The short-term results of this study indicate that the clinical outcomes and structural integrity of TOE double-row rotator cuff repair (the suture-bridge technique) have results that compare favorably with those reported for other double-row suture anchor techniques employed in rotator cuff repairs. Long-term follow-up will be necessary to determine if the durability of these repairs and the structural integrity of these constructs maintain their performance over time.

A 74-year-old man with primary aldosteronism had a small tumor (27 x 23 mm) of his right adrenal gland successfully removed by a transperitoneal laparoscopy. Despite absence of malignancy in the resected tumor and complete relief of all symptoms in the immediate postoperative period, recurrence occurred 6 months later. The tumor behaved as a carcinoma spread in the peritoneal cavity, and the patient eventually died with peritoneal carcinomatosis. We suggest that the laparoscopic technique coupled with pneumoperitoneum may have favored this recurrence.

A reproducible classification system that allows different surgeons to establish comparable homogeneous patient groups is useful for both therapeutic and prognostic purposes. We defined four types of subscapularis lesions that are easy to identify as either isolated lesions or combined with anterosuperior rotator cuff tears. Long head of biceps tendon abnormalities and fatty degeneration of the shoulder muscles can be added to our classification system. Studies of intraobserver and interobserver reproducibility are needed to complete the process of validating the diagnostic and/or prognostic usefulness of this new classification scheme.

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Recent investigations have suggested that human GH (hGH) and its receptor may have specific functions during human fetal life. To improve our understanding of the mechanisms of hGH action during gestation, we characterized the ontogenic appearance of hGH receptor messenger ribonucleic acid (mRNA) in multiple human fetal and postnatal tissues. Using RT-PCR assays, followed by Southern hybridization to confirm the specificity of the amplified fragments, we scanned the entire coding region of the hGH receptor mRNA. Transcription of the hGH receptor gene was observed in all fetal tissues studied (liver, kidney, skin, muscle, lung, adrenal, spleen, intestine, central nervous system, pancreas, and placental villi) from the earliest stage that could be examined [7-14.8 weeks fetal age (FA)]. Furthermore, we identified only 2 isoforms of the hGH receptor mRNA-coding region: exon 3 can be retained or deleted. Surprisingly, we found individual-specific, not tissue-specific, expression patterns of these two transcripts when we examined multiple tissues (n = 2-6) from 15 individuals (11.5-33 weeks FA); this individual-specific pattern of expression is maintained in cultured dermal fibroblasts for at least 12 generations (n = 2; 16 and 20 weeks FA). In addition, a cross-sectional study of 78 individuals (9 weeks FA to 43 yr postnatal age) showed that the exon 3-deleted transcript is predominantly expressed in tissues from fetuses of 9-20 weeks FA (P < 0.002). Finally, we showed that the absence of exon 3 from the mRNA is not due to genomic deletion of exon 3 by amplifying exon 3 from genomic DNA of 3 fetuses (13.3-19 weeks FA) expressing only the exon 3-deleted mRNA transcript. We conclude that 1) transcription of the hGH receptor gene occurs in multiple tissues as early as the first trimester of human fetal life; 2) the exon 3-retaining and -deleted transcripts are the only two isoforms of the hGH receptor mRNA-coding region during gestation; and 3) the pattern of expression of these transcripts is individual specific and may be developmentally regulated.

The reaction of chromate and ascorbate in a 1:1 molar ratio at pH 7.4 and 37 degrees C produces a Cr(V) signal observable by EPR at g = 1.980. When this reaction is carried out in aerated media and in the presence of formate, carboxylate radicals (COO.-) can be trapped as DMPO-COO.- spin adducts (DMPO, 5,5-dimethyl-1-pyrroline N-oxide). The use of a known complexant of Cr(V), 2-ethyl-2-hydroxybutyric acid, produces a different Cr(V) signal at g = 1.978 and a decrease of the DMPO-COO.- signal. Hydroxyl radicals are not detected in the media. The oxidizing behavior is suggested to be produced by activation of molecular oxygen present in the reaction mixture.

Our study confirms the good clinical and radiological results reported in the literature. Our classification system distinguishing four lesion patterns was applicable during the imaging workup. The main finding from this classification system was the difference in results between Type 2 and Type 3 lesions. The trend towards improvements over time requires confirmation by longer-term studies, which will also have to establish that the increased wasting of the upper subscapularis muscle and fatty degeneration of the muscle belly have no adverse effects.

No abstract