• Journal of Acupuncture Research
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• v.39 no.2
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• pp.105-114
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• 2022

Background: The objective structured clinical examination (OSCE) is used in the colleges of Korean Medicine, but few studies have validated the OSCE evaluation criteria or post-education questionnaires. Diagnostic ultrasound is used in Korean medicine treatment including acupuncture, acupotomy, and pharmacopuncture to increase the safety and efficacy of treatment. We aimed to develop and validate a OSCE checklist and questionnaire for diagnostic musculoskeletal ultrasound training. Methods: A OSCE checklist and rubric for diagnostic ultrasound training, and questionnaire was developed using literature research. Eight expert panelists verified each draft item in a single-round survey. Items with a content validity ratio (CVR) < 0.75 were excluded or modified to reflect the experts' opinions. Results: The OSCE checklist and rubric for diagnostic ultrasound training focusing on volar wrist and carpal tunnel syndrome included: 15 items revised according to CVR and expert opinions, the pre-examination procedure, structures to be identified by ultrasound, scans with 2 diagnostic criteria for carpal tunnel syndrome, an explanation of the exam results, and the post exam procedure. The questionnaire consisted of 15 items, including the overall evaluation of training, the effect of the OSCE, and the perception of the ultrasound. All 6 self-evaluation items were not revised, as they had a CVR of ≥ 0.75. Conclusion: An ultrasound OSCE for scanning the volar wrist and diagnosing carpal tunnel syndrome was developed using 15 validated tasks, 15 survey questions about ultrasound training, and 6 questions for self-evaluation. These results may be used in the future for education in diagnostic ultrasound.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.183-190
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• 2022

Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

• Journal of Biomedical Engineering Research
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• v.28 no.6
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• pp.803-810
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• 2007

Although synthetic aperture focusing techniques can improve the spatial resolution of ultrasound imaging, they have not been employed in a commercial product because they require a real-time N-channel beamformer with a tremendously increased hardware complexity for simultaneous beamforming along M multiple lines. In this paper, a hardware-efficient beamformer architecture for synthetic aperture focusing is presented. In contrast to the straightforward design using NM delay calculators, the proposed method utilizes only M delay calculators by sharing the same values among the focusing delays which should be calculated at the same time between the N channels for all imaging points along the M scan lines. In general, synthetic aperture beamforming requires M 2-port memories. In the proposed beamformer, the input data for each channel is first upsampled with a 4-fold interpolator and each polyphase component of the interpolator output is stored into a 2-port memory separately, requiring 4M 2-port memories for each channel. By properly limiting the area formed with the synthetic aperture focusing, the input memory buffer can be implemented with only 4 2-port memories and one short multi-port memory.

• The Korean Journal of Pain
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• v.26 no.3
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• pp.249-254
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• 2013

Background: The pes anserine bursa lies beneath the pes anserine tendon, which is the insertional tendon of the sartorius, gracilis, and semitendinosus muscles on the medial side of the tibia, but it can lie in different sites in the medial knee. Accurate diagnosis of the position of the bursa is critical for diagnostic and therapeutic goals. The aim of this study was to evaluate sonoanatomic variations of the pes anserine bursa in the medial knee. Methods: One hundred seventy asymptomatic volunteers were enrolled in this study. Using ultrasound imaging (transverse approach, 7-13 MHz linear array probe) the sonoanatomic position of the pes anserine bursa and its relation to the pes anserine tendon were evaluated. Additionally, we evaluated the sonoanatomic variation of the saphenous nerve. Results: The position of the pes anserine bursa was between the medial collateral ligament and the pes anserine tendons in 21.2%/18.8% (males/females) of subjects; between the pes anserine tendons and the tibia in 67.1%/64.7% (m/f); and among the pes anserine tendons in 8.2%/12.9% (m/f). No significant differences in the position of the bursa existed between males and females. The saphenous nerve was found within the pes anserine tendons in 77.6%/74.1% (m/f) of subjects, but outside the pes anserine tendons in 18.8%/15.3% (m/f). Visibility of sonoanatomic structures was not related to either gender or BMI. Conclusions: Ultrasound provides very accurate information about variations in the pes anserine bursa and the saphenous nerve. This suggests that our proposed ultrasound method can be a reliable guide to facilitate approaches to the medial knee for diagnostic and therapeutic objectives.

• Journal of Biomedical Engineering Research
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• v.41 no.1
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• pp.48-54
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• 2020

In this paper, we deal with a liver fibrosis classification problem using ultrasound B-mode images. Commonly representative methods for classifying the stages of liver fibrosis include liver biopsy and diagnosis based on ultrasound images. The overall liver shape and the smoothness and roughness of speckle pattern represented in ultrasound images are used for determining the fibrosis stages. Although the ultrasound image based classification is used frequently as an alternative or complementary method of the invasive biopsy, it also has the limitations that liver fibrosis stage decision depends on the image quality and the doctor's experience. With the rapid development of deep learning algorithms, several studies using deep learning methods have been carried out for automated liver fibrosis classification and showed superior performance of high accuracy. The performance of those deep learning methods depends closely on the amount of datasets. We propose an enhanced U-net architecture to maximize the classification accuracy with limited small amount of image datasets. U-net is well known as a neural network for fast and precise segmentation of medical images. We design it newly for the purpose of classifying liver fibrosis stages. In order to assess the performance of the proposed architecture, numerical experiments are conducted on a total of 118 ultrasound B-mode images acquired from 78 patients with liver fibrosis symptoms of F0~F4 stages. The experimental results support that the performance of the proposed architecture is much better compared to the transfer learning using the pre-trained model of VGGNet.

• Journal of radiological science and technology
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• v.46 no.4
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• pp.325-336
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• 2023

The purpose of this study was to analyze the structural relationship between job satisfaction levels felt during ultrasound examination of radiological technologists (RTs) using a structural equation model. The subjects were a total of 203 RTs currently working in medical institutions. The method was conducted as a survey study using a questionnaire consisting of a total of 29 questions consisting of demographic characteristics and job satisfaction levels that were self-efficacy, job competency, extrinsic compensation, and job satisfaction. The reliability was secured with the Cronbach's alpha coefficient of 0.6 or higher. For statistical analysis, a significant difference between the frequency analysis of demographic characteristics and the mean of the job satisfaction levels were performed by independent sample T-test and one-way analysis of variance (ANOVA) followed by Scheffe's post hoc test. The correlation analysis between variables was tested with Spearman's and Pearson's correlation coefficient. We analyzed the structural relationships between variables by structural equations. As a result, first, job competency and extrinsic compensation had a positive effect on job satisfaction on ultrasound examination of RTs. Second, the self-efficacy of ultrasound examination RTs showed a high correlation with job competency. Third, the job satisfaction levels showed in the order of job competency, job satisfaction, self-efficacy, and extrinsic compensation. In conclusion, this study are expected to be provided as data to identify factors that could improve job satisfaction during ultrasound examination of RTs by empirically analyzing the structural relationship of self-efficacy, job competency, and external compensation.

• Journal of Genetic Medicine
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• v.15 no.2
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• pp.79-86
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• 2018

Purpose: This study aimed to evaluate the clinical usefulness of non-invasive prenatal testing (NIPT) as an alternative testing of invasive diagnostic testing in pregnancies with ultrasound abnormalities. Materials and Methods: This was a retrospective study of pregnant women with abnormal ultrasound findings before 24 weeks of gestation between April 2016 and March 2017. Abnormal ultrasound findings included isolated increased nuchal translucency, structural anomalies, and soft markers. The NIPT or diagnostic test was conducted and NIPT detected trisomy 21 (T21), T18, T13 and sex chromosomal abnormalities. We analyzed the false positive and residual risks of NIPT based on the ultrasound findings. Results: During the study period, 824 pregnant women had abnormal ultrasound findings. Among the study population, 139 patients (16.9%) underwent NIPT. When NIPT was solely performed in the patients with abnormal ultrasound findings, overall false positive risk was 2.2% and this study found residual risks of NIPT. However, the discordant results of NIPT differed according to the type of abnormal ultrasound findings. Discordant results were significant in the group with structural anomalies with 4.4% false positive rate. However, no discordant results were found in the group with single soft markers. Conclusion: This study found different efficacy of NIPT according to the ultrasound findings. The results emphasize the importance of individualized counseling for prenatal screening or diagnostic test based on the type of abnormal ultrasound.

• Korean Journal of Veterinary Research
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• v.62 no.1
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• pp.7.1-7.4
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• 2022

A 7-year-old Scottish Straight cat presented with hypersalivation and generalized hyperesthesia. The cat was provided tuna-based food for 2 to 3 weeks before clinical symptoms appeared. Abdominal ultrasonography showed a heterogeneous, hyperechoic mesentery with hypoechoic foci. Pansteatitis was tentatively diagnosed and the cat was treated with vitamin E, anti-inflammatory drugs, and dietary changes. The clinical signs and changes in mesenteric fat on serial ultrasonography resolved. After feeding tuna-based food again, the same clinical signs and mesenteric changes on ultrasound recurred, which recovered through the same treatment. This study suggests that ultrasonography can be useful for diagnosis and monitoring of feline pansteatitis.

• Journal of IKEEE
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• v.12 no.3
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• pp.158-166
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• 2008

Medical ultrasound has benefits in mobility and safety than any other medical techniques such as X-ray, CT and MRI but has speckle noise which decrease the ability of an observer to distinguish the fine details in diagnostic examination. But simple removing of speckle often causes losing boundary information. Then, in this paper, we presented a novel neuro-fuzzy method which could remove speckle efficiently without loss of boundary information. Proposed method consists of image clustering by fuzzy algorithm and image processingby neural networks which was learned by back propagation. From the experiments for simulation image and real ultrasound image, we could verify the proposed method.

• JSTS:Journal of Semiconductor Technology and Science
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• v.14 no.5
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• pp.579-587
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• 2014

This paper presents a variable gain amplifier (VGA) for an analog front-end (AFE) of ultrasound medical imaging. This VGA has a closed-loop topology and shows a 37-dB-linear characteristic with a single-stage amplifier. It consists of an op-amp, a non-binary-weighted capacitor array, and a gain-control block. This non-binary-weighted capacitor array reduces the required number of capacitors and the complexity of the gain-control block. The VGA has been fabricated in a 0.35-mm CMOS process. This work gives the largest gain range of 37 dB per stage, the largest P1 dB of 9.5 dBm at the 3.3-V among the recent VGA circuits available in the literature. The voltage gain is controlled in the range of [-10, 27] dB in a linear-in-dB scale with 16 steps by a 4-bit digital code. The VGA has a bandpass characteristic with a passband of [20 kHz, 8 MHz].