Role of gradient echo sequence in delineation of Thenar muscles anatomy

Magnetic Resonance Imaging (MRI) is known to be the imaging modality of choice to assess human muscles anatomy superior to other modalities (eg: ultrasound and CT scan) due to its excellent ability to differentiate soft tissue contrast, good spatial resolution and wider field of view with no radiation effect. To date, proton Density (PD), T1W and T2W sequences are been utilised to assess muscular structures. However, delineation of each thenar muscle which are small in size can be difficult using these sequences

Želučana metastaza infiltrativnog karcinoma dojke 22 godine nakon prve operacije - prikaz slučaja

Gastric metastasis from breast carcinoma is uncommon and rarely encountered in our daily practice. We report a case of late gastric metastasis from previous infiltrating lobular carcinoma of the breast. The patient had extended disease-free interval of 22 years prior to metastasis. Gastroscopy and fluoroscopy showed changes appearing like linitis plastica of the body of the stomach. Computed tomography of the thorax and abdomen demonstrated pulmonary metastasis and mediastinal lymphadenopathy. Biopsy of the mediastinal lymph node and stomach lesion confirmed metastatic adenocarcinoma from breast carcinoma based on immunohistochemistry staining. Immunohistochemistry staining of both specimens revealed strong positivity for cytokeratin 7 and negative for cytokeratin 20.Metastaze karcinoma dojke u želudac nisu česte i rijetko se vide u svakodnevnoj praksi. Opisujemo slučaj kasne želučane metastaze iz prethodnog infiltrativnog lobularnog karcinoma dojke. Prije nastanka metastaze bolesnica je imala dugotrajno razdoblje bez bolesti od 22 godine. Gastroskopija i fluoroskopija pokazale su promjene poput linitis plastica na tijelu želuca. Kompjutorizirana tomografija prsnog koša i trbuha pokazala je plućnu metastazu i limfadenopatiju. Biopsija limfnog čvora medijastinuma i želučane promjene potvrdila je metastatski adenokarcinom iz karcinoma dojke na osnovi imunohistokemijskog bojanja pri čemu su oba uzorka bila snažno pozitivna na citokeratin 7 i negativna na citokeratin 20

Disseminated Melioidosis Presenting with Community-Acquired Pneumonia: A Presentation Not to be Missed – A Case Report

BACKGROUND: Melioidosis commonly presents with pneumonia and is associated with a high mortality rate. This case report discussed a case of confirmed disseminated melioidosis. The case focused on the chronological clinical progressions of melioidosis which initially masqueraded as community-acquired pneumonia (CAP) and subsequently developed into septicemia. This case report aims to create awareness among the primary care doctors working in a potentially endemic area for melioidosis to be vigilant of its non-specific presentation. CASE REPORT: We report a case of an 80-year-old man who was treated for CAP and presented with unresolved fever and subsequently sepsis. A contrast-enhanced computed tomography showed disseminated lesions of varying sizes in the lungs, liver, spleen, and blood cultures grew Burkholderia pseudomallei. A pigtail drainage catheter was inserted into the liver abscess. In addition, the patient received a 46-day course of intravenous ceftazidime and a 4-month maintenance regime of oral trimethoprim-sulfamethoxazole and oral doxycycline. CONCLUSION: Completion of antimicrobial treatment resulted in resolution of clinical signs and abscesses on imaging

Role of ultrasound in the evaluation of thenar muscles length

Proper functioning of the hand is centered on the use of the thumb, which is the only opposable finger among the five. Assessment of the thenar muscles that is essential for thumb movement is important in not only medical field as to look for any pathology, but also crucial in the engineering field. Assessment of these muscles can be applied to develop a prostatic thumb which can mimics the real actions of a real thumb as closely possible. Muscle length is one of the parameters needed to develop a prostatic thumb. Therefore, in this study, we utilized ultrasound technique to measure thenar muscles length and the precision of this technique is compared with the MRI examination as gold standard

EMG based classification of thumb posture using portable thumb training system

Loss of human limbs that are caused by traumatic accidents, vascular diseases and diabetes that lead to amputation has great impact to the well-being of the affected segment of societies. They usually require prostheses to restore the original functionality of the missing limbs so to be able to assist them in the activities of daily living. Extensive works have been reported in developing prostheses that not only could work as close as the natural limbs but also look alike the original ones. Many of these prostheses are based on the myoelectric control which requires the electromyography (EMG) signal to be measured and analyzed from the remaining nerves or muscles left after amputation. It is still a challenge however to detect, process, classify and apply the signal appropriately. In this paper, a study on the relationship of thumb-tip force related to EMG signals using a well-designed, portable thumb training system is conducted. The EMG signal is classified by using machine learning techniques when the thumb is flexed at different angles and exerts different magnitude of forces at its tip. The thumb training system is developed with compliances to fit different shape and size of human hands. The result from the analysis done using WEKA software shows that the EMG signal can be used to estimate the posture of the thumb at different flexed angles and thumb tip forces

Estimation of thumb-muscle length by ultrasound on portable thumb training system

Human limb amputation following severe injuries or bacterial infection caused by accidents, vascular diseases and diabetes has significant impact to the well-being of a person. Limb amputation is usually replaced by prostheses to restore the look of the limb as well as the basic function of the missing limb that can assist patient on activities of daily living. Improvement on robotic prostheses in these aspects has been done extensively in the previous decade. The focus on current prostheses development is to use electromyography (EMG) signals in myoelectric control of the system through analyzing the remaining signal generated from the nerves or muscles left after amputation. Hill’s muscle model requires both EMG signals and muscle length information to predict force that is produced at contact point. In this paper, the measurement of the muscle length using ultrasound imaging and magnetic resonance imaging (MRI) using a well-designed portable thumb training system is described. The measurement done using ultrasound image is compared to the pre-measurement done by MRI in order to establish a set of references. The thumb training system is designed to allow the thumb to flex to range of degrees that have been defined in this research work. The result from the ultrasound imaging shows good accuracy in measuring thumb muscle length and thus allows the research work to proceed to model thumb-tip force based on Hill’s muscle model

Thumb-tip force orediction based on hill’s muscle model using electromyogram and ultrasound signal

The use of prostheses is necessary to restore lost limbs to a level of functionality to enable activity of daily living. Many prostheses are now using myoelectric based control techniques to operate. However, to develop a model based controller for the system remains a challenge as accurate model is necessary. This study investigates the use of electromyogram and ultrasound signal to predict thumb tip force based on Hill’s Muscle model. The results obtained has shown a significant improvement in the prediction of thumb tip force as much as 31.45% of average RMSE over the benchmark model that leverages on biomechanics model and active marker to characterize the muscl

Thumb-tip Force Prediction Based on Hill’s Muscle Model using Electromyogram and Ultrasound Signal

The use of prostheses is necessary to restore lost limbs to a level of functionality to enable activity of daily living. Many prostheses are now using myoelectric based control techniques to operate. However, to develop a model based controller for the system remains a challenge as accurate model is necessary. This study investigates the use of electromyogram and ultrasound signal to predict thumb tip force based on Hill’s Muscle model. The results obtained has shown a significant improvement in the prediction of thumb tip force as much as 31.45% of average RMSE over the benchmark model that leverages on biomechanics model and active marker to characterize the muscle

Portable thumb training system for EMG signal measurement and analysis

Restoring human limb that is lost due to accidents or amputation because of vascular diseases with prosthesis is one challenging issue in engineering field. The loss of human body, especially the upper and lower limbs will limit the daily activities of patient in many ways. There were many studies that had been done previously in developing prostheses which were simpler in the forms than human limb. However, the performance of these units was mostly unnatural and is damped by constraint in the model of the limbs. In this paper, the development of thumb training system that allows the measurement of electromyography (EMG) signal when the thumb is flexed at different angles with varying force is discussed. The parameters are then possible to be used with conjunction of Hill’s muscle model to develop a more precise model of the thumb. The platform also features several adjustments so as to suit various size of human hands. The result from EMG measurement from the system shows that the system is able to characterize the EMG signal of thumb at different pose and force