• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.383-386
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• 2014

Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.1
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• pp.87-91
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• 2022

Ingestion of foreign bodies (FBs) is a common phenomenon among young children. Plain radiography is the first step diagnostic modality to detect the radio-opaque FBs. And computed tomography has been recommended by several guidelines as useful modalities for diagnosing ingested FBs. However, there is a risk of radiation exposure, making it burdensome to use in asymptomatic patients. Ultrasound (US) is not a commonly used technique for diagnosing ingested foreign bodies. However, US can provide real-time imaging with good resolutions without radiation exposure in pediatric patients. Herein, we report two pediatric cases of metallic foreign body ingestion that were successfully diagnosed using US for localizing foreign bodies. This study indicates that US may be used as an alternative method for detecting the localization of metallic foreign bodies in the gastrointestinal tract without exposure of radiation, particularly in pediatric patients.

• Imaging Science in Dentistry
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• v.49 no.4
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• pp.301-306
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• 2019

Purpose: This report presents a procedure for performing power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow and illustrates its application to practical patient cases. Materials and Methods: The salivary gland was scanned using ultrasound equipment (GE LOGIQ5 Expert^® device; GE Medical Systems, Milwaukee, WI, USA) to identify pathological findings related to the patient's chief complaint. To identify the orifice of the main duct, it should be cannulated using a lacrimal dilator. After inserting the catheter into the cannulated main duct, the position of the catheter within the duct was confirmed by ultrasound. A contrast agent was injected until the patient felt fullness, and ultrasound (B-mode) was used to confirm whether the contrast agent filled the main canal and secondary and tertiary ducts. Then, power Doppler ultrasound was performed to determine whether the salivary gland had increased blood flow. Results: In 2 cases in this report, a power Doppler ultrasound scan showed a significant increase in blood flow after contrast medium injection, which was not observed on a preoperative scan. Conclusion: Power Doppler ultrasound was found to be a simple, safe, and effective tool for real-time sialography monitoring.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• The Journal of the Korean dental association
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• v.55 no.11
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• pp.778-788
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• 2017

Ultrasound sonography(US) is used to evaluate various diseases of oral and maxillofacial region including salivary glands, soft tissue and jaw lesions because of easy accessibility and no hazard of ionizing radiation. Also, US can offer dynamic study showing real-time images during diagnostic or surgical procedure. US images provide accurate information about the internal features of lesions on the jaw prior to surgical treatment. Doppler images are used to visualize the vascular distribution of the lesions and to provide additional information to enhance diagnostic value. It is necessary to evaluate the diagnostic value of US and evaluate its usefulness by looking at clinical cases using US images. Therefore, US imaging may be recommended as an assistant image in evaluating jaw lesions. US images provided accurate information about the internal structure of lesions on the jaw prior to surgical treatment, and diagnostic value was enhanced by visualizing the vascular distribution of the lesion using doppler imaging. We report the protocol and suggest the effectiveness of US for various lesions and US-guided sialography.

• PNF and Movement
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• v.13 no.1
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• pp.25-30
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• 2015

Purpose: The aim of this study was to examine the effects of abdominal muscle contraction thickness using real-time ultrasound imaging while applying an abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC) to low back pain patients and healthy subjects. Methods: The subjects were 21 young adults; a group of 10 low back pain patients and a control group of 11 healthy subjects. Measurements were made with the subjects on a pillow in a supine position, with the knee joints flexed at 60 degrees. While the two groups conducted ADIM and PFC, their transverse abdominal muscle (TrA), internal abdominal oblique muscle (IO), and external abdominal oblique muscle (EO) thicknesses were measured using an ultrasound imaging system. Result: The TrA muscle contraction thickness ratio during PFC and ADIM was significantly lower in the low back pain group than in the healthy group (p<0.05). The EO muscle contraction thickness ratio during ADIM was also significantly lower in the low back pain group than in the healthy group. The healthy group's muscle contraction thickness ratio was significantly lower during PFC than during ADIM in the TrA, IO, and EO (p<0.05). The low back pain group's muscle contraction thickness ratio was lower during PFC than during ADIM in the TrA, IO, and EO, but the difference was not statistically significant. Conclusion: The results of this study indicate that oral direction during ADIM induced an appropriate contraction of the TrA. Therefore, the procedure reported here may be applied during rehabilitation for appropriate contraction of the TrA.

• Journal of Biomedical Engineering Research
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• v.19 no.1
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• pp.9-18
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• 1998

In this paper, we present the degradation of focusing induced by velocity inhomogeneity in human tissue. For simulation, the fatty layer which is the major factor of degradation for its lower velocity, is modeled as a uniform velocity perturbation layer. And we simulate the degradation of resolution resulting from change of beam path due to refraction and the time delay due to velocity difference. We show that focusing error can be compensated for considering the velocity inhomogeneity only. The proposed compensation method can be operated in real time in the presently used digital focusing systems.

• Journal of Biomedical Engineering Research
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• v.28 no.6
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• pp.798-802
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• 2007

The synthetic focusing in the ultrasonic imaging systems has been formed in the way that one element transmits a circular wave and receives an echo signal. The amplitude of the signal transmitted from one element is too small to propagate a long distance so that the SNR(Signal to Noise Ratio) is very low in an image obtained by the synthetic focusing. To solve this problem, a defocusing method which uses several elements has been proposed. In this method, the SNR is improved due to using several elements to transmit the circular wave. But if the number of transmitting elements increases, the phase distortion is severe in the defocusing method. In this paper, we propose a new method that can generate a circular wave using a lot of elements without phase distortion. At first, we generate limited plane waves with different propagation angles and then superpose them to make a circular wave. We show that the circular wave can be used to improve SNR in the real-time 3D ultrasonic imaging as well as the synthetic focusing through computer simulation and experiments.

• Journal of Korean Neurosurgical Society
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• v.61 no.4
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• pp.427-433
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• 2018

Obsessive compulsive disorder is a debilitating condition characterized by recurrent obsessive thoughts and compulsive reactions. A great portion of the obsessive compulsive disorder (OCD) patients are managed successfully with psychiatric treatment such as selective serotonin-reuptake inhibitor and cognitive behavioral psychotherapy, but more than 10% of patients are remained as non-responder who needs neurosurgical treatments. These patients are potential candidates for the neurosurgical management. There had been various kind of operation, lesioning such as leucotomy or cingulotomy or capsulotomy or limbic leucotomy, and with advent of stereotaxic approach and technical advances, deep brain stimulation was more chosen by neurosurgeon due to its characteristic of reversibility and adjustability. Gamma knife radiosurgery are also applied to make lesion targeting based on magnetic resonance (MR) imaging, but the complication of adverse radiation effect is not predictable. In the neurosurgical field, MR guided focused ultrasound has advantage of less invasiveness, real-time monitored procedure which is now growing to attempt to apply for various brain disorder. In this review, the neurosurgical treatment modalities for the treatment of OCD will be briefly reviewed and the current state of MR guided focused ultrasound for OCD will be suggested.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.1
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• pp.41-48
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• 2024

Objectives: Botulinum toxin type A (BTX), a powerful neurotoxin, can be an effective treatment choice for diverse muscular disorders and can reduce abnormal muscle activities. Abnormal movements of the mandible can be caused by involuntary and uncontrolled contractions of the lateral pterygoid muscle (LP) in various pathological situations. Previous reports have shown that BTX can reduce abnormal contractions of the LP. However, needle placement into the LP for BTX injection requires skill, experience, and sufficient anatomical knowledge. To place the needle precisely into the LP, ultrasonography (USG) can be used as an effective needle-guidance modality. USG is a non-invasive imaging modality able to create real-time images without any potential risks, including radiation exposure. Patients and Methods: The patients who had been performed USG-guided BTX injection into the LP using an intraoral approach were included in this study with a literature review and case presentations. Using the USG, four patients received BTX injections to treat recurrent temporomandibular dislocation and oromandibular dystonia resulting from involuntary LP activity. Result: Involuntary movements of the mandible were improved successfully in all patients, and showed satisfactory results without significant complication. Conclusion: The intraoral approach could prevent potential complications during needle placement. USG-guided BTX injection is an effective, convenient, and safe method that provides real-time imaging without unnecessary pain to the patient.