Arthroscopic Repair of Large Subscapularis Tear Over the First Facet.

BACKGROUND: Long-term studies on arthroscopic repair of large subscapularis (SSC) tears over the first facet with or without supraspinatus (SSP) tear are limited. PURPOSE: To assess the structural and clinical outcomes of arthroscopic repair of large SSC tears using magnetic resonance imaging (MRI) and identify the factors related to SSC retear and poor outcomes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This study involved 109 patients (84.0 ± 36.2 months of follow-up) who underwent arthroscopic repair of large SSC tears (Yoo and Rhee classification type III [n = 81] or IV [n = 28]) between 2011 and 2019. All patients underwent MRI at 6.1 ± 0.4 months after surgery, and 79 of 109 patients (72.5%) were followed up over 7 years. Clinical outcomes (active range of motion, functional scores, and belly press strength) and final poor clinical outcomes (reoperation, osteoarthritic change, and poor clinical outcome) were recorded. SSP tear size, rotator cuff atrophy and fatty infiltration (Goutallier classification), SSC tendon integrity (intact, intermediate, definite tear), and SSP tendon integrity (Sugaya classification) were evaluated by MRI. RESULTS: The overall SSC retear rate was 8.3% (9/109) (type III, 2/81 [2.5%]; type IV, 7/28 [25.0%]; P < .001). SSC Goutallier grade 4 showed a higher retear rate than grade 3 (7/33 [21.2%] vs 2/33 [6.1%]; P = .149). A large SSP tear (in millimeters) (odds ratio [OR], 1.5; P = .003), SSC Goutallier grade 4 (OR, 10.8; P = .047), and SSP Goutallier grade 3 or 4 (OR, 0.02; P = .013) were independent factors for SSC retear. Clinical outcomes, except for external rotation, were poorer in patients with SSC retear than in those without retear. Final poor clinical outcomes were observed in 27 of 79 patients (34.2%); female sex (OR, 7.7; P = .007), SSC retear (OR, 8.2; P = .025), and SSP retear (OR, 4.7; P = .031) were independent factors. CONCLUSION: Arthroscopic repair of large SSC tears has shown promising structural outcomes for type III tears but not type IV tears. SSC retear was affected by SSC atrophy, as well as SSP tear size and atrophy. Approximately one-third of the final poor clinical outcomes could be predicted, and SSC retear, SSP retear, and female sex were associated with long-term poor clinical outcomes, underscoring the importance of carefully selecting patients for arthroscopic repair of large SSC tears.

Evaluation of residual level and distribution characteristics of organochlorine pesticides in agricultural soils in South Korea.

In this study, we evaluated the residual levels and distribution characteristics of 10 organochlorine pesticides (OCPs) in the soil of agricultural lands (paddy field, vegetable field, and orchard, n = 150) nationwide. As a result of the investigation, 3-10 types of OCPs were detected in combination in 144 locations (96%) of the total 150 locations. Among those OCPs, dichlorodiphenyltrichloroethane (DDT) and endosulfan were detected in high amounts. The geometric mean concentrations of DDT and endosulfan were ∑DDT 0.31 ng g-1 (ND-2187.18 ng g-1) and ∑endosulfan 0.33 ng g-1 (ND-312.68 ng g-1), respectively. OCP concentrations were generally higher in orchards than in other agricultural fields due to a large amount of pesticides used. DDT in two orchards was detected at 2187.18 ng g-1 and 1061.78 ng g-1, exceeding the levels stated in the Canadian DDT Soil Quality Guidance (SQG, 700 ng g-1). The result of applying the isomer ratio to evaluate the recent or past use of DDT, endosulfan, and hexachlorocyclohexane (HCH), which had a high detection rate, showed that it could be attributable to historical usage. DDT and HCH showed statistically similar residual distribution patterns; however, endosulfan did not show a clear correlation with DDT and HCH due to the effect of its recent use. Thus, the results of evaluation of OCP residual levels and distribution characteristics can be used for the soil management policy of OCPs in agricultural lands in Korea.

Inhibition of glucose transport synergizes with chemical or genetic disruption of mitochondrial metabolism and suppresses TCA cycle-deficient tumors.

Efforts to target glucose metabolism in cancer have been limited by the poor potency and specificity of existing anti-glycolytic agents and a poor understanding of the glucose dependence of cancer subtypes in vivo. Here, we present an extensively characterized series of potent, orally bioavailable inhibitors of the class I glucose transporters (GLUTs). The representative compound KL-11743 specifically blocks glucose metabolism, triggering an acute collapse in NADH pools and a striking accumulation of aspartate, indicating a dramatic shift toward oxidative phosphorylation in the mitochondria. Disrupting mitochondrial metabolism via chemical inhibition of electron transport, deletion of the malate-aspartate shuttle component GOT1, or endogenous mutations in tricarboxylic acid cycle enzymes, causes synthetic lethality with KL-11743. Patient-derived xenograft models of succinate dehydrogenase A (SDHA)-deficient cancers are specifically sensitive to KL-11743, providing direct evidence that TCA cycle-mutant tumors are vulnerable to GLUT inhibitors in vivo.

Discovery and Optimization of Glucose Uptake Inhibitors.

Aerobic glycolysis, originally identified by Warburg as a hallmark of cancer, has recently been implicated in immune cell activation and growth. Glucose, the starting material for glycolysis, is transported through the cellular membrane by a family of glucose transporters (GLUTs). Therefore, targeting glucose transporters to regulate aerobic glycolysis is an attractive approach to identify potential therapeutic agents for cancers and autoimmune diseases. Herein, we describe the discovery and optimization of a class of potent, orally bioavailable inhibitors of glucose transporters, targeting both GLUT1 and GLUT3.

Intracranial Meningioma-induced Parkinsonism.

An intracranial tumor is a rare cause of secondary parkinsonism. Our patient presented to our clinic for recently-developed asymmetric parkinsonism without pyramidal signs. However, a meningioma located in the sphenoidal ridge was identified upon imaging studies. This case suggests that additional causes should be considered when approaching patients with parkinsonism and that imaging studies can provide useful information to make accurate diagnoses.

[Development and evaluation of "Hospice Smart Patient" service program].

PURPOSE: The purpose of this study was to develop and implement the Hospice Smart Patient Program and to evaluate its effectiveness. METHODS: It was quasi-experimental non-equivalent pre-post study. Breast cancer patients who underwent surgery, chemotherapy or radiotherapy, or who needed palliative care, participated in the study. Participants were divided into two groups, experimental and control groups based on their preferences. The program was developed after literature review and discussion among experts on hospice and palliative care. Participants who were in the experimental group received either face-to-face or phone "Hospice Smart Patient" Service at least once a week for 5 months. RESULTS: There was a significant difference in quality of life and communication skill between the two groups after the service was provided. In addition, participants in experimental group showed improved decision making skills, mastery sense, and understanding of hospice and palliative care, which would be beneficial in improving their quality of life. CONCLUSION: We have concluded that the "Hospice Smart Patient" Program is useful for cancer patients in decision making, improving self-control and choosing hospice care to improve their quality of life.

Kinetic study of the quenching reaction of singlet oxygen by common synthetic antioxidants (tert-butylhydroxyanisol, tert-di-butylhydroxytoluene, and tert-butylhydroquinone) as compared with alpha-tocopherol.

Effects of synthetic phenolic antioxidants (BHA, BHT, and TBHQ) on the methylene blue (MB) sensitized photooxidation of linoleic acid as compared with that of alpha-tocopherol have been studied. Their antioxidative mechanism was studied by both ESR spectroscopy in a 2,2,6,6-tetramethylpiperidone (TMPD)-methylene blue (MB) system and spectroscopic analysis of rubrene oxidation induced by a chemical source of singlet oxygen. Total singlet oxygen quenching rate constants (k(ox-Q)+k(q)) were determined using a steady state kinetic equation. TBHQ showed the strongest protective activity against the MB sensitized photooxidation of linoleic acid, followed by BHA and BHT. TBHQ (1 x 10(-3) M) exhibited 86.5% and 71.4% inhibition of peroxide and conjugated diene formations, respectively, in linoleic acid photooxidation after 60-min light illumination. The protective activity of TBHQ against the photosensitized oxidation of linoleic acid was almost comparable to that of alpha-tocopherol. The data obtained from ESR and rubrene oxidation studies clearly showed the strong singlet oxygen quenching ability of TBHQ. The k(ox-Q)+k(q) of BHA, BHT, and TBHQ were determined to be 3.37 x 10(7), 4.26 x 10(6), and 1.67 x 10(8) M(-1) s(-1), respectively. The k(ox-Q)+k(q) of TBHQ was within the same order of magnitude of that of alpha-tocopherol, a known efficient singlet oxygen quencher. There was a high negative correlation (r(2) = -0.991) between log (k(ox-Q)+k(q)) and reported oxidation potentials for the synthetic antioxidants, indicating their charge-transfer mechanism for singlet oxygen quenching. This is the 1st report on the kinetic study on k(ox-Q)+k(q) of TBHQ in methanol as compared with other commonly used commercial synthetic antioxidants and alpha-tocopherol.