Search

A woman in her 20s fell down during cheerleading practice and she was referred to our neurosurgical outpatient clinic the next day due to persistent headache, neck pain, and dizziness. Neurological examination showed left upper limb paresis. MRI revealed a remarkably dilated flow void along the dural sac on the left side between C2 and C3 levels. Cerebral angiography confirmed a shunt from the left vertebral artery to the vein. Preoperative ultrasonography showed that the diameter of the left vertebral artery was markedly dilated to 10mm, and the blood flow volume between the cervical vertebrae was 1,873ml/min. Retrograde flow was detected in the distal part of the left vertebral artery using the foramen magnum approach. The patient underwent coil embolization of the left vertebral arteriovenous fistula and the shunt blood flow was significantly reduced. Ultrasonography performed the day after embolization revealed the blood flow volume of 748ml/min, and the retrograde flow in the left vertebral artery remained. On the seventh postoperative day, the blood flow volume was 135ml/min, and the peripheral left vertebral artery had changed to antegrade flow. On the 90th postoperative day, the blood flow volume was 95ml/min, and vertebral angiography at the same time showed that shunt blood flow had disappeared. Vascular ultrasound was useful in the preoperative evaluation and follow-up of vertebrobasilar arteriovenous fistula. [ABSTRACT FROM AUTHOR]

Background: Dynamic parameters used for predicting fluid responsiveness require special equipment and are minimally invasive. Therefore, recent interest in the use of carotid artery ultrasound parameters, such as carotid corrected flow time (FTc) and peak velocity variation (ΔVpeak) has grown. Therefore, we performed this systematic review and meta-analysis to assess the ability of carotid FTc and/or ΔVpeak to accurately predict fluid responsiveness. Methods: We searched the PubMed and Embase databases for articles evaluating the diagnostic accuracy of carotid FTc or ΔVpeak for predicting fluid responsiveness. Two independent authors performed the search and selected studies published until May 2022. The studies were assessed for the inclusion and exclusion criteria using Rayyan (Rayyan Systems Inc., 2022). Results: Ten studies (n = 438) that fulfilled the inclusion criteria were selected. Studies were divided into those assessing carotid FTc and those assessing carotid ΔVpeak. Five studies (six datasets) assessed FTc. The pooled sensitivity and specificity of carotid FTc were 0.76 and 0.88, respectively. The summary receiver operating characteristic (SROC) curve for carotid FTc had an area under the curve (AUC) of 0.9092, with a Q value of 0.8412. Seven studies calculated carotid ΔVpeak. The pooled sensitivity and specificity for ΔVpeak were 0.83 and 0.81, respectively. The SROC curve had an AUC of 0.8941 and a Q value of 0.8250. Conclusions: Our meta-analysis showed that both carotid FTc and ΔVpeak are useful for predicting fluid responsiveness in anesthesia and critical care settings with good specificity and sensitivity. [ABSTRACT FROM AUTHOR]

We report a suspected case of fungal mass in the right internal jugular vein. A 70-year-old man was admitted to our hospital with heart failure. He had a persistent fever and the inflammatory response increased. Serum β-Dglucan level was elevated, and Candida albicans was identified from blood culture. He was diagnosed with a fungal infection. A central venous catheter had been inserted into the right internal jugular vein for 3weeks. The ultrasonography showed a full mass image of 6 × 5mm which was attached to a string-like organizing thrombus of approximately 25mm long in the right internal jugular vein. The echogram presented a spherical and smooth outline, and slightly heterogeneous inside of the mass with scattered vesicular structures. We attempted to retrieve a foreign body using a catheter under ultrasound guidance. However, it cannot be detached from the vessel wall. Next, surgical resection was planned under intraoperative ultrasound examination, however, the surgical procedure was not performed because his general condition deteriorated. Fortunately, the level of β-Dglucan decreased after administration of amphotericin B and the foreign body, suspected fungal mass, became smaller on ultrasonography. We experienced a suspected patient with a fungal mass in the right internal jugular vein. Ultrasonography was useful in diagnosis, treatment or follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Japanese Association for Human Auxology is the property of Japanese Association for Human Auxology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Since the rectus femoris muscle is associated with trauma and disorders such as muscle strain, it is often a target for evaluation and treatment. However, in many studies, measurement results were obtained from only a part of the rectus femoris muscle and used as a representative value without considering the differences across the muscle. The rectus femoris muscle may change shape with knee flexion because the structure is complicated; it has an intramuscular tendon. The purpose of this study was to assess the changes in shape of the rectus femoris muscle during flexion of the knee joint in different directions. Twelve lower limbs of 12 male university students were analyzed. The rectus femoris muscle was divided into eight parts, and short-axis images were taken with an ultrasonic diagnostic imaging device at the knee joint; in extension; flexion at 30 °, 60 °, 90 °, and 120 °; muscle thickness; muscle width; and cross-sectional area. It was suggested that the thickness of the rectus femoris muscle increased from “A” to “F” due to knee flexion, and that this increase occurred because of stretching at the same site. In “G,” there was no difference between the angle conditions; conversely, in “H,” the muscle thickness decreased due to knee flexion. It should also be noted that D and E have the greatest muscle thickness when measuring in the knee flexion position. [ABSTRACT FROM AUTHOR]

Neuromuscular ultrasound has become an integral part of the diagnostic workup of neuromuscular diseases in neurology. Neuromuscular ultrasound can detect nerve enlargement, selective muscle damage, and fasciculation easily and non-invasively, which allows differentiation between auto-immune/inflammatory and degenerative/hereditary diseases. It is significant and essential for all neurologists to master the neuromuscular ultrasound technique.

A 76-year-old woman was diagnosed with invasive bladder cancer and underwent cystectomy, bilateral external iliac, internal iliac and obturator lymph node dissection, and bilateral cutaneous ureterostomy. Pathological findings showed no lymph node metastasis ; however, the patient had lower abdominal pain and fever from the 14th postoperative day, and computed tomography (CT) revealed fluid retention in the pelvis. Retrograde pyelography showed no leakage from the urinary tract, and a drain was placed after percutaneous puncture of the pelvic cavity. There was copious drainage fluid and its nature and composition suggested lymphorrhea. Ultrasound-guided intranodal lymphangiography revealed contrast material leakage from the bilateral lymph node dissection sites. After lymphangiography, drainage from the drain decreased. Despite the drainage being minimal yet persistent, sclerotherapy was performed, the drain was removed and the patient was discharged. After discharge, there was leakage from the site of urethral extraction, and CT revealed recurrent lymph leakage. The patient was readmitted, and a second lymphangiography was performed. The leakage from the site of urethral extraction gradually decreased, and the patient was discharged on the 59th postoperative day. CT after discharge confirmed that the lymphorrhea had shrunk in size, and there has been no recurrence since then. Lymphangiography is a promising treatment option for lymphorrhea after pelvic surgery.

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the management of ulcerative colitis (UC), colonoscopy (CS) is considered essential for diagnosis;however, its invasiveness poses a challenge. Conversely, recent advancements in ultrasound diagnostic devices have improved imaging quality for the digestive tract, rendering them valuable in UC management. Therefore, this study aimed to elucidate the correlation between abdominal ultrasonography (AUS) and CS in assessing UC activity. The indices adopted for UC evaluation using AUS were as follows:1) bowel wall stratification, 2) bowel wall thickness, 3) bowel wall flow at power Doppler, 4) presence of increased brightness of inflammatory fat, and 5) presence of mesenteric lymph node swelling greater than 5mm. Subsequently, we developed a new AUS index for UC, termed the UCUS score, which comprises the aforementioned five indices. Finally, we compared the UCUS score with representative endoscopic indices, the Mayo endoscopic sub-score, and the Ulcerative Colitis Endoscopic Index of Severity. The results demonstrated that our proposed UCUS score better reflected disease activity than individual items assessed separately. ROC curve analysis revealed a UCUS score cutoff of 3 points. Therefore, a UCUS score of ≥3 points indicates the need for further examination with CS. Conversely, a score below 3 points suggests low disease activity, and in situations when evaluating treatment effectiveness, AUS could potentially substitute for CS. We believe that the UCUS score is an important source of information to understand the patient's condition and to motivate the patient to undergo endoscopy.

A man in his 60s with hyperamylasemia underwent contrast-enhanced computed tomography, which revealed masses in his pelvic cavity on the right side and in the left axilla. Hence, a detailed examination was performed. Upon performing Sonazoid ® (perfluorobutane) contrast-enhanced ultrasound, it was discovered that the right-sided pelvic cavity mass exhibited centripetal contrast-enhancement right from the early stage. Subsequently, the contrast material disappeared from the center and was washed out in the postvascular phase. The mass was suspected to be caused by vascular malformations. The right-sided pelvic cavity mass was excised, and upon histopathological examination, it was detected to be composed of capillary malformations. Thus, it was found that Sonazoid ® contrast-enhanced ultrasound examination could aid in diagnosing retroperitoneal masses.

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of the present study was to examine characteristics of muscle anatomical cross-sectional area (CSA) for different regions from proximal to distal parts of each muscle of the hamstring muscles in high-level sprinters, and to examine the relationship with those and the sprint performance. The CSA of the semitendinosus (ST), semimembranosus (SM), biceps femoris long head (BFL) and biceps femoris short head (BFS) at the four different region of hamstring muscles for twenty sprinters (SPRINT) and twenty healthy male control subjects (CTRL) were measured by using B-mode ultrasonography. The measured regions were divided into four parts from proximal to distal parts (PRO1, PRO2, DIS2, DIS1). The results clearly showed that absolute CSA values in distal parts for all muscles together with PRO2 in ST were greater in SPRINT than in CTRL. When relative CSA values to the entire hamstrings muscles in each region were compared, only relative CSA at PRO1 in ST was greater in SPRINT than in CTRL, conversely, that at proximal regions in BFL and distal regions in BFS were smaller in SPRINT. In the relationships with sprint performance, the CSAs at PRO1 and PRO2 in ST and at PRO1 in SM were only related negatively. These results suggest that distal parts of hamstring muscles for SPRINT may be characteristics for sprint runners. However, the movements related to the specific hypertrophy (PRO1 and PRO2 in ST, PRO1in SM) may play important roles of the improvement of their sprint performance. [ABSTRACT FROM AUTHOR]

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Japan Academy of Midwifery is the property of Japan Academy of Midwifery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Theranostics, a new medical term that combines therapeutics and diagnostics is considered an ideal system for medical care. Ultrasound is considered one of the most reasonable energies for the development of theranostics. Additionally, microbubbles, which are ultrasound contrast agents, have received considerable attention for their effectiveness in diagnosis and therapy. Microbubbles are composed of an inner gas and an outer shell composed of proteins or phospholipids. Under ultrasound exposure, the oscillation or collapse of microbubbles is induced depending on the intensity of the ultrasound. These mechanical effects are important for imaging, drug delivery, and ablation therapies. Therefore, it is essential that microbubbles reach the targeted site and induce mechanical effects to achieve effective and efficient diagnosis and therapy. We have previously developed novel microbubbles with high stability by optimizing the outer shell composition. Recently, microbubbles containing distearoylphosphatidyl glycerol showed high stability and prolonged circulation in the blood. These novel microbubbles may be useful for diagnosis and therapy. The combination of microbubbles and ultrasound has received considerable attention for brain-targeted drug delivery applications. We examined whether microbubbles can be used for brain-targeted drug delivery and evaluated the effect of the encapsulated gas on drug delivery. Thus, novel microbubbles combined with ultrasound can deliver molecules to the brain. Microbubbles containing perfluoropropane or perfluorobutane could efficiently deliver molecules to the brain. The novel microbubbles have long-circulating properties in the blood and could deliver molecules to the brain. The combination of novel microbubbles and ultrasound would contribute to the development of efficient thranostic systems.

A female patient in her 60s, treated with oral corticosteroids for scleroderma diagnosed 11 years ago, visited our hospital complaining of a persistent fever and liver dysfunction. She was treated with antibiotics, but her fever continued. Abdominal ultrasonography revealed multiple hypoechoic splenic masses. Splenic masses revealed multiple masses with no contrast effect in arterial and portal phases and nuclear in equilibrium phase by contrast computed tomography study, as well as hyperintensity masses with low signal areas in magnetic resonance imaging T2-weighted images. Liver tissue was obtained by percutaneous liver biopsy, and histological findings showed epithelioid cell granulomas without tumor cells. Further interview and physical examination revealed scratch scars from domestic cats and left axillary lymph node swelling. Hence, a cat scratch disease was suspected. She was diagnosed with cat scratch disease by serum indirect immunofluorescence. Her fever was resolved with minocycline administration. Therefore, persistent fever with splenic masses should be suspected of hepatosplenic cat scratch disease.

In animal studies, the motor nerve conduction velocity (NCV) is related to the axonal diameter of peripheral nerve. In humans, differences of NCV between dominant and non-dominant forearms have not been confirmed by the differences of the axonal diameter of peripheral nerve. Therefore, the purpose of this study was to measure the cross-sectional area of human ulnar nerve fascia (nCSA) directly and to examine the relationship between the NCV of the ulnar nerve and the nCSA in humans. The thirty healthy subjects were volunteered for this study. Electric stimuli were applied over the two separate points of the ulnar nerve and the latencies of this action potential in abductor digiti minimi muscles were measured, respectively. The NCVs in the forearms were calculated as the distances between two stimulating electrodes divided by the differences in their latencies. The five nCSA images from the medial epicondyle of the humerus to the ulnar head at equal intervals were measured by ultrasonography and averaged in each forearm, respectively. The maximum forearm circumferences (MFC) of both forearms were measured by a measuring tape. The NCV, nCSA and MFC were significantly greater in dominant than in non-dominant forearms. Although there is a significant positive relationship between the nCSA and MFC, nCSA cannot necessarily influence NCV. These results suggest that the size of human ulnar nerve fascia may not be necessarily related to the axonal diameter of ulnar nerve. [ABSTRACT FROM AUTHOR]

Copyright of Rigakuryoho Kagaku is the property of International Press Editing Center Incorporation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 48-year-old man presented with a painless nodule on the right ventral aspect of the penile shaft root. The patient visited the hospital and complained that the mass was growing. On physical examinations, a 5 cm mass without tenderness was palpated. An isoechoic mass about 4 cm in size was observed on ultrasonography. Inhomogeneous high signal intensity was observed on T2-weighted magnetic resonance imaging. A needle biopsy revealed schwannoma. During surgery for excision of the tumor, another small tumor was detected both tumors were resected. Both tumors were diagnosed as schwannoma by pathological examination. Out of 40 cases of penile schwannoma reported, eight were of multiple tumors. In our case, it was difficult to detect the other small tumor by preoperative diagnosis. Therefore, we recommend careful observation during surgery.

[Purpose] The purpose of this study was to investigate the differences in activities of the trunk muscles (mainly local muscles) between young adults and elderly adults in the supine and standing positions. [Subjects] The participants were 30 young adults (17 men and 13 women, mean ± SD age 25.4 ± 5.0, height 175.4 ± 8.2 cm, weight 64.2 ± 7.9 kg) and 35 elderly adults (20 men and 15 women, mean ± SD age 76.8 ± 8.4, height 161.1 ± 6.9 cm, weight 57.8 ± 7.9 kg). [Method] Using ultrasonography, the thicknesses of the trunk muscles at rest and under voluntary contraction were measured in both the supine and standing positions. In addition, changes in the thicknesses of these muscles in the standing position were recorded for one minute. [Results] The young adults were able to contract the local muscles of the trunk both in the standing and supine positions, whereas the elderly adults had difficulty contracting these muscles when standing. The thicknesses of the local muscles of the young adults did not change during the one-minute standing task while they decreased significantly in the elderly adults. [Conclusion] The results suggest that when standing, elderly people have difficulty contracting the local muscles voluntarily, because they tend to concentrate more on keeping postural balance. The fact that the thickness of the local muscles of elderly people decreases with time suggests that they cannot maintain contraction of these muscles. [ABSTRACT FROM AUTHOR]

[Purpose] We investigated cardiovascular responses and blood flow of the common carotid artery during head-up tilt (HUT) in patients with cerebrovascular accidents (CVA). [Subjects] Ten male patients with CVA and 9 healthy elderly males participated in the present study. [Method] Blood pressure, heart rate, and common carotid artery (CCA) blood flow values were measured every 1 min before and during 10 min of 60-degree HUT. [Result] Mean blood pressure in CVA patients fell in the first minute of HUT with increased heart rate, but subsequently blood pressure returned to the level at rest after 2 minutes of HUT. The CVA group showed a significantly larger CCA diameter with a significant decrease in mean blood flow velocity, but showed no significant difference in blood flow volume compared with healthy elderly subjects. Although CCA blood flow diameter and volume tended to be lower in the CVA patients during HUT, there was no significant difference between the two groups. [Conclusion] With this understanding of cardiovascular and CCA blood flow responses during orthostatic stress in CVA patients, we conclude that getting such patients to stand erect in their treatment is safe and should proceed smoothly. [ABSTRACT FROM AUTHOR]

[Purpose] In this case study, we investigated the effect of pulsed ultrasound therapy (US) for early knee osteoarthritis (OA) with severe synovitis and joint effusion. [Subject] The subject was a 70-year-old woman with left knee OA. [Method] The subject received 12 sessions (three times weekly) of pulse US therapy for 10 minutes per session at a frequency of 1.0 MHz, intensity of 0.5 W/cm2, and pulsed mode (20%). Findings by ultrasonography, pain, range of motion, muscular strength and JKOM were assessed before and after treatment. [Result] Synovitis and joint effusion measured by ultrasonography, pain, range of motion, muscular strength and JKOM improved. [Conclusion] These results show that pulsed US is an effective anti-inflammatory treatment for patients who have early knee osteoarthritis with severe synovitis and joint effusion. [ABSTRACT FROM AUTHOR]

[Purpose] We measured changes of indices of muscle architecture of the lateral head of the gastrocnemius in graded ankle plantar contraction, and examined the reliability of the measurement indices as well as the relationships of the changes of the respective muscle architecture indices with graded ankle plantar isometric contraction. [Subjects and Method] The subjects were 10 healthy males. We measured muscle thickness, pennation angle, superficial aponeurosis displacement, and deep aponeurosis displacement as indices of muscle architecture with ultrasonography analysis equipment. The exercise task was ankle plantar isometric contraction of 5, 10 and 15 kg, in the prone position with knee and ankle angles of 0 degrees. We performed the measurements again under the same conditions after an interval of about one week. [Results] By the test-retest method the intraclass correlation coefficients (1.1) were 0.77∼0.91 for superficial aponeurosis displacement, and 0.89∼0.94 for deep aponeurosis displacement, and the reliability was high. On the other hand, that of muscle thickness, 0.38∼0.87, and pennation angle, 0.10∼0.56, were low. Furthermore, deep aponeurosis displacement increased significantly (p<0.01) with increasing muscle strength, whereas the relationships of the other indices were not significant. [ABSTRACT FROM AUTHOR]

In this study, we took images of geometry variation of the gastrocnemius muscle of healthy people in passive foot joint dorsiflexion position retention in the sagittal plane by a non-invasive ultrasound method, which is widely used as a physical therapy procedure. The purpose of this study was to consider how the ultrasound method can help the study of the effectiveness of physical therapy by measuring in the obtained images the angle made by the tendon of insertion and muscle fascicle (pinnation angle) and the torque value of the plantar flexor muscle —pressure against the planta pedis— which is antagonistic to dorsiflexion retention. Each measurement value was found to be reliable. Furthermore, we found an increase in planta pedis pressure with decrease in pinnate angle in dorsiflex compared to plantar flexion. In conclusion, as macroscopic, basic information about muscle geometry variation in passive dosiflexion retention, the decrease if pinnation angle generated by passive tendon is suggested, and we consider the ultrasound method can be used to study the effectiveness of the physical therapy. [ABSTRACT FROM AUTHOR]

The article presents a study to clarify the influence of posture on lateral abdominal muscles thickness by using ultrasonography. Twelve male subjects go through muscle measurement and compared their muscle thickness in five postures: supine, sitting and standing postures with neutral pelvic tilt, anterior and posterior pelvic postures in sitting. The study suggests that the measuring lateral abdominal muscles thickness influenced by the pelvic tilt consideration and antigravity posture.

Testicular epidermoid cysts are relatively rare, accounting for about 1% of all testicular tumors, and are often treated by high orchiectomy. We describe here the case of a testicular epidermoid cyst treated by testicle-sparing surgery due to a preoperative diagnosis. A 23-year-old man complained of a painless mass in the right scrotum. Physical examination revealed a firm little fingertip-sized smooth-surfaced mass in the right testis. Ultrasonography showed a hypoechoic lesion with an echogenic rim in the right testis. A T2-weighted magnetic resonance image showed a well-demarcated mass with a low signal outline. On the basis of a preoperative diagnosis of epidermoid cyst, intraoperative testicular frozen section was performed, and the mass was resected surgically while preserving the testis.

We report a case of ileocecal intussusception due to Burkitt's lymphoma(BL). A 14-year-old boy was admitted to our hospital for abdominal pain and diarrhea. He was diagnosed an intussusception by the ultrasonography and the CT scan. Laparoscopic ileocecal resection was performed. A diagnosis of BL was made on basis of pathological examination. He was transferred for the chemotherapy on postoperative day 8. We conclude that, if the intussusception associated with malignant lymphoma is assumed from the preoperative findings, we have to keep minimal surgical invasion and start postoperative chemotherapy immediately.

This is the case of a 40-year-old, 34-week pregnant woman, who had bloody stools and abdominal pain from 20 weeks gestation. She presented to our department as she noted an exacerbation in her abdominal pain, and was admitted. Sonography and magnetic resonance imaging displayed a mass with an appearance consistent with intussusception, hence intussusception was diagnosed. The patient underwent a cesarean section and concurrent partial colectomy, which showed that she had a colon cancer. There were no postoperative complications. Colon cancer as a complication of pregnancy is rare. We encountered a case of a patient with colorectal cancer that caused intussusception in the latter half of pregnancy, and report it here with a review of the literature.

A 60-year-old female had a subcutaneous mass in the B region of the left breast. A needle aspiration cytologic examination revealed class IV, and she was referred to our surgical department for examination and treatment. She underwent an ultrasound echography on bilateral the mammary glands and axillary lymph nodes. Erythematous papules and plaques were revealed on her left breast, left axilla, and in the center of the chest area. The patient was referred to our dermatology department for evaluation of her skin eruption. Histopathological examination revealed the infiltration of lymphocytes and eosinophils in the perivascular of the upper dermis with spongiosis and liquid degeneration in the epidermis. A patch testing showed a positive reaction to ultrasonography gel. Based on the clinical course and examinations, we diagnosed her skin eruption as contact dermatitis due to ultrasonography gel. Her skin eruption improved rapidly by topical application of betamethasone butyrate propionate ointment. Recurrence of her skin eruption could be avoided by the removal of the gel after the ultrasonography examination. Our case report demonstrated to us that contact dermatitis could be prevented by promptly wiping off the ultrasonography gel from the skin after the examination.

Most patients with calyceal diverticula stones are asymptomatic, but some patients experience fever and low back pain. Here we report a case of calyceal diverticula stones treated by ureteroscopic management. A 41-year-old woman with backache visited a local doctor. She was diagnosed with a urinary tract infection, and prescribed an antibiotic. Her symptoms began to improve, but the ultrasonography showed she had a left renal cystic lesion, so she visited our hospital. Abdominal contrast-enhanced computed tomography (CT) showing in-flow of a contrast agent into the left renal calyceal diverticula located stones in the upper pole. We performed ureteroscopic management of the calyceal diverticula stones in two stages. First, we expanded the neck of the calyceal diverticula by indwelling the ureteral stent at the calyceal diverticula. Then, using a ureteral dilator, we expanded the neck of the calyceal diverticula further and removed the stones in the calyceal diverticula. Treatment with ureteroscopic management was possible due to the location of the calyceal diverticula stones and the success rate was increased by performing the treatment in two stages.

We investigated the accuracy and operability of two ultrasound devices for the bladder. The study included 232 adult patients who underwent surgery at our hospital. Before surgery, a nurse measured the amount of urine in the bladder using Lilium α-200® and Bladder Scan BVI 6100®. The amount was measured accurately later using a catheter. The measurements by the devices were compared with the amount measured by the catheter. Both Lilium and Bladder Scan had high accuracy (correlation coefficient for Lilium is 0.56 [95% CI : 0.46-0.64], and the correlation coefficient for Bladder Scan was 0.70 [95% CI : 0.63-0.76]). However, values obtained by the two devices significantly differed from the catheter measurement. The accuracy was improved by excluding patients with 0- ml readings by the two devices (the correlation coefficient for Lilium was 0.69 (95% CI : 0.61-0.76), and the correlation coefficient for Bladder Scan was 0.81 (95% CI : 0.76-0.86). Next, the operability was evaluated using a questionnaire. Both devices had high operability, but Bladder Scan was easier to operate. Based on the above, Bladder Scan had significantly higher accuracy and operability, but both devices had a sufficiently high accuracy and operability for clinical practice.

An 80-year-old woman presented with acute abdominal pain and distention. A diagnosis of acute chylous peritonitis was made via contrast-enhanced computed tomography and abdominal paracentesis. She underwent ultrasound-guided intranodal lymphangiography with Lipiodol ® (IL with Lipiodol), and her persistent abdominal pain was significantly reduced within a day. Moreover, her ascitic fluid showed marked improvement and paracentesis was no longer needed. Based on the findings of the study, IL with Lipiodol could be a promising minimally invasive approach in the treatment of acute chylous peritonitis.

Contrast medium-enhanced computed tomography revealed a mass in the liver of a 65-year-old man. The edge but not the center of the mass was enhanced. Ultrasonography-guided percutaneous needle biopsy revealed the diagnosis of angiosarcoma of the liver, and it was treated with chemotherapy. Angiosarcoma of the liver has various appearances on imaging and is not often diagnosed while patients are alive. If the tumor is difficult to diagnose by imaging and thought to be unresectable, a biopsy can help in guiding treatment, but treatment should be adapted with caution.