• Journal of Korean Medical Science
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• 제33권44호
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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.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.10-26
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• 2019

Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging new technology with considerable potential to treat various neurological diseases. With refinement of ultrasound transducer technology and integration with magnetic resonance imaging guidance, transcranial sonication of precise cerebral targets has become a therapeutic option. Intensity is a key determinant of ultrasound effects. High-intensity focused ultrasound can produce targeted lesions via thermal ablation of tissue. MRgFUS-mediated stereotactic ablation is non-invasive, incision-free, and confers immediate therapeutic effects. Since the US Food and Drug Administration approval of MRgFUS in 2016 for unilateral thalamotomy in medication-refractory essential tremor, studies on novel indications such as Parkinson's disease, psychiatric disease, and brain tumors are underway. MRgFUS is also used in the context of blood-brain barrier (BBB) opening at low intensities, in combination with intravenously-administered microbubbles. Preclinical studies show that MRgFUS-mediated BBB opening safely enhances the delivery of targeted chemotherapeutic agents to the brain and improves tumor control as well as survival. In addition, BBB opening has been shown to activate the innate immune system in animal models of Alzheimer's disease. Amyloid plaque clearance and promotion of neurogenesis in these studies suggest that MRgFUS-mediated BBB opening may be a new paradigm for neurodegenerative disease treatment in the future. Here, we review the current status of preclinical and clinical trials of MRgFUS-mediated thermal ablation and BBB opening, described their mechanisms of action, and discuss future prospects.

• 대한정형외과 초음파학회지
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• 제7권1호
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• pp.28-32
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• 2014

목적: 슬관절 이하 부위의 정형외과적 수술을 위해 좌골 신경 차단 술기가 흔히 시행되고 있다. 좌골 신경 분지는 해부학적 차이가 있어 통상적인 신경 차단은 불완전한 신경 차단을 유발한다. 본 연구는 마취의 성공율을 개선하기 위하여 한국 여성에서 좌골 신경 분지 위치를 초음파를 이용해 확인하였다. 대상 및 방법: 한국 여성 33명을 대상으로 하였으며 체중, 키를 측정하였다. 초음파 측정을 위해 M-Turbo ultrasound system (SonoSite,Bothell, WA,USA) 13-6 MHz, 38 mm high frequency linear array transducer를 사용하였다. 복와위 자세에서 슬와 주름부터 분지부까지의 거리, 분지부에서 피부부터 신경까지의 깊이를 cm 단위로 측정하여 체중과 키와의 상관관계를 확인하였다. 측정은 한 명의 전문의에 의해 측정되었다. 통계는 SAS version 9.3를 사용하여 multiple linear regression 방법으로 분석하였다. 결과: 33명 여성의 평균 나이는 53세(34~71세), 평균 체중 59.7(50~77.1 kg), 평균 키 157.4(145~173.9 cm), 평균 BMI 24.1(18.4-28.9)였다. 슬와 주름에서 좌골 신경 분지부까지의 평균 거리는 5.7(4.5~7.5 cm)이였으며, 분지부에서 피부부터 신경까지의 평균 깊이는 2.4(1.8~3.2 cm)였으며, 통계적 분석 결과에서 거리와 키 조사 p-value 0.55, 거리와 몸무게 조사 p-value 0.34, 깊이와 키 조사 p-value 0.5, 깊이와 몸무게 조사 p-value 0.036 이였다. 결론: 한국 여성의 좌골 신경 분지 위치는 차이가 있었으며, 특히 몸무게에 따른 깊이 변화는 의미가 있었다. 한국 여성에서 좌골 신경 차단 술기를 시행할 때 평균 거리, 깊이를 생각하고 몸무게를 고려한다면 성공율이 증가할 것으로 생각되며, 슬와 주름 7.5 cm 상방에서 시행할 것을 추천하다.

• 한국음향학회지
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• 제40권4호
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• pp.270-277
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• 2021

강력초음파 분야에 있어서, 트랜스듀서의 고정을 위한 프렌지의 위치설정은 트랜스듀서의 변환효율에 큰 영향을 주는 중요한 요소이다. 본 연구에서는 볼트 체결형 란주반 초음파 트랜스듀서의 공진모드에 따른 프렌지의 설치 위치를 결정하기 위한 실험적 방법을 제안하였다. 제안된 방법에서는 반원형 쐐기 형태의 지그를 제작하여 트랜스듀서의 측면을 따라 이동하며 지그에 일정한 압력을 가한 후 트랜스듀서의 진동특성을 분석하였다. 압력을 가하는 위치에 따른 트랜스듀서의 입력 어드미턴스의 변화를 분석하여 프렌지의 최적의 위치를 결정할 수 있었다. 이 위치들은 메이슨 등가회로를 적용하여 계산한 공진 주파수 및 전송선로 모델 해석으로부터 계산한 각 공진 모드에 대한 입자속도 분포로부터 예측한 진동 모드의 절의 위치와 좋은 대응을 보이고 있어 본 연구에서 제안된 방법의 유효성을 확인할 수 있었다.

• The Journal of Korean Physical Therapy
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• 제18권1호
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• pp.75-82
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• 2006

Purpose: This study conducted the following experiment to examine transdermal permeation effects or 500 KHz ultrasound with lidocaine HCl. Methods; First, to experiment skin permeation enhancement effects of 500 KHz ultrasound frequency, it produced apparatus and transducer of 500 KHz ultrasound and Franz diffusion cell for skim permenation experiment suitable to purposes of the experiment. Transdermal permeation experiment applied Lidocaine HCL gel to skin of hairless mouse depending on ultrasound frequency and duty cycle and analyzed permeation ratio with HPLC. Results: As a result of fixing lidocaine HCl gel at the same intensity with pulsed mode and continuous mode and comparing transdermal permeation ratio by frequency, transdermal permeation ratio was increased at 500 KHz ultrasound and remarkably increased at continuous ultrasound. It was found that 1 MHz and 500 KHz ultrasound in transdermal permeation experiment enhanced transdermal permeation of lidocaine HCl. In particular, transdermal permeation of 500 KHz using lidocaine HCl gel was highest. Conclusion: However, researches considering various frequencies, intensities and application hours in low frequency areas including 500 KHz ultrasound are needed to increase deep permeation or drugs.

• 대한방사선기술학회지:방사선기술과학
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• 제46권1호
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• pp.15-21
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• 2023

This study was purpose to assessment of the resolution characteristics by using ATS 535H Basic quality assurance (QA) phantom for ultrasound. The ultrasound equipment was used Logiq P6 (Ultrasound, GE Healthcare System, Chicago, IL, USA). And the ultrasound transducer were used Convex 4C (4~5.5 MHz), Linear 11L (10~13 MHz), Sector 3SP (3~5.5 MHz) probe. As for the noise power spectrum (NPS) comparison results by using ATS 535H Basic QA ultrasound phantom and Convex 4C, Linear 11L, Sector 3SP probe. The NPS value of the Convex 4C probe image was 0.0049, Linear 11L probe image was 0.0049, Sector 3SP probe image was 0.1422 when the frequency is 1.0 mm^-1. The modulation transfer function (MTF) comparison results by using ATS 535H Basic QA ultrasound phantom and Linear 11L probe the MTF value of the 3 cm focus image was 0.7511 and 4 cm focus image was 0.9001 when the frequency is 1.0 mm^-1. This study was presented characteristics of spatial resolution a quantitative evaluation methods by using ultrasound medical images for QA of ultrasound medical QA phantom. The quality control (QC) for equipment maintenance can be efficiently used in the clinic due to the quantitative evaluation of the NPS and MTF as the standard methods. It is meaningful in that it is applied mutatis mutandis and presented the results of physical resolution characteristics of the ultrasound medical image.

• Biomedical Engineering Letters
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• 제8권4호
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• pp.355-364
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• 2018

When focusing using an ultrasonic transducer array, a main lobe is formed in the focal region of an ultrasound field, but side lobes also arise around the focal region due to the leakage. Since the side lobes cannot be completely eliminated in the focusing process, they are responsible for subsequent ultrasound image quality degradation. To improve ultrasound image quality, a signal processing strategy to reduce side lobes is definitely in demand. To this end, quantitative determination of main and side lobes is necessary. We propose a theoretically and actually error-free method of exactly discriminating and separately computing the main lobe and side lobe parts in ultrasound image by computer simulation. We refer to images constructed using the main and side lobe signals as the main and side lobe images, respectively. Since the main and side lobe images exactly represent their main and side lobe components, respectively, they can be used to evaluate ultrasound image quality. Defining the average brightness of the main and side lobe images, the conventional to side lobe image ratio, and the main to side lobe image ratio as image quality metrics, we can evaluate image characteristics in speckle images. The proposed method is also applied in assessing the performance of side lobe suppression filtering. We show that the proposed method may greatly aid in the evaluation of medical ultrasonic images using computer simulations, albeit lacking the use of actual experimental data.

• Journal of information and communication convergence engineering
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• 제7권4호
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• pp.535-538
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• 2009

Speckle noise reduction for ultrasound CT image using morphological adaptive median filtering based on edge preservation is presented in this paper. Speckle noise is multiplicative feature and causes ultrasound image to degrade widely from transducer. An input image is classified into edge region and homogeneous region in preprocessing. The speckle is reduced by morphological operation on the 2D gray scale by using convolution and correlation, and edges are preserved. The adaptive median is processed to reduce an impulse noise to preserve edges. As the result, MAM of the proposed method enhances the image to about 10% in comparison with Winner filter by Edge Preservation Index and PSNR, and 10% to only adaptive median filtering.

• 대한의용생체공학회:의공학회지
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• 제22권4호
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• pp.321-330
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• 2001

In this paper, we propose a new synthetic aperture focusing scheme for improving the lateral resolution which is one of the most important factors determining the quality of ultrasound imaging. The proposed scheme enables full round-trip dynamic focusing with approximately limited property. This properties are obtained through transmitting plane waves of which the traveling angle varies with the receive subaperture position, as opposed to stepping the spherical wave source across an array in other synthetic aperture focusing schemes, and employing dynamic focusing in receive. In this paper, the properties of the proposed scheme is analyzed in which a hypothetical infinite line source is used to transmit the plane waves and verified through computer simulation results. Also, we show that the proposed scheme is realizable with an array transducer with a finite aperture size. In summary, it is shown through comparison between the field contours of the proposed scheme and the conventional scheme that the proposed scheme can improve greatly the lateral resolution of ultrasound imaging.

• Journal of the Korean Physical Society
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• 제73권9호
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• pp.1289-1294
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• 2018

The present study aims to investigate experimentally and theoretically thermal ablation in soft tissues by using high intensity focused ultrasound (HIFU) to assess tissue damage during HIFU thermotherapy. The HIFU field was calculated by solving the axisymmetric Khokhlov-Zabolotskaya-Kuznetsov equation from the frequency-domain perspective. The temperature field was calculated by solving Pennes' bioheat transfer equation, and the thermal dose required to create a thermal lesion was calculated by using the thermal dose formula based on the thermal dose of a 240-min exposure at $43^{\circ}C$. In order to validate the simulation results, we performed thermal ablation experiments in a tissue-mimicking phantom and ex-vivo porcine liver for two different HIFU source conditions by using a 1.1-MHz, single-element, spherically focused HIFU transducer. The small difference between the measured and the predicted lesion sizes suggests that the implementation of the numerical model used here should be modified to iteratively allow for temperature-dependent changes in the physical properties of tissues.