• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.15 no.2
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• pp.93-97
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• 2009

Anatomy: Facet joint syndrome most often affects the lower back and neck and refers to pain that occurs in the facet joints, which are the connections between the vertebrae in the spine that enable the spine to bend and twist. Many physicians have believed that the usual lesion of facet syndrome was an anatomical impairments of facet joint itself.. Facet joint injection using local anesthetics is a reliable method for the diagnosis and treatment for facet syndrome. Etiology: One of many possible causes is imbalances that can occur in stress levels, hormone levels, and nutritional levels. These imbalances can adversely affect posture, which can lead to neck and back pain. The common disorder called facet syndrome exhibits lower back pain, with or without, radiating pain to buttock and thigh due to facet joint arthropathy. Pain in the facet joint is supposedly the secondary effect of narrowing of joint space by sustained muscle contracture around joints. Syndrome: Facet joint syndrome tends to produce pain or tenderness in the lower back that increases with twisting or arching the body, as well as pain that moves to the buttocks or the back of the thighs. Other symptoms include stiffness or difficulty standing up straight or getting out of a chair. Pain can be felt in other areas such as the shoulders or mid-back area. Treatment: Non-drug treatments include hot packs, ultrasound, electrical stimulation, and therapeutic exercises. Stimulating blood flow using massage or a hot tub may also help. Alternative treatments include yoga and relaxation therapy. If your pain persists after trying these treatments, a surgical procedure called radiofrequency rhizotomy, which destroys the sensory nerves of the joint, may bring relief. Facet joint injection has been helpful in diagnosis and therapy for this facet syndrome. Radiofrequency thermocoagulation of medial branches is known to be an effective method of relieving pain caused by facet joint problems. We conclude that spasmolytic treatment of muscles connecting the two vertebral articular space would be better for treatment and diagnosis of facet syndrome rather than facet block with local anesthetic and steroid only.

• Journal of the Korean Institute of Intelligent Systems
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• v.22 no.3
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• pp.341-346
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• 2012

In rehabilitation where ultrasonographic diagnosis is not popular, it could be subjective by medical expert's experience. Thus, it is necessary to develop an objective automative procedure in ultrasonic image analysis. A disadvantage of existing automative analytic procedure in musculoskeletal system is to designate an incorrect muscle area when the figure of fascia is vague. In this study, we propose a new procedure to extract more accurate muscle area in abdomen ultrasonic image for that purpose. After removing unnecessary noise from input image, we apply End-in Search algorithm to enhance the contrast between fascia and muscle area. Then after extracting initial muscle area by Up-Down search, we trace the fascia area with a mask based on morphological and directional information. By this tracing of mask movements, we can emphasize the fascia area to extract more accurate muscle area in result. This new procedure is proven to be more effective than existing methods in experiment using convex ultrasound images that are used in real world rehabilitation diagnosis.

• The Korean Journal of Pain
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• v.27 no.2
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• pp.133-138
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• 2014

Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3-L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P < 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P < 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.158-164
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• 2011

Breast cancer is the most frequently appearing cancer in women, these days. To reduce mortality of breast cancer, periodic check-up is strongly recommended. X-ray mammography is one of powerful diagnostic imaging systems to detect 50~100 um micro-calcification which is the early sign of breast cancer. Although x-ray mammography has very high spatial resolution, it is not easy yet to distinguish cancerous tissue from normal tissues in mammograms and new tissue characterizing methods are required. Recently ultrasound elastography technique has been developed, which uses the phenomenon that cancerous tissue is harder than normal tissues. However its spatial resolution is not enough to detect breast cancer. In order to develop a new elastography system with high resolution we are developing x-ray elasticity imaging technique. It uses the small differences of tissue positions with and without external breast compression and requires an algorithm to detect tissue displacement. In this paper, computer simulation is done for preliminary study of x-ray elasticity imaging. First, 3D x-ray breast phantom for modeling woman's breast is created and its elastic model for FEM (finite element method) is generated. After then, FEM experiment is performed under the compression of the breast phantom. Using the obtained displacement data, 3D x-ray phantom is deformed and the final mammogram under the compression is generated. The simulation result shows the feasibility of x-ray elasticity imaging. We think that this preliminary study is helpful for developing and verifying a new algorithm of x-ray elasticity imaging.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.61-68
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• 2007

When an active muscle is stretched, its steady-state isometric force following stretch is greater than that of a purely isometric contraction as the corresponding muscle length, referred to as force enhancement (FE). The purpose of this study was to investigate possible effects of muscle architecture on the FE. While subject performed maximal isometric dorsiflexion (REF) and isometric-stretch-isometric dorsiflexion (ECC) contractions, ankle joint angle and dorsiflexion torque using a dynamometer and electromyography of the tibialis anterior and the medical gastrocnemius muscles were measure. Simultaneously, real-time ultrasound images of the tibialis anterior were acquired. Regardless of the speed of stretch of the ECC contractions. the torques produced during the isometric phase following stretch ($37.3{\pm}1.5\;Nm$ ($10{\pm}3%$ FE) and $38.3{\pm}1.5$ ($12{\pm}3%$ FE) for the ECC contractions with $15^{\circ}$/s and $45^{\circ}$/s stretch speeds, respectively) were greater than those of the REF contractions ($34.5{\pm}2.5\;Nm$). Moreover, the amount of FE was found to be stretch speed dependent. Angles of pennation ($\alpha$) during the isometric phase following stretch were the same for the REF ($15{\pm}1^{\circ}$) and the ECC ($14{\pm}1^{\circ}$(LS), $15{\pm}1^{\circ}$(LF)). During the same phase, muscle thicknesses were the same ($14.9{\pm}0.6$, and $14.9{\pm}0.5\;mm$ for the REF and the ECC contractions, respectively). For a large limb muscle, the tibialis anterior muscle, a similar amount of force enhancement was observed as did for other human skeletal muscles. Architectural variables, pennation angle and thickness, were not systematically different between the REF and ECC contractions when FE occurred. Therefore, the results of this study suggest that muscle architecture may have little influence on the production of FE.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.20-25
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• 2020

Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.52-58
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• 2016

Purpose: This study intended to mediate shoulder exercise using grasping and investigate examine how its effects on affects activities of the shoulder surrounding muscles of the shoulder and thickness of shoulder muscle to suggest effective exercise for patients with rotator cuff repair to return to daily life. Methods: This study has been done targeteding male patients more than 6 weeks after having En-masse Suture Bridge Technique as rotator cuff repair of the right shoulder, aged 40 to 55 in a medical institution located in Jeollanam-do. Experimental group I (n=15) was selected for a conducting common exercise therapy program and Experimental group II (n=15) was selected for an conducting exercise therapy program using grasping. %RVC was measured by surface electromyography and muscle thickness was measured by ultrasound before mediation to for analysisze of before and after results within group and between groups. Results: In comparison of change of %RVC, Tthere were meaningful differences in only posterior deltoid and infraspinatus in comparing a change of %RVC within experimental group I (p<0.001),. and Tthere were meaningful differences in both supraspinatus and infraspinatus in muscle thickness within experimental group I (p<0.001). In comparison of change of %RVC, Tthere were meaningful differences in anterior deltoid, posterior deltoid and infraspinatus in comparing a change of %RVC within experimental group II (p<0.05)(p<0.01) (p<0.001), and there were meaningful differences in both supraspinatus and infraspinatus in muscle thickness within experimental group II (p<0.001). In comparison of change of %RVC between groups, Tthere was a meaningful difference in only posterior deltoid in comparing a change of %RVC between groups (p<0.001). Conclusion: We found that exercise therapy using grasping has a positive effect on shoulder stability muscles such as supraspinatus muscle and infraspinatus muscle and activity of deltoid muscle.

• Journal of Veterinary Clinics
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• v.30 no.2
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• pp.131-133
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• 2013

A 9-year-old, intact female Jindo dog weighing 23 kg was presented to the Veterinary Medical Teaching Hospital of Chungnam National University with a history of two months of ocular discharge. Initial ocular examination showed a 2 cm elongated mass arising from the ventral bulbar conjunctiva of the left eye. Ocular ultrasound, performed to rule out any orbital and intraocular involvement, was negative. Thoracic radiographs and abdominal ultrasonography revealed no abnormalities. Fine needle aspiration (FNA) of mass was performed. Aspiration cytology showed the presence of a round cell population mostly characterized. A moderate amount of eosinophils was present among round cells. The mass was excised and identified hitologically as a mast cell tumor. Six months after surgical treatment, thoracic radiographs and abdominal ultrasonography did not reveal any clinical signs of local recurrence or metastatic disease.

• Journal of Genetic Medicine
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• v.17 no.1
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• pp.21-26
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• 2020

Purpose: To evaluate the additive value of prenatal chromosomal microarray analysis (CMA) in assessing increased nuchal translucency (NT) (≥3.5 mm) with normal karyotype and the possibility of detecting clinically significant genomic imbalance, based on specific indications. Materials and Methods: Invasive samples from 494 pregnancies with NT ≥3.5 mm, obtained from the Research Center of Fertility & Genetics of Hamchoon Women's Clinic between January 2019 and February 2020, were included in this study and CMA was performed in addition to a standard karyotype. Results: In total, 494 cases were subjected to both karyotype and CMA analyses. Among these, 199 cases of aneuploidy were excluded. CMA was performed on the remaining 295 cases (59.7%), which showed normal (231/295, 78.3%) or non-significant copy number variation (CNV), such as benign CNV or variants of uncertain clinical significance likely benign (53/295, 18.0%). Clinically significant CNVs were detected in 11 cases (11/295, 3.7%). Conclusion: Prenatal CMA resulted in a 3% to 4% higher CNV diagnosis rate in fetuses exhibiting increased NT (≥3.5 mm) without other ultrasound detected anomalies and normal karyotype. Therefore, we suggest using high resolution, non- targeting CMA to provide valuable additional information for prenatal diagnosis. Further, we recommend that a genetics specialist should be consulted to interpret the information appropriately and provide counseling and follow-up services after prenatal CMA.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.377-386
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• 2019

Purpose: Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation. Methods: We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (${\leq}8$ hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs. Results: One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter). Conclusion: Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.