• Archives of Plastic Surgery
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• 제47권4호
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• pp.365-370
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• 2020

The ability to directly harvest thin and superthin perforator flaps without jeopardizing their vascularity depends on knowledge of the microsurgical vascular anatomy of each perforator within the subcutaneous tissue up to the dermis. In this paper, we report our experience with ultrahigh-frequency ultrasound (UHF-US) in the preoperative planning of thin and superthin flaps. Between May 2017 and September 2018, perforators of seven patients were preoperatively evaluated by both ultrasound (using an 18-MHz linear probe) and UHF-US (using 48- and 70-MHz linear probes). Thin flaps (two cases) and superthin flaps (five cases) were elevated for the reconstruction of head and neck oncologic defects and lower limb traumatic defects. The mean flap size was 6.5×15 cm (range, 5×8 to 7.5×23 cm). No complications occurred, and all flaps survived completely. In all cases, we found 100% agreement between the preoperative UHF-US results and the intraoperative findings. The final reconstructive outcomes were considered satisfactory by both the surgeon and the patients. In conclusion, UHF-US was found to be very useful in the preoperative planning of thin and superthin free flaps, as it allows precise anticipation of very superficial microvascular anatomy. UHF-US may represent the next frontier in thin, superthin, and pure skin perforator flap design.

• 한국전문물리치료학회지
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• 제26권3호
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• pp.99-105
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• 2019

Background: Although magnetic resonance imaging is accurate, it is expensive to measure the movement of temporomandibular joint. The three-dimensional (3D) motion analysis system is an inexpensive measurement tool. Objects: This study examined the reliability of quantifying the mouth opening and lateral mandibular shift and differences between individuals with and without temporomandibular disorder (TMD) using the hygienic method of surface markers on the skin with 3D ultrasound-based motion analysis. Methods: This study included 24 subjects (12 with and 12 without TMD). Temporomandibular joint motion during mouth opening was recorded using two surface markers with 3D ultrasound-based motion analysis. An intraclass correlation coefficient [ICC (3,k)] was used to confirm the intrarater reliability of quantifying kinematic temporomandibular joint motion, and an independent t-test was used to evaluate differences in maximal mouth opening and lateral mandibular shift between the two groups. Results: Assessment of mouth opening and lateral mandibular shift showed excellent test-retest reliability with low standard error of measurement. The lateral mandibular shift and opening-lateral mandibular shift ratio were significantly increased in the TMD group during maximum mouth opening (p<.05). However, no significant difference in maximal mouth opening was observed between the groups with and without TMD (p>.05). Conclusion: This hygienic and simple surface marker method can be used to quantify the mouth opening and lateral mandibular shift at the end-range of mouth opening. The TMD group showed an increased lateral mandibular shift movement at the end-range of mouth opening. The lateral mandibular shift movement can be regarded as a symptom in the diagnosis and treatment of TMD.

• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.19-26
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• 2021

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 추계학술대회
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• pp.314-316
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• 1996

To diagnose cardiac malfunctions, various imaging techniques have been applied to heart : DSA(Digital Subtracted Angiography), Doppler Ultrasound, MR Angio. But it is difficult to observe three dimensional heart motion which is the most intuitive tool for diagnosis, only by using these methods. In this research, we have suggested 4-Dimensional reconstruction scheme of heart motion images that can be acquired by ECG-gated cine MR imaging. One cardiac cycle was devided into $9\sim15$ phases and for each phase 3D reconstructed volumn heart was made. We can observe 3D volumns along the cardiac cycle, time. So the results were 4-D reconstructed data.

• Investigative Magnetic Resonance Imaging
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• 제12권2호
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• pp.170-177
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• 2008

목적 : 순차적인 뇌초음파 검사 후 신생아 중환자실을 퇴원하는 고위험 환아에서 시행한 자기 공명 영상의 유용성을 알아보고자 하였다. 대상 및 방법 : 총 121명의 신생아에서 시행한 412 초음파와 121 자기공명 영상을 후향적으로 분석하여 초음파 검사에서 발견된 뇌병변과 자기 공명영상에서 발견된 병변을 비교하였다. 뇌병변은 배아기질 출혈 및 뇌실 내 출혈, 그 밖의 여러 출혈과 뇌실질 손상을 중심으로 비교 분석하였다. 결과 : 총 242개의 측뇌실 중 30뇌실의 배아기질 출혈 (GMH)을 초음파로 진단하였고 자기공명영상으로 7개의 GMH를 추가로 진단할 수 있었으며 46개 뇌실의 출혈 (IVH)을 추가로 진단하였다. 출혈의 1/2/3/4 등급은 초음파에서 각각 24/8/13/0 뇌실에서 진단하였고 자기공명영상에서 3/49/10/2 뇌실에서 진단하였다. 그 외에 자기공명영상에서 대뇌 출혈 (4예), 소뇌 출혈(4예), 경막하 및 지주막하 출혈 (8예), 미만성 백질 신호강도 변화 (72예), 조직손실이 없는 작은 실질 병변 (4예), 뇌연화증 (2예), 그리고 뇌실확장 (5예)이 추가로 발견되었다. 결론 : 자기공명영상은 초음파 검사 후 두개강내 출혈과 뇌실질 손상을 추가적으로 진단하는 유용한 검사였으며 특히 뇌실 출혈과 백질 손상의 진단에 우수한 반면 배아기질 출혈은 초음파 추적검사가 더 유용할 것으로 생각한다.

• 대한핵의학회지
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• 제26권2호
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

• Advances in nano research
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• 제13권6호
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• pp.575-585
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• 2022

Due to its biofilm formation and colonization of the osteocyte-lacuno canalicular network (OLCN), Staphylococcus aureus (S.aureus) implant-associated bone infection (SIABI) is difficult to cure thoroughly, and may occur recurrently subsequently after a long period dormant. It is essential to explore an alternative therapeutic strategy that can eradicate the pathogens in the infected foci. To address this, the polymethylmethacrylate (PMMA) bone cement and Fe3O4 nanoparticles compound cylinder were developed as implants based on their size and mechanical properties for the alternative magnetic field (AMF) induced thermal ablation, The PMMA mixed with optimized 2% Fe₃O₄ nanoparticles showed an excellent antibacterial efficacy in vitro. It was evaluated by the CFU, CT scan and histopathological staining on a rabbit 1-stage transtibial screw model. The results showed that on week 7, the CFU of infected soft tissue and implants, and the white blood cells (WBCs) of the PMMA+2% Fe₃O₄+AMF group decreased significantly from their controls (p<0.05). PMMA+2% Fe₃O₄+AMF group did not observe bone resorption, periosteal reaction, and infectious reactive bone formation by CT images. Further histopathological H&E and Gram Staining confirmed there was no obvious inflammatory cell infiltration, neither pathogens residue nor noticeably burn damage around the infected screw channel in the PMMA+2% Fe₃O₄+AMF group. Further investigation of nanoparticle distributions in bone marrow medullary and vital organs of heart, liver, spleen, lung, and kidney. There were no significantly extra Fe₃O₄ nanoparticles were observed in the medullary cavity and all vital organs either. In the current study, PMMA+2% Fe₃O₄+AMF shows promising therapeutic potential for SIABI by providing excellent mechanical support, and promising efficacy of eradicating the residual pathogenic bacteria in bone infected lesions.

• Korean Journal of Radiology
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• 제20권5호
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• pp.749-758
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• 2019

Objective: To investigate whether a computer-aided diagnosis (CAD) system based on a deep learning framework (deep learning-based CAD) improves the diagnostic performance of radiologists in differentiating between malignant and benign masses on breast ultrasound (US). Materials and Methods: B-mode US images were prospectively obtained for 253 breast masses (173 benign, 80 malignant) in 226 consecutive patients. Breast mass US findings were retrospectively analyzed by deep learning-based CAD and four radiologists. In predicting malignancy, the CAD results were dichotomized (possibly benign vs. possibly malignant). The radiologists independently assessed Breast Imaging Reporting and Data System final assessments for two datasets (US images alone or with CAD). For each dataset, the radiologists' final assessments were classified as positive (category 4a or higher) and negative (category 3 or lower). The diagnostic performances of the radiologists for the two datasets (US alone vs. US with CAD) were compared Results: When the CAD results were added to the US images, the radiologists showed significant improvement in specificity (range of all radiologists for US alone vs. US with CAD: 72.8-92.5% vs. 82.1-93.1%; p < 0.001), accuracy (77.9-88.9% vs. 86.2-90.9%; p = 0.038), and positive predictive value (PPV) (60.2-83.3% vs. 70.4-85.2%; p = 0.001). However, there were no significant changes in sensitivity (81.3-88.8% vs. 86.3-95.0%; p = 0.120) and negative predictive value (91.4-93.5% vs. 92.9-97.3%; p = 0.259). Conclusion: Deep learning-based CAD could improve radiologists' diagnostic performance by increasing their specificity, accuracy, and PPV in differentiating between malignant and benign masses on breast US.

• 대한기계학회논문집A
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• 제28권10호
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• pp.1451-1457
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• 2004

Bone density parameters of children, unlike that of adult, might reflect growth effect along longitudinal direction as well as bone mass. The clinical test was performed for 859 male/female children with age 6-16 years. Ultrasonic imaging system was used to measure bone density, and relationship of bone density to age was evaluated. The bone quality index appeared to be highly correlated with age for male/female children. It was found that bone quality index rose rapidly in the first growth period. The bone quality index was then kept almost unchanged in the period of puberty, and slowly rose after puberty. It was also found that growth of female stopped earlier than that of male. Also, if more clinical examinations are performed by applying various sizes of region of interest, relationship between bone density and age is expected to be more reliable.

• 대한의용생체공학회:의공학회지
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• 제15권3호
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• pp.275-280
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• 1994

In the case of the image reconstruction from unknown projection data such as imaging the object with opaque obstructions, conventional reconstruction algorithms may reconstruct a degraded image. In this paper, a new method for the estimation of the unknown projection data based on known projection data and the bandwidth of projection data is proposed. The proposed method successfully estimates the unknown projection data through iterative transformation between projection space and frequency space using the known projection data and the bandwidth of the projection data. Computer simulation shows that the proposed method significantly improves image quality and convergence behavior over conventional algorithms. In addition, the proposed method is successfully applied to ultrasound attenuation CT using a sponge phantom.