• Archives of Plastic Surgery
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• 제48권6호
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• pp.622-629
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• 2021

Background Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision. Methods Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement. Results Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group. Conclusions Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.

• 한국동물위생학회지
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• 제45권2호
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• pp.139-143
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• 2022

A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.

• 한방재활의학과학회지
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• 제33권2호
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• pp.77-85
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• 2023

Objectives The aim of this study is to retrospectively evaluate the shoulder lesions in patients experiencing shoulder pain through the use of musculoskeletal ultrasound during Korean medicine intervention treatments. Methods A total of 20 cases were collected, including biceps tendinitis (n=4), calcification (n=3), SASD bursitis (n=4), partial tear (n=2), full-thickness tear (n=1), tendinopathy (n=5), and impingement syndrome (n=1). Musculoskeletal ultrasound was used by Korean medicine doctors to perform real-time scanning and to explain the patient's condition during treatment sessions. Results The use of musculoskeletal ultrasound allowed Korean medicine doctors to perform treatments such as pharmacoacupuncture, acupotomy, and acupuncture more safely and effectively. Patients were able to better understand their conditions through real-time imaging and explanations provided by the doctors. Conclusions Musculoskeletal ultrasound has the potential to enhance the safety and efficacy of Korean medicine intervention treatments for patients with shoulder pain. Institutional or governmental support is needed to further promote the use of medical devices by Korean medicine doctors, ultimately leading to an increase in cases and clinical evidence.

• PNF and Movement
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• 제21권2호
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• pp.243-253
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• 2023

Purpose: This study aimed to investigate the effects of an abdominal drawing-in maneuver (ADIM) with a light load while sitting on transverse abdominis contraction in subjects with and without low back pain. Methods: In this study, 20 participants with chronic low back pain and 20 controls participated. Ultrasonography was used to assess the thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) muscles. Muscle thickness was measured at rest and during ADIM in three different sitting postures: (1) just sitting, (2) sitting loaded position (holding a 1 or 2 kg dumbbell in each hand), and (3) sitting loaded shoulder flexion position (holding a 1 or 2 kg dumbbell in each hand). Results: The contraction ratio (CR) and preferential activation ratio (PAR) of the TrA during ADIM had no significant interactional effect between the group and the sitting postures. However, the CR and PRA of the TrA during the ADIM showed significant differences among the three different sitting postures. The CR of the TrA during the ADIM in the sitting loaded shoulder flexion position was significantly increased compared to that in the sitting position (p<0.05). Moreover, the PRA of the TrA muscle during ADIM in sitting loaded and sitting loaded shoulder flexion positions was significantly higher than that in the sitting position (p<0.05). Conclusion: The findings suggest that ADIM in the sitting-loaded shoulder flexion position should be implemented to facilitate TrA activity.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권4호
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• pp.193-200
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• 2023

Purpose: Crohn's disease (CD) is a chronic, idiopathic bowel disorder that can progress to partial or complete bowel obstruction. At present, there are no reliable diagnostic tests that can readily distinguish between acute inflammatory, purely fibrotic and mixed inflammatory and fibrotic. Our aim is to study the utility of contrast enhanced ultrasound (CEUS) in combination with shear wave elastography (SWE) to differentiate fibrotic from inflammatory strictures in children with obstructive CD of the terminal ileum. Methods: Twenty-five (19 male) children between 2016-2021 with CD of the terminal ileum were recruited into the study. Among these patients, 22 had CEUS kinetic measurements of tissue perfusion, including wash-in slope (dB/sec), peak intensity (dB), time to peak intensity (sec), area under the curve (AUC) (dB sec), and SWE. In total, 11 patients required surgery due to bowel obstruction. Histopathologic analysis was performed by a pathologist who was blinded to the CEUS and SWE test results. Results: Patients that underwent surgical resection had significantly higher mean area under the curve on CEUS compared to patients responsive to medical therapy (p=0.03). The AUC also correlated with the degree of hypertrophy and the percent fibrosis of the muscularis propria, as determined by histopathologic grading (p<0.01). There was no difference in the mean elastography measurements between these two patient groups. Conclusion: CEUS is a useful radiological technique that can help identify pediatric patients with medically refractory obstructive fibrotic strictures of the terminal ileum that should be considered for early surgical resection.

• 운동영양학회지
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• 제16권1호
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• pp.43-50
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• 2012

This study was designed to investigate the effect of vibratory stimulation on recovery of muscle function from delayed onset muscle soreness (DOMS). Volunteers performed 3 set of 70 % maximal voluntary eccentric muscle contraction and induced DOMS. volunteers were allocated to one of three treatment group after DOMS : group I (control), group II (ultrasound), group III (vibration). Maximal Voluntary Isometric Contraction (MVIC), Visual Analog Scale (VAS), Range Of Motion (ROM), Root Mean Square (RMS), Median frequency (MDF), Blood Serum Creatine Kinase (CK), Lactic dehydrogenase (LDH) were recorded at baseline, and 24, 48, 72 hours post-exercise. In MVIC measurement, there was a statistically significant difference in group III compared to group I (p < .05). In VAS measurements, there were a statistically significant difference in group II and III compared to group I (p < .05). In ROM measurement, there was a statistically difference in group II and III compared to group I (p < .05). In Muscle Volume with Ultrasonography measurement, there was no statistically significant difference in any groups (p > .05). In RMS and MDF measurement, there were a statistically significant difference in group II and III compared to group I (p < .05). In Blood samples of CK and LDH measurements, There were no statistically significant difference in any groups (p > .05). From the above result, Vibratory stimulation had a positive effect on recovery of muscle function from delayed onset muscle soreness. Further studies should be undertaken to ascertain the more effectiveness of vibratory stimulation and may be a promising treatment modality.

• PNF and Movement
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• 제21권3호
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• pp.309-317
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• 2023

Purpose: This study set out to investigate the effects of prone hip extension with knee flexion (PHEKF) exercises according to external load on the thickness of the gluteus maximus (Gmax) and biceps femoris (BF). Methods: Twenty-three healthy men participated in this study. All subjects randomly practiced PHEKF under the burden of external loads created by sandbags (0 kg, 1 kg, and 2 kg). Rehabilitative ultrasound imaging (RUSI) was used to measure the thickness of the Gmax and BF during the PHEKF with different external loads. Results: The thickness of the Gmax was highest during the 2 kg resistance exercise and lowest at 0 kg. The thickness of the Gmax was significantly increased at 1 kg and 2 kg compared to 0 kg and significantly increased at from 1 kg to 2 kg (p < 0.05). The thickness of the biceps femoris was highest at 0 kg and lowest at 2 kg. The thickness of the biceps femoris muscle was significantly reduced at 1 kg and 2 kg compared to 0 kg (p < 0.05), but there was no significant difference between 1 kg and 2 kg (p > 0.05). Conclusion: The thickness of the Gmax was increased by applying PHEKF with a higher external load, whereas the muscle thickness of the biceps femoris decreased. These results suggest that the application of external loads during PHEKF exercises may be an effective method for selective strengthening of the Gmax.

• Korean Journal of Radiology
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• 제21권5호
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• pp.598-604
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• 2020

Objective: Proper management of lymph nodes (LNs) with ultrasonographic (US) indeterminate features in thyroid cancer patients remains elusive. We aimed to evaluate the malignancy risk and US findings predictive of malignancy for US indeterminate LNs in preoperative thyroid cancer patients through node-by-node correlation. Materials and Methods: A total of 348 LNs in 284 thyroid cancer patients, who underwent fine-needle aspiration or core-needle biopsy between December 2006 and June 2015, were included. We determined the malignancy risks for US probably benign, indeterminate, and suspicious categories. For US indeterminate LNs, which had neither echogenic hilum nor hilar vascularity in the absence of any suspicious finding, US findings were compared between benign and metastatic LNs using Mann-Whitney U test and Fisher's exact test. Results: US imaging diagnoses were probably benign in 20.7% (n = 72) cases, indeterminate in 23.6% (n = 82), and suspicious in 55.7% (n = 194). Malignancy risk of US indeterminate LNs (19.5% [16/82]) differed from those of the US probably benign (2.8% [2/72]) (p = 0.002) and US suspicious LNs (78.4% [152/194]) (p < 0.001). Among US indeterminate LNs, there were no significant differences in short, long, and long-to-short diameter (L/S) ratios between benign and metastatic LNs (3.9 vs. 3.8 mm, p = 0.619; 7.3 vs. 7.3 mm, p = 0.590; 1.9 vs. 1.9, p = 0.652). Conclusion: US indeterminate LNs were frequently encountered during preoperative evaluation and had intermediate malignancy risk. Given the lack of discriminative power of size criteria and L/S ratio, clinical factors such as surgical strategy and node size should be considered for proper triage of US indeterminate LNs in thyroid cancer.

• Korean Journal of Radiology
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• 제23권2호
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• pp.280-288
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• 2022

Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

• 대한수의학회지
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• 제64권2호
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• pp.14.1-14.6
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• 2024

In human, ultrasonography is used to measure the pennation angle in various muscles to identify muscle functions such as force production, and to study alterations of the pennation angle during muscle contraction, hypertrophy, and atrophy. However, assessments of the pennation angle have not yet been conducted in dogs. This study aims to assess the normal pennation angle of the tibialis cranialis muscle in dogs using ultrasound and to detect changes in this angle in dogs with muscular atrophy. Sixty-eight healthy dogs were examined to establish normal values, while 12 ataxic and 12 lame dogs with suspected hindlimb muscle atrophy were also included. The pennation angle was measured using ultrasound at the midpoint between the proximal end of the tibia and the malleolus, measuring the angle between the muscle bundle and the deep aponeurosis. To confirm the significance between the 5 breeds and to identify a difference between normal and atrophied muscles, statistical analysis was conducted. The study found no significant difference in pennation angle between breeds, with mean values (± standard deviation) of 4.97° (± 1.88) in neutral, 7.25° (± 2.68) in flexion, and 3.31° (± 1.33) in extension positions. Decrease of the pennation angle was identified in muscle atrophy and the flexion position was determined to be the most appropriate for pennation angle measurement of tibialis cranialis muscle. We recommend considering the pennation angle as a valuable indicator of muscle health in dogs, as it demonstrates significant potential for diagnosing and monitoring muscular conditions.