Evaluation of muscle damage using ultrasound imaging.

[Purpose] This study aimed to quantitatively analyze characteristics of and changes in internal muscle structure according to the time of delayed onset muscle soreness (DOMS) using ultrasound imaging, thereby presenting clinical evidential data for evaluation of muscle damage. [Subjects] We recruited 38 male subjects. [Methods] Ultrasound images of the medial gastrocnemius muscle prior to induction of DOMS and immediately after, 24 hours after, 48 hours after, and 72 hours after induction of DOMS were obtained, and the thickness and pennation angle of the muscle were measured. [Results] The muscle thickness gradually increased until 48 hours after induction of DOMS and decreased after 72 hours. The pennation angle also gradually increased until 48 hours after induction of DOMS and decreased after 72 hours. [Conclusion] Ultrasound imaging is considered useful for assessment of structural characteristics of muscles when muscle damage like DOMS takes place.

Adenoma malignum of the uterine cervix: Clinicopathologic analysis of 18 cases.

The aim of this study was to evaluate the clinical and pathologic features of a rare tumor (adenoma malignum, AM). We retrospectively analyzed the medical records of 18 patients diagnosed with AM at a single institute between March 1992 and November 2009. The median age of the patients was 45.8 years (range 29-76 years) and the mean follow-up period was 49.2 months (range 4-168 months). A preoperative cytologic diagnosis (Papanicolaou smear) of AM was made in 22.2% (4/18) of the cases. Ten (55.6%) of the 18 patients were misdiagnosed with other benign diseases and underwent hysterectomies, which confirmed AM. Sixteen patients with AM were in the early stage (IB1, 11/18; IB2, 5/18) and the other two patients were in the advanced stage. Fourteen of 18 patients (77.8%) had pure AM alone. Adjuvant therapy was administered to eight of the patients (44.4%) with AM. The recurrence rate was zero, but the disease progressed in two of the patients (11.1%), who died of the disease. The 5-year survival rate was 88.8%. A cytological diagnosis of AM based on a Papanicolaou smear is rarely made; a deep biopsy (cone biopsy or endocervical curettage) is necessary to diagnose this rare tumor preoperatively when there is any clinical suspicion of AM.

Cerebral oxygenation monitoring of patients during arthroscopic shoulder surgery in the sitting position.

BACKGROUND: Cerebral hypotension and desaturation can occur during shoulder surgery in the seated position. We evaluated the correlation of cerebral oxygen saturation (rSO(2)) using near infra-red spectroscopy (NIRS) and mean arterial pressures (MAP) (at the levels of the brain and heart). METHODS: Fifty patients, scheduled for the arthroscopic shoulder surgery in the seated position, were enrolled to monitor the rSO(2), bispectral Index (BIS), and MAPs at the levels of the brain and heart. The values of each parameter were collected at 5 min after intubation, immediately after placing the patient in the sitting position, 5 min after the patient was seated, immediately after the surgical incision, and every 30 min after incision. RESULTS: A correlation between the cerebral rSO(2) and the MAP at the level of brain were statistically significant. Cerebral rSO(2) and MAP after a change of posture from supine to sitting position were significantly decreased, compared to the baseline value. CONCLUSIONS: Monitoring cerebral rSO(2) and MAP at the level of brain can be helpful to detect the possibility of cerebral deoxygenation earlier.