• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.49-66
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• 2014

Traditionally, cervical interventions have been performed under fluoroscopy. But radiation exposure is the major concern when obtaining fluoroscopic images and even under real-time fluoroscopy with contrast media or CT guidance, some cases of serious spinal cord injuries, cerebellar and brain stem infarction have been reported by unintentional intra-arterial injections especially during the transforaminal root blocks. Recently, the use of ultrasound-guided cervical interventions have increased. Ultrasound offers visualization of soft tissues including major neurovascular structures and also allows to observe the spread of injectant materials around the target structure. Ultrasound is radiation free, easy to use and the image can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound allows visualization of major nerves and vessels and thus leads to improve safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore reviewed to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.43 no.5 s.311
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• pp.89-100
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• 2006

The carotid intima-media thickness (IMT) is very important, because the severity of it is an independent predictor of transient cerebral ischemia, stroke, and coronary events such as myocardial infarction. The conventional image processing to measure the IMT has not been satisfactory, because the methods have relied on the manual section drawing and a regional segmentation by differential estimation. We propose a new image processing technology effective to extract features from the carotid artery image whose pixels have the directional vector properties with composed color distribution. The technique we presented here is not by differential variation but by verification of the layer properties of carotid artery image. Iterated vertical and horizontal analysis and segmentation of the IMT image show the vector characteristics. This new technique makes it possible to cluster the layers statistically, and to classify mathematical correlation between regions and resulting in correct measurements of thickness and its variation. The advantages and effectiveness of this approach are applicable to region process and character extraction of such a vector image.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.497-503
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• 2004

Numerical simulation of blood flow has been conducted based on real vessel geometries generated front DICOM medical images of abdominal and iliac bifurcated arteries of a healthy man. A program was developed to read cross sectional images of the three dimensional arteries and smoothly extract boundary coordinates of vessels. Commercial programs were employed for mesh generation and flow simulation. Pressures, velocities, and flow distributions were found to lie within normal physiological ranges. Peak velocity measured in the iliac artery by ultrasound was 20% smaller than that obtained by simulation. The trend of velocity variation in a cardiac cycle was fairly similar between the simulation and the ultrasonic measurements. Simulation based on real vessel geometry of individual patient provides information on pressure, velocity, and its distribution in the diseased arteries or arteries to be surgically treated. The results of simulation may help surgeons to better understand hemodynamic status and surgical need of the patient by revealing variation of the hemodynamic parameters. Futhermore, they may serve as basic data for surgical treatment of arteries. This research is expected to develop to a program in the future that early diagnose atherosclerosis by showing distribution of a hemodynamic index closely related to atherosclerosis in arteries.

• Journal of Veterinary Clinics
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• v.28 no.6
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• pp.613-616
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• 2011

A 5-year-old male German shepherd dog was presented with a 4 day-history of anorexia and depression. Abdominal radiographs showed a large soft tissue mass and loss of serosal detail. Ultrasonographs revealed splenomegaly with the lacy pattern parenchyma, perivenous hyperechoic region at the splenic hilum, and loss of splenic venous flow. Computed tomographic findings included the enlarged non-enhanced spleen except perivenous region at the splenic hilum and a whirled soft tissue mass at the splenic hilum. Exploratory laparotomy confirmed the diagnosis of splenic torsion. Ultrasonographic findings including lacy appearance, hyperechoic perivenous echogenicity and absence of splenic blood flow and CT findings including no or minimal enhancement of the spleen and a whirled appearance of splenic pedicle could be useful for diagnosing isolated splenic torsion in the dog.

• Neonatal Medicine
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• v.17 no.1
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• pp.136-140
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• 2010

Galactosemia is a group of inherited enzyme deficiencies characterized by increase in the blood galactose levels. This condition may be associated with deficiencies of galactose-1-phosphate uridyl transferase, galactokinase, or uridine diphosphate galactose-4-epimerase. However, the elevated galactose identified by neonatal screening tests has several other possible etiologies, including hepatic hemangioendothelioma, hepatic hemangioma, and patent ductus venosus with hypoplasia of the portal vein. We report a 13-day-old Korean male with hepatic hemangioendothelioma, which was incidentally detected during the evaluation for suspected galactosemia. Laboratory studies revealed that mildly elevated levels of galactose, galactose-1-phosphate and alpha- fetoprotein, at the time of admission, were graduallydecreased to the normal range over the 6 months of observation. Ultrasonography showed a well-defined heterogeneous hypoechoic mass in the liver, and magnetic resonance imaging study showed multiple enhanced mass lesions, which was compatible with the diagnosis of a hepatic hemangioendothelioma. Thus, hepatic imaging, especially ultrasonography, should be performed if neonatal screening suggests galactosemia.

• Journal of the Korea Society for Simulation
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• v.16 no.1
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• pp.21-29
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• 2007

In this paper, we present a method of detecting the boundary of the intima-media complex for automated measurement based on dynamic programming from carotid artery B-mode ultrasound images and then show the experimental results. We apply the dynamic programming for determining the optimal locations that a cost function is minimized. The cost function includes cost terms which are representing image features such as intensity, intensity gradient and geometrical continuity of the vessel interfaces. Moreover, we improve the boundary continuity by applying the B-spline to smooth the rough boundary due to noise such as speckle, dropout and weak edges. The proposed method has obtained more accurate reproducible results than conventional edge-detection by considering multiple image features and ensures efficient automated measurement by solving the problems of the inter- and intra-observer variability and its inefficiency due to manual measurement.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.385-392
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• 2023

Caroli's disease is a fibrocystic liver disease. Autosomal recessive disorder is characterized by congenital multiple dilatation of the bile duct. Computerized tomography, magnetic resonance imaging, cholangiography and ultrasound are among the methods for diagnosing caroli disease. Computerized tomography is essential for detecting and distinguishing fibroplastic liver disease and is useful for determining intrahepatic bile duct dilatation. However, awareness of the possible side effects of using contrast mediums is necessary. A typical method of magnetic resonance cholangiography is used for magnetic resonance imaging. A non-invasive examination can reduce the pain of the patient, and the anatomical structure of the bile pancreatic duct and the presence or absence of lesions can be easily and quickly observed. Biliary contrast is an effective diagnostic method that can directly visualize various cystic dilatations throughout the enlarged bile duct. However, since this procedure is also an invasive procedure, it is recommended not for diagnosis but for treatment purposes. Ultrasonography can confirm similar findings to computerized tomography. The hepatic artery root is difficult to prove with conventional grayscale ultrasound. However, it is of clinical value in that it can not only describe dilated bile ducts with vascular roots in the tube but also easily identify color Doppler signals in the tube. With the development of video diagnostics, early diagnosis has become possible through computerized tomography, magnetic resonance imaging, cholangiography, and ultrasound. In order to further contribute to the development of video diagnostics so that long-term prognosis can be improved after treatment through early diagnosis, we examined what aspects of each test's caroli disease appear.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1512-1518
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• 2002

Purpose : Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors. Methods : A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital. Results : Gestational age was $33.7{\pm}3.2weeks$, birth weight was $1,992{\pm}592g$. Interval between one fetal death being detected and the delivery of a live co-twin was $32.4{\pm}29.5days$. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin. Conclusion : We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.465-472
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• 2023

In predicting vascular disease, this study attempted to identify changes in the carotid intima-media thickness in patients who underwent carotid artery ultrasonography and hematological tests and to find out the effect of risk factors on the expression of atherosclerotic plaque. A retrospective analysis was conducted on 469 healthy adults who visited the hospital for the purpose of medical examination and performed carotid artery ultrasonography. As a result, carotid intima-media thickness, age, body mass index, waist circumference, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and glucose were analyzed as significant predictors of atherosclerotic plaque (p<0.001). The risk ratio was calculated based on the cut off value of the risk factors of the atherosclerotic plaque determined through ROC curve analysis, followed by 8.06 times the carotid intima-media thickness, 7.53 times the age, 3.97 times the waist circumference and 2.02 times the glucose. Therefore, in this study it was possible to prepare a Korean standard for clinical risk factors that affect the presence of absence of atherosclerotic plaque and observation of carotid artery ultrasonography is thought to help diagnose or predict cardiovascular disease early.

• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.567-574
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• 2022

Coronary artery disease (CAD) and atrial fibrillation (AF) are known to share many risk factors. In particular, in the case of acute coronary syndrome, it may be difficult to clearly determine the diameter of the vessel due to complete occlusion of the vessel and thrombus. Thus, the relationship between the diameter of the coronary arteries was evaluated to be used as a reference data before the treatment of coronary arteries and drug selection in patients with AF. From January 2020 to August 2022, images of coronary angiography (CAG) with AF and normal sinus rhythm (NSR) on electrocardiography were target. In both subjects, images of normal coronary artery without lesions as a result of CAG were used. For all vessels, the diameters of the vessels were measured by dividing them into proximal, middle, and distal parts, and the measured diameters were divided by the average for evaluation. As a result of analyzing the left anterior descending artery diameter, the vessel diameter of the AF patient was 2.24±0.26 mm, which was smaller than that of the NSR patient, 2.86±0.38 mm, and was statistically significant. (p<0.001) As a result of analyzing the left circumflex artery diameter, the vessel diameter of the AF patient was 2.34±0.28 mm, which was smaller than the vessel diameter of the NSR patient, 2.87±0.29 mm, and was statistically significant. (p<0.001) As a result of analyzing the diameter of the right coronary artery, the vessel diameter of the AF patient was 2.68±0.5 mm, which was smaller than the vessel diameter of the NSR patient, 3.35±0.4 mm, and was statistically significant. (p<0.001) Considering that the coronary artery size of AF patients is significantly smaller than the coronary vessel size of NSR patients, it is considered as a useful study to be used as a reference for evaluating coronary artery diameter when the arrhythmia is AF. In particular, it is considered to be a study that can be helpful in diagnosing lesions, using drugs before and after surgery, and choosing to use auxiliary devices such as intravascular ultrasound.