Proximity Labeling Expansion Microscopy (PL-ExM) resolves structure of the interactome.

Elucidating the spatial relationships within the protein interactome is pivotal to understanding the organization and regulation of protein-protein interactions. However, capturing the 3D architecture of the interactome presents a dual challenge: precise interactome labeling and super-resolution imaging. To bridge this gap, we present the Proximity Labeling Expansion Microscopy (PL-ExM). This innovation combines proximity labeling (PL) to spatially biotinylate interacting proteins with expansion microscopy (ExM) to increase imaging resolution by physically enlarging cells. PL-ExM unveils intricate details of the 3D interactome's spatial layout in cells using standard microscopes, including confocal and Airyscan. Multiplexing PL-ExM imaging was achieved by pairing the PL with immunofluorescence staining. These multicolor images directly visualize how interactome structures position specific proteins in the protein-protein interaction network. Furthermore, PL-ExM stands out as an assessment method to gauge the labeling radius and efficiency of different PL techniques. The accuracy of PL-ExM is validated by our proteomic results from PL mass spectrometry. Thus, PL-ExM is an accessible solution for 3D mapping of the interactome structure and an accurate tool to access PL quality.

Inguinal endometriosis: a differential diagnosis of right groin swelling in women of reproductive age.

We reported a case of right inguinal endometriosis in a 41-year-old woman with unremarkable surgical and gynaecological history. She presented with right groin swelling for a month since her last menstrual period. Clinically the swelling was first diagnosed as inguinal hernia and later histologically proven to be endometriosis.

Predictors of nonunion and reoperation in patients with fractures of the tibia: an observational study.

BACKGROUND: Tibial shaft fractures are the most common long bone fracture and are prone to complications such as nonunion requiring reoperations to promote fracture healing. We aimed to determine the fracture characteristics associated with tibial fracture nonunion, and their predictive value on the need for reoperation. We further aimed to evaluate the predictive value of a previously-developed prognostic index of three fracture characteristics on nonunion and reoperation rate. METHODS: We conducted an observational study and developed a risk factor list from previous literature and key informants in the field of orthopaedic surgery, as well as via a sample-to-redundancy strategy. We evaluated 22 potential risk factors for the development of tibial fracture nonunion in 200 tibial fractures. We also evaluated the predictive value of a previously-identified prognostic risk index on secondary intervention and/or reoperation rate. Two individuals independently extracted the data from 200 patient electronic medical records. An independent reviewer assessed the initial x-ray, the post-operative x-ray, and all available sequential x-rays. Regression and chi-square analysis was used to evaluate potential associations. RESULTS: In our cohort of patients, 37 (18.5%) had a nonunion and 27 (13.5%) underwent a reoperation. Patients with a nonunion were 97 times (95% CI 25.8-366.5) more likely to have a reoperation. Multivariable logistic regression revealed that fractures with less than 25% cortical continuity were predictive of nonunion (odds ratio = 4.72; p = 0.02). Such fractures also accounted for all of the reoperations identified in our sample. Furthermore, our data provided preliminary validation of a previous risk index predictive of reoperation that includes the presence of a fracture gap post-fixation, open fracture, and transverse fracture type as variables, with an aggregate of fracture gap and an open fracture yielding patients with the highest risk of developing a nonunion. CONCLUSIONS: We identified a significant association between degree of cortical continuity and the development of a nonunion and risk for reoperation in tibial shaft fractures. In addition, our study supports the predictive value of a previous prognostic index, which inform discussion of prognosis following operative management of tibial fractures.

Variability in the definition and perceived causes of delayed unions and nonunions: a cross-sectional, multinational survey of orthopaedic surgeons.

BACKGROUND: Despite the large number of fracture outcome studies, there remains variability in the definitions of fracture-healing. It is unclear how orthopaedic surgeons are diagnosing and managing delayed unions and nonunions in clinical practice. We aimed to explore the current opinions of orthopaedic surgeons with regard to defining, diagnosing, and treating delayed unions and nonunions in extremity fractures. METHODS: We developed a survey using previous literature, key informants in the field of orthopaedic surgery, and a sample-to-redundancy strategy. Our final survey contained four sections and twenty-nine questions focusing on demographics and surgical experience, definitions of fracture union, prognostic factors for union, and the need for clinical trials. The Internet-based survey and follow-up e-mails were continued until our a priori sample size of a minimum of 320 completed and eligible responses were collected. RESULTS: Three hundred and thirty-five surgeons completed the survey. The typical respondent was a North American, male orthopaedic surgeon or consultant over the age of thirty years who had completed trauma fellowship training, worked in an academic practice, supervised residents, and had more than six years of experience in treating orthopaedic injuries. Most surgeons endorsed a lack of standardization in definitions for delayed unions (73%) and nonunions (55%); almost all agreed that defining a delayed union and nonunion should be done on the basis of both radiographic and clinical criteria (88%). Most respondents believed that the degree of soft-tissue injury (approximately 93%), smoking history (approximately 82%), and vascular disease (approximately 76%) increased the risk of healing complications. CONCLUSIONS: Surgeons use similar prognostic factors to define and assess delayed unions and nonunions, but there is a lack of consensus in the definitions of delayed union and nonunion. The need for standardization and future randomized trials was strongly endorsed.