An efficient and stereoselective syntheses of all the possible stereoisomers of coronafacic acid (CFA) has been developed. The stereochemistries of C3a and C7a were controlled in a diastereoselective Diels-Alder type cycloaddition using a chiral auxiliary. CFA and 6-epi-CFA were synthesized by hydrogenation of a common intermediate. During the synthesis of 6-epi-CFA, we established that its cis-fused configuration is important for the introduction of C4-C5 double bond by dehydration. This report is the first practical synthesis of both 6-epi-CFA, and its enantiomer.This study aimed to investigate the antimicrobial, antibiofilm, and cytotoxic effects of biosurfactant lipopeptides synthesized by Bacillus subtilis TR47II. For this purpose, the lipopeptides were partially purified using a three-step process and characterized. In the first step, the crude extract obtained from acid precipitation exhibited strong antibacterial activity against the Gram-negative opportunistic pathogens Alcaligenes faecalis ATCC 8750, Achromobacter xylosoxidans ATCC 13138, Pseudomonas alcaligenes ATCC 14909, and Pseudomonas putida ATCC 15175. Moreover, partial inhibition was observed against Klebsiella aerogenes ATCC 13048 (42%), Escherichia coli ATCC 25922 (16%), and Pseudomonas aeruginosa ATCC 27853 (47%).  https://www.selleckchem.com/products/tacrine-hcl.html  The lipopeptides in the crude extract were extracted with methanol and fractioned on a silica gel chromatography column, rendering four TLC-pooled chromatographic fractions, named F1, F2, F3, and F4. The chromatographic fraction F4 was the most bioactive, with MIC values between 300 and 600 µg mL-1. Besides, F4 at sub-MIC doses dislodged the biofilms of A. faecalis, A. xylosoxidans, and P. alcaligenes by about 100, 85, and 81%, respectively. No cytotoxic effect was observed in mammalian cells at MIC. MALDI-TOF-MS analysis revealed that F4 contained cyclic lipopeptides belonging to two families iturins (m/z 1004 to 1087) and fengycins (m/z 1424 to 1545). The dual effect of F4 on planktonic and sessile growth could suggest that the synergistic application of these biosurfactants could be efficient in the control of these opportunistic pathogens.We present a case of a 54-year-old male who was involved in a motorcycle accident. His head computed tomography (CT) scan on arrival at our Level 1 institution was positive for hyperdensity suspicious for subarachnoid hemorrhage (SAH). Spine CT showed anterior compression fractures of T7-T9 vertebral bodies along with the presence of contrast within the subarachnoid space in the thoracic and lumbar spine, raising suspicion for a dural tear. CT of the chest, abdomen, and pelvis revealed open book pelvic fracture, left sacral ala fracture extending into the left sacroiliac joint and S1 neural foramen, coccygeal fracture, and extraperitoneal bladder rupture. This rare case report highlights the possibility of a spinal meningeal tear in severe pelvic trauma with concomitant bladder injury as a pathway of contrast entry into the normally impermeable cerebrospinal fluid (CSF) space mimicking traumatic subarachnoid hemorrhage.Intussusception is a rare cause of late complication after gastric bypass. We report the case of a 53-year-old woman having a gastric bypass in 2011. The patient presented to the emergency department with abdominal pain and vomiting. The diagnosis of intussusception was made by CT scan. Laparoscopy found an invaginated intestinal segment at the level of the jejuno-jejunal anastomosis without necrosis. Adhesiolysis and revision of the anastomosis were performed. The post-operative course was favorable. The diagnosis of intussusception was made by CT scan.Gastrointestinal (GI) leak is a well-known and catastrophic surgical complication. Its impact on patients, surgeons, and the healthcare system is tremendous. Efforts to constraint the occurrence and consequences of GI leak contributed to better assessment and management planning, especially with advanced technology. Detail information about the problem extent and new management options became available and effective for specific categories. Therefore, a full and accurate assessment and understanding of the disease presentation assists in choosing the appropriate management plan. The pathophysiologic process encompasses a severe inflammatory process with a superimposed infection inside sterile body tissue and cavities initiated by contaminated GI leaked content. The extent of the morbidity resulting from GI perforation and leak is variable and may not be predictable. Leak might not be the same in every case. Patients with GI leak present at variable severity depending on several factors. Accordingly, management should be individualized to target the underlying pathophysiology and the extent of the complication. Operative intervention and repair of the perforation site surgically or endoscopically are the standard of care frequently used. However, it may not always be needed. In this article, a practical review of the diversity and underlying pathologies of GI leak will be presented to inform case-specific management plans.Diagnosis and treatment of neurosurgical pathology present unique challenges in underserved areas, and many conditions may go undiagnosed, misdiagnosed, or untreated for prolonged periods. The development of an unusual complication, seemingly unrelated to an area of neurosurgical intervention, may be particularly perplexing to non-neurosurgical providers, particularly in areas where neurosurgical procedures have not historically been available. A 44-year-old male presented with a giant meningioma which was successfully resected. A nasal encephalocele was noted preoperatively but was not addressed due to lack of associated symptoms and distance from the tumor. The patient lived on a remote island and was lost to follow-up. He developed delayed cerebral spinal fluid (CSF) rhinorrhea three months after surgery, which was diagnosed and treated by local providers as allergic rhinitis for 11 months until he presented with new-onset seizure. Imaging demonstrated descent of the lateral ventricle into the encephalocele. The encephalocele was amputated and the skull base defect was repaired successfully. The alteration of ventricular anatomy and CSF fluid dynamics following tumor resection appears to have created an environment where a non-traumatic CSF leak could develop where it had previously shown no signs of developing. It may be prudent to treat skull base defects prophylactically to prevent this type of complication, particularly in patients of remote regions where regular follow-up is difficult.