• 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.

• International Journal of Vascular Biomedical Engineering
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• v.1 no.1
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• pp.13-23
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• 2003

Backgrounds: The present study in angulated coronary stenosis was to evaluate the influence of velocity and wall shear stress (WSS) on coronary atherosclerosis, the changes of hemodynamic indices following coronary stenting, as well as their effect of evolving in-stent restenosis using human in vivo hemodynamic parameters and computed simulation quantitatively and qualitatively. Methods: Initial and follow-up coronary angiographies in the patients with angulated coronary stenosis were performed (n=80). Optimal coronary stenting in angulated coronary stenosis had two models: < 50 % angle changed(model 1, n=43), > 50% angle changed group (model 2, n=37) according to percent change of vascular angle between pre- and post-intracoronary stenting. Flow-velocity wave obtained from in vivo intracoronary Doppler study data was used for in vitro numerical simulation. Spatial and temporal patterns of velocity vector and recirculation area were drawn throughout the selected segment of coronary models. WSS of pre/post-intracoronary stenting were calculated from three-dimensional computer simulation. Results: Follow-up coronary angiogram demonstrated significant difference in the percent of diameter stenosis between two groups (group 1: $40.3{\pm}30.2$ vs. group 2: $25.5{\pm}22.5%$, p<0.05). Negative WSS area on 3D simulation, which is consistent with re-circulation area of velocity vector, was noted on the inner wall of post-stenotic area before stenting. The negative WSS was disappeared after stenting. High spatial and temporal WSS before stenting fell into within physiologic WSS after stenting. This finding was prominent in Model 2 (p<0.01) Conclusions: The present study suggests that hemodynamic forces exerted by pulsatile coronary circulation termed as WSS might affect on the evolution of atherosclerosis within the angulated vascular curvature. Moreover, geometric change, such as angular difference between pre / post-intracoronary stenting might give proper information of optimal hemodynamic charateristics for vascular repair after stenting.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.23-33
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• 2019

Background Venous malformations (VMs) are a common type of vascular malformation. However, their causes and management remain unclear, and few studies specific to VMs of the head and neck have been reported. This study describes our experiences with VMs of the head and neck. Methods This retrospective study included 82 patients who underwent treatment for head and neck VMs, among 222 who visited our vascular anomalies center. Medical records between 2003 and 2016 were reviewed to identify common features in the diagnosis and treatment. The diagnosis of suspected head and neck VMs was based on the results of imaging studies or biopsies, and the VMs were analyzed based on magnetic resonance imaging, computed tomography, and Doppler sonography findings. Results VMs were slightly more common in female patients (59.8%), and 45.1% of patients developed initial symptoms at the age of 10 or younger. Lesions were slightly more common on the right side (47.3%). The main sites involved were the cheek (27.7%) and lip area (25.5%). The muscle layer was commonly involved, in 98.7% of cases. Small lesions less than 5 cm in diameter accounted for 60.8% of cases, and well-defined types were slightly more prevalent at 55.4%. Improvement was observed in 77.1% of treated patients. Conclusions Early and accurate diagnosis and appropriate treatment according to individual symptoms are important for successful treatment of VMs. If treatment is delayed, the lesions can worsen, or recurrence becomes more likely. Therefore, VMs require a multidisciplinary approach for early and accurate diagnosis.

• Journal of Biomedical Engineering Research
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• v.19 no.3
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• pp.313-320
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• 1998

Tri-phasic pulsatile flow is the general flow pattern of human circulary system. In emulating the various situation of cardiovascular system, it is essential to make tri-phasic source flow. To emulate tri-phasic pulsatile flow, we used electro-hydronic style LVAD(Left Ventricular Assist Device) with glass phantom and rubber tube. We have selected control parameters and examined the changing effect of each parameter by using Doppler ultrasound. In this experiment, it was shown that the distal compliance and the break time were the major factors to form tri-phasic flow. The results make it possible to emulate and explain the various situation of human vascular system. In this point, this results will be an useful method in the clinic application.

• Journal of Acupuncture Research
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• v.18 no.5
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• pp.147-154
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• 2001

Amun(GV15), Habkook(LI4) and Shinsu(B23) have been used as a meridian point for apoplexy, hypertention, vertigo etc. The effects of GV 15, LI4 and B23 on the vascular system is not known. The purpose of this Study was to investigate the effect of several meridian points on the regional cerebral bloof flow(rCBF), mean arterial blood pressure(BP) in rats. The changes of BP and rCBF were tested Laser-Doppler Flowmetry(LDF). Results : The results of this Study were obtained as follows ; 1. GV15 and LI4 were increased significantly rCBF. 2. GV15, LI4 and B23 were increased BP, but have not significance. Conclusion : This results suggest that GV15 was increased rCBF by increasing pial arterial diameter, and LI4 was increased rCBF by increasing BP.

• Archives of Reconstructive Microsurgery
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• v.13 no.1
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• pp.29-35
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• 2004

Materials and Methods: Total number of peroneal perforator flap is 14 cases, which 10 cases were man, 4 cases were woman. The range of age was 12 years old minimally and until 63 years old. The trauma was most common etiology, which was like traffic accidents, 9 cases. We confirmed tibialis anterior artery patency by doppler flow meter, angiography as preoperative evaluation. Results: 1. The success rate was 91%, that in 14 cases, 13 cases were succeded. 2. To obtain successful result of peroneal flap, one must have the anatomic concept for vascular pattern, 8 cases were between peroneus muscle and soleus muscle branch type but, 3 cases were through soleus muscle branch type, so we treated these cases by using soleus muscle including peroneal perforating branch not to injury perforating artery directly. 3. The pedicle size was between minimally $2{\times}2.5cm$ and maximally $6.5{\times}8.5cm$ so we could treat large recipient site. 4. The pedicle length was between minimally 3.2 cm and maximally 11.5cm, average 7.5 cm. 5. The diameter of perforating artery was estimated by inspection, that was about 0.2-0.5 cm Conclusion: The peroneal perforating artery flap has merits that we can approach in avascular zone and has wide movable range from foot to distal femur and little donor site mobidity and can harvest osteocutaneous flap. The weak point was the irregular anatomy of nutrient artery and not to contain sensory nerve.

• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.181-185
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• 2019

Intraosseous hemangioma is a rare, slow-growing, benign tumor of blood vessels. Primary hemangioma of the skull is a benign lesion that may appear as a palpable mass or accidentally detected during image evaluation. Simple radiography is the most commonly used technique to localize a lesion and computed tomography (CT) may help determine the effect of a lesion. We report a case of multifocal intraosseous calvarial hemangioma developed in the subgaleal plane of an elderly male patient. Ultrasonography examination revealed hyperechoic striated septae parallel to the skin and discontinuity of the focal cortex, however, the underlying bone cortex appeared relatively intact. No significant flow is observed on Doppler ultrasonography. Based on these evaluations, the mass was interpreted by a radiologist as a subgaleal lipoma. This case highlights the importance of additional CT examination in a patient presenting with a scalloping sign of the underlying calvarium. Clinicians also should be aware of the possibility of intraosseous calvarial hemangiomas in lesion. Furthermore, the proper choice of congenital vascular malformation term is still quite confusing with misconception present in the literature.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.646-650
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• 2021

Head and neck reconstruction poses unique challenges in rehabilitating surgical defects in terms of integrity, function, and form. The radial forearm free flap (RFFF) has been widely used for defect coverage, especially in the head and neck area, but its versatility allows it to be used for soft-tissue reconstruction in various parts of the body. The vascular features of the flap are quite constant and reliable. Nevertheless, abnormalities of the forearm vascular tree have been described over the decades. We report a case of intraoral reconstruction after verrucous carcinoma recurrence in a 74-year-old woman with an unusual forearm flap, which we called the median forearm free flap, based on a median branch of the radial artery that was preoperatively detected using handheld Doppler ultrasonography. The distally located skin paddle was predominantly supplied by the aberrant median vessel with its perforators. The flap was thus safely harvested with this atypical pedicle. Successful reconstruction of the intraoral defect was achieved, with an uneventful postoperative course.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.759-772
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• 2019

Objective: To investigate the value of ultrasound (US) microflow assessment in distinguishing malignant from benign solid breast masses as well as the association between US parameters and histologic microvessel density (MVD). Materials and Methods: Ninety-eight breast masses (57 benign and 41 malignant) were examined using Superb Microvascular Imaging (SMI) and contrast-enhanced US (CEUS) before biopsy. Two radiologists evaluated the quantitative and qualitative vascular parameters on SMI (vascular index, morphology, distribution, and penetration) and CEUS (time-intensity curve analysis and enhancement characteristics). US parameters were compared between benign and malignant masses and the diagnostic performance was compared between SMI and CEUS. Subgroup analysis was performed according to lesion size. The effect of vascular parameters on downgrading Breast Imaging Reporting and Data System (BI-RADS) category 4A masses was evaluated. The association between histologic MVD and US parameters was analyzed. Results: Malignant masses were associated with a higher vascular index (15.1 ± 7.3 vs. 5.9 ± 5.6), complex vessel morphology (82.9% vs. 42.1%), central vascularity (95.1% vs. 59.6%), penetrating vessels (80.5% vs. 31.6%) on SMI (all, p < 0.001), as well as higher peak intensity (37.1 ± 25.7 vs. 17.0 ± 15.8, p < 0.001), slope (10.6 ± 11.2 vs. 3.9 ± 4.2, p = 0.001), area (1035.7 ± 726.9 vs. 458.2 ± 410.2, p < 0.001), hyperenhancement (95.1% vs. 70.2%, p = 0.005), centripetal enhancement (70.7% vs. 45.6%, p = 0.023), penetrating vessels (65.9% vs. 22.8%, p < 0.001), and perfusion defects (31.7% vs. 3.5%, p < 0.001) on CEUS (p ≤ 0.023). The areas under the receiver operating characteristic curve (AUCs) of SMI and CEUS were 0.853 and 0.841, respectively (p = 0.803). In 19 masses measuring < 10 mm, central vascularity on SMI was associated with malignancy (100% vs. 38.5%, p = 0.018). Considering all benign SMI parameters on the BI-RADS assessment, unnecessary biopsies could be avoided in 12 category 4A masses with improved AUCs (0.500 vs. 0.605, p < 0.001). US vascular parameters associated with malignancy showed higher MVD (p ≤ 0.016). MVD was higher in malignant masses than in benign masses, and malignant masses negative for estrogen receptor or positive for Ki67 had higher MVD (p < 0.05). Conclusion: US microflow assessment using SMI and CEUS is valuable in distinguishing malignant from benign solid breast masses, and US vascular parameters are associated with histologic MVD.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.719-724
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• 2011

Purpose: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing noninvasive operator-independent details of the vascular anatomy. This tool was used to perform an $in$ $vivo$ anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. Methods: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. Results: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. Conclusion: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.