Bacterial Conjunctivitis in Childhood: Etiology, Clinical Manifestations, Diagnosis, and Management.

Background: Bacterial conjunctivitis is a common reason for children to be seen in pediatric practices. A correct diagnosis is important so that appropriate treatment can be instituted.

Objective: To provide an update on the evaluation, diagnosis, and treatment of bacterial conjunctivitis in children.

Roux-en-Y or Billroth II Reconstruction After Radical Distal Gastrectomy for Gastric Cancer: A Multicenter Randomized Controlled Trial.

Objective: The aim of the study was to compare the clinical symptoms between Billroth II (B-II) and Roux-en-Y (R-Y) reconstruction after distal subtotal gastrectomy (DG) for gastric cancer.

Background: Surgery is the mainstay of curative treatment for gastric cancer. The technique for reconstruction after DG remains controversial.

Spontaneous formation of nanometer scale tubular vesicles in aqueous mixtures of lipid and block copolymer amphiphiles.

Many common amphiphiles self-assemble in water to produce heterogeneous populations of discrete and symmetric but polydisperse and multilamellar vesicles isolating the encapsulated aqueous core from the surrounding bulk. But when mixtures of amphiphiles of vastly different elastic properties co-assemble, their non-uniform molecular organization can stabilize lower symmetries and produce novel shapes. Here, using high resolution electron cryomicroscopy and tomography, we identify the spontaneous formation of a membrane morphology consisting of unilamellar tubular vesicles in dilute aqueous solutions of binary mixtures of two different amphiphiles of vastly different origins.

Insight into the da Vinci® Xi - technical notes for single-docking left-sided colorectal procedures.

Background: The adoption of robot-assisted laparoscopic colorectal surgery has been hampered by issues with docking, operative duration, technical difficulties in multi-quadrant access, and cost. The da Vinci® Xi has been designed to overcome some of these limitations. We describe our experience with the system and offer technical insights to its application in left-sided colorectal procedures.

Cryo-EM structures of the autoinhibited ATP synthase in three rotational states.

A molecular model that provides a framework for interpreting the wealth of functional information obtained on the F-ATP synthase has been generated using cryo-electron microscopy. Three different states that relate to rotation of the enzyme were observed, with the central stalk's ε subunit in an extended autoinhibitory conformation in all three states. The F motor comprises of seven transmembrane helices and a decameric c-ring and invaginations on either side of the membrane indicate the entry and exit channels for protons.

Our Clinical Experience of Self-Expanding Metal Stent for Malignant Central Airway Obstruction.

Background: We studied the safety, effectiveness, and limitations of airway stenting using self-expanding metal stent (SEMS) in patients with malignant central airway obstruction (CAO).

Methods: A retrospective review of records of patients undergoing SEMS placement for malignant CAO during year 2013 - 2014 was done.

Results: Sixteen patients (11 males and five females) underwent SEMS placement for malignant CAO.

3.9 Å structure of the nucleosome core particle determined by phase-plate cryo-EM.

The Volta phase plate is a recently developed electron cryo-microscopy (cryo-EM) device that enables contrast enhancement of biological samples. Here we have evaluated the potential of combining phase-plate imaging and single particle analysis to determine the structure of a small protein-DNA complex. To test the method, we made use of a 200 kDa Nucleosome Core Particle (NCP) reconstituted with 601 DNA for which a high-resolution X-ray crystal structure is known.

Small bowel obstruction in the virgin abdomen: time to challenge surgical dogma with evidence.

Background: Although adhesions account for more than 70% of small bowel obstruction (SBO), they are thought to be less likely aetiologies in patients without previous abdominal surgery. Expedient surgery has historically been advocated as prudent management in these patients. Emerging evidence appears to challenge such a dogmatic approach.

Can venous base excess replace arterial base excess as a marker of early shock and a predictor of survival in trauma?

Introduction: Arterial base excess is an established marker of shock and predictor of survival in trauma patients. However, venous blood is more quickly and easily obtained. This study aimed to determine if venous base excess could replace arterial base excess as a marker in trauma patients at presentation and if venous base excess is predictive of survival at 24 hours and one week.

Structural and Functional Insights into the Evolution and Stress Adaptation of Type II Chaperonins.

Chaperonins are essential biological complexes assisting protein folding in all kingdoms of life. Whereas homooligomeric bacterial GroEL binds hydrophobic substrates non-specifically, the heterooligomeric eukaryotic CCT binds specifically to distinct classes of substrates. Sulfolobales, which survive in a wide range of temperatures, have evolved three different chaperonin subunits (α, β, γ) that form three distinct complexes tailored for different substrate classes at cold, normal, and elevated temperatures.

Transanal natural orifice specimen extraction in colorectal surgery: bacteriological and oncological concerns.

Introduction: Natural orifice techniques have been developed to reduce incision-related morbidity in laparoscopic colorectal surgery. We describe our method of performing transanal specimen extraction in laparoscopic colorectal surgery, addressing bacteriological and oncological concerns in its implementation.

Methods: Data of consecutive patients undergoing natural orifice specimen extraction (NOSE) laparoscopic colorectal surgery in our institution were retrospectively analysed.

Extracellular vesicles are rapidly purified from human plasma by PRotein Organic Solvent PRecipitation (PROSPR).

Extracellular vesicles (EVs) such as exosomes and microvesicles mediate intercellular communication and regulate a diverse range of crucial biological processes. Host cells that are damaged, infected or transformed release biomarker-containing EVs into the peripheral circulation, where they can be readily accessed for use in diagnostic or prognostic testing. However, current methods of EV isolation from blood plasma are complex and often require relatively large sample volumes, hence are inefficient for widespread use in clinical settings.

Structure of BipA in GTP form bound to the ratcheted ribosome.

BPI-inducible protein A (BipA) is a member of the family of ribosome-dependent translational GTPase (trGTPase) factors along with elongation factors G and 4 (EF-G and EF4). Despite being highly conserved in bacteria and playing a critical role in coordinating cellular responses to environmental changes, its structures (isolated and ribosome bound) remain elusive. Here, we present the crystal structures of apo form and GTP analog, GDP, and guanosine-3',5'-bisdiphosphate (ppGpp)-bound BipA.

Secondary stent-in-stent self-expanding metallic stent placement for early stent occlusion due to mucosal oedema in the gastrojejunal anastomosis after palliative subtotal gastrectomy for locally advanced gastric cancer.

Herein, we report a case of early in-stent occlusion due to the ingrowth of soft oedematous mucosal tissue through the lattices of an uncovered stent, which was used for palliation of a postoperative gastrojejunal anastomotic stricture. The in-stent occulsion was treated with the deployment of a second stent, which was covered, within the first stent. This led to successful resolution of the occlusion.

Laparoscopic mesh repair of parahiatal hernia: a case report.

We report a case of a primary parahiatal hernia that was repaired laparoscopically with a composite mesh. A 51-year-old woman presented with vomiting and epigastric pain. CT scan showed a giant paraesophageal hernia with intrathoracic gastric volvulus.

Localized acquired hypertrichosis associated with the application of a splint.

We describe a 16-year-old boy whose left forearm and hand were cut by a piece of glass from a broken window as a result of the fall. He had surgical repair of his left extensor pollicis brevis, abductor pollicis brevis, and dorsal branch of the left radial nerve. Following the surgery, he was put on a splint so as to immobilize the left forearm and wrist.

Rare cause of acute surgical abdomen with free intraperitoneal air: Spontaneous perforated pyometra. A report of 2 cases.

Background: The acute abdomen accounts for up to 40% of all emergency surgical hospital admissions and a large proportion are secondary to gastrointestinal perforation. Studies have shown the superiority of the abdominal CT over upright chest radiographs in demonstrating free intraperitoneal air. Spontaneous perforated pyometra is a rare cause of the surgical acute abdomen with free intraperitoneal air.

The effect of biceps reattachment site.

Background: We hypothesize that an anatomic repair of the distal biceps tendon would recreate native tendon moment arm and forearm rotation, while a nonanatomic insertion would compromise moment arm and forearm rotation.

Methods: Isometric supination torque was measured at 60° of pronation, neutral, and 60° of supination for the native distal biceps tendon and 4 repair points in 6 cadaveric specimens using a computer controlled elbow simulator. The slope of the regression line fitted to the torque versus biceps load data was used to define the moment arm for each attachment location.

Proper insertion angle is essential to prevent intra-articular protrusion of a knotless suture anchor in shoulder rotator cuff repair.

The advent of new arthroscopic devices has led to the development of novel techniques of arthroscopic rotator cuff repair. However, failure to recognize specific technical aspects and improper application of these devices can lead to complications. We report a case of intra-articular protrusion of knotless anchors (PEEK PushLock SP, 4.

Elbow fractures: distal humerus.

A distal humerus fracture can be a debilitating and difficult injury to treat. The anatomy of the distal humerus is highly complex, as it articulates with both the radius and ulna and allows for motion in multiple planes. Furthermore, comminution and osteopenia may render the metaphyseal-diaphyseal junction weak, making adequate stabilization difficult.

The use of routine wrist radiography is not useful in the evaluation of patients with a ganglion cyst of the wrist.

The purpose of this study was to evaluate the cost-effectiveness of routine wrist radiography in the evaluation of patients with a wrist ganglion. In the setting of a University-based hand surgery practice, 103 consecutive patients with a dorsal or volar wrist ganglion underwent posteroanterior, lateral, and oblique radiographs of the involved wrist. There were 24 men and 79 women with an average age of 34 years (range 4-67 years).

Esophageal pH profile following laparoscopic total fundoplication compared to anterior fundoplication.

In Barrett's esophagus, total abolition of reflux may give maximum protection against the development of malignancy. To determine whether laparoscopic anterior fundoplication gives the same degree of antireflux control as a total fundoplication, we analyzed a prospectively followed cohort of patients from randomized controlled trials of laparoscopic antireflux surgery. There were 167 patients who returned for routine esophageal pH studies within 6 months of surgery (123 laparoscopic total fundoplications and 44 anterior fundoplications).