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The human microbiome is a complex network of microorganisms that includes viruses, bacteria, and fungi. The gut virome is an essential component of the immune system, which is responsible for regulating the growth and responses of the host's immune system. The virome maintains a crucial role in the development of numerous diseases, including inflammatory bowel disease (IBD), Crohn's disease, and neurodegenerative disorders. The human virome has emerged as a promising biomarker and therapeutic target. This comprehensive review summarizes the present understanding of the virome and its implications in matters of health and disease, with a focus on the Human Microbiome Project., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Hereditary colorectal cancer syndromes, such as Lynch syndrome and familial adenomatous polyposis (FAP), present significant clinical challenges due to the heightened cancer risks associated with these genetic conditions. This review explores genetic profiling impact on surgical decisions for hereditary colorectal cancer (HCRC), assessing options, timing, and outcomes. Genotypes of different HCRCs are discussed, revealing a connection between genetic profiles, disease severity, and outcomes. For Lynch syndrome, mutations in the MLH1, MSH2, MSH6, and PMS2 genes guide the choice of surgery. Subtotal colectomy is recommended for patients with mutations in MLH1 and MSH2, while segmental colectomy is preferred for those with MSH6 and PMS2 mutations. In cases of metachronous colon cancer after segmental colectomy, subtotal colectomy with ileorectal anastomosis is advised for all mutations. Surgical strategies for primary rectal cancer include anterior resection or abdominoperineal resection (APR), irrespective of the specific mutation. For rectal cancer occurring after a previous segmental colectomy, proctocolectomy with ileal pouch-anal anastomosis (IPAA) or APR with a permanent ileostomy is recommended. In FAP, surgical decisions are based on genotype-phenotype correlations. The risk of desmoid tumors post-surgery supports a single-stage approach, particularly for certain APC gene variants. Juvenile Polyposis Syndrome (JPS) surgical decisions involve genetic testing, polyp characteristics with attention to vascular lesions in SMAD4 mutation carriers. However, genetic profiling does not directly dictate the specific surgical approach for JPS. In conclusion this review highlights the critical role of personalized surgical plans based on genetic profiles to optimize patient outcomes and reduce cancer risk. Further research is needed to refine these strategies and enhance clinical guidelines., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Background and Objectives: This study aimed to investigate the possible prognostic significance of interferon alpha-beta receptor subunit 2 (IFNAR2) and tyrosine kinase 2 (TYK2) expressions., Methods: We conducted a retrospective study including COVID-19 adult patients. All blood samples were collected before any interventions. The expressions of IFNAR2 and TYK2 were assessed using real-time PCR in venous blood samples of 54 cases and 56 controls. The transcript quantities of IFNAR2 and TYK2 genes were assessed using a Delta-Ct method., Results: Our findings show no significant differences in gene expression levels for IFNAR2 and TYK2 between patients who required oxygen (O2) therapy and those who did not (p-value = 0.732 and p-value = 0.629, respectively). Likewise, there were no significant differences in IFNAR2 and TYK2 expressions between patients hospitalized for less than 7 days and those hospitalized for 7 days or more (p-value = 0.455 and p-value = 0.626, respectively). We also observed a weak correlation between IFNAR2 expression and CRP (p-value = 0.045, r = 0.192). There was a negative correlation between the expression levels of IFNAR2 and TYK2 transcripts in COVID-19 patients (p-value = 0.044; partial correlation coefficient = -0.283). Additionally, IFNAR2 and TYK2 were significantly downregulated in the COVID-19 group compared to healthy subjects (p-value = 0.002 and p-value = 0.028, respectively). However, neither IFNAR2 nor TYK2 expression was significantly different between the case subgroups based on COVID-19 severity. The IFNAR2 ΔΔCt (B = -0.184, 95% CI: -0.524-0.157, p-value = 0.275) and the TYK2 ΔΔCt (B = 0.114, 95% CI: -0.268-0.496, p-value = 0.543) were not found to be significant predictors of hospitalization duration. The area under the curve (AUC) for IFNAR2 expression is 0.655 (p-value = 0.005, 95% CI: 0.554-0.757), suggesting its poor discriminative value., Conclusion: We were unable to comment definitively on the prognostic power of IFNAR2 and TYK2 expressions in COVID-19 patients, and larger-scale studies are needed. The principal limitations of this study included the lack of longitudinal analysis and limited sample size., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Razavi, Raei, Hatami, Chokami, Goudarzi, Ghasemian, Alizadeh-Navaei, Yarmohammadi, Soltanipur, Tabarestani, Valadan, Meshkinfam Haghighi, Tarsi and Razavi.)

In many clinical and in vitro studies, the effect of laser radiation on meniscal tissue was examined. Clinical studies referred to clinical criteria like swelling, effusion, and pain to evaluate laser effects. In vitro studies showed the laser effect in the moment of cutting the tissue. But the effect of laser radiation on biological tissue also depends on the vital reaction of the tissue. So, the real extent of tissue damage caused by laser irradiation can only be examined in long-term in vivo studies. This was the purpose of this study. Seventy-two knees of pigs underwent arthroscopic meniscal cuts in the anterior horn of the medial meniscus. The pigs were divided into 6 groups: The first 5 groups were operated with 5 different laser systems: Neodym: YAG 1,440-nm wavelength; Nd:YAG 1,064-nm wavelength, Excimer, Holmium:YAG, and CO2. The sixth group was operated with mechanical punches. From each group, the menisci of the pigs were examined macroscopically and by light-microscope after survival periods of 0, 2, 6, 12 weeks. Results were as follows. (1) All laser systems caused greater damage to the meniscal tissue than mechanical instruments. (2) This damage was a biological reaction of the tissue, characterized by a necrotic zone surrounding the meniscus cut. (3) This necrotic zone was not visible intraoperatively but only 2, 6 and 12 weeks after operation. The diameter of the necrotic zone ranged between 1.5 nm and 9 mm. (4) Meniscus cuts with mechanical instruments showed no necrotic zone in the surrounding tissue. (5) Laser cuts in the meniscus caused more extensive healing reaction than cuts with mechanical instruments. (6) The quality of this healing reaction varied with the different laser systems: the Nd:YAG 1,064-nm, Ho:YAG, and CO2 laser caused only an incomplete healing because the tissue repair showed by tissue growing from the synovial edge into the defect only. The Nd:YAG 1,440-nm wavelength and Excimer led to tissue growing from the synovial edge and to remodeling of original meniscal tissue, recognizable by reduction of the necrotic zone. Arthroscopic surgeons should be aware that the damage to meniscus tissue caused by a laser is much greater than can be seen intraoperatively and is much greater than the damage caused by mechanical punches. The healing reaction of the tissue is more extensive after laser application than after use of mechanical instruments. Results of in vitro studies on the tissue damage caused by lasers are insufficient to describe the whole extent of laser effects on living tissue.

Twenty acutely traumatised patients with a rupture of the anterior talofibular ligament were studied by MRI. The results of 3D-studies were correlated with conventional stress x-ray studies. The ruptured ligament was directly visualised in all cases as a thickened structure of high signal intensity. In case of complete ruptured ligaments free flowing ligamentous structures were seen in the signal intense exudation in the ankle joint. MRI can help to decide between surgery or conservative therapy.

We treated 34 patients during 1987-1990 with a collagen wound dressing. Eleven patients had traumatic soft tissue defects, 10 patients had 3 degrees-grade open fractures, 7 patients had infected soft tissue wounds and 6 patients had deep 2 degrees and 3 degrees-degree burns. Our clinical experience confirmed the excellent clinical experimental results of collagen wound dressings. In all cases after 4 until 6 days of treatment good granulation and vascularisation of the wound bed was obtained, so that a skin transplant could be performed, which in all cases healed primarily. Moreover, the wound dressing had a good antibacterial effect and integrated actively in the wound healing process.

This article describes the differential diagnosis between hereditary Madelung's deformity and acquired posttraumatic Pseudo-Madelung's deformity. Three cases of posttraumatic Pseudo-Madelung's deformity were reported. Aspects of aetiology, clinical radiological appearance of hereditary Madelung's deformity and acquired Pseudo-Madelung's deformity are discussed. Differential diagnostic criteria for the discrimination between both forms are also discussed. A rare case of acquired posttraumatic "reversed" Madelung's deformity is also reported.

20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress x-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress x-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR.

Late reconstruction after neglected Monteggia lesions in children is discussed. On the basis of the literature (20 cases) and 2 personal cases it is deduced that open reduction of the radial head should be combined with osteotomy of the ulna according to the pathophysiology of the lesion. Details of the operative procedure are given. Reconstruction of the annular ligament is the least important part. Reconstruction is indicated in children under the age of 10-12 years even if the dislocation has been present for years. Unfavorable conditions for operative reconstruction are long-lasting dislocations in older children, deformation of the radial head, and imminent skeletal maturity.

This is a report of a seven-year-old polytraumatised boy with perforation of a duodenal stress-ulcer. Aspects of the etiology and pathogenesis were discussed. The main therapeutical efforts by stress-ulcer risk patients consist in an early sufficient shock therapy and adequate stress-ulcer prophylaxis to prevent the origin of stress-ulcers and their complications like bleeding and perforation.

116 supracondylar fractures of the humerus were treated from 1973 to 1979. A plaster cast was applied to 68 patients after repositioning of fractures of the type Baumann I and II. 34 children were given an extension according to v. Ekesparre (fractures according to Baumann type II, III), whereas 14 patients were given surgical treatment by fixation with Kirschner wires (type III) according to Baumann). The good results obtained encouraged us to consider the extension treatment according to v. Ekesparre as a good method. Surgery appears to be indicated only if good results cannot be expected with conservative treatment or extension, or if the circulation remains disturbed or if paralysis persists.

Clinical experiences with Fibrin-Nebacetin-bone marrow combination for the treatment of chronic bone infection and as local prophylaxis by operation of non-infected bone diseases. Since 1979 we have carried out 33 autologous bone graftings in children and used the Fibrin-Nebacetin-bone marrow combination. Nebacetin provides a most effective local antibiotic therapy as supplementary and consecutive treatment are surgical procedures executed in bone infection. The chronic bone infection of 15 children subsided completely. In 18 children with bone transplants no infections was observed and all the patients showed primary healing. The use of fibrin did not disturb the bone reconstruction. After 12 weeks the reconstruction of the bone was almost complete. In two cases only we had to make a reoperation, caused by a recurrent cyst. We could not observe any hepatitis in our patients. The operative technique and advantages of treatment were discussed.

Within 7 years 12 children with a intercondylar eminence fracture (Typ I 5, Typ II 3, Typ III 4 times) according to Meyers and McKeever were treated in the Department of Pediatric Surgery of the Rudolf-Virchow-Hospital in Berlin. 7 avulsed intercondylar eminences were treated operatively by means of transepiphysial compression screws and wires. Temporary, transepiphysial screwing or wiring for a period of maximal six weeks is recommended. The results were excellent in 11 children and good in one child.

Bone tumors in children show a large variety in Kind. Often there is no clear distinction between benign and malignant tumors. So in between according to Zollinger there are semimalignant tumors with potential malignity. Adequate excision of these tumors or resection enbloc inhibit the tumor recurrence and give a good prognosis to semimalignant tumors. 31 children with benign bone tumors were operated between 1972 and 1979. They have been followed up medically and radiologically from 1 to 7 years. Up to now we could neither find a recurrence nor a sign of malignant degeneration.

Temporary implantation of Gentamycin PMMA beads and chains provides a most effective local antibiotic therapy as supplementary and consecutive treatment after surgical procedures executed in bone and soft tissue infections. Gentamycin beads and chains are used as an alternative to irrigation-suction drainage. From 1977 to 1979 70 patients were treated for chronic post-traumatic osteomyelitis and infection of the soft tissue. The chronic bone infections subsided completely in 90% of the patients, but 8.3% re-infections were observed within 3 to 24 months after termination of treatment. In 18 patients with gunshot wounds 66.6% of the patients got primary healing and 33.4% secondary healing.

The article reports on etiology, clinics and treatment of pathological fractures caused by benign, semimalign bone tumors as well as tumorlike lesions and inflammatory bone alterations in childhood. Our patients treated between the years of 1972 and 1986 were reexamined and the results reconsidered thoroughly. Of 47 children with pathological fractures 38 were treated surgically. The treatment consisted of tumor excision or milling out respectively, perforation of the excavation and its subsequent filling with autologous spongiosa combined with additional stabilization by osteosynthesis. With this surgical therapy 3 recurrent cysts were observed of which one resulted in a refracture. With the majority of the children the pathological fracture lead to the discovery of the tumor.

Segmentary resection of a traumatic ruptured spleen was carried out in two children. Bleeding of the resected area was prevented by stitching, and the resected space was sealed up by means of a layer of a collagen preparation and with fibrin adhesive. Furthermore, the parenchymal space was enveloped in a dexon net that was fastened under slight tension to the capsule of the residual spleen by means of fibrin adhesive. Postoperative progress of both children was without complications. Postoperatively a residual spleen was seen sonographically having approximately the size of an organ of substandard dimension.

Report on a 9-year-old boy with right-sided renal carbuncle. The symptoms, diagnosis and treatment of the renal carbuncle are described. The possibility of maintaining the function and reconstructing the kidney through fibrin adhesive is discussed.