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Background: To determine the corneal densitometry(CD) values by using Scheimpflug imaging in myopic and hyperopic children and to compare the results with emmetropic children., Methods: The CD measurements of the subject were obtained with Scheimpflug tomography. The values were automatically measured in standardized grayscale units over an area 12mm in diameter, which was subdivided into 4 annular concentric zones(0-2mm, 2-6mm, 6-10mm, 10-12mm) and 3 corneal depths(anterior layer: anterior 120µm; central layer: from 120µm to the last 60µm; posterior layer: last 60µm). In addition, we evaluated the correlation between spherical equivalence and anterior corneal morphological parameters and the CD values., Results: A total of 211 participants were included in this prospective cross-sectional study. The eyes were divided into three groups related to their spherical equivalent(SE) refractive error values as follows: 88(41.7%) hyperopic eyes, 62(29.4%) myopic eyes, and 61(28.9%) emmetropic control eyes. The hyperopic eyes were found to have lower corneal densitometry values in 4 annular zones and the total 0-12 diameter of all layers except the central layer. However, only the 6-10mm annular zone of the central and posterior layers of the myopic eyes had lower corneal densitometry values than emmetropic eyes. There was also a significant correlation between spherical equivalent and corneal densitometry values in the anterior layer(0-2mm, 2-6mm zones), central layer(0-2mm, 10-12mm zones), posterior layer(6-10mm, 10-12mm zones, and the total 0-12mm diameter), and total corneal thickness(0-2mm zone) of the hyperopic eyes., Conclusions: Backward scattering of light was lower in hyperopic eyes and this could indicate better visual quality., Competing Interests: Declaration of Competing Interest None of the authors have a financial nor a proprietary interest in the subject matter or materials discussed in this manuscript., (Copyright © 2022. Published by Elsevier B.V.)

Evaluation of the surgical outcome and the patient satisfaction between the modified Wies technique and the Jones retractor plication technique for involutional lower eyelid entropion without horizontal eyelid laxity. Patients who underwent the modified Wies technique (group 1) and the Jones retractor plication technique (group 2) for correction of involutional lower eyelid entropion without horizontal eyelid laxity between January 2014 and January 2020 were retrospectively reviewed. Patients with horizontal eyelid laxity; cicatricial, congenital or iatrogenic entropion; and less than 6 months of follow-up time were excluded. The main outcome measures were the recurrence rate, correct anatomical position of the eyelid, symptom relief, and postoperative complications for both groups. 37 patients (41 eyes) in Group 1 and 34 patients (34 eyes) in Group 2 were enrolled in the study. Mean age ± SD was 75.6 ± 8.5 years in Group 1 and 73.4 ± 7.9 years in Group 2 (p:0.255). The mean follow-up time (range) was 24.3 (6-80) months in group 1 and 25.3 (6-78) months in group 2 (p:0.818). Two patients in Group 1 and seven patients in Group 2 had a recurrence during the follow-up period (p:0.07). Based on the results of the study, it seems that the modified Wies technique may be a good alternative in suitable patients, as it has satisfactory surgical results., Competing Interests: Declaration of competing interest The authors declare that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript., (Copyright © 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Epigenetic regulation by histone methyltransferase G9a is known to control autophagic responses. As the link between autophagy and metabolic homeostasis is widely accepted, we investigated whether G9a affects metabolic circuitries to affect autophagic response in glioma cells. Both pharmacological inhibition and siRNA mediated knockdown of G9a increased autophagy marker LC3B in glioma cells. G9a inhibitor BIX-01294 (BIX) induced Akt-dependent increase in HIF-1α expression and activity. Inhibition of Akt-HIF-1α axis reversed BIX-mediated (i) increase in LC3B expression and (ii) decrease in Yes-associated protein 1 (YAP1) phosphorylation. YAP1 over-expression abrogated BIX induced increase in LC3B expression. Interestingly, BIX induced increase in metabolic modelers TIGAR (TP53-induced glycolysis and apoptosis regulator) and PKM2 (Pyruvate kinase M2) were crucial for BIX-mediated changes, as transfection with TIGAR mutant or PKM2 siRNA reversed BIX-mediated alterations in pYAP1 and LC3B expression. Coherent with the in vitro observation, BIX had no significant effect on the tumor burden in heterotypic xenograft glioma mouse model. Elevated LC3B and PKM2 in BIX-treated xenograft tissue was accompanied by decreased YAP1 levels. Taken together, our findings suggest that Akt-HIF-1α axis driven PKM2-YAP1 cross talk activates autophagic responses in glioma cells upon G9a inhibition., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Joint pains are a common reason for children to present to primary care. The differential diagnosis is large including some diseases that do not primarily affect the musculoskeletal system. Although the cause for many patients will be benign and self-resolving, in rare cases the diagnosis is associated with long-term morbidity and mortality if not detected early and appropriately treated. These include primary and secondary malignancies, septic arthritis, osteomyelitis, inflammatory arthritis, slipped upper femoral epiphysis (SUFE) and non-accidental injury. We highlight the importance of a thorough history and directed yet comprehensive examination. A diagnostic algorithm is provided to direct primary care physicians' clinical assessment and investigation with the evidence base where available. In many cases, tests are not required, but if there is suspicion of malignancy, infection or inflammatory conditions, laboratory tests including full blood count, blood film, erythrocyte sedimentation rate, C-reactive protein and lactate dehydrogenase help to support or exclude the diagnosis. Autoimmune tests, such as antinuclear antibodies and rheumatoid factor, have no diagnostic role in juvenile idiopathic arthritis; therefore, we advise against any form of 'rheumatological/autoimmune disease screen' in primary care. Imaging does have a place in the diagnosis of joint pains in children, with plain radiographs being most appropriate for suspected fractures and SUFE, whilst ultrasound is better for the detection of inflammatory or infective effusions. The appropriate referral of children to paediatric rheumatologists, oncologists, orthopaedic surgeons and the emergency department are discussed., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

We demonstrated the presence of the agent of human granulocytic anaplasmosis (HGA), Anaplasma phagocytophilum, and the agent of Lyme borreliosis, Borrelia burgdorferi sensu lato, in north-western Turkey. A total of 241 questing Ixodes ricinus adult ticks were sampled by flagging from recreational parks of the Asiatic and European sides of the heavily populated Istanbul metropolitan area and rural forests of Kirklareli located in the Thrace region in 2008. Both tick-borne pathogens were detected and identified by PCR and DNA sequencing analysis. A. phagocytophilum infection rates were 2.7% in Istanbul and 17.5% in the Kirklareli area. B. burgdorferi sensu lato infection rates were 38.7% in Istanbul and 11.4% in the Kirklareli area. Only 3 of 241 ticks were coinfected with A. phagocytophilum and B. burgdorferi sensu lato., (Copyright © 2011 Elsevier GmbH. All rights reserved.)

Background: Endothelial monocyte-activating polypeptide-II (EMAP-II) is a proinflammatory cytokine with antiangiogenic properties. Serum EMAP-II levels have not been investigated previously in non-small-cell lung cancer (NSCLC). The aim of this study was to examine the relationship between serum EMAP-II levels and clinicopathologic features, including prognosis, in patients with NSCLC., Patients and Methods: We measured serum EMAP-II levels in 30 healthy control subjects and 48 patients with untreated NSCLC by enzyme linkedimmunosorbent assay., Results: Patients with NSCLC had significantly higher serum EMAP-II levels than did the control group (492 pg/mL +/- 1126 pg/mL vs. 266 pg/mL +/- 1013 pg/mL; P = .015). No significant association was found between serum EMAP-II levels and various clinicopathologic features (age, smoking history, performance status, histopathology, tumor stage, lymph node stage, or distant metastasis). Median survival time was 10.13 months (range, 2-53.8 months). The high-EMAP-II (>or= 100 pg/mL) group had a shorter survival compared with the low-EMAP-II (< 100 pg/mL) group (P = .023), and the serum EMAP-II level was still an important predictor of survival in a multivariate analysis, along with disease stage., Conclusion: Our results showed that serum EMAP-II levels are significantly higher in patients with NSCLC than in healthy subjects and suggest it is of potential prognostic value.

Background: Bronchiectasis is a common disabling but rarely fatal disease. However the long-term prognosis and risk factors for mortality are not well known., Objective: The aim of this study was to determine prospectively the survival and predictive factors of mortality in patients with bronchiectasis, during 4-year follow-up., Patients and Methods: From September 2000 to January 2005 survival of bronchiectasis (as evaluated by computed tomography) and predictors of mortality were assessed in 98 outpatients. Fifty-one of the patients had self-reported history of pulmonary infection including tuberculosis. Baseline data, reevaluated in every single year according to scheduled visits., Results: The mean age was 61+/-10 and 74% of the patients were female. In total, 16 patients (16.3%) died; mean survival time was 44.06+/-1.6 months. The survival rates were 97%, 89%, 76%, 58% at 1, 2, 3 and 4 years, respectively. Cox proportional hazard model revealed that long-term mortality was significantly associated with age, body mass index (BMI), Medical Research Council (MRC) dyspnea scale, vaccination, radiographic extent, hypoxemia, hypercapnia and functional parameters. However, MRC and BMI had more significant effects on the mortality than the functional parameters., Conclusions: These results suggest that high BMI, regular vaccination and scheduled visits may have beneficial effects on the survival of bronchiectasis. Besides, presence of hypoxemia, hypercapnia, dyspnea level and radiographic extent were more closely correlated with mortality.

Background: Angiogenesis, the formation of new blood vessels from the existing vascular bed, is essential step for the growth and invasion of the primary tumor. Vascular endothelial growth factor (VEGF) is known to play crucial role in tumor angiogenesis. Increased serum VEGF levels may be associated with poor prognosis in patients with non-small cell lung cancer (NSCLC)., Methodology: In the present study, we measured plasma VEGF levels in 20 normal subjects and 75 patients with untreated NSCLC; 23 operable (stages I, II, IIIA) and 52 inoperable (stages IIIB, IV) (Histology: squamous cell carcinoma, 40; adenocarcinoma, 27; undetermined, 8). VEGF was measured by enzyme-linked immunosorbent assay., Results: The median VEGF level in patient group was 119 pg/ml (29-1235), which was significantly higher than the control group (P = 0.044). Median survival of patients was 210 days (30-220). The patients were divided into high VEGF (> 119 pg/ml) and low VEGF (< 119 pg/ml) groups using the median value as a cut-off. It was investigated if there were significant associations between serum VEGF level and clinico-pathological parameters like age, sex, histopathological diagnosis and TNM staging. Also high VEGF and low VEGF patient groups were compared according to the median survival., Conclusions: Serum VEGF level is significantly associated with the clinical staging of the patients (operable and inoperable) (P = 0.031) and it also correlates with the prognosis of the patients (P = 0.0006).

We investigated the association between complement resistance and phenotypes of pathogenicity of Borrelia burgdorferi sensu lato isolates cultivated in a LEW/N rat tibiotarsal joint-derived tissue feeder layer-supported co-culture system. Guinea pig complement and immune serum raised in LHS/Ss hamsters caused complete lysis of B. burgdorferi sensu stricto isolate 297, B. afzelii and B. garinii in Barbour-Stoenner-Kelly's medium; however, tissue co-cultured B. burgdorferi sensu stricto contained complement escape variants. The arthritogenicity and infectivity of these variants were tested in 3-week-old Syrian hamsters and in a vaccinated hamster model in which formalin-killed B. burgdorferi sensu stricto C-1-11 vaccinated animals develop severe arthritis after challenge with live, pathogenic, low-passage 297 isolate. Non-animal-passaged complement escape variants were infectious in both animal models as demonstrated by re-isolation from the infected animals and competitive PCR. IP injection of animal-passaged complement escape variants caused development of severe arthritis in vaccinated animals 5 weeks post-injection; animal passage of complement escape variants was necessary for isolation of arthritogenic spirochetes from high-passaged, non-arthritogenic, attenuated borrelia cultures. Complement escape variants synthesized outer surface protein E as demonstrated by SDS-PAGE and western blotting analyses. The complement-mediated selection technique in tissue co-culture provides a novel approach to the studies of Lyme disease, enables us to isolate pathogenically distinct borrelia populations from attenuated cultures and prepare a moderately infectious, non-pathogenic live vaccine against this illness.