Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.
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Integrating Ultrasound-Guided Multifidus Injections with Repeated Peripheral Magnetic Stimulation for Low Back Pain: A Feasibility Study Wei-Ting Wu, Ke-Vin Chang, Levent Özçakar Journal of Pain Research.2024; Volume 17: 2873. CrossRef
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Background This study aimed to elucidate the association between total lean muscle mass and the incidence of non-alcoholic fatty liver disease (NAFLD) in the adult Korean population.
Methods Utilizing data derived from the 18-year prospective cohort of the Korean Genome and Epidemiology Study, NAFLD was diagnosed via the hepatic steatosis index with an established cutoff value of 36. Lean muscle mass was assessed via bioelectrical impedance analysis and subsequently divided into tertiles. A generalized mixed model with a logit link was employed for repeated measures data analysis, accounting for potential confounders.
Results Analysis encompassed 7,794 participants yielding 49,177 measurements. The findings revealed a markedly increased incidence of NAFLD in the lower tertiles of muscle mass, specifically, tertile 1 (odds ratio [OR], 20.65; 95% confidence interval [CI], 9.66–44.11) and tertile 2 (OR, 4.57; 95% CI, 2.11–9.91), in comparison to tertile 3. Age-dependent decreases in the OR were observed within the tertile 1 group, with ORs of 10.12 at age of 40 years and 4.96 at age of 80 years. Moreover, each 1%-point increment in total muscle mass corresponded with an estimated OR of 0.87 (95% CI, 0.82–0.93) for NAFLD resolution.
Conclusions The study demonstrates a significant association between total muscle mass and NAFLD prevalence among Korean adults. Given the potential endocrine role of muscle mass in NAFLD pathogenesis, interventions aimed at enhancing muscle mass might serve as an effective public health strategy for mitigating NAFLD prevalence.
The diagnosis of a gluteal muscle tear or strain is based on clinical findings. However, for an accurate diagnosis, imaging examinations are also needed. Herein, we describe the case of a patient with a gluteus maximus muscle tear confirmed by ultrasonography (US) and magnetic resonance imaging (MRI). A 58-year-old woman complained of dull pain in the left lateral gluteal region that she had been experiencing for 8 days. In the axial US image, retraction of the left gluteus maximus muscle was noted around its insertion site in the iliotibial band. On an MRI, a partial tear in the left gluteus maximus was observed at its insertion site in the left iliotibial band. In addition, fluid infiltration due to edema and hemorrhage was observed. A partial left gluteal muscle tear was diagnosed. The patient was treated with physical therapy at the involved region and oral analgesics. She reported relief from the pain after 1 month of treatment. Based on this experience, we recommend US or MRI for accurate diagnosis of muscle tear or strain.
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Intercostal nerve injury is known to occur during thoracotomy; however, rectus abdominis muscle atrophy has rarely been reported. We describe a 52-year-old man who underwent primary closure of esophageal perforation and lung decortication via left thoracotomy. He was discharged 40 days postoperatively without any complications. He noticed an abdominal bulge 2 months later, and computed tomography revealed left rectus abdominis muscle atrophy. We report thoracotomy induced denervation causing rectus abdominis muscle atrophy.
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Background Body fats, especially both of abdominal fat pad mass and skeletal muscle fat content, are inversely related to insulin action. Therefore, methods for decreasing visceral fat mass and muscle triglyceride content may be helpful for the prevention of insulin resistance.
Methods Thalidomide, used for its anti-angiogenic and anti-inflammatory properties, was administered to rats for 4 weeks. A 10% solution of thalidomide in dimethyl sulfoxide was injected daily into the peritoneal cavity as much as 100 mg/kg of body weight.
Results The total visceral fat pad mass in the thalidomide-treated group was 11% lower than in the control group. The size of adipocytes of the epididymal fat pad mass in the thalidomide-treated group was smaller than in the control group. The intraperitoneal thalidomide treatment increased triglyceride concentrations by 16% in the red muscle, but not in the white muscle.
Conclusion The results suggested that intraperitoneal thalidomide treatment inhibited abdominal fat accumulation, and that the free fatty acids in the blood were preferentially accumulated in the red muscle rather than in the white muscle.
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Thalidomide suppresses migration and invasion of colorectal cancer cells by inhibiting HOXB7‐mediated activation of the Wnt/β‐catenin signaling pathway Liyang Liu, Wusong Xue Chemical Biology & Drug Design.2024;[Epub] CrossRef
Various changes in ocular position are possible during general anesthesia as opposed to the awakening state. However, unexpected ocular deviation under general anesthesia is a disconcerting event as it can lead to difficult complications intraoperatively. To date, sudden fixed upward ocular deviation has been rarely reported previously. This phenomenon was observed in an 8-year-old boy during strabismus surgery. Suddenly fixed upward ocular deviation occurred when the speculum was inserted into the right eye. When the eyeball was pulled down, using forceps, there was some resistance, such as contracture of superior rectus. The eyeball sprang back into the upward position when the forceps was released. These changes could hamper the good exposition of the surgical field, leading to significant intraoperative difficulties and complications. Surgeons should be aware of this possibility, despite general anesthesia; if it occurs, proceed with the surgery as planned preoperatively, and both ophthalmic and anesthetic interventions should be used to solve this problem.
Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.
The incidence of breast cancer, the second most prevalent cancer type in South Korea, has increased by 6.8% annually in the lastsix years.The higher number of breast cancer patients has led to an increase in the cases of skin-sparing mastectomies, thereby increasing the need for reconstructive procedures. The reconstruction options include alloplastic techniques such as implant or autologous reconstruction with numerous flaps. The abdominal area is the preferred donorsite for the harvest of autologous tissue for breast reconstruction. Breast reconstruction using abdonimal tissue is commonly accomplished using the transverse rectus abdominis myocutaneous (TRAM) flap. The establishment of microvascular surgery led to the development of the free TRAM flap because of its increased vascularity and decreased rectus abdominis sacrifice. The muscle-sparing TRAM, DIEP, and SIEA flap techniques were later developed in an effort to decrease the abdominal-donor-site morbidity by decreasing the injury to the rectus abdominis muscle and fascia. This article summarizes the various abdominal flaps for breast reconstruction.
Endothelial cells play a key role in pathological processes such as cancer cell metastasis, atherosclerosis, and diabetic retinopathy. Vascular smooth muscle cells directly involve in the formation of atheroma in atherosclerosis. Some kinds of the endothelial cells are simply harvested from the umbilical veins, the tunica intima of aortic walls, the retina using various enzymes solutions. Those purely isolated cells provide a powerful tool in vitro studies of the endothelial cell related diseases. In this context, the cultured smooth muscle cells after the isolation from the tunica media of aortic walls are also used for elucidating the pathogenesis of atherosclerosis. Here, I briefly introduce articles that include the isolation of human umbilical vein endothelial cells (HUVEC), aortic endothelial and smooth muscle cells, retinal microvascular endothelial cells (RMEC), as well as the diseases' applications of these cells.
A microdebrider is increasingly used in endoscopic sinus surgery. Although it has many advantages over conventional instruments, it has been associated with severe complications. We treated a case of rupture of the left medial rectus muscle after use of a microdebrider during endoscopic sinus surgery in a 50 year-old female patient who complained of binocular diplopia and exotropia. The patient showed marked limitation on adduction and about 40 prism diopters of left exodeviation. The orbital computed tomography showed a bony defect at the left medial orbital wall, and injury of the medial rectus muscle. The exodeviation was corrected after ophthalmologic surgery. We report a case of the rupture of the medial rectus muscle after use of a microdebrider during endoscopic sinus surgery and review the medical literature.
BACKGROUND Atherosclerosis has emerged as the leading cause of death in developed countries. At present, human umbilical vein endothelial cells (HUVEC) are most commonly used for the investigation of Endothelial cells (EC). However, HUVEC are not found in arteries but only in veins. Currently there are many reports on methods used to isolate EC;, most of these methods require special equipment to remove contaminating smooth muscle cells (SMC). MATERIALS AND METHODS: The method described here may be used to isolate not only ECs but also SMCs;,the approach presented here did not require special equipment. Rat aorta was treated with 2 mg/ml of type II collagenase solution for 45 minutes. The isolated cells from the aorta were incubated in medium G for a week;, only ECs could be separated. After the collagenase treatment, the rest of aorta was cut lengthwise, and left undisturbed to obtain SMCs in the culture dish for 10 days. To verify the purity of the isolated cells, we performed immunofluorescence and evaluated the results with transmission electron microscopy analysis. RESULTS: The immunofluorescence study demonstrated specific expression of CD31 and alpha-smooth muscle actin in the isolated ECs and SMCs, respectively. Cultured ECs and SMCs showed their own fine structure characteristics. CONCLUSION: These results suggest that this method for isolating ECs and SMCs may be especially useful for the study of atherosclerosis.
BACKGROUND Body weight is an important factor that influence the bone density in postmenopausal women except estrogen dificiency. However, different results are reported about the relationship between body composition and bone density in the postmenopausal women. We have studied the relationship between age, body weight, body mass index (BMI), waist hip ratio (WHR), muscle mass, fat mass, fat free mass and bone density. MATERIALS AND METHODS: We have studied 127 persons of postmenopausal women who visited university medical center and examined the inbody 3.0 and Dual Energy X-ray Absorptiometry (DEXA) from Jan, 2001 to Jun, 2002. they didn't have any disease and didn't received hormone therapy, osteoporosis therapy or other medication that influence the bone density. RESULTS: The numbers of study subjects is total 127 persons. Mean age is 56.9+/-5.14, mean weight is 59.3+/-8.7 kg, mean BMI is 25.37+/-3.16 (kg/m2), mean fat mass is 20.02+/-5.05 kg, mean muscle mass is 37.49+/-4.50 kg, mean fat free mass is 39.80+/-4.70, mean BMD is 0.828+/-0.148 (g/cm2). In the result of linear regression analysis, age, height, weight, muscle mass, fat free mass, fat mass, BMI are significant determinants of BMD. In stepwise multiple regression analysis, age is the most significant determinant of BMD and besides age, fat free mass is the most significant determinant of BMD among body composition. CONCLUSION: In postmenopausal women, age, height, weight, BMI, muscle mass, fat free mass, fat mass are significant determinants of BMD and besides age, fat free mass is the most significant determinant of BMD among the body composition. So, diet and exercise that increase fat free mass will contribute to bone density increment.
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Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle Nami Chun, Hyunju Chae Korean Journal of Women Health Nursing.2015; 21(1): 43. CrossRef
Association between bone mineral density and remaining teeth in postmenopausal women Kyeong-Soo Lee, Chang-Suk Kim Journal of Korean society of Dental Hygiene.2014; 14(3): 319. CrossRef
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BACKGROUND This study was undertaken to evaluate the diagnostic sensitivity of several muscles in repetitive nerve stimulation test (RNST) for myasthenia gravis (MG) patients. MATERIALS AND METHODS: The study population consisted of 39 MG patients classified by modified Ossermann's classification. Using Stalberg's method, RNST was systematically performed in facial (orbicularis oculi and nasalis) and upper extremity (flexor carpi ulnaris, abductor digiti quinti and anconeus) muscles. RESULTS: The significant electrodecremental response of RNST were noted in orbicularis oculi (58.9%), nasalis (51.3%), flexor carpi ulnaris (42%), anconeus (41%) and abductor digiti quinti muscles (27%). Among the 3 muscles of upper extremity (abductor digiti quinti, flexor carpi ulnaris and anconeus), the positive electrodecremental response of anconeus muscles was significantly higher than other two muscles (p<0.05) in type IIa, IIb and there were no statistical differences of the positive electrodecremental response between orbicularis oculi and nasalis muscles. The facial muscles showed more prominent decremental responses than upper extremity muscles in type I MG(p<0.05). In type IIa MG patients, there were no significant statistical differences between facial and upper extremity muscles but significant statistical differences among upper extremity muscles. In type IIb MG patients, there were no significant statistical differences in all tested muscles in spite of the increased positive electrodecremental response of RNST. CONCLUSION: On the basis of this study, RNST would be initially performed for the orbicularis or nasalis in type I MG and for the anconeus in type IIa or IIb MG.
BACKGROUND It is doubtful that aging causes deteriorated glucose metabolism and insulin resistance of skeletal muscle. Some researchers had different results about it. So we have studied the mechanism responsible for the abnormal glucose tolerance associated with aging in rapidly growing and matured rats. MATERIALS AND METHODS: Animals were used S.D. rats. Growing rats were 7 weeks old (BW: 160-190 gm) and matured rats were 28 weeks old (BW: 420-525 gm). RESULTS: Fasting blood glucose and plasma insulin levels were significantly elevated in matured rat compared with growing rats. And during oral glucose tolerance test the glucose level was also significantly elevated in matured rats. These results confirmed an insulin resistant state of aging. Insulin levels at 30 minutes of oral glucose tolerance test was significantly elevated in growing rat. But at 120 minutes it was maintained at higher level in matured rats than in growing rats. It suggested the possibility of increased insulin secretion by initial stimulation of beta-cells in growing rats, and increased secretion and decreased catabolic rate of insulin in matured rats. Glucose uptake rate of soleus muscle in matured rats was lower than that of growing rats, but the difference was not statistically significant. The dose(insulin)- responsive (glucose uptake) curve of soleus muscle was only slightly deviated to the right side. CONCLUSION: Glucose metabolism of rat skeletal muscle was worsened by aging. The data of glucose uptake experiments suggested the possibility of insulin resistance of skeletal muscle in matured rats, but the mechanism of insulin resistance of skeletal muscle need further studies.
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The effects of hyperglycemia and hyperlipidemia on utilization of muscle glycogen during 45 minutes treadmill running(26 m/min, 8 % grade) were evaluated in Sprague Dawley rats, and the charateristic of the 4 different type of muscles, soleus, white and red gastrocnemius, and plantaris, on glycogen utilization were simultameously investigated. Hyperglycemia, 145-165 mg/dL, was induced by oral glucose ingestion, and hyperlipidemia, 444 uEq/L, was induced by combined treatment of intraperitoneal heparine injection and oral 10 % intralipose ingestion. During the hyperglycemic trial, the glycogen utilization of plantaris muscle was decreased by 13 % at 45 minutes duration of treadmill running comparing to the control trial(p<0.05), and the glycogen utilization of white gastrocnemius was also decreased. The sparing tendency of soleus and red gastrocnemius by 5-13 % was observed at 30 and 45 minutes of treadmill running in hyperglycemic trial. There was no glycogen sparing effect of hyperlipidemia in the soleus, red gastrocnemius and plantaris muscle subjected in this experiment during exercise. However, only a slight sparing tendency of white gastrocnemius muscle was observed. In summary, the glycogen sparing effect of hyperglycemia during exercise was observed in plantaris and white gastrocnemius muscles in rats. However, there was no glycogen sparing effect of hyperlipidemia in the 4 hindlimb muscles. It was observed that the glycogen sparing effect of hyperglycemia is more prominant in fast glycolytic muscle fiber.