• Title/Summary/Keyword: therapeutic ultrasound

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Magnetic Resonance-Guided Focused Ultrasound in Neurosurgery: Taking Lessons from the Past to Inform the Future

  • Jung, Na Young;Chang, Jin Woo
    • Journal of Korean Medical Science
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    • v.33 no.44
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    • pp.279.1-279.16
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    • 2018
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is a new emerging neurosurgical procedure applied in a wide range of clinical fields. It can generate high-intensity energy at the focal zone in deep body areas without requiring incision of soft tissues. Although the effectiveness of the focused ultrasound technique had not been recognized because of the skull being a main barrier in the transmission of acoustic energy, the development of hemispheric distribution of ultrasound transducer phased arrays has solved this issue and enabled the performance of true transcranial procedures. Advanced imaging technologies such as magnetic resonance thermometry could enhance the safety of MRgFUS. The current clinical applications of MRgFUS in neurosurgery involve stereotactic ablative treatments for patients with essential tremor, Parkinson's disease, obsessive-compulsive disorder, major depressive disorder, or neuropathic pain. Other potential treatment candidates being examined in ongoing clinical trials include brain tumors, Alzheimer's disease, and epilepsy, based on MRgFUS abilities of thermal ablation and opening the blood-brain barrier. With the development of ultrasound technology to overcome the limitations, MRgFUS is gradually expanding the therapeutic field for intractable neurological disorders and serving as a trail for a promising future in noninvasive and safe neurosurgical care.

The Effect of Sit to Stand Training Combined with Ultrasound on Spasticity, Muscle Strength and Gait Speed in Patients with Stroke

  • Jung, Kyoungsim;In, Taesung
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.344-349
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    • 2022
  • Objective: The purpose of the present study was to determine whether sit to stand training combined with ultrasound improves the spasticity, muscle strength and gait speed in stroke patients Design: Randomized controlled study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the sit to stand training with ultrasound (USTS) group (n=20) and the sit to stand training (STS) group (n=20). All the participants underwent 30 sessions of STS training (thirty minutes, five days per week for six weeks). Additionally, the USTS group received ultrasound therapy. The present study evaluated the spasticity of ankle plantar-flexors by the composite spasticity score. The muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively. Results: The USTS group and the STS group showed significant improvements in spasticity, muscle strength and gait speed after the intervention (p<0.05). Significant improvement in the spasticity, muscle strength, and gait speed were observed in the USTS group compared to the control group (p < 0.05). Conclusions: The results of the current study imply that sit to stand training combined with ultrasound is a beneficial and effective therapeutic modality that can be employed to improve the spasticity, muscle strength and gait speed in stroke patients.

A Fat-Tissue Mimic Phantom for Therapeutic Ultrasound

  • Kim, Mi Seon;Kim, Ju Young;Jung, Hyun Du;Kim, Jae Young;Choi, Heung Ho
    • IEIE Transactions on Smart Processing and Computing
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    • v.3 no.3
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    • pp.153-159
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    • 2014
  • As the number of treatments in the therapeutic ultrasound field targeted at fat tissue increase, the performance of the equipment should be evaluated for safety using a fat phantom. In this study, a fat phantom was fabricated using olive oil and a tissue-mimicking material (TMM) phantom. To evaluate the acoustic properties of the TMM phantom according to the changes in the olive oil, the composition ratio of a liquid mixture of olive oil with a surfactant was adjusted from 5-20% in 5% steps. The acoustic properties of the phantom were evaluated using the sound velocity, attenuation coefficient, density, and acoustic impedance. The experimental results showed that the sound velocity decreased with increasing amount of olive oil but the other acoustic properties did not change. In addition, the phantom using an olive-oil mixture with a 15% composition ratio was most similar to the acoustic characteristics of fat tissue with a sound velocity of 1477.35 m/s, an attenuation coefficient of 0.514 dB/MHz-cm, a density of $1.07g/cm^3$, and an acoustic impedance of 1.575 MRayl. These experimental results are expected contribute to the accuracy of the results using a TMM phantom and will be useful for the therapeutic ultrasound field targeted at subcutaneous fat tissue.

Enhancement of Transdermal Drug Delivery Using Ultrasound (초음파를 이용한 경피약물수송의 촉진)

  • Park, Seung-Kyu;Kim, Tae-Youl
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.719-726
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    • 2001
  • Transdermal drug delivery offers various advantages over conventional drug delivery systems, such as avoidance gastrointestinal degradation and hepatic first-pass effect. encourages patient compliance. and possible sustained release of drugs. However, transdermal transport of drugs is low permeability of the stratum corneum, the superficial layer of the skin. Many physicochemical and biological factors influencing transdermal transport is described together with the corresponding experimental and clinical results. Phonophoresis is medical treatment with drugs introduced into the skin by ultrasound energy. Enhanced drug penetration is through to result from the biophysical alterations of skin structure by ultrasound waves. The frequency used for phonophoresis is usually from 20 kHz to 15MHz. Phonophoresis can be categorized in to three ranges: low-frequency range(below 1 MHz). therapeutic frequency range(1 to 3MHz), and high-frequency range(above 3 MHz). The depth of penetration of ultrasound into skin is inversely proportional to the frequency. Cavitation may cause mechanical stress. temperature elevation, or enhanced chemical reactivity causing drug transport. One theory is that ultrasound affects the permeation of the stratum corneum lipid structure as the limiting step in permeating through the skin. The range of indications for phonophoresis is wide. Aspecific classification of the range of indications is obtained by classification of pathological conditions. The continuous research is needed for many interesting issucs of phonophoretic transdermal delivory in new future.

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Acoustic Characteristics of High Intensity Focused Ultrasound for Necrosis of CTO (CTO 괴사를 위한 고강도 집속 초음파의 음향학적 특성)

  • Park, Chan Hee;Jeong, Sang Hwa
    • Journal of the Korean Society of Manufacturing Technology Engineers
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    • v.24 no.5
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    • pp.481-488
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    • 2015
  • It is difficult to see a therapeutic effect from cardiovascular disease treatment methods in the case of a hardened chronic total occlusion (CTO), owing to the calcification of the deposition materials. However, lesion cells, such as CTOs, can be selectively necrotized without affecting the normal tissue using high-intensity ultrasound focused on one point. In this study, a phantom CTO was necrotized by a high-intensity focused ultrasound (HIFU) energy system, and the acoustic characteristics in the focal region were analyzed. An experimental HIFU device was constructed to discover the appropriate conditions for the necrosis of a phantom CTO. The transfer characteristics of the ultrasound changed in the focal region by the density difference of the phantom CTO. These changes were acoustically analyzed to choose the available frequency band for each density. On-off temperature control in the focal region was applied to prevent rapid temperature rises, which would otherwise affect normal tissue.

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

  • Kim, Seung Jae J.;Kang, Yusuhn;Kim, Dae Ha;Lim, Jae Young;Park, Joo Hyun;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.22 no.1
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    • pp.40-45
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    • 2019
  • Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients' magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients' symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.

A Case Report on Korean Medicine Treatment for a Patient Diagnosed with Acute Gastric Mucosal Lesion on Ultrasound Imaging (초음파 영상에서 급성 위점막 병변으로 진단된 환자에 대한 한의치료 치험 1례)

  • Chae-eun Kim;Tae-hyun Baek
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1354-1361
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    • 2023
  • Objectives: This study reports a clinical case that showed improvement in the symptoms of a patient with acute gastric mucosal lesion (AGML) through ultrasound. Methods: A 90-year-old woman with AGML was treated with Korean medicine treatments, including Hyangsapyeongwisan Soft Ext, acupuncture, and moxibustion. The responses before and after treatment were evaluated using ultrasound imaging and the numerical rating scale (NRS). Results: After treatment, ultrasound imaging showed improvement in gastric mucosa thickness, from 1.45 cm to 0.53 cm at the anterior wall and from 1.25 cm to 0.36 cm at the posterior wall. The NRS scores for epigastric pain, nausea, and dizziness all decreased, and the symptoms of diarrhea disappeared. Conclusion: This study suggests that Korean medicine treatment can be a therapeutic option in treating the symptoms of patients with AGML.

Effects on Knee Joint Pain by Phonophoresis of Piroxicam Gel (피록시캄 겔의 음파영동이 슬관절 통증에 미치는 효과)

  • Choi, Sug-Ju;Yoon, Se-Won
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.1 no.2
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    • pp.31-38
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    • 2003
  • This study was to compared the effectiveness of piroxicam gel phonophoresis with conventional ultrasound therapy in knee osteoarthritis. Eighteen patients with a means age of $55.7{\pm}5$ years were randomly assigned to phonophoresis or ultrasound groups. Continuous ultrasonic waves of 1 MHz frequency and $1\;W/cm^2\;SATA_i$ were applied for 5 minutes to the target knee joint. This study indicated their pain level by marking on a visual analog scale(VAS) at the start of treatment and at the end of 3day. Osteoarthritis VAS scores, pain on rest state, non weight bearing range of motion, 20 meters walking, and walking step by the patients were evaluated before and after therapy. Both therapeutic modalities were found to be effective and generally well tolerated after 3 therapy sessions. But piroxicam phonophoresis was not superior to conventional ultrasound in patients with knee osteoarthritis.

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Endoscopic Management of Large Peripancreatic Fluid Collections in Two Pediatric Patients by Endoscopic Ultrasound-guided Transmural Drainage

  • Walsh, Leonard T.;Groff, Andrew;Mathew, Abraham;Moyer, Matthew T.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.105-109
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    • 2020
  • The incidence of acute pancreatitis (AP) has increased in the pediatric population over the past few decades and it stands to follow that the complications of severe AP, including symptomatic pancreatic fluid collections (PFCs) will increase as well. In adults, the therapeutic options for this situation have undergone a dramatic evolution from mainly surgical approaches to less invasive endoscopic approaches, mainly endoscopic ultrasound-guided transmural drainage (EUS-TD) followed be direct endoscopic necrosectomy if needed. This has proven safe and effective in adults; however, this approach has not been well studied or reported in pediatric populations. Here we demonstrate that EUS-TD seems to offer a safe, efficacious and minimally invasive approach to the management of large PFCs in pediatric patients by reviewing two representative cases at our institution.

Role of Endoscopic Ultrasound in the Assessment of Superficial Esophageal Cancer (조기 식도암에서 내시경초음파의 역할)

  • Cho, Yu Kyung
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.19-22
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    • 2011
  • Endoscopic ultrasound in the diagnosis of esophageal carcinoma is an indispensable procedure, not only to discuss the preoperative staging of the lesion, but also to evaluate the therapeutic effect of chemo-radiation therapy. The recent increase in the incidence of superficial esophageal cancer and promising developments in potentially curative endoscopic therapies have placed EUS to a central position in decision making. Recent data have called into question the staging accuracy of EUS to distinguish mucosal from submucosal lesions, particularly in patients with early disease. In those cases, diagnostic endoscopic resection may be useful for staging and curative in superficial lesions. Nonetheless, EUS has been regarded as the most accurate staging tool and should be performed to identify potential candidates for endoscopic resection.

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