Diagnostic difficulties in the radiological assessment of subscapularis tears.

BACKGROUND: Radiological evaluation of rotator cuff tears are sensitive and specific. Accuracy may be low in diagnosing subscapularis tears. MATERIALS AND METHODS: We retrospectively reviewed shoulder arthroscopies performed by two surgeons over 45 months. We reviewed patients who had subscapularis repairs and their preoperative imaging. RESULT: 286 cases had imaging (193 MRIs, 93 USS) with 77 subscapularis repairs. MRI suggested 31 tears, arthroscopy confirmed 16 (30% sensitivity, 89% specificity). USS suggested 6 tears, arthroscopy confirmed 4 (13% Sensitivity, 97% specificity). DISCUSSION: Results demonstrated low accuracy for preoperative radiological subscapularis tear assessment. This has logistical, diagnostic and implications on treatment.

Serum and glucocorticoid-regulated kinase 1 regulates neutrophil clearance during inflammation resolution.

The inflammatory response is integral to maintaining health by functioning to resist microbial infection and repair tissue damage. Large numbers of neutrophils are recruited to inflammatory sites to neutralize invading bacteria through phagocytosis and the release of proteases and reactive oxygen species into the extracellular environment. Removal of the original inflammatory stimulus must be accompanied by resolution of the inflammatory response, including neutrophil clearance, to prevent inadvertent tissue damage. Neutrophil apoptosis and its temporary inhibition by survival signals provides a target for anti-inflammatory therapeutics, making it essential to better understand this process. GM-CSF, a neutrophil survival factor, causes a significant increase in mRNA levels for the known anti-apoptotic protein serum and glucocorticoid-regulated kinase 1 (SGK1). We have characterized the expression patterns and regulation of SGK family members in human neutrophils and shown that inhibition of SGK activity completely abrogates the antiapoptotic effect of GM-CSF. Using a transgenic zebrafish model, we have disrupted sgk1 gene function and shown this specifically delays inflammation resolution, without altering neutrophil recruitment to inflammatory sites in vivo. These data suggest SGK1 plays a key role in regulating neutrophil survival signaling and thus may prove a valuable therapeutic target for the treatment of inflammatory disease.

Balancing the dilution and oddity effects: decisions depend on body size.

BACKGROUND: Grouping behaviour, common across the animal kingdom, is known to reduce an individual's risk of predation; particularly through dilution of individual risk and predator confusion (predator inability to single out an individual for attack). Theory predicts greater risk of predation to individuals more conspicuous to predators by difference in appearance from the group (the 'oddity' effect). Thus, animals should choose group mates close in appearance to themselves (eg. similar size), whilst also choosing a large group. METHODOLOGY AND PRINCIPAL FINDINGS: We used the Trinidadian guppy (Poecilia reticulata), a well known model species of group-living freshwater fish, in a series of binary choice trials investigating the outcome of conflict between preferences for large and phenotypically matched groups along a predation risk gradient. We found body-size dependent differences in the resultant social decisions. Large fish preferred shoaling with size-matched individuals, while small fish demonstrated no preference. There was a trend towards reduced preferences for the matched shoal under increased predation risk. Small fish were more active than large fish, moving between shoals more frequently. Activity levels increased as predation risk decreased. We found no effect of unmatched shoal size on preferences or activity. CONCLUSIONS AND SIGNIFICANCE: Our results suggest that predation risk and individual body size act together to influence shoaling decisions. Oddity was more important for large than small fish, reducing in importance at higher predation risks. Dilution was potentially of limited importance at these shoal sizes. Activity levels may relate to how much sampling of each shoal was needed by the test fish during decision making. Predation pressure may select for better decision makers to survive to larger size, or that older, larger fish have learned to make shoaling decisions more efficiently, and this, combined with their size relative to shoal-mates, and attractiveness as prey items influences shoaling decisions.