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Objectives: Glucocorticoids (GC) are widely accepted as the standard first-line treatment for giant cell arteritis (GCA). However, relapse rates are reported up to 80% on GC-only protocol arms in controlled trials of tocilizumab and abatacept in 12-24 months. Herein, we aimed to assess the real-life relapse rates retrospectively in patients with GCA from Turkey., Methods: We assembled a retrospective cohort of patients with GCA diagnosed according to ACR 1990 criteria from tertiary rheumatology centres in Turkey. All clinical data were abstracted from medical records. Relapse was defined as any new manifestation or increased acutephase response leading to the change of the GC dose or use of a new therapeutic agent by the treating physician., Results: The study included 330 (F/M: 196/134) patients with GCA. The mean age at disease onset was 68.9±9 years. The most frequent symptom was headache. Polymyalgia rheumatica was also present in 81 (24.5%) patients. Elevation of acute phase reactants (ESR>50 mm/h or CRP>5 mg/l) was absent in 25 (7.6%) patients at diagnosis. Temporal artery biopsy was available in 241 (73%) patients, and 180 of them had positive histopathological findings for GCA. For remission induction, GC pulses (250-1000 methylprednisolone mg/3-7 days) were given to 69 (20.9%) patients, with further 0.5-1 mg/kg/day prednisolone continued in the whole group. Immunosuppressives as GC-sparing agents were used in 252 (76.4%) patients. During a follow-up of a median 26.5 (6-190) months, relapses occurred in 49 (18.8%) patients. No confounding factor was observed in relapse rates. GC treatment could be stopped in only 62 (23.8%) patients. Additionally, GC-related side effects developed in 64 (24.6%) patients, and 141 (66.2%) had at least one Vasculitis Damage Index (VDI) damage item present during follow-up., Conclusions: In this first multi-centre series of GCA from Turkey, we observed that only one-fifth of patients had relapses during a mean follow-up of 26 months, with 76.4% given a GC-sparing IS agent at diagnosis. At the end of follow-up, GC-related side effects developed in one-fourth of patients. Our results suggest that patients with GCA had a low relapse rate in real-life experience of a multi-centre retrospective Turkish registry, however with a significant presence of GC-associated side effects during follow-up.

In this paper, we investigate the electronic and optical properties of an electron in both symmetric and asymmetric double quantum wells that consist of a harmonic potential with an internal Gaussian barrier under a nonresonant intense laser field. The electronic structure was obtained by using the two-dimensional diagonalization method. To calculate the linear and nonlinear absorption, and refractive index coefficients, a combination of the standard density matrix formalism and the perturbation expansion method was used. The obtained results show that the electronic and thereby optical properties of the considered parabolic-Gaussian double quantum wells could be adjusted to obtain a suitable response to specific aims with parameter alterations such as well and barrier width, well depth, barrier height, and interwell coupling, in addition to the applied nonresonant intense laser field.

In this study, we considered the linear and non-linear optical properties of an electron in both symmetrical and asymmetrical double quantum wells, which consist of the sum of an internal Gaussian barrier and a harmonic potential under an applied magnetic field. Calculations are in the effective mass and parabolic band approximations. We have used the diagonalization method to find eigenvalues and eigenfunctions of the electron confined within the symmetric and asymmetric double well formed by the sum of a parabolic and Gaussian potential. A two-level approach is used in the density matrix expansion to calculate the linear and third-order non-linear optical absorption and refractive index coefficients. The potential model proposed in this study is useful for simulating and manipulating the optical and electronic properties of symmetric and asymmetric double quantum heterostructures, such as double quantum wells and double quantum dots, with controllable coupling and subjected to externally applied magnetic fields.

Aim: Sacroiliac joint (SJ) imaging is the key point in the diagnosis of ankylosing spondylitis (AS). The curved anatomy of the SJ makes the interpretation of imaging difficult. The aim of this study is to evaluate the interclass and intraclass reliability of specific lesions (bone marrow edema [BME], joint space narrowing, erosions, effusion, ankylosis, bridging, sclerosis, fat deposition, and other additional pathologies) on SJ magnetic resonance imaging (MRI)., Method: In a total of 310 randomly chosen patients, 620 SJs were evaluated by three different radiologists with different radiology experiences of specialties other than musculoskeletal radiology., Results: The agreement between readers for BME was fair to substantial, for active sacroiliitis was moderate to substantial, for sacroiliac narrowing was fair at best, for erosions was fair to moderate, for SJ sclerosis was none to slight, for chronic sacroiliitis was slight to fair, for degenerative sacroiliitis was none to slight, for normal SJ was slight, for SJ effusion was none to slight, and for fatty deposition was none. Intraclass correlation for readers 1 and 3 was usually good to excellent and for reader 2 was poor to fair., Conclusion: This study was designed to assess the agreement between radiologists who were not familiar with SJ MRI. The agreement between readers was usually fair to substantial and even intraclass correlation was poor to fair for reader 2. Future studies can be designed for standardization and validation of each MRI lesion for better interpretation of SJ MRI., (© 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

In this study, we investigated the exciton binding energy and interband transition between the electron and heavy-hole for the single and double quantum wells which have different hyperbolic-type potential functions subject to electric, magnetic, and non-resonant intense laser fields. The results obtained show that the geometric shapes of the structure and the applied external fields are very effective on the electronic and optical properties. In the absence of the external fields, the exciton binding energy is a decreasing function of increasing well sizes except for the strong confinement regime. Therefore, for all applied external fields, the increase in the well widths produces a red-shift at the absorption peak positions. The magnetic field causes an increase in the exciton binding energy and provides a blue-shift of the absorption peak positions corresponding to interband transitions. The effect of the electric field is quite pronounced in the weak confinement regime, it causes localization in opposite directions of the quantum wells of the electron and hole, thereby weakening the Coulomb interaction between them, causing a decrease in exciton binding energy, and a red-shift of the peak positions corresponding to the interband transitions. Generally, an intense laser field causes a decrease in the exciton binding energy and produces a red-shift of the peak positions corresponding to interband transitions.

In this paper, we have researched the electronic and optical properties of cylindrical quantum dot structures by selecting four different hyperbolic-type potentials in the axial direction under an axially-applied electric field. We have considered a position-dependent effective mass model in which both the smooth variation of the effective mass in the axial direction adjusted to the way the confining potentials change and its abrupt change in the radial direction have been considered in solving the eigenvalue differential equation. The calculations of the eigenvalue equation have been implemented considering both the Dirichlet conditions (zero flux) and the open boundary conditions (non-zero flux) in the planes perpendicular to the direction of the applied electric field, which guarantees the validity of the results presented in this study for quasi-steady states with extremely high lifetimes. We have used the diagonalization method combined with the finite element method to find the eigenvalues and eigenfunction of the confined electron in the cylindrical quantum dots. The numerical strategies that have been used for the solution of the differential equations allowed us to overcome the multiple problems that the boundary conditions present in the region of intersection of the flat and cylindrical faces that form the boundary of the heterostructure. To calculate the linear and third-order nonlinear optical absorption coefficients and relative changes in the refractive index, a two-level approach in the density matrix expansion is used. Our results show that the electronic and, therefore, optical properties of the structures focused on can be adjusted to obtain a suitable response for specific studies or goals by changing structural parameters such as the widths and depths of the potentials in the axial direction, as well as the electric field intensity.

In this paper, we calculated the electronic and optical properties of the harmonic oscillator and single and double anharmonic oscillators, including higher-order anharmonic terms such as the quartic and sextic under the non-resonant intense laser field. Calculations are made within the effective mass and parabolic band approximations. We have used the diagonalization method by choosing a wave function based on the trigonometric orthonormal functions to find eigenvalues and eigenfunctions of the electron confined within the harmonic and anharmonic oscillator potentials under the non-resonant intense laser field. A two-level approach in the density matrix expansion is used to calculate the linear and third-order nonlinear optical absorption coefficients. Our results show that the electronic and optical properties of the structures we focus on can be adjusted to obtain a suitable response to specific studies or aims by changing the structural parameters such as width, depth, coupling between the wells, and applied field intensity.

In this work, a finite periodic superlattice is studied, analyzing the probability of electronic transmission for two types of semiconductor heterostructures, GaAs/AlGaAs and InSe/InP. The changes in the maxima of the quasistationary states for both materials are discussed, making variations in the number of periods of the superlattice and its shape by means of geometric parameters. The effect of a non-resonant intense laser field has been included in the system to analyze the changes in the electronic transport properties by means of the Landauer formalism. It is found that the highest tunneling current is given for the GaAs-based compared to the InSe-based system and that the intense laser field improves the current-voltage characteristics generating higher current peaks, maintaining a negative differential resistance (NDR) effect, both with and without laser field for both materials and this fact allows to tune the magnitude of the current peak with the external field and therefore extend the range of operation for multiple applications. Finally, the power of the system is discussed for different bias voltages as a function of the chemical potential.

Purpose: To evaluate the retinal and optic disc microvascular changes according to disease severity in patients with stable chronic obstructive pulmonary disease (COPD), and the correlation of pulmonary parameters with optical coherence tomography angiography (OCTA) findings., Methods: Forty patients with COPD and 30 age- and sex-matched subjects (control group) were included in this cross-sectional prospective study. The COPD group was then divided into two subgroups according to GOLD classification and disease severity as mild-to-moderate COPD group (group 1) and severe COPD group (group 2). OCTA was performed with 6 mm × 6 mm sections for the macula and 4.5 mm × 4.5 mm sections for the optic disc. Foveal retinal thickness (FRT), peripapillary retinal nerve fiber layer (RNFL) thickness, and vessel density in different sections of the retina and optic disc were analyzed., Results: The mean ages, gender, intraocular pressures, peripapillary RNFL thickness, FRT, and optic disc vessel densities were similar among the groups. Compared to the control group and group 1, group 2 showed significantly lower mean foveal vessel density measurements in superficial and deep capillary plexus (P = 0.014 and P = 0.007, respectively). Cigarette packets/year, exacerbation per year, and Modified Medical Research Council showed significant negative correlations, whereas forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity showed significant positive correlations with foveal vessel densities., Conclusion: COPD severity seems to have a negative effect on OCTA measurements. OCTA may reflect the severity of inflammation and hypoxia in COPD and may provide useful detailed information on the role of retinal vascular changes in the follow-up and progression of patients with COPD., Competing Interests: None

Objective: This study aimed to investigate the relationship between plantar pressure pedobarographic measurements and disease activity, radiological abnormalities, and foot indexes in patients with rheumatoid arthritis (RA)., Methods: Sociodemographics, foot symptoms, anatomical distribution, pain intensity and duration, and podiatry services access data were collected. Disease activity scale of 28 joints (DAS28) was used for the disease activity, and Health Assessment Questionnaire (HAQ) was used for the functional status. Foot function index (FFI) was used to measure the impact of foot pathology on its function. The Modified Larsen scoring was used to assess radiological abnormalities. Pedobarographic measurements were used to analyze foot loading characteristics., Results: A total of 104 feet of 52 patients with RA was evaluated. DAS28 scores did not correlate with the plantar pressure values (p>0.05). A significant correlation was found between HAQ scores and right medial midfoot loading pressure (r=0.355; p<0.01). FFI scores were positively correlated with right lateral midfoot loading pressure (r=0.302; p<0.05). No relationship was found between Manchester Foot Pain and Disability Index and plantar loading characteristics. The radiological scores were correlated with left lateral hindfoot plantar pressure (r=0.286; p<0.05)., Conclusions: Pedobarographic measurements can be considered as a follow-up evaluation tool for the evaluation of all foot parts (forefoot, midfoot, and hindfoot). Rheumatoid feet investigation showed that foot involvement is independent of the disease duration, whereas midfoot plantar pressures are associated with the body mass index. Additionally, DAS28 may fall short as a marker of disease activity because it neglects foot problems., Competing Interests: Conflict of Interest: The authors have no conflict of interest to declare., (© Copyright Istanbul Medeniyet University Faculty of Medicine.)

Nanoflakes ultra-thin quantum dots are theoretically studied as innovative nanomaterials delivering outstanding results in various high fields. In this work, we investigated the surface properties of an electron confined in spherical ultra-thin quantum dots in the presence of an on-center or off-center donor impurity. Thus, we have developed a novel model that leads us to investigate the different nanoflake geometries by changing the spherical nanoflake coordinates ( R , α, ϕ). Under the infinite confinement potential model, the study of these nanostructures is performed within the effective mass and parabolic band approximations. The resolution of the Schrödinger equation is accomplished by the finite difference method, which allows obtaining the eigenvalues and wave functions for an electron confined in the nanoflakes surface. Through the donor and electron energies, the transport, optoelectronic, and surface properties of the nanostructures were fully discussed according to their practical significance. Our findings demonstrated that these energies are more significant in the small nanoflakes area by altering the radius and the polar and azimuthal angles. The important finding shows that the ground state binding energy depends strongly on the geometry of the nanoflakes, despite having the same surface. Another interesting result is that the presence of the off-center shallow donor impurity permits controlling the binding energy, which leads to adjusting the immense behavior of the curved surface nanostructures.

Using the effective mass approximation in a parabolic two-band model, we studied the effects of the geometrical parameters, on the electron and hole states, in two truncated conical quantum dots: (i) GaAs-(Ga,Al)As in the presence of a shallow donor impurity and under an applied magnetic field and (ii) CdSe-CdTe core-shell type-II quantum dot. For the first system, the impurity position and the applied magnetic field direction were chosen to preserve the system's azimuthal symmetry. The finite element method obtains the solution of the Schrödinger equations for electron or hole with or without impurity with an adaptive discretization of a triangular mesh. The interaction of the electron and hole states is calculated in a first-order perturbative approximation. This study shows that the magnetic field and donor impurities are relevant factors in the optoelectronic properties of conical quantum dots. Additionally, for the CdSe-CdTe quantum dot, where, again, the axial symmetry is preserved, a switch between direct and indirect exciton is possible to be controlled through geometry.

Psoriatic arthritis (PsA) is a heterogeneous disease with both environmental and genetic factors playing a role in this diversity. The aim of this study is to compare the patient profiles and outcomes in PsA patients in three countries from three continents. PsA patients from Turkey (n = 184), Canada (n = 200), and Italy (n = 177) from the Psoriatic Arthritis-International Database (PsArt-ID) were compared for patient demographics, disease features, treatments, and minimal disease activity (MDA) rates. Patient profiles were different across countries, patients from Italy being older [median (Q1-Q3): 59 (51-65)] than patients from Turkey [48 (37-58)] and Canada [55 (44-65)] and Italian patients having more frequent comorbidities and being more frequently smokers. For disease phenotypes, patients from Italy had axial disease less frequently (12%) than others (Turkey 23%, Canada 52%). Similarly, disease activity in patients from Italy was higher with higher tender and swollen joint counts and body surface area for psoriasis. The lowest rate of biologic use was observed in Italy [ Italy: 18.4%, Turkey: 26.1%, Canada: 33.9%]. MDA was achieved more in Canada [OR (CI): Canada vs Italy = 3.326 (1.983-5.577); Canada vs Turkey = 2.392 (1.498-3.818); Turkey vs Italy = 1.391 (0.786-2.460)]. PsA patient characteristics differ across countries which may be leading to differences in treatments and MDA rates. The differences can be a combination of genetic or geographical differences as well as the demographics of the general population in that area. Therefore, the unmet needs of PsA patients may vary globally. Key Points • PsA disease characteristics, phenotypes, activity levels and treatments differ across countries. • Unmet needs of PsA need to be determined individually., (© 2021. International League of Associations for Rheumatology (ILAR).)

Objective: To investigate the relationship between physical examination (PE) and sonographic features of enthesitis, based on anatomical sites., Methods: The analysis was done using merged raw data of 3 studies on 2298 entheses., Results: Patients with clinical Achilles enthesitis had more abnormalities on ultrasound (US): hypoechogenicity, p < 0.001; thickening, p = 0.001; Doppler signals, p = 0.002; and erosions, p = 0.02. The patellar tendon origin also correlated with PE but distal patellar tendon insertion and plantar aponeurosis were uncoupled from the US., Conclusion: The relationship between clinical and sonographic findings for large entheses is dependent on the anatomical site. For the patellar tendon origin and Achilles entheses, PE is significantly linked to US findings.

Context: To evaluate the stability provided by a new bilateral fixation technique using an in vitro investigation for posterior lumbar segmental instrumentation. Design: Experimental cadaver study. In this study, we propose an alternative technique for a posterior lumbar fixation technique called "inferior-oblique transdiscal fixation" (IOTF). Setting: Study performed at Engineering Center for Orthopedic Research Exellence (ECORE) in Toledo University-Ohio. Participants: Six human lumbar cadaveric specimen used in this study. Interventions: In this study, we propose an alternative technique for a posterior lumbar fixation technique called "inferior-oblique transdiscal fixation" (IOTF). As a novel contribution to the classical technique, the entry point of the screw is the supero-lateral point of the intersecting line drawn between the corpus and the pedicle of the upper vertebra. This approach enables the fixation of two adjacent vertebrae using a single screw on each side without utilizing connecting rods. Outcome Measures: Flexion (Flex), extension (Ext), right and left lateral bending (LB & RB), and right and left axial rotation (LR & RR), and the position data were captured at each load step using the Optotrak motion measurement system and compared for IOTF and posterior transpedicular stabilization. Results: The Posterior stabilization system (PSS) and IOTF significantly reduced the ROM of L4-L5 segment compared to intact segment's ROM. During axial rotation (AR) IOTF fused index segment more than PSS. Besides this, addition of transforaminal lumbar interbody fusion (TLIF) cage improved the stabilization of IOTF system during flexion, extension and lateral bending. Whereas, PSS yielded better fusion results during extension compared to IOTF with and without interbody fusion cages. Conclusions: We hypothesized that the new posterior bilateral system would significantly decrease motion compared to the intact spine. This cadaver study showed that the proposed new posterior fusion technique IOTF fused the index segment in a similar fashion to the classical pedicle screw fusion technique.

In the present work, the effect of non-resonant intense laser field on the nonlinear optical rectification and second and third harmonic generation of n -type double δ -doped GaAs quantum well is studied in detail. The energy eigenvalues and eigenfunctions of this structure are calculated within the framework of effective mass and envelope function approximations. Analytic formulas for the coefficients of nonlinear optical rectification and second and third harmonic generation are obtained using the compact-density matrix approach (CDMA) and iterative method. Based on this model, our obtained numerical results are reported as a function of incident photon energy for several values of non-resonant intense laser field. The results show that the coefficients of nonlinear optical rectification and second and third harmonic generation are strongly affected by the non-resonant intense laser field.

Objectives: AS and PsA share clinical and immunological features centred on enthesitis. However, a strong association between PsA and preceding injury has been recognized. The aim of this study was to test the hypothesis that the entheseal damage seen by US is commoner in PsA patients than in AS patients., Methods: Seventy-nine AS and 85 PsA patients had US scans of 1640 entheses to calculate entheseal inflammation (hypoechogenicity, thickening and Doppler) and damage scores (calcifications, enthesophytes and erosions). Regression modelling was done to evaluate the effect of diagnoses on outcomes, controlling for age, gender, BMI, clinical enthesitis, HLA-B27, and anti-TNF use., Results: Both inflammation and damage scores on US were correlated with BMI (r = 0.392; r = 0.320) and age (r = 0.308; r = 0.538) (P < 0.001), and men had higher inflammation scores than women [12.3 (7.5) vs 8.9 (7.3), P = 0.001]. In multivariate analysis, despite similar (anti-TNF-treated patients) or slightly less inflammation (anti-TNF-naïve patients) in the PsA group, they had 4.22 times more US damage than their counterparts with AS. The difference was even higher in the anti-TNF-naïve patients (5.6 times)., Conclusion: On US assessment, PsA patients have greater entheseal insertion damage scores compared with AS, suggesting potential differences in tissue repair, immunobiology or response to injury at insertions.

Objectives: Conventional radiography is key to assessing AS-related spinal involvement and has become increasingly important given that spinal fusion may continue under biologic therapy. We aimed to compare the reliability of radiographic scoring of the spine by using different approaches to understand how different readers agree on overall scores and on individual findings., Method: Six investigators scored 68 plain radiographs of the cervical and lumbar spine of 34 patients with a 2-year interval, for erosions, sclerosis, squaring, syndesmophytes and ankyloses using the Spondyloarthritis Radiography (SPAR) module. The intraclass correlation coefficients were calculated compared with two gold standards. The reproducibility of each finding in 1632 vertebral corners and new syndesmophytes in each corner was calculated by kappa analysis and positive agreement rates., Results: The intraclass correlation coefficients mostly revealed good to excellent agreement with the gold standards (0.69-0.95). The kappa analysis showed worse agreement, being relatively higher for syndesmophytes (0.163-0.559) and ankylosis (0.48-0.95). Positive agreement rates showed that erosions were never detected at the same vertebral corner by two readers (positive agreement rate: 0%). The mean (range) positive agreement rates were 10.1% (0-27.7%) for sclerosis and 19.2% (0-59.7%) for squaring, and were higher for syndesmophytes [38.8% (21.4-62.5%)] and ankylosis [77.3% (64-95.3%)]., Conclusion: Our results show that there is a poor agreement on the presence of grade 1 lesions included in the Modified Stoke Ankylosing Spondylitis Spine Score-mostly for erosions and sclerosis-which may increase the measurement error. The currently used definitions of reliability have a risk of overestimating reproducibility., (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com)

In this study, the best ultrasound (US) aspect for detection of fifth metatarsophalangeal (MTP) joint erosions, the most frequently eroded joint, in rheumatoid arthritis (RA) patients is investigated. Forty-eight RA patients (F/M = 35/13, mean age and disease durations 50.3 ± 11.8 and 7.9 ± 6.9 y, respectively) were evaluated by B-mode US for erosion. Images were obtained from the dorsal, lateral and plantar aspect of the fifth MTP joint, in longitudinal and transverse scans. The fifth MTP erosions were detected in 36 of 48 patients (75%) and 67 of 96 feet (69.8%). Of the erosions, 15 (22.4%), 53 (79.1%) and 59 (88.0%) were observed at dorsal, lateral and plantar aspects, respectively. Despite not being statistically different, the detection rate of fifth MTP erosions was numerically higher in the plantar aspect than both the lateral and dorsal aspects. In conclusion, the fifth MTP erosions in RA patients are more commonly detected in the plantar aspect US than in dorsal and lateral assessments., (Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Within the envelope function approach and the effective-mass approximation, we have investigated theoretically the effect of an intense, high-frequency laser field on the bound states in a GaxIn1 - xNyAs1 - y/GaAs double quantum well for different nitrogen and indium mole concentrations. The laser-dressed potential, bound states, and squared wave functions related to these bound states in Ga1 - xInxNyAs1 - y/GaAs double quantum well are investigated as a function of the position and laser-dressing parameter. Our numerical results show that both intense laser field and nitrogen (indium) incorporation into the GaInNAs have strong influences on carrier localization.

Using a variational approach, we have investigated the effects of the magnetic field, the impurity position, and the nitrogen and indium concentrations on impurity binding energy in a Ga1-xInxNyAs1-y/GaAs quantum well. Our calculations have revealed the dependence of impurity binding on the applied magnetic field, the impurity position, and the nitrogen and indium concentrations.

A 17-year-old female patient presented with chronic symmetrical oligoarthritis of both knees and ankles, xerostomia, xerophthalmia, multiple bilateral lymphadenopathies in the cervical region, and bilateral parotid enlargement with the histological finding of chronic sialoadenitis. She had been already given methotrexate, chloroquine, and corticosteroids with the diagnosis of rheumatoid arthritis (RA) before referral to our outpatient clinic. Because her complaints and the lumps did not remit and she could be classified as neither RA nor primary Sjögren's syndrome (SS) according to 1987 ACR RA criteria or European preliminary criteria for SS, lymph node biopsy was repeated and revealed the diagnosis of Rosai-Dorfman disease (RDD) with the histological findings of histiocytes, phagocyting lymphocytes in enlarged sinuses, and mature plasma cells infiltrating the pulpa. All the medications were stopped after the pathological diagnosis of RDD and consulting with the Division of Hematology. She was reevaluated with magnetic resonance imaging, which showed dense infiltrative areas around knee and ankle joints, and computed tomography that showed a soft tissue mass surrounding the descending aorta and upper part of the abdominal aorta. Activated partial thromboplastin time was found to be prolonged in prebiopsy examinations, and factor XII deficiency was detected after detailed hematological evaluation. The symptoms of joint involvement were relieved with nonsteroidal antiinflammatory drugs. She has been followed-up without medication without obvious clinical or laboratory change. We herein report a patient with RDD mimicking RA and SS. We consider that RDD should be kept in mind especially in patients with resistant symptoms to conventional therapies, younger disease onset, and predominant parotid and lymph node enlargement.

Objective: To study the effect of 2,3,5-Trimethyl-6-(12-hydroxy-5,10-dodecadiynyl)-1,4-benzoquinone (AA-861) on intercellular adhesion molecule 1 (ICAM-1) and P-selectin expression, leukotriene B4 (LTB4) level, and myeloperoxidase (MPO) activity 24 hours after traumatic brain injury (TBI)., Methods: This study was carried out in the laboratory of the Department of Clinical Pharmacology, Osmangazi University, Eskisehir, Turkey in 2006. Traumatic brain injury was induced in 2 sets of animals using Feeney`s weight-drop method. The first set was used to study the expression of ICAM-1, P-selectin, CD11a, and mouse anti-rat granulocyte monoclonal antibody (HIS48). The second was used to study tissue changes in LTB4 level, and MPO activity. The rats were sacrificed at 0.5, 4, 24, 48, and 72 hours post-injury., Results: Intercellular adhesion molecule (p=0.000001) and P-selectin expression (p=0.00002) peaked at 24 hours, remained high at 48 hours (p=0.00012 for ICAM-1, and p=0.00002 for P-selectin), and 72 hours (p=0.000008 for ICAM-1, p=0.0011 for P-selectin). The HIS48 intensity was significantly increased at 24-72 hours (p=0.022), while the intensity of CD11a became significant only at 72 hours (p=0.040). Myeloperoxidase activity increased notably at 24 hours (p=0.00077), and peaked at 48 hours (p=0.00001). The LTB4 increased markedly at 4 hours (p=0.000004), and peaked at 24 hours (p=0.000001). Pretreatment with AA-861 considerably suppressed the expression of ICAM-1 (p=0.0053), and P-selectin (p=0.0018) on microvascular endothelium, and lowered MPO activity (p=0.0007), and LTB4 level (p=0.008) at 24 hours., Conclusion: The present results suggest that AA-861 might be a potential mediator in the treatment of brain inflammation in TBI.

Purpose: During recent years, the interaction of cell surface molecule, extracellular matrix proteins, and cytoskeletal elements has been a topic for research for the purpose of understanding the mechanisms of pathologic conditions. This study aims to evaluate the expression of CD44, as a cell surface adhesion molecule; fibronectin (FN), as an extracellular and a cell surface protein; vinculin and actin/á-smooth muscle actin (alfa-SMA), as cytoskeletal elements; and the interactions of these proteins in the microenvironment of proliferative vitreoretinopathy (PVR)., Methods: This experimental study was designed by the intravitreal Dispase model in rabbits and proteins' expression were evaluated via immunohistochemical staining., Results: As a cell surface protein, CD44 expression was determined in only four eyes focally and weakly, but in a small number of cells. Among the cytoskeletal proteins, vinculin expression was the most extensive and the strongest in intensity in epi- and subretinal membranes. Alpha-SMA expression was mostly present within small foci of cells. Fibronectin expression was determined in some of the eyes only faintly., Conclusions: Vinculin seems to be involved in PVR pathogenesis. Variability in co-distribution of the expression of vinculin, FN, and alfa-SMA reflects the dynamic interactions evolving between cell and extracellular matrix during the epi- and subretinal membrane formations. The results of this study were determined not to be in support of the assumption that CD44 has a functional role in the pathogenesis of PVR.

Objective: To investigate the effect of infliximab on the frequency of uveitis attacks and the visual prognosis in male patients with Behçet's disease in whom uveitis was resistant to combination therapy with corticosteroids, azathioprine, and cyclosporine., Methods: The study group comprised patients who were receiving combination therapy but experienced at least 2 attacks of posterior uveitis/panuveitis or retinal vasculitis during the 6-month period prior to enrollment. Infliximab infusions (5 mg/kg) were administered at weeks 0, 2, 6, and 14. Weeks 0-22 were defined as the infusion period, and weeks 23-54 were defined as the observation period. Patients continued to receive azathioprine and corticosteroids, but cyclosporine was discontinued after the screening visit. The primary outcome measures were the absence of uveitis attacks during the infusion period (remission), and the absence of uveitis attacks throughout the study period (sustained remission)., Results: Thirteen patients were enrolled in the study. Thirty-two uveitis attacks involving the posterior segment occurred during the previous-treatment period. During the infusion period, 4 patients (30.8%) remained attack-free, and 9 patients had a total of 13 uveitis attacks. Ten of these attacks (76.9%) occurred at either week 14 or week 22. One of 13 patients fulfilled the definition of sustained remission, and the remaining 12 patients had a total of 36 uveitis attacks during the observation period. The mean number of uveitis attacks and daily corticosteroid doses were significantly lower during the infusion period than during the previous-treatment period or the observation period. Although potential visual acuity was regained following infliximab infusion, this beneficial effect was not preserved until week 54. None of the patients experienced a serious adverse event., Conclusion: The results of this trial suggest that infliximab is effective in suppressing the occurrence of uveitis attacks, has a corticosteroid-sparing effect, and has favorable implications for the visual prognosis of patients with resistant Behçet's uveitis.

The frequency and the distribution of HLA-B27 subtypes in spondylarthropathy (SpA) patients and controls were investigated in a sample Turkish population. B27 subtyping was performed by PCR-SSP method in two groups: 49 unrelated HLA-B27 positive Turkish patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group Criteria, and 55 HLA-B27 positive healthy controls. The frequency of HLA-B*27 was 2.6% in the Turkish population, and B*2705 was the predominant allele among patients with SpA. The difference was mainly between male patients and male controls The proportion of B*2705 among B27-positive patients and controls was significantly different (P=0.02). Our study supports other reports from different populations which showed that B*2705 and B*2702 were more frequent in Caucasian patients with SpA.

Eosinophilia has long been known as a hallmark of Churg-Strauss syndrome but has rarely been reported in Wegener's granulomatosis (WG). Here we describe a patient with WG who had skin, kidney and lung involvement as well as striking peripheral eosinophilia and hyperimmunoglobulinaemia E (hyper-IgE). The patient's clinical picture was complicated by intra-alveolar haemorrhage resulting in severe anaemia and respiratory failure. The pulmonary symptoms recovered completely, but the renal involvement evolved into end-stage renal failure despite intensive immunosuppressive treatment, intravenous immunoglobulin and plasmapheresis. We suggest that the presence of eosinophilia and hyper-IgE might contribute to the development of different disease patterns in WG.

We present a 30-year-old man with nephrotic syndrome presenting with bilateral perirenal massive collection compatible with transudation. After drainage of collections kidney biopsy was performed and the histologic diagnosis was focal and segmental glomerulosclerosis. The patient was treated with cyclophosphamide, prednisone, furosemide and enalapril. After remission of nephrotic syndrome renal ultrasound showed complete resolution of perirenal collections. In conclusion, the case shows that perirenal subcapsular transudation is a rare complication of nephrotic syndrome and massive collections can be treated successfully by percutaneous drainage., (Copyright 2002 S. Karger AG, Basel)