Search

Analyzing abdominal muscles and measuring useful associated morphological features is important in many clinical researches. While ultrasonography is a non-invasive reliable tool for such tasks, it may cause the experimenter dependent subjective diagnosis thus a computer vision based automatic muscle detector/analyzer is much needed in this area. In this paper, we propose such an automatic vision based method using a series of image processing algorithms. The novelty of our method is to extract internal oblique muscle from abdominal ultrasonographic image which was excluded in previous study due to their irregular features. Previously, we used Mask searching method to restore vague part of abdominal image but the third layer of muscle (transverse abdominis) was not clearly extracted because of the image distortion in the process. In order to analyze muscle morphometric features like the thickness, the second layer (internal oblique muscle) should also be extracted correctly thus we develop a new muscle extraction process that includes extracting the second layer by using unsharp masking. Extraction of transverse abdominis is also improved by developing a new data structure Both-Map in candidate search process. In that process, we save the morphological features of initially extracted muscle area and later such information is used to restore the fascia area with various image processing techniques to extract target muscle accurately. The effectiveness of the proposed method is verified by the practical diagnostic field of rehabilitation in the extraction accuracy and the magnitude of the muscle thickness measurement error that lies within 0.02cm in more than 60% of cases used in the experiment.

Identified in December 2019, SARS-CoV-2 quickly spread worldwide with a resultant increase in global morbidity, mortality, and economic disruption on a scale not seen since the 1918 Spanish flu. Health officials recommended universal masking to further reduce human-to-human spread of SARS-CoV-2. The state of Hawaii and the Department of Defense (DOD) adopted strict mask policies early in the pandemic and is shown to be effective at reducing transmission. We report a case of Staphylococcus aureus bacteremia in an immunocompetent 21-year-old man attributed to local skin irritation with resultant infection in the setting of continuous reuse of a mask that resulted in bilateral cavernous venous thrombosis and septic pulmonary embolism.

Sugammadex hypersensitivity is an uncommon event that typically occurs at higher doses. We report a case of suspected sugammadex hypersensitivity in a patient who developed hypoxia and bronchospasm following three administrations of the standard 2 mg/kg doses of sugammadex within 26 hours due to flap takebacks. Hypersensitivity to sugammadex was not initially suspected given that the patient had previous exposures. Diagnoses of pneumothorax, hemothorax, mucus plug, and tracheal tube malposition were immediately ruled out. Furthermore, the onset of hypoxia with sudden loss of tidal volume, development of high peak airway pressures, and temporal correlation with sugammadex administration all supported bronchospasm secondary to a hypersensitivity reaction. Sugammadex is a useful agent for neuromuscular blockade reversal; however, it is critical to carefully examine all adverse reactions. This case report highlights the importance of considering hypersensitivity reactions in the setting of repeat sugammadex administrations in a limited timeframe, such as in free flap reconstruction requiring multiple takebacks to the operating room in the setting of flap compromise.