Background/Aims: Leptin is associated with metabolic disorders, which predispose one to non-alcoholic fatty liver disease (NAFLD). The role of leptin in NAFLD pathogenesis is not fully understood. We aim to investigate the association between serum leptin level and severity of NAFLD using U.S. nationally representative data. Methods: Data were obtained from the United States Third National Health and Nutrition Examination Survey. NAFLD was defined by ultrasound detection and severity of hepatic steatosis in the absence of other liver diseases. The severity of hepatic fibrosis was determined by NAFLD fibrosis score (NFS). We used multivariate survey-weighted generalized logistic regression to evaluate the association between leptin level and the degree of NAFLD. We also performed subgroup analyses by body mass index (lean vs. classic NAFLD). Results: Among 4,571 people, 1,610 (35%) had NAFLD. By ultrasound findings, there were 621 people with mild, 664 with moderate, and 325 with severe steatosis. There were 885 people with low NFS (<-1.455, no significant fibrosis), 596 with intermediate NFS, and 129 with high NFS (>0.676, advanced fibrosis). Leptin levels for normal, mild, moderate and severe steatosis were $10.7{\pm}0.3ng/mL$, $12.1{\pm}0.7ng/mL$, $15.6{\pm}0.8ng/mL$, $16{\pm}1.0ng/mL$, respectively (trend P-value<0.001). Leptin levels for low, intermediate, and high NFS were $11.8{\pm}0.5ng/mL$, $15.6{\pm}0.8ng/mL$, $28.5{\pm}3.5ng/mL$, respectively (trend P-value<0.001). This association remained significant even after adjusting for known demographic and metabolic risk factors. In the subgroup analysis, this association was only prominent in classic NAFLD, but not in lean NAFLD. Conclusions: Serum leptin level is associated with the severity of NAFLD, especially in classic NAFLD patients.
An, Soyeon;Hur, Soyoung;Kim, Eujin;Hwang, Cho-Hyun;Jang, Eungyeong;Lee, Jang-Hoon;Kim, Youngchul
The Journal of Internal Korean Medicine
/
v.42
no.3
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pp.431-436
/
2021
Objectives: This study aims to determine whether Korean medicine improves epigastric symptoms of biliary dyskinesia without unfavorable side effects. Methods: A 37-year-old woman who had chronic dyspepsia with intermittent back pain had gallstone-like sludge identified on ultrasound scan. We administered Saenggan-tang and used ultrasound examination to observe the changes in symptoms such as dyspepsia, the occurrence of back pain, and gallbladder contraction. Results: After 2 months of taking Saenggan-tang, symptoms such as dyspepsia, abdominal pain, headache, and back pain improved. In addition, biliary motility improvement was evaluated by ultrasonography. Moreover, there was no occurrence of any side effects. Conclusion: This study suggests that Korean medicine might be effective for managing biliary dyskinesia.
The purpose of this study is to examine the status of quality control using multipurpose phantom of ultrasound equipment used in hospital of veterinary college in South Korea by using ATS-539 multipurpose phantom so as to examine quantitative and objective new image evaluation method. Specialists discussed and analyzed multipurpose phantom images acquired by using convex transducer of 10 ultrasound imaging devices, currently used in 9 veterinary colleges, at 4.0-6.0 MHz. Total 8 items that can be measured with ATS-539 multipurpose phantom including dead zone, vertical and horizontal measurement, axial/lateral resolution, sensitivity, focal zone, functional resolution and gray scale/dynamic range were evaluated. For qualitative evaluation, valid decisions were made based on dead zone, axial/lateral resolution, and gray scale/dynamic range which are resolution index, and coefficient of variation (COV) and blind referenceless image spatial quality evaluator (BRISQUE) were found to increase objectivity. As a result of experiment, all the targeted ultrasonic devices were found appropriate from qualitative evaluation items of dead zone, axial/lateral resolution, and gray scale/dynamic range. In other evaluation items, they were found to be appropriate from focal zone and vertical measurement of quantitative evaluation while inappropriate from horizontal measurement, sensitivity, and functional resolution. COV value was 0.12 ± 0.04, and BRISQUE value was 47.77 ± 2.77, both analysis results show that the noise level of all ultrasonic devices was located within tolerance range. Upon image examination using ATS-539 multipurpose phantom, they were 100% appropriate with inspection standards of dead zone, axial/lateral resolution, and gray scale/dynamic range, and besides, focal zone and functional resolution can be used as evaluation items. In the field of veterinary medicine, 8 standard items using ATS-539 multipurpose phantom and image evaluation items using COV and BRISQUE can be used as standards for quality control of ultrasonography machine.
Background: There has not been a thoroughly reported study of the comparison between spectral domain-optical coherence tomography (SD-OCT) with both ultrasound biomicroscopy (UBM) and gonioscopy on the evaluation of the iridocorneal angle (ICA) in dogs. Objectives: To investigate the diagnostic value of SD-OCT for the early detection of narrowing ICA by comparing and assessing inter-device agreement in anterior chamber angle (ACA) measurements obtained by SD-OCT and UBM, and ICA evaluations by gonioscopy. Methods: A total of 28 eyes from 28 client-owned dogs with normal intraocular pressure were included for examination. The ACA and angle opening distance (AOD) were measured from the SD-OCT and UBM images, and gonioscopy images were analyzed using the ICA grade and ZibWest angle index. Results: The mean ACA and AOD for SD-OCT were 28.31° ± 5.37° and 658.42 ± 219.90 ㎛, and for UBM, 28.34° ± 5.82° and 859.29 ± 221.80 ㎛, respectively. The mean difference in ACA between the average values of SD-OCT and UBM measurements was 0.03° with a 95% limit of agreement (LoA) span of 16.2°, indicating positive agreement; that in AOD was 200.85 ㎛ with a 95% LoA span of 1,110.95 ㎛, indicating poor agreement. The Pearson correlation coefficient of the ACA of SD-OCT and ZibWest indices of gonioscopy was 0.624, indicating strong agreement; that of UBM and gonioscopy was 0.43, indicating moderate agreement. Conclusions: SD-OCT is well tolerated by canine patients due to its non-contact method and might be an alternative option for early screening of ICA narrowing in clinical settings.
Objective: To find that the patients who conducted home self-exercise in conjunction with intra-articular corticosteroid injection will have better improvement in subacromial subdeltoid (SASD) bursitis symptoms than those who received only an injection. Method: A prospective, nonrandomized, comparison study was conducted in outpatient rehabilitation clinic in a tertiary university hospital. Patients diagnosed with SASD bursitis with physical examination and ultrasound evaluation were included and received ultrasound guided injection (UGI). Patients were divided into two groups according to the compliance of self-exercise: UGI-exercise group and UGI only group. Visual analog scale (VAS) was checked before, at 3 weeks, 3 months, and 6 months after the UGI. A patient's global impression of change (PGIC) survey was made at 3 months after the UGI. Results: A total of 82 patients with SASD bursitis were included. At 3 weeks after the injection, the mean VAS for the UGI-exercise group was 2.6 ± 1.7 and for UGI only group was 1.9 ± 1.3 (p=0.030). At 3 months after the injection, the mean VAS for the UGI-exercise group was 4.0 ± 1.3 and for UGI only group was 5.4 ± 1.4 (p<0.001). Conclusion: We concluded that home-based self-exercise of the shoulder provides an additional benefit for pain alleviation possibly with prolonging the effect of injection in SASD bursitis.
Heera Yoen;Hyun-Ah Chung;So-Min Lee;Eun-sung Kim;Woo Kyung Moon;Su Min Ha
Korean Journal of Radiology
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v.25
no.2
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pp.157-165
/
2024
Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P = 0.027). The overall satisfaction scores did not differ between the two groups (P = 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion: US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.
Breast ultrasound has many advantages over mammography but suffers from a shortcoming of being not suitable in detecting microcalcification. We studied on a method based on acoustic resonance and power Doppler to detect calcification of breast tissue using a typical 7.5 MHz linear probe used in breast ultrasound examination. We first constructed a breast tissue phantom made of gelatin and then observed calcified legions as external vibrations varied. Calcification injected to the breast tissue phantom being resonated different from the surrounding medium, and its acoustic resonance driven by external vibrations was visualized by differences for color brightness and area in ROI of power doppler. In low frequency regions, the acoustic resonance almost not appeared and showed a plateau in $300{\sim}600\;Hz$ and the color vanished as the frequency further increased.
Chan Kang;Jae-Hwang Song;Yougun Won;Eric W. Tan;Gi-Soo Lee
Journal of Korean Foot and Ankle Society
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v.28
no.1
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pp.27-30
/
2024
Several types of soft tissue masses occur in the lower extremities. A mass associated with blood vessels is often difficult to diagnose. A 15-year-old male patient visited the author's hospital with discomfort and edema in his right calf that had persisted for six months. A physical examination showed no palpable mass other than mild edema. Three masses were found during the ultrasound scan along the small saphenous vein. The masses had a cyst-like appearance and were filled with thrombus. In duplex ultrasound, vascular reflux was represented inside the masses. During surgery, it was suspected that vascular deformation occurred in the small saphenous vein, and simple ligation and resection treatments were performed. The patient was finally diagnosed with venous aneurysms accompanied by thrombosis based on the histology tests. The symptoms disappeared after surgery, and there were no recurrences or unusual findings at the follow-up one year later. Venous aneurysms occurring in the superficial veins of the lower extremities are rarely reported, but treatment and diagnosis are important. This paper reports a case of an aneurysm on the small saphenous vein.
Purpose: Ceftriaxone, a potent parenteral third-generation semisynthetic cephalosporin is widely used for the treatment of a variety of bacterial infections in both children and adult. Review of recent data indicates that ceftriaxone treatment has been associated with the development of reversible biliary pseudolithiasis and that is thought by many to be a benign process. Despite, several reports describe patients with ceftriaxone pseudolithiasis who required cholecystectomy for presumed acute cholecystitis. In this study we evaluated the incidence, risk factors, and prognosis of gallbladder pseudolithiasis after ceftriaxone treatment. Methods: Between march, 1997 and January, 1998, any child admitted to the Children's hospital of National University of Seoul and prescribed ceftriaxone for probable or definite bacterial infection were eligible for the study. 21 of them had ultrasound examination on the 2~12 days later after the start of ceftriaxone treatment, 8 of whom documented gallbladder precipitates or pseudolithiasis during treatment by serial abdominal ultrasound. Repeat abdominal ultrasound was performed 10~80 days later after the end of ceftriaxone treatment. The children with underlying liver disease or decreased renal function were excluded in this study. Results: 1) 21 children had ultrasound examinations of gallbladder during ceftriaxone treatment and 8 (38%) of them acquired pseudolithiasis. 2) The patients who developed gallbladder pseudolithiasis were significantly older ($6.3{\pm}2.9$ yr. vs $2.2{\pm}3.1$ yr.)(p<0.05), and older than 24 months were probably the significant risk associated with this phenomenon (p<0.05). However, no significant differences in sex, type of infection, fasting, and ceftriaxone treatment regimen (dose, duration of therapy). 3) The abnormality found on gallbladder ultrasonography was a strikingly hyperechogenic material with post-acoustic shadowing in 5 patients without post-acoustic shadowing in 3 patients 4) Follow up of gallbladder ultrasound was performed in 6 patients after cessation of ceftriaxone treatment. Sonographic abnormalities completely resolved within 14 days post cessation of therapy in 2 patients; 30 days, 1 patient; 80 days, 3 patients. Conclusions: We suggest that routine abdominal ultrasound should be considered in all children who received high dose ceftriaxone in more than 24 months of age and developed hepatobiliary symptoms during or just after ceftriaxone treatment.
Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.
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