyle (GP), and the Tanner-Whitehouse (TW3)-are used frequently for age determination in Turkey. The purpose of this study was to evaluate the applicability of these three methods related to the skeletal age assessment for Turkish adolescents. MATERIALS AND METHODS The conventional roentgenograms of the left hands and wrists, elbows, shoulders, and pelvises of 333 healthy Caucasian children (164 females, 169 males) who fit the study and the criteria of each atlas were obtained. The mean differences (+/- standard deviation [S.D.] in years) between the chronologic age (CA) and the skeletal age (BA), which were obtained by using each age estimation method, were calculated and tested using t-test. RESULTS For girls, the most accurate method was the TW3 (mean differences (d): -0.21 (p<0.05)), following by the GP (d: 0.66 (p<0.001), and the GOK (d: 2.99 (p<0.001)). For boys, the most accurate method was the GP (d: -0.02 (p>0.05)), followed by the TW3 (d: -0.18 (p<0.05)) and GOK (d: 1.05 (p<0.001)). DISCUSSION AND CONCLUSIONS Results show that the TW3 (for girls) and the GP (for boys) methods are more appropriate than the GOK atlas for estimating the BA. GOK could be used for boys aged 11-14 years but it should not be used for girls.

Doppler waveforms of the hepatic veins in children with diffuse fatty infiltration of the liver.

OBJECTIVE The aim of this study was to investigate the effect of fatty infiltration of the liver (FIL) on the Doppler waveform pattern in the hepatic veins of obese children. METHODS In this prospective study, 59 patients with diffuse FIL and 45 normal healthy children who served as control group underwent hepatic vein B-mod and duplex Doppler sonography. The Doppler sonography spectrum of the right hepatic vein was classified into three groups: triphasic waveform, biphasic waveform, and monophasic or flat waveform. RESULTS There was a statistically significant difference in the phasicity of hepatic venous flow between patients and control subjects (p<0.001). The Doppler flow pattern in the right hepatic vein was triphasic in 28 (47.5%), biphasic in 28 (47.5%), and monophasic in 3 (5%) children with fatty liver, while it was triphasic in 43 (95.6%) and biphasic in 2 (4.4%) control subjects. There was an inverse correlation between the sonographic grade of fatty infiltration of the liver and the phasicity of hepatic venous flow (r=-0.479, p<0.001). CONCLUSIONS Abnormal right hepatic vein Doppler waveform, biphasic as well as monophasic, can be seen in healthy obese children with diffuse FIL.

CONGENITAL IMPERFORATE HYMEN WITH BILATERAL HYDRONEPHROSIS, POLYDACTYLY AND LARYNGOCELE: A Rare Neonatal Presentation

Imperforate hymen is a rare congenital malformation to present with symptoms in the neonatal period. We present a case of a 5-day-old neonate with a marked interlabial swelling causing urinary retention. Imaging revealed hydrometrocolpos, hydrosalpinx, and bilateral hydronephrosis. Additionally, our patient had polydactyly of both feet and hands, and laryngocele that have not been previously described in literature. Hymenectomy is the mainstay of management to prevent the development of hematocolpos, pain, and possible retrograde menstruation.

Investigation of the Effect of Exhaust Particles on Ocular Blood Flow in Highway Toll Collectors Using Color Doppler Ultrasonography

Purpose: To investigate the effect of exhaust particles on orbital blood flow velocity of the ophthalmic artery, central retinal artery, and posterior ciliary artery by color Doppler ultrasonography in highway toll collectors. Material and Methods: Color Doppler imaging was used to measure the peak-systolic and end-diastolic flow velocities and resistivity indices of the ophthalmic artery, central retinal artery, and posterior ciliary artery in 20 toll collectors and 20 controls. Results: Both the peak-systolic and the end-diastolic flow velocities were decreased in the ophthalmic artery, central retinal artery, and posterior ciliary artery, and the resistivity index was increased in the central retinal artery in toll collectors when compared with control groups. Results were considered statistically significant if P<0.05. Conclusion: It was determined that the effect of exhaust particles reduced ocular blood flow velocity in toll collectors as measured by color duplex Doppler ultrasonography.

Relationship between breast arterial calcifications detected on mammography and brachial artery intima-media thickness

SummaryPurposeAlthough breast arterial calcification (BAC) was shown to be related with coronary artery disease (CAD), hypertension (HT), diabetes mellitus (DM) and carotid intima-media thickness (C-IMT), but the association between BAC and brachial intima-media thickness (B-IMT) has not been evaluated yet. Our aim was to investigate whether associations existed between BAC and measure B-IMT and atherosclerosis (AS) by comparing these patients with healthy control subjects.MethodsA Total of 75 patients were included in the study. Subjects with or without BAC were assigned into one of two groups and those with a BAC were graded. Main brachial artery IMT was measured.ResultsWhen the effect of age was partialled out statistically, we found a statistically significant difference in mean B-IMT between BAC (+) (0.54 ± 0.09) and BAC (-) (0.45 ± 0.08) groups (p = 0.001) after the groups were adjusted for age.ConclusionsIn conclusion, even though the relationship between B-IMT and BAC was significant, like the relationship between C-IMT and BAC, significant age difference between BAC (+) and BAC (-) groups and no significant relationship between BAC and time after menopause, after adjustment for age, suggest a strong association between BAC and age rather than AS. This can be elucidated by pathological correlation studies in larger series of subjects.ZusammenfassungZiel der StudieObwohl gezeigt werden konnte, dass arterielle Kalzifikationen der Brust mit koronarer Herzkrankheit, Hypertonie, Diabetes mellitus und Carotid Intima-Media-Dicke korrelieren, wurde eine mögliche Beziehung zwischen Verkalkungen der Brust und der brachialen Intima-Media-Dicke bisher nicht untersucht. Ziel unserer Studie war es, zu untersuchen, ob eine solche Beziehung besteht, beziehungsweise ob eine Beziehung mit Atherosklerose vorliegt, wobei die Daten von Patienten und gesunden Kontrollpersonen verglichen wurden.MethodenInsgesamt wurden 75 Patienten in die Studie eingeschlossen. Patienten mit oder ohne arteriellen Verkalkungen in der Brust wurden einer von zwei Gruppen zugeteilt. Die Patienten mit einer Verkalkung wurden entsprechend dem Schweregrad graduiert. Die mittlere Intima-Media-Dicke der Brachialarterie wurde gemessen.ErgebnisseNach statistischer Ausschaltung des Einflusses vom Alter fanden wir einen statistisch signifikanten Unterschied in der mittleren Dicke der Intima-media der Arteria brachialis von Patienten mit arterieller Verkalkungen der Brust (+) (0,54 ± 0,09) im Vergleich zu jener von Patienten ohne diese Verkalkungen (-) (0,45 ± 0,08) (p = 0,001).SchlussfolgerungenUnsere Ergebnisse legen trotz der beobachteten signifikanten Korrelation zwischen der Intima-Media-Dicke der Arteria brachialis und den arteriellen Verkalkungen in der Brust eher eine Abhängigkeit der arteriellen Verkalkungen in der Brust vom Alter als von der Atherosklerose nahe. Diese Annahme beruht auf dem beobachteten signifikanten Altersunterschied zwischen den Patienten mit arteriellen Brustverkalkungen und jenen ohne, sowie der fehlenden Signifikanz einer Beziehung zwischen arteriellen Brustverkalkungen und der Zeit nach Beginn der Menopause nach Berücksichtigung des Alters.