Sex determination from scapula by volume rendering technique in Turkish population / Determinación del sexo a partir de la escápula mediante la técnica de representación de volumen en la población turca

SUMMARY: The aim of this study is to measure the significant parameters on scapula at computed tomography images and to determine the effects of these parameters for sex determination. The second aim is to find the most effective single and combined parameters to use for sex determination using scapula in Turkish population. In this study, morphometric measurements of scapula on the computed tomography images of 60 male and 60 females were evaluated and their impacts on sex determination were examined via stepwise logistic regression analysis. 10 parameters and 6 indexes calculated via using these parameters were measured. Scapular breadth of the right scapulae (86.7%), maximum scapular length of the left scapulae (85%), scapular breadth of all scapulae (80%) were found to be the most effective single parameters. Combination of the scapular breadth and maximum scapular length were 85%, 90%, 86.7% effective in sex determination on the right scapulae, on the left scapulae and on all of the scapulae, respectively. We believe that the results of this study will contribute to sex determination studies using the scapula in Turkish population for anatomist, anthropologist and forensic scientists.

El objetivo de este estudio fue medir los parámetros significativos en la escápula en imágenes de tomografía computarizada y determinar los efectos de estos parámetros para la determinación del sexo. El segundo objetivo fue encontrar los parámetros individuales y combinados más efectivos para determinar el sexo utilizando la escápula en la población turca. Se evaluaron las medidas morfométricas de la escápula en las imágenes de tomografía computarizada de 60 hombres y 60 mujeres y se examinó su impacto en la determinación del sexo mediante un análisis de regresión logística paso a paso. Se midieron 10 parámetros y 6 índices calculados mediante el uso de estos parámetros. El ancho escapular de la escápula derecha (86,7 %), la longitud escapular máxima de la escápula izquierda (85 %), el ancho escapular de todas las escápulas (80 %) resultaron ser los parámetros individuales más efectivos. La combinación del ancho escapular y la longitud máxima escapular fueron 85%, 90%, 86,7% efectivas en la determinación del sexo en la escápula derecha, en la escápula izquierda y en todas las escápulas, respectivamente. Creemos que los resultados de este estudio contribuirán a los estudios de determinación de sexo utilizando la escápula en la población turca para anatomistas, antropólogos y científicos forenses.

Presenting clinical features and outcome in intussusception.

OBJECTIVE: To evaluate if a correlation exists between the clinical and radiologic characteristics at presentation; and the success of conservative management, morbidity and outcome of patients with intussusception. METHODS: All patients (total 179) treated for intussusception in our unit between 1993 and 2003, were retrospectively reviewed to find out the effects of physical examination (general appearance, consciousness, body temperature, abdominal distention and tenderness, blood on rectal examination), laborat (leukocyte count) and radiologic (air-fluid level on X-ray, free abdominal fluid on ultrasonography) findings on selection of first step therapeutic modality, conservative management (reduction with barium or air) success rate and surgical complication (serosal defect, intestinal perforation) rate. Additionally, the patients were subdivided into three subgroups as group A (patients for whom surgical management was performed primarily), group B (the ones who were operated after failure of reduction attempt with barium or air), group C (patients who had successful conservative reduction). These groups were compared within each other with regard to duration of nasogastric suction, antibiotic therapy; onset of oral feeding and duration of hospitalization. The chi-square, Kruskal-Wallis and ANOVA tests were used for the statistical analysis and p value less than 0.05 was considered to be significant. RESULTS: Incidence of selecting conservative treatment primarily was lower in patients with toxic appearance (p=0.02) and with free fluid on ultrasonography (p=0.007). Success rate of conservative treatment was lower in patients with moderate general appearance (p=0.000), lethargy (p=0.011), blood on rectal examination (p=0.004), air-fluid level on X-ray (p=0.039), free fluid on ultrasonography (p=0.001). Surgical complication rate was higher in patients with moderate general appearance (p=0.000), lethargy (p=0.007), air-fluid level on radiograph (p=0.009). In group A; the duration of N/G suction, antibiotic therapy and hospitalization was longer; the onset of oral feeding was later than the other two groups (p=0.000). In group B; the duration of N/G suction, antibiotic therapy and hospitalization was longer; the onset of oral feeding was later than group C (p=0.000). CONCLUSION: Toxic appearance, lethargy and air-fluid level on radiograph not only decrease the success rate of conservative management, but increase the surgical complication rate as well. Thus, these parameters deserve more importance in the management scheme. Reduction with conservative management is the most important factor which decreases the morbidity. Morbidity is lower in cases who are operated after failure of conservative management than the ones for whom surgery is performed primarily. Thus, conservative management should be tried for all patients unless there is a clear cut contraindication such as peritonitis and/or pneumoperitoneum.