Penile degloving injury in an adolescent with congenital hypothyroid.

This case follows a 17-year-old boy with congenital hypothyroidism who sustained penile skin avulsion secondary to a dog bite. Initially, an attempt was made to repair the wound using the avulsed skin flap itself as coverage. The repair was done immediately upon presentation to enhance the chances of adequate flap viability; however, the dorsal portion of the reconstruction necrosed within the following week. Ultimately a full thickness surgical graft (FTSG) repair was performed to ensure the most desirable outcome.

Hepatothorax: a rare outcome of high-speed trauma.

Diaphragmatic ruptures are the result of severe blunt trauma or penetrating trauma. Motor vehicle crashes are a common mechanism associated with blunt diaphragmatic rupture (BDR). Incorporating diagnostic tools and laparotomy assist in the diagnosis and treatment of BDR. However, diagnosing BDR can be a challenge for practitioners. Early diagnosis and treatment improve the patient's outcomes. This paper details the events of a patient received in a level I trauma unit.

Sequence-dependent folding and unfolding of ligand-bound purine riboswitches.

Riboswitch regulation of gene expression requires ligand-mediated RNA folding. From the fluorescence lifetime distribution of bound 2-aminopurine ligand, we resolve three RNA conformers (C(o), C(i), C(c)) of the liganded G- and A-sensing riboswitches from Bacillus subtilis. The ligand binding affinities, and sensitivity to Mg(2+), together with results from mutagenesis, suggest that C(o) and C(i) are partially unfolded species compromised in key loop-loop interactions present in the fully folded C(c). These data verify that the ligand-bound riboswitches may dynamically fold and unfold in solution, and reveal differences in the distribution of folded states between two structurally homologous purine riboswitches: Ligand-mediated folding of the G-sensing riboswitch is more effective, less dependent on Mg(2+), and less debilitated by mutation, than the A-sensing riboswitch, which remains more unfolded in its liganded state. We propose that these sequence-dependent RNA dynamics, which adjust the balance of ligand-mediated folding and unfolding, enable different degrees of kinetic discrimination in ligand binding, and fine-tuning of gene regulatory mechanisms.