• Clinical and Experimental Pediatrics
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• 제62권1호
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• pp.30-35
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• 2019

Purpose: Obesity is risk factor for nonalcoholic fatty liver disease (NAFLD). However, nonobese patients are also increasingly susceptible to NAFLD. The aim of this study was to compare the clinical characteristics of obese and nonobese pediatric patients with NAFLD. Methods: We retrospectively studied 68 patients who were diagnosed with NAFLD between January 2010 and October 2016 at 10-18 years of age. Body mass index ${\geq}95th$ percentile for age and sex was defined as obesity. Abdominal ultrasonography and laboratory, anthropometrics measurements were evaluated. Results: Among the 68, 26 (38.2%) were nonobese patients. The ratio of male to female was 5.8:1, and the median age at diagnosis was 13 years (range, 10-17 years). Significant higher triglyceride (223.0 mg/dL vs. 145.9 mg/dL, P=0.047) and total cholesterol levels (211.6 mg/dL vs. 173.2 mg/dL, P=0.011) were shown in nonobese than obese patients. High-density lipoprotein cholesterol level <40 mg/dL (hazard ratio [HR], 6.5; 95% confidence interval [CI], 2.13-7.10; P=0.048), total cholesterol level >200 mg/dL (HR, 5.6; 95% CI, 1.23-15.31; P=0.038) and abdominal obesity (HR, 2.53; 95% CI, 1.22-4.68; P=0.013) were significant risk factors for NAFLD in nonobese patients. Conclusion: Nonobese patients present a substantial proportion of pediatric NAFLD cases. Significant abnormal lipid concentrations were found in nonobese and abdominal obesity was important risk factor for nonobese NAFLD.

• 대한방사선치료학회지
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• 제29권2호
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• pp.75-81
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• 2017

목 적: 전립선암 환자에 대한 비침습적이고 피폭선량에 대한 부담이 없는 초음파를 이용한 영상유도방사선치료의 Setup 오차 분석을 통해 치료의 재현성을 평가해 보고자 한다. 대상 및 방법: 치료가 종료된 전립선암 환자 26명의 1,105영상에 대하여 앞-뒤(anterior-posterior, AP), 좌-우(right-left, RL), 위-아래(superior-inferior, SI) 방향의 Setup 오차에 대해 평균, 표준편차와 3D-error을 분석하였다. 또한 오차범위 0-1 mm, 1-3 mm, 3-5 mm, 5 mm 이상에 대한 각 오차 빈도수(frequency, %) 분석을 통하여 AP, RL, SI 방향에 대한 방향성을 확인 하였다. 결 과: Setup 오차는 AP, RL, SI 방향에 대하여 평균과 표준편차는 $1.87{\pm}1.36mm$, $1.73{\pm}1.22mm$, $2.01{\pm}1.40mm$였다. 3D-error는 평균 $3.63{\pm}1.63mm$였다. 각 방향에 대한 Setup 오차값의 빈도(frequency, %)는 AP 방향에 대한 오차범위 0-1 mm에서 29 %, 1-3 mm에서 50.2 %, 3-5 mm에서 19.6 %, 5 mm 이상에서 1.3 %였다. RL 방향에 대하여 오차범위 0-1 mm에서 31.3 %, 1-3 mm에서는 52.5 %, 3-5 mm에서는 15.8 %, 5 mm 이상에서 0.5 %였다. 마지막으로 SI 방향에 대한 오차범위 0-1 mm에서 26.3 %, 1-3 mm에서 50.2 %, 3-5 mm에서 22.4 %, 5 mm 이상에서 1.1 %였다. 결 론: Setup error는 SI 방향에서 $2.01{\pm}1.40mm$로 가장 컸으며 오차 빈도는 모든 방향에서 50 % 이상 오차 범위 1-3 mm에 들어온 것으로 확인되었다. $Clarity^{TM}$ Auto scan을 이용한 초음파영상유도 방사선치료는 치료 전에 방광의 전처치 상태, target의 구조 등을 관찰이 가능하고, 치료 중 target의 움직임을 실시간으로 monitoring하여 빠른 repositioning이 가능하다. 결과적으로 초음파를 이용한 실시간 영상유도방사선치료는 치료의 재현성을 높일 수 있을 것으로 사료된다.

• 한국임상수의학회지
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• 제18권4호
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• pp.442-447
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• 2001

A 2-year-old 4.0-kg female Shih Tzu with history of hematemesis and melena was referred to Veterinary Medical Teaching Hospital, Seoul national University for further evaluation and treatment. During physical examination, the dog revealed mild depression, dry mucous membrane and abdominal pain. Hematologic values were normal and serum chemical values showed increased serum bile acid (53.47 umol/l, preprandial), fasting serum ammonia concentration (184 g/dl), alanine transferase (98 U/L), alkaline phosphatase (871 U/L) and gamma glutamyl transpeptidase (21 U/L), and decreased blood urea nitrogen (4 mg/dl), total protein (4.1 g/dl) and albumin (1.2 g/dl). Microhepatica was shown in abdominal radiography. During the ultrasound examination, dilated tortuous vein communicating with caudal vena cava ws observed near the stomach. Intraoperative jejunal vein portography was performed during laparotomy to confirm the location and size of shunt vessel. According to history taking, physical examination, hematologic and serum chemical examination and radiographic study, it was diagnosed as single extrahepatic portosystemic shunt. The anomalous vessel (7 mm, o.d.) that enter the caudal vena cava from the left gastric vein, near the level of the diaphragm, was identified. A Ameroid constrictor (5 mm, i.d.) was applied to the shunting vessel near the caudal vena cava. Hematologic and serum chemical values recovered gradually and were revealed normal values 4 months after surgery. Four month after surgery serum bile acids concentrations were 0.56 $\mu$mol/l (preprandial) and 18.45 umol/l (postprandial). Abdominal radiograph showed normal gastric axis and it revealed normal size of the liver. Fine texture and increased echogenecity of liver and enlargement of portal vein were shown in ultrasonography. Single extrahepatic portosystemic shunt might be treated surgically using Ameroid constrictor.

• 한국수정란이식학회지
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• 제24권3호
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• pp.151-157
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• 2009

Serial ultrasonography was conducted on Miniature Schnauzer bitches, on purpose to observe the ultrasonographic appearance of normal ovaries and ovarian structures during the estrous cycle. The size of ovaries was increased from $76.8{\pm}7.5mm^2(Mean{\pm}S.D)$ on Day-12 (Day-0=ovulation day) to $114.4{\pm}5.5mm^2$ on Day-8 and there was no significantly different between both ovaries. The ovaries were recognized by its proximity to the caudal renal pole and appeared moderately echogenic oval shape with a smooth contour. The size of follicles was increased from $8.1{\pm}4.5mm^2$ on Day-12 to $114.4{\pm}5.5mm^2$ on Day-0 and there was no significantly different between both ovaries. The number of follicles was increased from $2.8{\pm}0.7$ on Day-12 to $1.1{\pm}0.1$ on Day-0 and there was no significantly different between both ovaries. The follicles were small anechoic fluid-filled structures in early of proestrus, more increased, and indistinguished from each follicles in late of proestrus. The size of corpora lutea was increased from $19.3{\pm}2.1mm^2$ on Day-0 to $26.4{\pm}8.1mm^2$ on Day-8 and there was no significantly different between both ovaries. The number of corpora lutea was increased from $1.4{\pm}0.6$ on Day-0 to $2.9{\pm}0.4$ on Day-38 and there was no significantly different between both ovaries. The corpora lutea were small anechoic cavity and thin hyperechoic wall in early of diestrus, became more hyperechoic, and increased homogenous structures. The results of this study would be useful for differential diagnosis between normal and abnormal structures of ovaries.

• 한국수정란이식학회지
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• 제18권3호
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• pp.187-193
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• 2003

본 연구는 한우에 GnRH ＋ PGF$_2$$\alpha$＋GnRH (Ov-synch)를 처리하여 배란동기화를 시켰으며, 2차 GnRH 투여후 배란시간, 수태율, 계절별 수태율, 산차별 수태율을 조사하였으며, 시험축은 2산 이상의 개체를 무작위로 선발하여 실험에 공시하였으며, 배란동기화 처리후 1회 인공수정을 실시하고 수태율을 환산하였다. 호르몬 처리방법으로는 GnRH ＋ PGF$_2$$\alpha$ ＋ Gn-RH(Ov-synch)법을 이용하였으며, 배란시간의 조사는 초음파를 이용하여 2차 GnRH 투여 후 24시간부터 31시간까지 2시간 간격으로 난소를 촬영하여 배란 여부를 조사하였다. 1. 배란동기화 처리후 24시간부터 31시간까지 2시간 간격으로 난소의 상태를 확인한 결과 28∼30시간 사이에 80%(20/25)로 가장 많이 배란된 것으로 나타났다. 2. 수태율에 있어서는 계통별 1회 수정 수태율은 고급육 계통이 48.1%(38/79)로 다소 높게 나타났다. 3. 산차에 따른 수태율은 1∼2, 3∼4산차에서 각각 44.3, 55%로 나타났다. 4. 계절별로는 여름보다는 봄과 가을에서 47.3%로 다소 높은 경향이였다.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1317-1325
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• 2020

Objective: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. Materials and Methods: We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0-F4) and necroinflammatory activity grade (A0-A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. Results: Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. Conclusion: The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology.

• Physical Therapy Rehabilitation Science
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• 제6권3호
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• pp.152-157
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• 2017

Objective: The aim of this study was to determine the intra-rater and inter-rater reliability of the dual rehabilitative ultrasound imaging (D-RUSI) when simultaneously measuring muscle thickness changes at rest and during co-contraction of the biceps brachii (BB) and triceps brachii (TB). Design: Cross-sectional study. Methods: This study included 36 healthy participants (23 men, 13 women). The participants sat on a chair in a comfortable position with a cushion placed under their elbow to maintain a 90-degree elbow flexion angle. The muscle thickness of the biceps brachii and triceps brachii was measured twice using the D-RUSI by two examiners during resting and co-contraction states. One week later, the same procedure was performed once again. Results: The intra-class correlation coefficients (ICCs) for intra-rater reliability ranged from 0.887 to 0.989 and the confidence interval was within an acceptable range of 0.778 to 0.994. The standard error of measurement (SEM) values ranged from 0.303 to 0.866 and the minimal detectable change (MDC) values ranged from 0.84 to 2.40. The ICCs for inter-rater reliability ranged from 0.758 to 0.925. The SEM values ranged from 0.702 to 1.486 and the MDC values ranged from 1.95 to 4.12. Conclusions: The use of the D-RUSI of the BB muscle had a very good intra-rater reliability and very good inter-rater reliability at the resting state, and a, good inter-rater reliability at the co-activation state. ICC values showed very good intra-reliability and inter-reliability for the TB muscle. the D-RUSI is a useful tool for simultaneously measuring the thickness of two muscles when the BB is an agonist and the TB is an antagonist during co-activation of the upper arm.

• Korean Journal of Radiology
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• 제20권6호
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• pp.880-893
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• 2019

Objective: To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness. Materials and Methods: The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient. Results: The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3-3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7-11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82-0.90) and 0.93 (95% CI, 0.89-0.95), respectively, suggesting good to excellent reliability. Conclusion: 2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.

• 한국음향학회지
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• 제27권2호
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• pp.57-65
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• 2008

초음파 진단기의 설정은 영상의 질에 영향을 준다. sonographer는 최적의 영상을 얻기 위해 초음파 영상의 질에 영향을 주는 설정 변수에 대한 효과를 이해해야 한다. 본 연구에서는 4가지 대표적인 영상 조절 변수 즉 TGC (Time Gain Control), 이득 (Gain), 주파수 (Frequency), DR (Dynamic Range)를 고려하였다. 초음파 영상의 질은 LCS (Law Contrast Sensitivity) 관점에서 정량적으로 비친 평가하였다. 실험은 임상용 초음파 진단기 (SA-9000 PRIME, Medison, Korea)를 사용하여 초음파 평가 팬텀 (539, ATS, USA)의 LCS 타겟을 영상화하였다. 영상 조절 변수의 설정을 변화하면서, 각 설정에 대한, 6개의 LCS 영상 (+15 dB, +C dB, +3 dB, -3 dB, -6 dB, -15 dB)을 취득하고, 영상에 대한 LCS픽셀 값을 계산하였다. 실험결과 TGC가 최대, Gain은 중간에서 최대사이, 주파수가 Pen모드, DR이 40-66 dB일 때 타겟 영상 (LCS)의 평균 픽셀 값이 높았다. 모든 타겟 영상에서 DR이 40 dB일 때에 LCS가 좋은 영상을 얻었다. 본 결과는 임상에서 잘 발견되는 solid lesion (+15, +6, +3 dB 타겟과 유사) 또는 cystic lesion (-15, -6, -3 dB 타겟과 비슷)이 있는 mass 평가 시 적절한 영상조절 변수 설정에 유용한 정보를 제공할 것으로 기대된다.

• Parasites, Hosts and Diseases
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• 제55권5호
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• pp.533-540
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• 2017

Schistosoma mansoni is highly endemic in Tanzania and affects all age groups at different degrees. However, its control approach does not include adult individuals who are equally at risk and infected. To justify the inclusion of adult individuals in MDA programs in Tanzania, the present study focused on determining the prevalence of S. mansoni infection and its related morbidities among adult individuals. This was a cross sectional study conducted among 412 adult individuals aged 18-89 years living in selected villages of Rorya and Butiama districts located along the shoreline of the Lake Victoria. A pretested questionnaire was used to collect socio-demographic and socio-economic information of participants. Ultrasonographic examinations were conducted for all study participants using the Niamey protocol. A single stool sample was obtained from all study participants and examined for S. mansoni using the Kato-Katz technique. The study revealed a high prevalence of S. mansoni (56.3%), and the majority of infected individuals had a light intensity of infection. Ultrasonographic findings revealed that 22.4% of adult individuals had periportal fibrosis (PPF) (grade C-F), with 18.4% having grade C and D and 4% having grade E and F. Males had the highest prevalence of PPF (31.7% vs 10.8%, P<0.001). Organomegaly was common with 28.5% and 29.6% having splenomegaly and hepatomegaly, respectively. S. mansoni infection and its related morbidities included PPF, hepatomegaly, and splenomegaly were common among adult individuals. To reduce the level of transmission of S. mansoni infection, planned mass drug administration campaigns should include adult individuals living in these villages.