Epicardial adipose tissue (EAT) thickness on non-gated chest CT as an alternative to EAT volume on cardiac CT.

BACKGROUND: Epicardial adipose tissue (EAT) volume is usually measured with ECG-gated computed tomography (CT). Measurement of EAT thickness is a more convenient method; however, it is not clear whether EAT thickness measured with non-gated CT is reliable and at which localization it agrees best with the EAT volume. PURPOSE: To examine the agreement between ECG-gated EAT volume and non-gated EAT thickness measured from various localizations and to assess the predictive role of EAT thickness for high EAT volume. MATERIAL AND METHODS: EAT thickness was measured at six locations using non-contrast thorax CT and EAT volume was measured using ECG-gated cardiac CT (n = 68). The correlation and agreement (Bland-Altman plots) between the thicknesses and EAT volume were assessed. RESULTS: EAT thicknesses were significantly correlated with EAT volume (P < 0.001). The highest correlation (r = 0.860) and agreement were observed for the thickness adjacent to the right ventricular free wall. Also, EAT thickness at this location has a strong potential for discriminating high (>125 cm3) EAT volume (area under the ROC curve=0.889, 95% CI=0.801-0.977; P < 0.001). The sensitivity, specificity, and positive and negative predictive values of EAT thickness for high EAT volume were 76.5%, 88.2%, 68.4%, and 91.8%, respectively, for the cutoff value of 5.75 cm; and 47.1%, 100%, 100%, and 85%, respectively, for the cutoff value of 8.10 cm. CONCLUSION: EAT thickness measured on non-gated chest CT adjacent to the right ventricular free wall is a reliable and easy-to-use alternative to the volumetric quantification and has a strong potential to predict high EAT volume.

Coronary artery calcium score percentiles: data from a single center in Turkey.

PURPOSE: The coronary artery calcium (CAC) score is used in decision-making for preventive medications in patients with borderline clinical risk scores. Both absolute and percentile CAC scores can be used; however, a percentile CAC score is especially useful in young patients and women. The aim of this study is to present CAC score percentiles across age categories in women and men using a large database. METHODS: Bilkent City Hospital database was screened for patients who underwent CAC score measurements between January 2021 and March 2022. Of the 4,487 patients, 546 were excluded due to 1) a history of coronary stent implantation or bypass surgery or 2) missing information regarding a history of revascularization or calcium scores. Therefore, the final study population included 3,941 participants. The percentiles for age categories within each sex were tabulated, and percentile plots were created for each sex using locally weighted scatterplot smoothing regression. RESULTS: The proportion of men included in the study was higher compared with that of women (57.09% vs. 42.91%). The mean age was 52.20 ± 11.11 years, and it was higher in women than in men (54.07 ± 10.47 vs. 50.80 ± 11.37, respectively; P < 0.001). A zero CAC score was observed in 2,381 (60.42%) patients; the percentage was higher in women than in men (68.60% vs. 54.27%; P < 0.001). When the cut-off value for the high-risk category was taken as the 75th percentile, a non-zero CAC score directly assigned a patient into the high-risk category in women aged <55 years and men aged <45 years. Percentile plots were also provided for each sex. CONCLUSION: In this large-scale study, including patients referred for CAC scoring and/or coronary computed tomography angiography, CAC score percentiles were provided for women and men across the selected age categories which may be in therapeutic decision-making. As an approximate rule of thumb, a non-zero CAC score corresponds to the high-risk category in women aged <55 years and in men aged <45 years.

The evaluation of subcutaneous and visceral adipose tissue changes by computed tomography in coronavirus disease 2019 and comparison with quantitative analysis of lung involvement.

BACKGROUND: This study aims to reveal the relationship between lung involvement and visceral adipose tissue changes between chest-computed tomography (CT) scans taken in short intervals in COVID-19 patients. METHODS: The retrospective study included 52 patients who tested positive for SARS-CoV-2. All patients had two chest CT exams. Lung involvement measurements were calculated by using an artificial intelligence tool. Visceral and subcutaneous fat tissue was measured at the level of the first lumbar vertebra on chest CT. Additionally, demographic and laboratory data were collected. RESULTS: 52 patients were included (36.5 % female, mean age 50). Visceral fat area and visceral fat thickness changes were significantly positive predictors of total lung involvement changes (p=0.033, p=0.00024). Subcutaneous fat area and subcutaneous fat thickness changes were not associated with lung involvement change (p>0.05). CRP, IL-6, d-dimer, and ferritin levels were higher in patients who need intensive care units. CONCLUSION: Visceral adipose tissue changes may indicate that it can have a role as a reservoir of virus involvement.

Pediatric cranial injuries: the Syrian civil war.

OBJECTIVE: Kilis, Turkey, a city near Aleppo, Afrin and Azez, Syria, where conflicts are intense, is one of the cities that provides initial emergency treatment. The aim in this study was to analyze the clinical and radiological characteristics of and treatment methods and results in pediatric patients admitted to Kilis State Hospital with cranial gunshot wounds obtained during the Syrian war. MATERIALS AND METHODS: In this study, 62 pediatric patients treated for cranial gunshot wounds obtained during the civil war in Syria between December 2011 and May 2017 at the Neurosurgery Clinic of Kilis State Hospital on the Turkish side of the Turkey-Syria border were retrospectively analyzed. RESULTS: A total of 62 patients were evaluated. Forty-six (74.2%) patients were male and 16 (25.8%) were female. The mean age of the patients was 11.4 ± 6.3 (range: 1 month to 18 years) years. The mean Glasgow coma scale (GCS) score was 7.2 ± 3.8. Surgical treatment was performed in 36 patients (58.1%). Six (16.7%) of the surgically treated patients and 15 (57.7%) of the conservatively treated patients died (p < 0.001). While good clinical results (GOS4-5) were obtained in 24 (66.7%) patients who underwent surgical treatment, only 8 (30.8%) patients who underwent conservative treatment had good clinical results (GOS 4-5). The treatment results in patients with a GCS score of between 9 and 15 who were treated with both methods were significantly better (GOS score of 4-5) (p < 0.05) than those in patients with a GCS score of 8 or lower. The treatment results of the patients aged 10-18 years were significantly better than those of patients aged 0-9 years (GOS 4-5) (p < 0.05). CONCLUSION: In this study, the GCS score on admission was a significant predictive factor for survival in pediatric patients with cranial gunshot wounds. The outcomes of patients aged 0-9 years with severe neurological damage were worse than those in patients aged 10-18 years. On the basis of the analyses of the treatment methods and GCS and GOS scores of the patients in our study, we conclude that surgical treatment should be performed immediately in all patients with radiological indications and a GCS score higher than 3. Additionally, we conclude that child soldiers exist in Syria.

Thickness of carotid artery intima is an independent risk factor for psoriasis.

Psoriasis (PsO) has been associated with lipoprotein abnormalities, visceral adiposity, atherosclerosis, and coronary artery disease (CAD) in several studies; however, data concerning the risk of psoriasis relevant to these parameters is not well established. We aimed to evaluate the relation between PsO and small dense low-density lipoprotein cholesterol (sd-LDL-C), serum lipid profile (SLP), blood pressures, anthropometric measurements, intima media thickness of the common carotid artery (CIMT), distribution of visceral adipose tissue (VAT; evaluated at 3 different measurement sites including VATa, VATb, VATc) along with subcutaneous (Sc-d1) and preperitoneal (Pre-d2) adipose tissue, and disease characteristics, so as to define relevant risk factors for PsO. In this cross-sectional and observational study, 62 patients with plaque-type PsO and 31 age- and sex-matched controls were enrolled. Data about metabolic profile, CIMT and VAT were obtained. There was a significant association between PsO and hypertension, smoking, diastolic blood pressure, sd-LDL-C/LDL-C ratio, CIMT, VATc, and Pre-d2. Following adjustments for hypertension and smoking, sd-LDL-C/LDL-C ratio, CIMT, and Pre-d2 still remained different between patients and controls (P = 0.03, P = 0.043, and P = 0.05, respectively). Each 0.1 unit increase in the CIMT increased the risk of PsO 1.51-fold (95%CI: 1.08 - 2.12, P = 0.016). PsO associates with a predisposition to develop thick preperitoneal fat tissue and thick intima of carotid arteries, all of which contribute to the increased risk of atherosclerosis and subsequent CAD. CIMT was considered as an independent risk factor for PsO.

Treatment of cervical subaxial injury in the very young child.

INTRODUCTION: Infant's cervical spine has serious differences compared to other pediatric age groups and adults. Anatomical and biomechanical constitution of an infant is unique, and the pediatric spine gradually begins to resemble the structure of the adult spine after age 10. In addition, clinical presentation of the cervical spinal traumas has many distinctions from birth to the end of adolescence. In young children, cervical spine traumas are mainly localized in the upper cervical region. Trauma localized in subaxial cervical region and fracture-dislocations are rare in infants. CASE REPORT: Here, we present a case history of a 7-month-old infant with surgically treated severe subaxial flexion-distraction injury. Neurologic examination revealed complete loss of motor function below C5. A whole-body CT was taken and we observed that C5-6 dislocated anteriorly approximately one vertebra size and also unilateral facet joint was locked. The patient was intubated and closed reduction was attempted with fluoroscopy under general anesthesia, but it was unsuccessful. Whereupon C5-6 microdiscectomy was performed with the anterior approach and fixation was provided with the craniofacial miniplate. Despite anterior stabilization, exact posterior alignment could not been achieved so, posterior approach was added to the surgery. At 12 month follow-up, the patient improved from quadriparesis to paraparesis and we achieved a satisfactory radiological outcome.

Parenchymal Pressure Inconsistency in Different Brain Areas After Kaolin Injection into the Subarachnoid Space of Neonatal Rats.

AIM: To describe the relationship between the parenchymal pressure changes and the development of hydrocephalus in kaolininjected neonatal rats according to cerebral regions and time intervals of developing hydrocephalus. MATERIAL AND METHODS: Neonatal rats aged 2 to 3 days were examined in 5 groups as kaolin frontal "K-F", kaolin parietal "KP", saline frontal "SF-F", saline parietal "SF-P" and control "C", based on the injected material and injection sites. All injections were performed into the cortical subarachnoid space of the right frontal and right parietal regions. The fifth group was injection free. On the 3 < sup > rd < /sup > , 7 < sup > th < /sup > , 15 < sup > th < /sup > , 30 < sup > th < /sup > and 60 < sup > th < /sup > days after injection, parenchymal pressures (PP) of 5-7 rats from each group were measured from different regions. RESULTS: We compared the control group with saline-injected and kaolin-injected groups and found statistically significant parenchymal pressure differences based on regional measurements. In the kaolin groups, the mean PP values were obviously higher than the saline-injected group. Within each kaolin-injected group, the pressure values were variable and inconsistent regarding the parenchymal regions. CONCLUSION: Hydrocephalus cannot be totally explained with existent "bulk-flow" or "hydrodynamic" theories. Although our experimental design was planned to develop hydrocephalus according to the bulk flow theory, our results were more compatible with the hydrodynamic theory. The present comments on the occurrence and pathogenesis of hydrocephalus are still open to debate and may require further comprehensive studies.

Neuroprotective Effect of Genistein in Peripheral Nerve Injury.

AIM: To investigate the effects of genistein in a rat model of sciatic nerve crush injury and complete sciatic nerve transection. The effects of genistein were compared with those of gabapentin, which is widely used in clinical practice for peripheral nerve injury. MATERIAL AND METHODS: Forty-eight rats were randomly divided into six groups (8 rats in each group): group 1 (sham); group 2, sciatic nerve crush injury (control); group 3, sciatic nerve crush injury+genistein 20 mg/kg; group 4, sciatic nerve crush injury+gabapentin 90 mg/kg; group 5, sciatic nerve transection+genistein 20 mg/kg; group 6, sciatic nerve transection+gabapentin 90 mg/kg. The effects of genistein and gabapentin were assessed with immunohistochemical staining for growth associated protein-43 (GAP-43) and myelin basic protein (MBP). Interleukin-1ß and tumor necrosis factor α levels in the injured nerve specimens were assessed as a measure of inflammatory response; walking track analysis and sciatic function index for neurological recovery and the paw mechanical withdrawal threshold were examined for neuropathic pain. RESULTS: On histopathological examination, genistein use was associated with a greater immunoreactivity for GAP-43 and MBP compared with that associated with gabapentin. Genistein and gabapentin had similar effects on anti-inflammatory activity, functional recovery, and neuropathic pain. CONCLUSION: Genistein and gabapentin exhibit positive effects on histopathology, inflammation, and clinical findings of peripheral nerve injury. When the systemic side effects of gabapentin are considered, genistein (a basic soy isoflavone that has no side effects) can be used as an alternative to medical treatment in peripheral nerve injury.

Efficiacy of resveratrol and quercetin after experimental spinal cord injury.

BACKGROUND: The aim of this study was to investigate the effect of natural antioxidants resveratrol and quercetin on oxidative stress and secondary cell damage in rats with acute spinal cord injury. METHODS: In this experimental study, 42 male Sprague-Dawley rats were used. Spinal cord injury was performed with clip compression method at level of T4-5. The study was conducted using 6 groups: control, trauma, trauma and solvent, trauma and resveratrol, trauma and quercetin, and trauma with combined resveratrol and quercetin. All rats were euthanized 48 hours after the procedure. Effects of resveratrol and quercetin on serum and tissue total antioxidant capacity and paraoxanase activity level were examined. RESULTS: Compared to trauma group, there was a significant increase in total antioxidant capacity and paraoxanase activity level in resveratrol, quercetin, and combined treatment groups. There was no significant difference between resveratrol and quercetin groups with regard to total antioxidant capacity and paraoxanase activity level. Total antioxidant capacity and paraoxanase activity level were significantly higher in solvent group than trauma group. In histopathological evaluation, there was a decrease in polymorphonuclear leukocyte infiltration in solvent, resveratrol, quercetin, and combined treatment groups. CONCLUSION: Biochemical and histological staining results of present study showed that resveratrol and quercetin may be effective in preventing secondary damage in spinal cord injury.

Histopathological Evaluation of the Effects of CAPE in Experimental Spinal Cord Injury.

AIM: < /B > Spinal cord injuries negatively affect the individuals and the life quality of their families due to neurological deficits caused by trauma. The prevalence of spinal cord injury is 15-45/1 million in the world. Caffeic acid phenethyl ester (CAPE) is the most active component of propolis and has neuroprotective, anti-oxidant and anti-apoptotic effects. Our aim was to determine the effects of CAPE on the prevention of secondary injury and to compare with methylprednisolone. MATERIAL AND METHODS: Forty rats were divided into 4 groups. The control group did not undergo surgery (Group I), only trauma group (Group II), trauma+CAPE treatment group (Group III), and trauma+methylprednisolone treatment group (Group IV). Histopathological assessment was performed with two staining methods as hematoxylin-eosin (HE) and terminal deoxynucleotidyl Transferase Biotin - dUTP Nick End Labeling (TUNEL). The groups were statistically compared. RESULTS: The apoptotic cells decreased in treatment groups compared with the trauma. CAPE has more anti-apoptotic effect than methylprednisolone. The histological difference between the Group II, and Groups III and IV was statistically significant. CONCLUSION: CAPE has a positive effect on spinal cord injuries by preventing apoptosis.

Relationship between retinopathy and asymptomatic atherosclerosis determined by measurement of carotid intima-media thickness in patients with type 2 diabetes mellitus.

OBJECTIVE: Presence of diabetic retinopathy (DR) may be used as an early marker of atherosclerosis in type 2 diabetes mellitus (DM) patients. This study aimed to investigate the relationship between the presence of DR and carotid intima-media thickness (CIMT), which is an indicator of early atherosclerosis in patients with type 2 DM. METHODS: Thirty DM patients with retinopathy (DR group), 28 DM patients without retinopathy (non-DR group), and 27 healthy controls (control group) were included in the study. CIMT was assessed using a high-resolution B-mode ultrasonography device. RESULTS: Mean CIMT was found to be 0.9±0.17 mm in the DR group, 0.8±0.16 mm in the non-DR group, and 0.7±0.13 mm in the control group. CIMT was found to be statistically significantly higher in the DR group compared to the other 2 groups (p<0.001). When multivariate analysis was performed, presence of DR still remained as an independent risk factor for increased CIMT values. CONCLUSION: Presence of DR in type 2 DM patients is an independent risk factor in terms of increased CIMT, which is considered to be a finding of subclinical atherosclerosis. Therefore, we believe that type 2 DM patients with retinopathy should be closely followed in terms of cardiovascular events.

Changes in the before and after thyroxine treatment levels of adipose tissue, leptin, and resistin in subclinical hypothyroid patients.

BACKGROUND: Subclinical hypothyroidism (SH) occurs when serum thyroid stimulating hormone (TSH) concentrations are raised and serum thyroid hormone concentrations are normal. The effect of SH on the proinflammatory adipose cytokine releasing visceral adipose tissue (VAT) is not clear. The aim of this study is to identify the difference between the pre and posttreatment levels of VAT, leptin, and resistin in SH patients. METHODS: There were 51 SH patients and 43 age- and gender-matched healthy subjects included in the study. Thyroid functions, biochemical tests, leptin, resistin, and visceral and subcutaneous fat measurements were made. The measurements were repeated in the SH group in the third month following L-thyroxin treatment. RESULTS: Initially, high sensitivity C-reactive protein, carotid artery intima-media thickness (mm), leptin, and resistin levels were significantly higher in the SH group compared to the controls, while the other parameters were similar. While no correlation was observed between TSH levels and adipokines, a positive correlation was detected between waist circumference and leptin levels (r = 0.549, p < 0.01). Visceral adipose tissue was positively correlated to age, waist circumference, and leptin levels, but negatively correlated to free thyroxin (T4) levels (r = 0.419, p = 0.009; r = 0.794, p < 0.01; r = 0.515, p < 0.01 and r = - 0.416, p = 0.009, respectively). A significant decrease was observed in VAT volume, leptin, and resistin levels of SH patients following levothyroxine treatment. Conclusion The reduced VAT volume, leptin, and resistin levels in SH patients following treatment may support the idea that TSH affects adipose tissue functions.

Erratum to: Docetaxel, cisplatin, and fluorouracil combination in neoadjuvant setting in the treatment of locally advanced gastric adenocarcinoma: Phase II NEOTAX study.

Erratum to: Cancer Chemother Pharmacol (2014), 74:1139­1147, DOI 10.1007/s00280­014­2586­6. Unfortunately, the part of acknowledgement detail was omitted in the published article and the below line must be considered as the last sentence: "This study is a Turkish Oncology Group trial".

Multiple simultaneous venous and arterial thromboses in a patient with factor V Leiden disorder: Detection by multislice computed tomography.

Arterial thrombosis is extremely rare in patients with factor V Leiden (FVL) mutation. Recent advances in multislice computed tomography (MSCT) technology facilitated diagnosis of thromboembolic events accurately without delay. We report a patient with FVL mutation and acute bilateral lower extremity deep venous thromboses, pulmonary thromboembolism, and acute left anterior descending artery thrombosis, all diagnosed by MSCT. MSCT has been utilized for prompt diagnosis of the concomitant thrombotic pathologies simultaneously.

The evaluation of the retrobulbar orbital fat tissue and optic nerve with strain ratio elastography.

AIM: The aim of this study was to evaluate the diagnostic performance of strain ratio elastography in the assessment of retrobulbar orbital fat tissue. MATERIALS AND METHODS: The retrobulbar fat tissue of 14 eyes in 14 participants was scanned by sonoelastography. All the participants had permanent vision loss secondary to glaucoma in at least one eye. The elasticity scores were determined and the strain ratio was based on the comparison of the average strain measured in the retrobulbar fat tissue around the optic nerve at the same depth. RESULTS: The mean strain values for the optic nerve (B) and the retrobulbar fat tissue (A) were 0.78+/-0.61 and 1.43+/-0.99, respectively (p=0.005). The mean strain ratio (B/A) was 0.56+/-0.24. CONCLUSION: This preliminary study showed that by providing strain values and ratios of different orbital tissues sonoelastography may have a potential use in the diagnosis and follow-up of orbital inflammatory and infiltrative diseases.

A late and extreme complication of lumboperitoneal shunt.

BACKGROUND CONTEXT: Lumboperitoneal (LP) shunting is an effective treatment modality for commmunicating hydrocephalus, pseudotumor cerebri, postoperative pseudomeningoceles, and cerebrospinal fluid fistulas. However, LP shunts are associated with some complications. Here, we report an extreme complication resulting in the formation of granulation tissue. PURPOSE: To report a late extreme complication of LP shunt. STUDY DESIGN: A case report. METHODS: A late and unusual complication of an LP shunt with unique radiologic findings is presented. RESULTS: Spinal magnetic resonance imaging studies depicted a mass on the right anterior section of the dural sac encircling the catheter throughout its course from the L3-L4 interspinous level to the catheter tip. CONCLUSIONS: The etiopathologic mechanism, the prolonged duration, and the unusual radiologic findings in this case are unique and remarkable.

Application of lumbar drainage in vasospasm after spontaneous subarachnoid hemorrhage and prevention of late cerebral infarction.

Cerebral vasospasm, especially delayed cerebral ischemia following subarachnoid hemorrhage (SAH) is the most important complication that effects mortality and morbidity of patients with intracranial aneurysms. The presence of cerebral vasospasm has been correlated with an increase in mortality in the first 2 weeks after SAH. Despite clinical studies and research, the etiopathogenesis of cerebral vasospasm is not understood exactly and there is not yet an effective therapy. The aim of our study was to investigate the effect of application of lumber drainage on vasospasm and delayed cerebral infarction following SAH and to examine the incidence of complications. Patient groups were determined by retrospective screening of 70 patients who underwent a surgical operation at the Osmangazi University Medical Faculty Department of Neurosurgery between 2009 and 2013 after a diagnosis of ruptured aneurysmal SAH. After the application of lumbar drainage, the complications and mortality after aneurysm surgery was significantly decreased and correlated with the amount of hemorrhagic cerebrospinal fluid drainage.

Docetaxel, cisplatin, and fluorouracil combination in neoadjuvant setting in the treatment of locally advanced gastric adenocarcinoma: Phase II NEOTAX study.

PURPOSE: This phase II trial aimed to evaluate the efficacy and safety of docetaxel, cisplatin, and fluorouracil (DCF) combination in neoadjuvant setting in patients with locally advanced gastric adenocarcinoma. METHODS: Fifty-nine patients with resectable or unresectable locally advanced gastric and gastroesophageal cancer were recruited in this multicenter, single-arm, open-label, local clinical phase II study conducted at three centers from Turkey between June 2006 and March 2012. Patients had T3-4 or lymph node-positive disease. After staging with imaging and laparotomy or laparoscopy, they received three cycles of DCF with lenograstim. Imaging studies were repeated after the last two cycles. Patients who underwent surgery were followed up for at least 1 year after the surgery. Toxicity and response were evaluated in accordance with NCI-CTC version3.0 and RECIST 1.0. RESULTS: At baseline, 66.1 % of patients were considered resectable. In 47 patients evaluable, partial response in 16 (34.0 %), stable disease in 27 (57.5 %), and progressive disease in four (8.5 %) were observed. Forty-six patients underwent surgery. In 38 (64.4 %; 95 % confidence interval (CI) 52.2-76.6 %) out of 59 patients, complete resection (R0) was achieved. Median overall and disease-free survival were 19.1 months (95 % CI 13.5-24.7) and 11.6 months (95 % CI 5.9-17.4), respectively. The most frequent grade 3-4 adverse events were neutropenia (52.5 %), febrile neutropenia (11.9 %), leukopenia (39.0 %), and diarrhea (10.5 %). One patient died from an unknown cause. CONCLUSIONS: Classical DCF triplet with lenograstim showed a good clinical response with acceptable safety profile in the treatment of locally advanced gastric and gastroesophageal cancer with a significant R0 rate and manageable toxicity.

Early decompressive surgery after combined intra-venous thrombolysis and endovascular stroke treatment.

BACKGROUND AND PURPOSE: The prognosis of malignant middle cerebral artery infarctions (MCA) is poor. The poor prognosis is attributable to the severe cerebral edema that causes a brain herniation and death. Decompressive surgery reduces mortality and may further improve patient outcomes. However, the safety and effectiveness of decompressive surgery in patients who underwent combined intravenous (IV) thrombolysis and endovascular stroke treatment are not certain. Moreover, the evidence on the timing of decompressive surgery is lacking. METHODS: The purpose of the open, prospective and non-randomized study was to compare the outcome and complication rates of patients with malignant MCA strokes who underwent early decompressive surgery after combined intravenous thrombolysis and endovascular treatment with those of decompressive surgery patients without prior recanalization treatment strategy. All patients underwent decompressive surgery within 24h of symptom onset. RESULTS: Thirty patients were included in the study. Twelve of the 30 patients were treated with combined IV thrombolysis and endovascular approach and 18 patients received standard treatment. The proportion of patients with a modified Rankin score ≤3 at the sixth month follow-up was 33% in the standard group and 44% in the combined treatment group (p=0.712). Mortality, and major and minor complications including symptomatic intracerebral hemorrhage after decompressive surgery did not differ between the two groups (p>0.05). CONCLUSION: Early decompressive surgery can be safely performed in patients who received combined IV thrombolysis and endovascular treatment and there was no difference in outcome of these patients compared with patients who did receive the standard medical treatment before early decompressive surgery.

Evaluation of the relationship between epicardial fat volume and left ventricular diastolic dysfunction.

PURPOSE: The aim of the present study was to evaluate the relationship between epicardial fat tissue (EFT) volume and left ventricular diastolic function. MATERIALS AND METHODS: A total of 63 patients (29 male, 34 female, mean age 57.8 ± 10.9 years) were enrolled in the study. Multidetector computed tomography (MDCT) and 2D transthoracic echocardiography were performed in 29 patients with left ventricular diastolic dysfunction and 34 patients with normal diastolic function. EFT volume and coronary calcium score were measured by MDCT. RESULTS: Mean EFT volume was 137.2 ± 56.2 cm(3) for the whole study group. Mean EFT was 114.1 ± 46.6 cm(3) in patients with normal left ventricular diastolic function and 164.4 ± 54.9 cm(3) in those with left ventricular diastolic dysfunction (p = 0.0002). Diastolic dysfunction had no significant correlation with diabetes, hypertension, and coronary calcium scoring (p > 0.05). Also in our patient group EFT volume had no significant correlation with coronary calcium score (r = 0.148, p = 0.248). CONCLUSION: Patients with left ventricular diastolic dysfunction had significantly increased EFT volume.