Isometric and dynamic strength and endurance of knee extensors were tested in 18 young males. The relative composition of slow (ST) and fast twitch (FT) fibers in the vastus lateralis muscle was registered from needle biopsies. Thigh muscle volume was evaluated from ultrasonic measurements. Six subjects served as controls, six trained with 50%, and six with 80% dynamic strength three times per week for 7 weeks with 20 and 12 repetitions per session, respectively. The training load was adjusted to the increases in strength observed during training. Dynamic strength increased by 42.3% in the 80% group (p less than 0.01). In the control group and 50% group no significant increases were observed. Dynamic endurance: Controls showed no change. There was an over-all increase in the 50% group, while the 80% group only increased dynamic endurance for heavier loads. Isometric strength and endurance and fiber composition did not change in any group. In the 50% group the area of FT-realtive to ST-fibers increased 12.4% (p greater than 0.05). Dynamic strength relative to muscle cross section increased by 30% in the 80% group (p less than 0.01) positively correlated to relative content of FT fibers. The present results confirm the specificity of training and indicate that a high content of FT fibers is a prerequisite for a successful strength training.
In patients with renal hypertension, determination of renal volume may be valuable for evaluating possible compensatory hypertrophy for correlating renal size to renal function, and for evaluating the transplanted kidney in relation to rejection and its response to therapy. We performed parallel transverse ultrasonic scans through each kidney and computed volume based on the cross-sectional areas outlined on the scans. In 16 autopsy studies a highly significant correlation between calculated and true values were obtained, rs = 0.847, p less than 0.001. The 5th and 95th percentiles of the median divergence were -21 and 27 ml respectively. In 30 healthy subjects, double determinations showed 5th and 95th percentiles of the median interobserver variation of -7 and 3 ml respectively. There was no demonstrable difference between volumes of right and left kidneys, and no difference in relation to sex. Total renal volume was most accurate when correlated with the body weight, rs = 0.698, p less than 0.001. Normal values of total renal volume per kilogram of body weight were 4.3 to 8.0 ml/kg. In normal subjects, the smallest kidney's volume should not be less than 37% of the total renal volume.
A new method of endoscopic ultrasound (EUS) guided fine needle aspiration using an ultrasonic endoscope with a curved array transducer mounted in front of the optic lens was developed. As a result of the sector shaped sound field and the direction of the scanning plane it was possible to visualise ultrasonically a needle inserted through the biopsy channel. EUS guided biopsy was performed in 37 patients (with 39 lesions) using three types of needles. Based upon initial testing of several prototype needles a 160 cm long, 0.8 mm diameter needle placed in a Teflon catheter was developed after preliminary results with the first two types were unsatisfactory (positive results for malignancy in 3/11 and 4/8 cases). The third prototype was tested in seven patients with malignant tumours of the upper GI tract. In these patients EUS guided biopsy was positive for malignancy in 7 of 8 solid lesions. Problems related to the technique and criteria for a successful outcome are discussed. The preliminary results show that it is possible to advance a needle into a malignant lesion inside or outside the GI wall during EUS examination and aspirate material for cytologic examination from various lesions. Controlled studies are needed to determine the indications for use and the accuracy of the technique.
We report here the first case of a one-step endosonography(EUS)-guided pseudocyst drainage. A prototype large channel curved array echo endoscope (Pentax FG-38 UX) and a prototype delivery system for placement of an endoprosthesis was used for the procedure. The delivery system (GIP MedicinTechnik GmbH/Medi-Globe Corporation) consists of a handle part with a piston, a metal ring sheath, a plastic catheter with a diathermy needle and a double pigtail endoprosthesis (8.5 Fr). When mounted on the endoscope the endoprosthesis can be advanced out of the distal end of the endoscope. The introduction of the stent as well as the stent release can be monitored entirely by ultrasound. The procedure was tested in a 76-year-old woman with a pseudocyst measuring 60 mm in diameter located in the tail of the pancreas. The procedure was well tolerated by the patient, and there were no procedural complications. The advantage of a large channel echo endoscope and our new prototype delivery system is that the endoprosthesis can be inserted in to a pancreatic cyst guided exclusively by EUS without exchange of endoscopes, catheters or guide wires. Further studies are warranted.
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