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Objective: More information is needed on "low-risk" preterm infants' neurological outcome so that they can be included in follow-up programs. A prospective study was performed to examine the regional brain volume changes compared to term children and to assess the relationship between the regional brain volumes to cognitive outcome of the low-risk preterm children at 9 years of age., Patients: Subjects comprised 22 preterm children who were determined to be at low risk for neurodevelopmental deficits with a gestational age between 28 and 33 weeks without a major neonatal morbidity in the neonatal period and 24 age-matched term control children term and matched for age, sex, and parental educational and occupational status., Methods: Regional volumetric analysis was performed for cerebellum, hippocampus, and corpus callosum area. Cognitive outcomes of both preterm and control subjects were assessed by Weschler Intelligence Scale for Children Revised (Turkish version), and attention and executive functions were assessed by Wisconsin Card Sorting Test and Stroop Test TBAG version., Results: Low-risk preterm children showed regional brain volume reduction in cerebellum, hippocampus, and corpus callosum area and achieved statistical significance when compared with term control. When the groups were compared for all WISC-R subscale scores, preterm children at low risk had significantly lower scores on information, vocabulary, similarities, arithmetics, picture completion, block design, object assembly, and coding compared to children born at term. Preterm and term groups were compared on the Stroop Test for mistakes and corrections made on each card, the time spent for completing each card, and total mistakes and corrections. In the preterm group, we found a positive correlation between regional volumes with IQ, attention, and executive function scores. Additionally, a significant correlation was found between cerebellar volume and attention and executive function scores in the preterm group., Conclusion: Low-risk preterm children achieve lower scores in neurophysiological tests than children born at term. Preterm birth itself has a significant impact on regional brain volumes and cognitive outcome of children at 9 years of age. It is a risk factor for regional brain volume reductions in preterm children with low risk for neurodevelopmental deficits. The significant interaction between cerebellar volume reduction and executive function and attention may suggest that even in preterm children at low risk can have different trajectories in the growth and development of overall brain structure.

Purpose: To reveal the magnetic resonance imaging (MRI) properties of incidental petrous apex cephalocele (PAC) and coexisting empty sella-arachnoid cyst., Materials and Methods: We reviewed our archive from June 2005 to July 2008. Four patients were diagnosed with PAC (four females; age range, 41-60 years; mean, 48.5). All patients underwent MRI examination of the cranium. We evaluated the lesions for extension into the neighboring structures, content, signal intensity, enhancement, and relation to Meckel's cave, petrous apex and for the presence of empty sella., Results: The presenting symptoms included headache for three patients and diplopia for one patient. All patients had bilateral PAC, more prominent on one side. All lesions were centered posterolateral to the Meckel's cave. They were isointense to cerebrospinal fluid signal intensity and continuous with Meckel's cave on T1W, T2W and FLAIR sequences. In two patients, there was no diffusion restriction on diffusion-weighted MR images and the ADC map. Three patients had empty sella. One patient had arachnoid cyst., Conclusion: Coexistence with empty sella-arachnoid cyst raises the possibility of cerebrospinal fluid inbalance in the etiology.

Background: Carotid artery intima-media thickness (CIMT) has been used as a marker of atherosclerosis. An insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with various cardiovascular diseases. This study is aimed at evaluating early atherosclerotic involvement of carotid vessels and the relation to known risk factors and ACE gene I/D in hemodialysis (HD) patients., Methods: We measured CIMT using high-resolution B-mode ultrasonography in 51 non-diabetic HD patients and in 70 age- and sex-matched healthy controls, and evaluated the factors influencing CIMT. An I/D polymorphism in intron 16 of the gene coding for ACE was analysed by polymerase chain reaction., Results: The mean CIMT was significantly higher in HD patients than in healthy subjects (p<0.0001). In multiple regression analysis, independent risk factors for increased CIMT in HD patients were predialysis systolic blood pressure (p<0.001) and ACE D allele (p<0.01)., Conclusions: The present data suggest that CIMT is enlarged in HD patients. The ACE gene seems to be a candidate for influencing the CIMT and might therefore be involved in an HD patient's predisposition to the development of atherosclerosis.

In this study, 35 patients with euthyroid diffuse goiter and 35 patients with euthyroid nodular goiter were treated with Levothyroxine (L-T4) for six months. The aim was to evaluate the efficacy of treatment on thyroid and nodule volumes and to evaluate the correlation between volume changes and thyroglobulin levels. Serum thyroid hormones, TSH, thyroglobulin, thyroid and nodule volumes were measured at the initial visit and after 6 months. Radioactive iodine uptakes of the thyroid gland were evaluated before treatment. The mean decrease of thyroid volume at six months was about 20% (20.4 +/- 8.8 ml vs. 16 +/- 7.9 ml, P<0.001) in patients with diffuse goiter. All patients with diffuse goiter showed some decrement in their goiter sizes. Thyroid nodules, in response to thyroid hormone treatment, showed a variable behavior. A reduction of 50% or more in volume was detected in 31% (11/35) of the patients. 54% of the patients (19/35) showed a 10-49% decrease in nodule volume. Five of the patients were found to be insensitive to the therapy. Their nodule volumes either increased or did not change during therapy. Free T4 and free T3 levels increased and TSH levels decreased with L-T4 treatment in all patient groups. Patients with higher TSH levels (within normal limits) showed more volume reduction in the diffuse goiter group. No uniform correlation was found between volume changes and thyroglobulin levels in either of the patient groups. In conclusion, suppressive thyroxine treatment is effective in reducing the size of the goiter, and nodules and thyroglobulin levels cannot be taken as an indicator of the efficacy of L-T4 therapy.

Purpose: This study investigated the effect of ophthalmic betaxolol, a beta, selective adrenoceptor antagonist, on ocular blood flow and visual function in patients with normotension glaucoma (NTG)., Methods: Thirty-six eyes of eighteen patients with NTG, but otherwise free of systemic disease, were included. Blood fibrinogen, sedimentation rates, Goldmann intraocular pressure, Humphrey automated perimetry, and color Doppler imaging were done at baseline and after one year of twice-daily bilateral topical ocular dosing with 0.5% betaxolol HCI., Results: After treatment, the resistivity index of the ophthalmic artery was significantly reduced, and visual fields were significantly improved. The resistivity indexes of the central retinal artery and posterior ciliary artery were also reduced but did not achieve statistical significance. Intraocular pressure was significantly reduced. There was no change in blood fibrinogen and sedimentation rates., Conclusions: These findings indicate that long-term treatment with ophthalmic betaxolol improves ocular hemodynamics by lowering the resistivity index of the ophthalmic artery and results in an improvement in the visual fields of patients with NTG. In view of this positive effect on blood flow and visual function, betaxolol is recommended in the management of patients with NTG.