• The Korean Journal of Pain
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• 제29권3호
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• pp.179-184
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• 2016

Background: Recently, ultrasound has been commonly used. Ultrasound-guided interscalene brachial plexus block (IBPB) by posterior approach is more commonly used because anterior approach has been reported to have the risk of phrenic nerve injury. However, posterior approach also has the risk of causing nerve injury because there are risks of encountering dorsal scapular nerve (DSN) and long thoracic nerve (LTN). Therefore, the aim of this study was to evaluate the risk of encountering DSN and LTN during ultrasound-guided IBPB by posterior approach. Methods: A total of 70 patients who were scheduled for shoulder surgery were enrolled in this study. After deciding insertion site with ultrasound, awake ultrasound-guided IBPB with nerve stimulator by posterior approach was performed. Incidence of muscle twitches (rhomboids, levator scapulae, and serratus anterior muscles) and current intensity immediately before muscle twitches disappeared were recorded. Results: Of the total 70 cases, DSN was encountered in 44 cases (62.8%) and LTN was encountered in 15 cases (21.4%). Both nerves were encountered in 10 cases (14.3%). Neither was encountered in 21 cases (30.4%). The average current measured immediately before the disappearance of muscle twitches was 0.44 mA and 0.50 mA at DSN and LTN, respectively. Conclusions: Physicians should be cautious on the risk of injury related to the anatomical structures of nerves, including DSN and LTN, during ultrasound-guided IBPB by posterior approach. Nerve stimulator could be another option for a safer intervention. Moreover, if there is a motor response, it is recommended to select another way to secure better safety.

• Clinical Endoscopy
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• 제56권1호
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• pp.107-113
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• 2023

Background/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018-2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions: EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

• 대한한의진단학회지
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• 제20권1호
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• pp.37-44
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• 2016

Ultrasonic imaging is the most widely modality among modern imaging device for medical diagnosis. Nevertheless, medical ultrasound images suffer from speckle noise and low contrast. In this paper, we propose probabilistic edge map for ultrasound image edge enhancement using automatic alien algorithm. The proposed method used applied speckle reduced ultrasound imaging for edge improvement using sequentially acquired ultrasound imaging. To evaluate the performance of method, the similarity between the reference and edge enhanced image was measured by quantity analysis. The experimental results show that the proposed method considerably improves the image quality with region edge enhancement.

• 대한의용생체공학회:의공학회지
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• 제40권2호
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• pp.39-47
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• 2019

Ultrasound sonication along with microbubble (MB) could enhance drug delivery to promote the absorption of anticancer drugs into cancers in a noninvasive and targeted manners. In this study, we verify the acute drug delivery enhancement (within an hour) of two representative focused ultrasound driven drug delivery enhancement methods (MB and Doxorubicin-coated Nanoparticle complex (MB-NP) based). Experiments were conducted using in vivo mouse model with MDA-MB-231 breast cancer cell line. Ultrasound generated by single-element 1 MHz focused ultrasound transducer was delivered in pulsed sonication consisted of 0.125 msec bursts at a pulse repetition frequency of 2 Hz for 20 seconds without a significant increase in local temperature (less than $0.1^{\circ}C$) or hemorrhage. Doxorubicin concentrations in tumors were improved by 1.97 times in the case of MB-NP, and 1.98 times by using Doxorubicin and MB separately. These results indicate anticancer drug delivery based on MB and MB-NP can significantly improve the effect of anticancer drugs delivered to tumors in a short time period by using low-intensity focused ultrasound.

• 한방재활의학과학회지
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• 제29권3호
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• pp.157-163
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• 2019

This study is to report the usefulness of ultrasound in diagnosing rib fracture and the effectiveness of ultrasound-guided essential bee venom pharmacopuncture as a treatment of it. A 46-year-old unable to find a fracture by chest radiography was diagnosed it on ultrasound. The patient was applied integrative Korean medical treatments and ultrasound-guided essential bee venom pharmacopuncture at the fracture site for 4 weeks, 18 times total. Numeral rating scale (NRS) was used to evaluate the amount of pain. The chest pain when turning over the body was reduced from NRS 8 to 2 for 4 weeks. The remarkable aspect is that the pain was immediately relieved after phamacopuncture and its effect lasted for 3 hours. This report suggests ultrasound can be useful for diagnosing rib fracture and also helpful for safety and accuracy of pharmacopuncture. Additionally, essential bee venom can be considered one of the methods of treating rib fracture.

• Korean Journal of Radiology
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• 제20권1호
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• pp.166-170
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• 2019

Objective: To establish a cost-effective and easily available phantom for training residents in ultrasound-guided fine needle thyroid nodule targeting punctures. Materials and Methods: Tofu, drinking straws filled with coupling gel, a urine tube, and 21-gauge needles were used to generate a phantom thyroid with nodules for training. Twelve radiology residents were involved in the study. The puncture success rates were recorded and compared before and after phantom training using the Wilcoxon signed-rank test. Results: On ultrasonography, tofu mimicked the texture of the thyroid. Drinking straws filled with coupling gel mimicked vessels. The urine tube filled with air mimicked the trachea, and 21-gauge needles mimicked small nodules in the transverse section. The entire phantom was similar to the structure of the thyroid and surrounding tissues. The puncture success rates of radiology residents were significantly increased from 34.4 ± 14.2% to 66.7 ± 19.5% after training (p = 0.003). The phantom was constructed in approximately 10 minutes and materials cost less than CNY 10 (approximately $ 1.5) at a local store. Conclusion: The tofu model was cost-effective, easily attainable, and effective for training residents in ultrasound-guided fine needle thyroid nodule targeting punctures in vitro.

• Clinical and Experimental Reproductive Medicine
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• 제39권4호
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• pp.182-186
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• 2012

Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

• 대한의용생체공학회:의공학회지
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• 제43권6호
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• pp.390-398
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• 2022

Ultrasound examination using ultrasound equipment is an ultrasound device that images human organs using sound waves and is used in various areas such as diagnosis, follow-up, and treatment of diseases. However, if the quality of ultrasound equipment is not guaranteed, the possibility of misdiagnosis increases, and the diagnosis rate decreases. Accordingly, The Korean Society of Radiology and Korea society of Ultrasound in Medicine presented guidelines for quality management of ultrasound equipment using ATS-539 phantom. The DenseNet201 classification algorithm shows 99.25% accuracy and 5.17% loss in the Dead Zone, 97.52% loss in Axial/Lateral Resolution, 96.98% accuracy and 20.64% loss in Sensitivity, 93.44% accuracy and 22.07% loss in the Gray scale and Dynamic Range. As a result, it is the best and is judged to be an algorithm that can be used for quantitative evaluation. Through this study, it can be seen that if quantitative evaluation using artificial intelligence is conducted in the qualitative evaluation item of ultrasonic equipment, the reliability of ultrasonic equipment can be increased with high accuracy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8149-8153
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• 2014

Background: To compare the value of contrast-enhanced ultrasound (CEUS) qualitative and quantitative analysis in the identification of breast tumor lumps. Materials and Methods: Qualitative and quantitative indicators of CEUS for 73 cases of breast tumor lumps were retrospectively analyzed by univariate and multivariate approaches. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. Results: The CEUS qualitative indicator-generated regression equation contained three indicators, namely enhanced homogeneity, diameter line expansion and peak intensity grading, which demonstrated prediction accuracy for benign and malignant breast tumor lumps of 91.8%; the quantitative indicator-generated regression equation only contained one indicator, namely the relative peak intensity, and its prediction accuracy was 61.5%. The corresponding areas under the ROC curve for qualitative and quantitative analyses were 91.3% and 75.7%, respectively, which exhibited a statistically significant difference by the Z test (P<0.05). Conclusions: The ability of CEUS qualitative analysis to identify breast tumor lumps is better than with quantitative analysis.

• Korean Journal of Radiology
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• 제23권3호
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• pp.308-321
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• 2022

Transabdominal ultrasound (TAUS) is useful in all aspects of lesion screening, monitoring activity, or treating/diagnosing any related complications of inflammatory bowel disease. Its ability to screen or diagnose complications is almost the same as that of other methods, such as CT or MRI. Moreover, its noninvasiveness makes it a first-line examination method. A TAUS image depicting ulcerative colitis will show large intestinal wall thickening that is continuous from the rectum, which is mainly due to mucosal layer thickening, while for Crohn's disease, a TAUS image is characterized by a diversity in the areas affected, distribution, and layer structure. Indicators of activity monitoring include wall thickness, wall structure, and vascular tests that use Doppler ultrasound or contrast agents. While all of these have been reported to be useful, at this time, no single parameter has been established as superior to others; therefore, a comprehensive evaluation of these parameters is justified. In addition, evaluating the elasticity of lesions using elastography is particularly useful for distinguishing between fibrous and inflammatory stenoses. However, the lack of objectivity is the biggest drawback of using ultrasound. Standardizing and popularizing the ultrasound process will be necessary, including scanning methods, equipment settings, and image analysis.