多平面重建在弥漫性肺疾病中的应用价值

目的评价多层螺旋CT(MDCT)多平面重建(MPR)对肺弥漫性病变的诊断价值。资料与方法对67例经临床确诊表现为肺内弥漫性病变的病例进行MDCT扫描和薄层冠状位MPR,并与轴位高分辨率CT(HRCT)比较。图像分析共分3组,2人3次完成阅片。结果轴位HRCT和冠状位MPR评价磨玻璃密度影、气腔样实变和小结节等高密度病灶和含气病灶的敏感度分别是100%和87%～100%,特异性分别为100%和97%～100%,差别无显著性。HRCT和MPR图像在显示肺内细网状影、线样影和牵张性细支气管扩张的敏感度分别为92%～100%和71%～100%,特异性分别为88%～100%和90%～100%,差别无显著性。HRCT和MPR图像在评价肺弥漫性病变的分布上无显著性差别。观察者对MPR评价磨玻璃密度影、气腔样实变和蜂窝影、肺气肿、肺大泡的满意度较高(95%～100%);对线样影、细网状影、小结节或微结节、牵张性支气管扩张等的满意度较低(10%～68%),差别有显著性(P<0.05)。结论目前采用1.25mm准直的MDCT扫描所得的MPR图像在评价磨玻璃密度影、肺实变、蜂窝影和肺气肿、肺大泡等病变的能力等同于轴位HRCT;评价线样影、细网状影及牵张性支气管扩张和微结节等病变的能力不及轴位HRCT。

Treatment with clopidogrel and proton pump inhibitors in combination: a review of emerging evidence

Proton pump inhibitors often are prescribed in combination with clopidogrel to decrease risk of gastrointestinal bleeding after acute coronary syndrome. Clopidogrel is a prodrug that has to be metabolized in the liver to generate the active metabolite. Both medications are metabolized largely by the CYP2C19 enzyme;therefore, concerns exist that a drug-drug interaction during concomitant treatment with clopidogrel and a proton pump inhibitor may result in reduction of platelet inhibition. We have reviewed observational and randomized control studies that have evaluated the potential influence of proton pump inhibitors on the platelet inhibitory effect of clopidogrel, along with cardiovascular outcomes. We also have summarized regulatory and academic guidelines for treatment of patients in which concomitant therapy with clopidogrel and proton pump inhibitors may be indicated. Confounding issues, including differential effects of individual proton pump inhibitors on the pharmacodynamics of clopidogrel and variation in clopidogrel metabolism mediated by CYP2C19 gene polymorphisms, also are discussed.

Moisture conservation practices and nutrient management on growth and yield of <i>rabi</i>sorghum (<i>Sorghum bicolor</i>) in the Vertisols of peninsular India

The effect of moisture conservation and nutrient management on growth and yield of rabi sorghum was studied at the Zonal Agricultural Research Station, Babbur Farm, Hiriyur Karnataka under rainfed conditions on medium black soil during rabi seasons of 2007-2008 and 2008-2009. Paired row planting (30-60-30 cm) and opening of furrow in wide rows at 35 Days After Sowing (DAS) proved superior over sowing across the slope and even ridges and furrows with tied ridging in terms of grain yield (1.10 t/ha), stover yield (1.51 t/ha) and 1000 grain weight (24.6 g). Similarly application of 50% recommended dose of fertilizer (RDF + Farm Yard Manure (FYM) 2.5 t/ha + Microbial consortia (Trichoderma, Azospirillum and Phosphate Solubilizing Bacteria (PSB) recorded significantly higher plant height (121 cm), panicle length (8.7 cm), panicle diameter (7.4 cm), 1000 grain weight (24.3 g), grain yield (0.95 t/ha) and stover yield (1.42 t/ha) over other treatments but on par with the application of 100% RDF + FYM 2.5 t/ha. Paired row planting (30-60-30 cm) and opening of furrow in wide rows at 35 DAS was also superior with maximum output energy of 43350 MJ/ha, rainwater use efficiency of 5.15 Kg/ha/mm and BC ratio of 2.31. Similarly application of 50%RDF + FYM 2.5 t/ha + Microbial consortia recorded higher output energy of 39525 MJ/ha and rainwater use efficiency of 4.48 Kg/ha/mm.

Comparison of pancreatic acinar cell carcinoma and adenocarcinoma using multidetector-row computed tomography

AIM:To distinguish acinar cell carcinoma(ACC)from pancreatic adenocarcinoma(AC)by comparing their computed tomography findings.METHODS:Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens.The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases(non-contrast,arterial,portal venous,and delayed phase)were compared.The scan delay times were 40,70,and 120 s for each contrast-enhanced phase.The visual pattern,tomographic attenuation value,and time attenuation curve were assessed and compared between AC and ACC cases using the 2test,Wilcoxon signed-rank test,and Mann Whitney U test.RESULTS:The adenocarcinomas tended to be hypodense in all 4 phases.The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhancedphases,although their computed tomographic attenuation values were higher.Further,5 of the 6 acinar cell carcinomas(83%)were isodense in the non-contrast phase.The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases,and all adenocarcinomas showed peak enhancement during the delayed phase.The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases.None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.CONCLUSION:The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas,and multidetector-row computed tomography can thus distinguish these tumors.

不同行距下两个花生品种的水分利用,生长发育和荚果产量(英文)

研究在本农艺学院开展,对每日平均气温、降水和光照均作记录.处理设六种不同株行距(0.70×0.12,0.50×0.12,0.70×0.06,0.30×0.12,0.50×0.06和0.30×0.06m),对应密度是12,18,24,28,33和55株/m2.测定0～100cm土壤样品水分含量,用于计算作物水分蒸发蒸腾量(ET)、作物光截获量(α)、土壤蒸发量(Es)、作物水分利用率(WUE)和蒸腾率(Te).最低密度(0.70×0.12m)单株生长最好,最高密度处理则导致最低的单株干物质产量,其余4个处理单株干物质产量居于二者之间.两个品种的不同间距处理同样对单株荚果饱果数、荚果和种子产量有显著影响,高密度下使其均降低,但单位面积荚果和种子产量提高,但Florman的产量要好于Colorado.种植处理显著影响作物水分蒸发蒸腾量.行距0.30m和0.50m下,两个品种都达到46和60 DAS;行距0.70m下,Colorado是66DAS而Florman是87DAS.两个品种的蒸腾率都受到行距的影响,两个品种的WUE都受到间距影响,0.70m行距下WUE最低,Colorado在0.50m和0.30m行距下,Florman在0.30m下WUE最高.行距对Te的影响因品种而异,Colorado在不同行距下无显著差异,而Florman的Te则随行距减少而增加.不同间距和品种对光合效率都没有很大影响(Colorado是3.1×10-2 Kcal/ha,Florman是3.0×10-2 Kcal/ha).

Effect of wide-narrow row arrangement in mechanical pot-seedling transplanting and plant density on yield formation and grain quality of japonica rice

Mechanical pot-seedling transplanting is an innovatively developed transplanting method that has the potential to replace mechanical carpet-seedling transplanting. However, the initial pot-seedling transplanting machine lacked optimized density spacing and limited yield potential for japonica rice. Therefore, ascertaining the optimized density by wide-narrow rows and the appropriate transplanting method for yield formation and grain quality of japonica rice is of great importance for high-quality rice production. Field experiments were conducted using two japonica rice cultivars Nanjing 9108 and Nanjing 5055 under three transplanting methods in 2016 and 2017: mechanical pot-seedling transplanting with wide-narrow row(K, average row spacing of 30 cm);equidistant row(D, 33 cm×12 cm);and mechanical carpet-seedling transplanting(T, 30 cm×12.4 cm). In addition, five different density treatments were set in K(K1–K5, from 18.62×10~4 to 28.49×10~4 hills ha^(–1)). The results showed that the highest yield was produced by a planting density of 26.88×104 hills ha^(–1) in mechanical pot-seedling transplanting with wide-narrow row with a greater number of total spikelets that resulted from significantly more panicles per area and slightly more grain number per panicle, as compared with equidistant row, and yield among density in wide-narrow row showed a parabolic trend. Compared with mechanical carpet-seedling transplanting, the treatment of the highest yield increased yield significantly, which was mainly attributed to the larger sink size with improved filled-grain percentage and grain weight, higher harvest index, and increased total dry matter accumulation, especially the larger amount accumulated from heading stage to maturity stage. With the density in wide-narrow row decreasing, processing quality, appearance quality, and nutrition quality were all improved, whereas amylose content and the taste value were decreased. Compared with mechanical carpet-seedling transplanting, mechanical pot-seedling transplanting improved processing quality and nutrition quality, but decreased amylose content and deteriorated appearance quality. These results suggested that mechanical pot-seedling transplanting with wide-narrow row coupling produced a suitable planting density of 26.88×10~4 hills ha^(–1) and may be an alternative approach to improving grain yield and quality for japonica rice.

Spontaneous Coronary Artery Disease in a Healthy Fibromuscular Dysplasia Patient: A Case Report

Our case is a 72-year-old female with Fibromuscular Dysplasia (FMD) presented to the Emergency Department (ED) with acute coronary syndrome (ACS), more specifically NSTEMI. In ED, troponin levels were elevated and non-ST segment elevation myocardial infarction (NSTEMI) was detected on electrocardiogram (ECG). Computed tomography (CT) scan showed Internal Carotid artery (ICA) pseudoaneurysm. Cardiac catheterization (CATH) was performed and revealed occlusion of the Left anterior descending (LAD) artery. Spontaneous coronary artery dissection (SCAD) was suspected due to the history of FMD without a history of hypertension, smoking or substance use.

Clinical relevance of clopidogrel-proton pump inhibitors interaction

Clopidogrel is a widely used antiplatelet agent for the secondary prevention of cardiovascular events in patients with stable coronary heart disease, acute coronary syndromes and ischemic stroke. Even though clopidogrel is safer than aspirin in terms of risk for gastrointestinal(GI) bleeding, the elderly, and patients with a history of prior GI bleeding, with Helicobacter pylori infection or those who are also treated with aspirin, anticoagulants, corticosteroids or nonsteroidal antiinflammatory drugs are at high risk for GI complications when treated with clopidogrel. Accordingly, proton pump inhibitors are frequently administered in combination with clopidogrel to reduce the risk for GI bleeding. Nevertheless, pharmacodynamic studies suggest that omeprazole might attenuate the antiplatelet effect of clopidogrel. However, in observational studies, this interaction does not appear to translate into increased cardiovascular risk in patients treated with this combination. Moreover, in the only randomized, double-blind study that assessed the cardiovascular implications of combining clopidogrel and omeprazole, patients treated with clopidogrel/omeprazole combination had reduced risk for GI events and similar risk for cardiovascular events than patients treated with clopidogrel and placebo. However, the premature interruption of the study and the lack of power analysis in terms of the cardiovascular endpoint do not allow definite conclusions regarding the cardiovascular safety of clopidogrel/omeprazole combination. Other proton pump inhibitors do not appear to interact with clopidogrel. Nevertheless, given the limitations of existing observational and interventional studies, the decision to administer proton pump inhibitors to patients treated with clopidogrel should be individualized based on the patient's bleeding and cardiovascular risk.

Effects of mesoclimate and microclimate variations mediated by high altitude and row orientation on sucrose metabolism and anthocyanin synthesis in grape berries

Climate change and extreme weather pose significant challenges to the traditional viticulture regions.Emerging high-altitude grape-producing regions with diverse orientations have shown great potential in coping with this challenge.Stable,high-quality wine grape production may be achieved by synchronizing the meso-and microclimate.To clarify the role of high altitude and row orientation in meso-and microclimate and the response of berries to it,we evaluated seven years(2012-2018)of climate data,two years of basic grape(Cabernet Sauvignon,Vitis vinifera L.)quality,and one-year microclimate from veraison to harvest.By comparing two locations(Sidon 2047 m,Sinon 2208 m)in Yunnan Province,China,we found that the average temperature has been stable at approximately 15℃ for seven years,with no extreme weather or,noticeable global warming.The light intensity(LI)in the north-south(NS)was more balanced than the east-west(EW)direction,and the east-west to the south(EW-S)canopy side was almost higher than the other sides.High LI was associated with high photosynthetically active radiation(PAR),ultraviolet(UV),and infrared(IR)light and vice versa.The north-south to the east(NS-E)and east-west to the north(EWN)sides were characterized by lower LI and higher UV and IR light,and higher total anthocyanin content.Most anthocyanin synthesis-related genes,for example,VvF3'H and VvF3'5'H,were highly expressed in NS-E from veraison to maturity.Perhaps UV and IR light induced their expression.This study provides new insights on the role of differently orientated rows in controlling grape quality due to varied light quality.The findings are globally significant,particularly in the context of climate change,and offer fresh insights into berry physiological responses and decision-making for the management of existing vineyards.

Response of Soybean and Lentil to a Seed-Row Placed Starter Nitrogen-Phosphorus Fertilizer Blend in a Brown Chernozem in South-Central Saskatchewan

Soybean and lentil are important legume crops in southern Saskatchewan (SK) that can supply the majority of their nitrogen (N) requirement through biological N fixation (BNF). However, the onset of BNF can be slow in cold;dry prairie soils and a small amount of seed-row placed fertilizer containing both N and phosphorus (P) may benefit the crop. Nevertheless, high rates of fertilizer in close proximity to the seed can also cause injury. This study was conducted to determine the response of lentil and soybean to a starter N-P fertilizer blend applied in the seed-row. A farm field located at the boundary of the Brown and Dark Brown soil zones in south-central Saskatchewan was selected to evaluate the effect of seed-row placed N-P fertilizer blend: 50% Urea + 50% mono-ammonium phosphate (MAP) applied at 0, 10, 20 and 30 kg N and P2O5 ha-1 on emergence, yield, and nutrient uptake. The proportion of nitrogen derived from fixation (ndff) was determined in the soybean using N-15 dilution technique. The rate of 10 kg N and P2O5 ha-1 was found to be the rate that did not significantly reduce emergence, stand count or proportion of N derived from fixation, and was sufficient to maximize yield, N and P uptake for both soybean and lentil under field conditions. Rates higher than 10 kg N ha-1 in the seed row as starter 28-26-0 blend reduced emergence and decreased the proportion of ndff.

Effect of clopidogrel combined with atorvastatin on NIHSS and Barthel score in patients with progressive cerebral infarction

Objective:Study the clinical effect of atorvastatin combined with clopidogrel on patients with progressive cerebral infarction of intracranial aortic stenosis.Methods: Chose eighty-eight patients with progressive cerebral infarction in our hospital from June 2014 to October 2015. They were randomly divided into study group and study group, 44 cases in each group. The patients in the control group were treated with oral clopidogrel. On the basis of this, the patients in the study group were treated with atorvastatin;all patients were treated for 4 weeks. Compared the total effective rate, adverse reaction rate, coagulation function index and blood lipid level between the two groups, and compared the NIHSS score and daily life ability (ADL) score between the two groups before and after treatment.Results: The total effective rate (90.90%) was significantly higher in the study group than in the control group (72.73%). After treatment, the NIHSS score of the study group was significantly lower than that of the control group. The levels of LDL-C, TG and TC in the study group were significantly lower than those in the control group, and HDL-C was significantly higher than that in the control group. There was no significant difference between the two groups.Conclusion: Clopidogrel combined with atorvastatin has a significant effect on the patients with intracranial large artery stenosis and improve the neurological function and quality of life. It is safe and reliable. It is worthy to be popularized.

美国圣地亚哥的公园路(Park Row)居住区的设计构想和建设

圣地亚哥是美国南部的港口城市,根据城市预测,2005年城市中心的居住人口将增加一倍,从目前的6000人上升到11,000-14,000人;市中心的就业人数将增加40％,从目前68,000人上升到100,000—110,000人;市中心的办公面积也将从7,700,000平方英尺提高到16,000,000—180,000。

Usefulness of an Anisotropic Diffusion Method in Cerebral CT Perfusion Study Using Multi-Detector Row CT

Purpose: To present an application of the anisotropic diffusion (AD) method to improve the accuracy of the functional images of perfusion parameters such as cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) generated from cerebral CT perfusion studies using multi-detector row CT (MDCT). Materials and Methods: Continuous scans (1 sec/rotation ×60 sec) consisting of four 5-mm-thick contiguous slices were acquired after an intravenous injection of iodinated contrast material in 6 patients with cerebrovascular disease using an MDCT scanner with a tube voltage of 80 kVp and a tube current of 200 mA. New image data were generated by thinning out the above original images at an interval of 2 sec or 3 sec. The thinned-out images were then interpolated by linear interpolation to generate the same number of images as originally acquired. The CBF, CBV and MTT images were generated using deconvolution analysis based on singular value decomposition. Results: When using the AD method, the correlation coefficient between the MTT values obtained from the original and thinned-out images was significantly improved. Furthermore, the coefficients of variation of the CBF, CBV and MTT values in the white matter significantly decreased as compared to not using the AD method. Conclusion: Our results suggest that the AD method is useful for improving the accuracy of the functional images of perfusion parameters and for reducing radiation exposure in cerebral CT perfusion studies using MDCT.

Separation of Enantiomers of Clopidogrel on Chiral Stationary Phases by Packed Column Supercritical Fluid Chromatography

A packed column supercritical fluid chromatography (SFC) method for the separation of clopidogrel enantiomers on a chiral stationary phase and CO2 with modifier as mobile phase has been developed at an analytical scale. Among 11 different 2 stationary phases the Chiral cel OD-H column showed by far the best separation properties. The influence of different modifiers, injection solvents, temperature, and pressure, and density of the fluid, respectively, on the separation behaviour has been studied. It was found that the separation behaviour strongly depends on the type of modifier and the modifier content. Temperature and pressure are of less influence.

Clinical importance of aspirin and clopidogrel resistance

Aspirin and clopidogrel are important components of medical therapy for patients with acute coronary syndromes, for those who received coronary artery stents and in the secondary prevention of ischaemic stroke. Despite their use, a significant number of patients experience recurrent adverse ischaemic events. Interindividual variability of platelet aggregation in response to these antiplatelet agents may be an explanation for some of these recurrent events, and small trials have linked "aspirin and/or clopidogrel resistance", as measured by platelet function tests, to adverse events. We systematically reviewed all available evidence on the prevalence of aspirin/clopidogrel resistance, their possible risk factors and their association with clinical outcomes. We also identified articles showing possible treatments. After analyzing the data on different laboratory methods, we found that aspirin/clopidogrel resistance seems to be associated with poor clinical outcomes and there is currently no standardized or widely accepted definition of clopidogrel resistance. Therefore, we conclude that specific treatment recommendations are not established for patients who exhibit high platelet reactivity during aspirin/clopidogrel therapy or who have poor platelet inhibition by clopidogrel.

Experimental Evaluation of CT Number Changes in 320-Row CBCT Volume Scan for Proton Range Calculation

We investigated the longitudinal positional dependence of CT number in 320-row Cone Beam Computed Tomography (CBCT) volume scan (320-row volume scan) using a simple geometric phantom (SGP) and a chest simulation phantom (CSP) in order to evaluate its effect on proton range calculation. The SGP consisted of lung substitute material (LSM) and a cylindrical phantom (CP) made of high-density polyethylene. The CSP was an anthropomorphic phantom similar to the human chest. The two phantoms were scanned using 320-row volume scan in various longitudinal positions from the central beam axis. In experiments using the SGP, an image blur at the boundary of the two materials became gradually evident when the LSM was placed far away from the beam central axis. The image blur of the phantom was consistent with the gradation in CT number. The maximum difference in CT numbers between the 64-row helical scan and 320-row volume scan at the boundary of the two materials was consistent with approximately 50% of the relative proton stopping power. In contrast, the CT number profile in each longitudinal position was fairly consistent and longitudinal positional dependence rarely occurred in the CSP experiments. Pass lengths of CT beams through areas with widely different electron densities were shorter, and thus did not significantly impact CT numbers. Based on findings from the CSP experiments, we considered 320-row volume scan to be feasible for proton range calculation in clinical settings, although the relatively large longitudinal positional dependence of CT number should be accounted for when doing so.

阿科玛任命Richard Rowe为北美执行总裁

法国阿科玛化学公司宣布任命Richard Rowe为北美执行总裁,2015年7月1日起效。Rowe接替Bernard Roche,Bernard Roche——自2008年一直担任执行总裁,在阿科玛任职42年。Rich Rowe拥有巴克内尔大学化学学士学位。他于1996年加入阿托芬得利公司,担任全球总经理。1999年在阿托菲纳担任北美聚合物性能区域集团总裁。2002年,他担任阿科玛供应链副总裁负责采购与物流。在2004年2006年期间,Rowe领导了添加剂和有机过氧化物两个部门并管理它们合并。2007年,他被任命为功能性添加剂部门的全球集团总裁。2011年,

Planting Geometry Effects on the Growth and Yield of Dryland Cotton

The declining Ogallala Aquifer beneath the Southern High Plains may necessitate dryland crop production and cotton (Gossypium hirsutum L.) is a well-adapted and potentially profitable alternative crop. The limited growing season duration of the Texas Panhandle and southwestern Kansas, however, imposes significant production risk due to incomplete boll maturation. Emphasizing earlier boll production that is usually confined to sites on lower fruiting branches may reduce risk, but offsetting high planting densities are needed to maintain desirable lint yield. Our objectives were to quantify planting: 1) row width and 2) in-row spacing effects on growth, yield, and fiber quality of dryland cotton. Field tests of row widths from 0.25 to 0.76 m and plant densities with in-row spacing ranging from 0.075 to 0.15 m were conducted from 1999 to 2005 on a nearly level Pullman clay loam (fine, mixed, superactive, thermic Torrertic Paleustoll) managed in a wheat (Triticum aestivum L.), cotton, fallow (W-Ctn-F) rotation. To expand the basis of comparison, cotton growth and yields were simulated using GOSSYM and long-term (1958-2000) weather records from Bushland, TX, as input for all combinations of 0.38 or 0.76 m row widths and plant spacing of 0.075, 0.10 and 0.15 m. Experimental and computer simulated plant height and harvested boll number increased significantly with increased row spacing and, occasionally, in-row plant spacing. Modeled lint yield for 0.38 m rows decreased by approximately 50% compared with the 582 kg·ha-1 yield for conventional row spacing, which was practically duplicated by field observations in 2001 and 2004. Measured fiber quality occasionally improved with conventional row spacing over ultra-narrow rows, but was unaffected by plant spacing. Because narrow rows and frequent plant spacing did not improve lint yield or fiber quality of dryland cotton, we do not recommend this strategy to overcome a thermally limited growing season.

Effect of row spacing and direction of sowing on yield and yield attributing characters of wheat cultivated in Western Chitwan, Nepal

A field experiment was conducted to study the growth and productivity of wheat as affected by row spacing and direction of sowing at Rampur, Chitwan, Nepal during the 2007-2008 wheat growing season. The experiment was carried out in 3-factors factorial randomized complete block design comprising two varieties (Gautam and BL-2800), three row spacings (15, 20 and25 cm) and two row directions of sowing (east-west and north-south). The effects of variety and row direction of sowing on grain yield were significant (p < 0.05), but the grain yield was not affected by the row spacing treatment. BL-2800 variety produced higher grain yield (3.53 t·ha-1) as compared to Gautam (3.11 t·ha-1). Both wheat varieties yielded about 11% higher (p < 0.05) grain in the north-south sowing as compared to the eastwest sowing.

Rotator cuff tears: An evidence based approach

Lesions of the rotator cuff(RC) are a common occurrence affecting millions of people across all parts of the globe. RC tears are also rampantly prevalent with an agedependent increase in numbers. Other associated factors include a history of trauma, limb dominance, contralateral shoulder, smoking-status, hypercholesterolemia, posture and occupational dispositions. The challenge lies in early diagnosis since a high proportion of patients are asymptomatic. Pain and decreasing shoulder power and function should alert the heedful practitioner in recognizing promptly the onset or aggravation of existing RC tears. Partial-thickness tears(PTT) can be bursalsided or articular-sided tears. Over the course of time, PTT enlarge and propagate into full-thickness tears(FTT) and develop distinct chronic pathological changes due to muscle retraction, fatty infiltration and muscle atrophy. These lead to a reduction in tendon elasticity and viability. Eventually, the glenohumeral joint experiences a series of degenerative alterations- cuff tear arthropathy. To avert this, a vigilant clinician must utilize and corroborate clinical skill and radiological findings to identify tear progression. Modern radio-diagnostic means of ultrasonography and magnetic resonance imaging provide excellent visualization of structural details and are crucial in determining further course of action for these patients. Physical therapy along with activity modifications, antiinflammatory and analgesic medications form the pillars of nonoperative treatment. Elderly patients with minimal functional demands can be managed conservatively and reassessed at frequent intervals. Regular monitoring helps in isolating patients who require surgical interventions. Early surgery should be considered in younger, active and symptomatic, healthy patients. In addition to being costeffective, this helps in providing a functional shoulder witha stable cuff. An easily reproducible technique of maximal strength and sturdiness should by chosen among the armamentarium of the shoulder surgeon. Grade 1 PTTs do well with debridement while more severe lesions mandate repair either by trans-tendon technique or repair following conversion into FTT. Early repair of repairable FTT can avoid appearance and progression of disability and weakness. The choice of surgery varies from surgeon-to-surgeon with arthroscopy taking the lead in the current scenario. The double-row repairs have an edge over the single-row technique in some patients especially those with massive tears. Stronger, costeffective and improved functional scores can be obtained by the former. Both early and delayed postoperative rehabilitation programmes have led to comparable outcomes. Guarded results may be anticipated in patients in extremes of age, presence of comorbidities and severe tear patters. Overall, satisfactory results are obtained with timely diagnosis and execution of the appropriate treatment modality.