We recently demonstrated that gluteal muscle damage can be detected by MRI in a negligible number of patients who had undergone abdominal, urologic, or gynecologic surgery. We also found that gluteal skin damage was concurrent in some of the patients who exhibited gluteal muscle damage and that the damage observed in the gluteal muscle differed from compression-induced deep tissue injury. In this report, we hypothesized that the gluteal muscle damage was caused by the heat produced during the passage of electric current between the tip of the electric scalpel and the return electrode. We used finite element method to simulate the distribution of generated heat from the electric scalpel; this was based on universal 3D reconstructions model of the abdomen and pelvis. Under conditions in which the electric scalpel was used in the lower abdomen, the simulation analysis suggested that the calorific value, which is the quantity of heat generated per unit of time, became remarkably higher in the region of the gluteus muscle. We therefore speculate that this heat generated by electric current could cause both gluteal muscle and skin injury. We hope that our proposal of a new mechanism underlying postoperative gluteal muscle and skin injury can contribute to the prevention of this overlooked iatrogenic tissue damage.
We report herein two cases of male primary syphilis with penile ulcers. The TPLA test (Mediace Treponema Pallidum Latex Agglutination; Sekisui Chemical Co.) was positive, but the RPR test (Mediace Rapid Plasma Reagin; Sekisui Chemical Co.) was negative. TP-IgM and TP-IgG antibodies were detected in both cases by the Western blotting. The RPR results were probably negative because the patients had been treated at an early stage. TPLA, which uses latex agglutination, is thought to be able to yield positive results earlier than RPR because of the shortened of the window period.
Biological therapy has established the efficacy and safety profile for psoriasis treatment. The possible development of tuberculosis is one of the important issues during treatment, so an interferon-γ releasing assay (IGRA) such as QFT or T-spot is generally used to monitor tuberculosis in daily practice. We retrospectively investigated the clinical courses of QFT or T-spot testing in 386 patients with psoriasis during biologics treatments. Of these patients, 33 cases were positive in the IGRA assay, and 7 cases showed changes from positive to negative. These results suggest that IGRA assays can be affected by biological therapy.