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    Case report: Percutaneous bowel drainage for jaundice due to afferent loop obstruction following pancreatoduodenectomy
    (2003) Yazici, Burhan; Safak, Alp Alper; Pehlivan, Mevlüt; Gökgöz, Taner
    We present percutaneous biliary drainage in a patient with jaundice due to afferent loop obstruction following a pancreatoduodenectomy. Treatment strategy for this type of jaundice is discussed with a review of the literature. The dilated loop of the jejunum was drained percutaneously with 10 F abscess drainage catheter. The obstructive jaundice was improved.
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    Is the assessment of bone age by the Greulich-Pyle method reliable at forensic age estimation for Turkish children?
    (Elsevier Ireland Ltd, 2007) Bueken, Bora; Safak, Alp Alper; Yazici, Burhan; Bueken, Erhan; Mayda, Atilla Senih
    Background: Estimation of age is an important task for forensic experts especially in developing countries where birth records are often not well maintained. In this study, we investigated whether or not the Greulich-Pyle (G-P) method is sufficient at forensic age estimation for Turkish children. Methods: Plain radiographies of left hands and wrists of 492 (241 (49.0%) female, 251 (51.0%) male) healthy children between 11 and 18 years of age for girls and 11 and 19 years of age for boys were taken. Mean chronological ages (CA) were compared with mean skeletal ages according to G-P atlas for each gender and in the second step the differences those for each age group were determined. The children were Caucasian and had a low-middle socioeconomic status in this study population. The paired sample t test was used to indicate the difference between G-P (mean skeletal age according to G-P atlas) and CA (mean chronological age). In order to indicate the relation Pearson correlation coefficient was used. Modeling the relationship between G-P and CA linear regression was used. The analyses were done under SPSS 11.5. Results: The G-P compared to their CA. The CA was 14.52 +/- 2.18 S.D. years, S.E.: 0.14 (median: 14.47, range: 11.07-18.92 years) whereas G-P was 15.06 +/- 2.31 S.D. years, S.E.: 0.15 (median: 15.00, range: 10-18 years) for girls. The difference between the two parameters was statistically significant (p < 0.00 1). The CA was 15.28 +/- 2.41 S.D. years, S.E.: 0.15 (median: 15.09, S.E. range 11. 13-19.94 years) and G-P was 15.41 +/- 2.92 S.D. years, S.E.: 0.18 (median: 15.60, range 9-19 years) for boys. The difference was not statistically significant (p > 0.05). There was a high correlation (Pearson r = 0.882, p < 0.00 1) for girls and (Pearson r = 0.900, p < 0.001) for boys. The determination coefficient (R-2) is equal to 0.778 for girls and 0.81 for boys. The regression model also tested by ANOVA and it is found significant (p < 0.01) for both genders. According to age groups G-P was advanced (0.17-1.1 year) almost for all ages and differences were significant at 11, 12, 14, 16 ages for girls. G-P was delayed at 11-14 ages (0.01-0.58 year) but not significant except for 13 years and G-P were significantly advanced in 15-17 ages (0.880.98 years) but then delayed in 18-19 years of age (0.02-0.48) for boys. The difference's standard deviation at 12, 13, 15, 16 years of ages for girls and between 12 and 16 and 18 years of ages for,boys were more than 1 year. Conclusion: When the results of the previous study and this study are compared, the test method could be used technically by pediatricians and other clinicians, but it is even more important for ethically unacceptable errors to disappear, especially in cases involving the possible criminal liability of the supposed minor. So standard deviation at 12, 15 years of ages for girls and 12, 15, 18 years of ages for boys were more than I year. But it is not known that the other methods whether more useful or not than this method. For the time being unless any other methods will be proved more useful, we have to use this method cautiously for possible criminal liability cases in forensic age diagnosis. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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    Is the Tanner-Whitehouse (TW3) method sufficiently reliable for forensic age determination of Turkish children?
    (Tubitak Scientific & Technological Research Council Turkey, 2010) Buken, Bora; Safak, Alp Alper; Buken, Erhan; Yazici, Burhan; Erkol, Zerrin; Erzengin, Omer Utku
    Aim: The purpose of our study was to determine the accuracy of Tanner-Whitehouse 3 (TW3-RUS) bone age (BA) assessments for forensic age estimations of Turkish children. Materials and methods: Plain radiographs of left hands and wrists of 324 children were evaluated. Mean chronological age (CA) was compared with mean bone age (BA) according to the TW3 atlas for each sex, and differences by age group were determined. Pearson correlation coefficients and cubic regression were used to determine the differences and model the relationships between mean BA and CA. Statistical analyses were carried out using R-project. Results: The difference between the mean CA and the mean BA was statistically significant, and there was a high correlation between them for both sexes. No P values were statistically significant for any age group for girls but P values were statistically significant at 13 and 14 years for boys. The dispersion formula was determined for each sex. Conclusion: We propose that this atlas can be used for Turkish children, until a new atlas that has been distributed and formed according to the results of multiple studies made throughout the country.