• Korean Journal of Radiology
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• v.25 no.6
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• pp.559-564
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• 2024

Incidental pancreatic cystic lesions are a common challenge encountered by diagnostic radiologists. Specifically, given the prevalence of benign pancreatic cystic lesions, determining when to recommend aggressive actions such as surgical resection or endoscopic ultrasound with sampling is difficult. In this article, we review the common types of cystic pancreatic lesions including serous cystadenoma, intraductal papillary mucinous neoplasm, and mucinous cystic neoplasm with imaging examples of each. We also discuss high-risk or worrisome imaging features that warrant a referral to a surgeon or endoscopist and provid several examples of these features. These imaging features adhere to the latest guidelines from the International Consensus Guidelines, American Gastroenterological Association (2015), American College of Gastroenterology (2018), American College of Radiology (2010, 2017), and European Guidelines (2013, 2018). Our focused article addresses the imaging dilemma of managing incidental cystic pancreatic lesions, weighing the options between imaging follow-up and aggressive interventions.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.78-84
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• 2020

Purpose: This paper compares the clinical outcomes of patients who were treated with a cervical nerve block by ultrasound and C-arm and reports the complication. Materials and Methods: A total of 97 patients were treated with an ultrasound-guided nerve root block from May 1, 2015 to February 8, 2018. On the other hand, 94 patients were treated with a C-arm guided nerve root block. The consequences of the cervical pain and the radiating pain before and after the procedures were reviewed using the verbal numeric rating scale (VNRS). In addition, the complications related to the procedures from the daily notes from the chart were inspected. Results: Sixty-six cases out of 97 cases of ultrasound-guided nerve root block were enrolled in the study. The average age of the patients was 57 years, including 41 males and 25 females. Seventy seven out of 94 cases by a C-arm guided root block were included in the study. The average age of the patients was 55 years, including 40 males and 37 females. Before the nerve root block, the mean numeric rating pain scale (NRS) of the cervical pain in ultrasound-guided block decreased from 5.4 points to 2.7 points at three weeks and 1.4 points at six weeks (p=0.0023, p<0.001), and 3.1 points in the C-arm (p<0.001, p<0.001) at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the case of radiating pain, the mean NRS in the ultrasound-guided nerve root block group improved from 6.3 points after the procedure to 2.8 points at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the C-arm guided nerve root block group, the NRS improved from 7.4 points after the procedure to 3.3 points at three weeks and 1.9 points at six weeks. In the case of complications, Horner's syndrome and propriospinal myoclonus were observed in one case of C-arm guided block group. Conclusion: The clinical results of the patients who underwent ultrasound-guided cervical nerve root block were not significantly different from those who underwent a C-arm guided cervical nerve root block.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.228-232
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• 2001

Gastrointestinal involvement occurs in two thirds of children with Henoch-Sch$\"{o}$nlein purpura (HSP) and intussusception is by far the most common abdominal complication. Intussusception in HSP almost originates in the small bowel, which is in contrast with idiopathic intussusception. Earlier diagnosis and prompt treatment of intra-abdominal complications can reduce the mortality and ultrasound is the imaging modality of choice in evaluation the bowel manifestations of HSP. We report a case of jejuno-jejunal intussusception associated with HSP in a 5-year-old boy who presented with diffuse abdominal pain and vomiting after a few days of HSP onset. Abdominal ultrasound demonstrated intussusception in the jejunum with well defined target appearance because of the thickened intussusceptum, which disappeared on the computerized tomographic examination checked approximately 24 hours later. A brief review of literature was made.

• Journal of Oral Medicine and Pain
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• v.45 no.3
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• pp.49-55
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• 2020

Purpose: This study investigated the association between the objective indicator of masticatory function assessment and the masseter muscle thickness (MMT) using ultrasound imaging. Methods: A total of 99 subjects (males: 24, females: 75, mean age: 76) were analyzed. The maximum bite force (MBF) was measured with a pressure-sensitive sheet and an image scanner. The mixing ability index (MAI) was calculated by image analysis after asking the subjects to chew a wax specimen. The MMT during rest and clenching were obtained with a diagnostic ultrasound system, and the difference in MMT during rest and MMT during clenching was defined as the difference in masseter muscle thickness (DMMT). Multiple regression analysis was performed to determine the independent variables affecting MBF and MAI. Results: The MBF showed correlation with the number of remaining teeth (β=0.346, p=0.002) and DMMT (β=0.251, p=0.011). The MAI correlated with only the number of remaining teeth (β=0.476, p<0.001). Conclusions: The DMMT reflects the state of masseter muscle contraction, and can be used as a predictor as well as the number of teeth when assessing masticatory function.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.186-189
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• 2013

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) now provides an important alternative diagnostic modality in patients with intrathoracic tuberculosis lymphadenopathy. The procedure is well tolerated in the outpatient setting, provides access to the mediastinal and hilar lymph node locations commonly in tuberculosis and also allows bronchial washing to be performed at the same procedure. However, there is no report of EBUS-TBNA applied to children to diagnose tuberculosis. We report a case of EBUS-TBNA applied to children who had intrathoracic tuberculosis lymphadenopathy.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.333-339
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• 2018

Background Flap volume is an important factor for obtaining satisfactory symmetry in breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) free flap. We aimed to develop an easy and simple method to estimate flap volume. Methods We performed a preoperative estimation of the TRAM flap volume in five patients with breast cancer who underwent 2-stage breast reconstruction following an immediate tissue expander operation after a simple mastectomy. We measured the height and width of each flap zone using a ruler and measured the tissue thickness by ultrasound. The volume of each zone, approximated as a triangular or square prism, was then calculated. The zone volumes were summed to obtain the total calculated volume of the TRAM flap. We then determined the width of zone II, so that the calculated flap volume was equal to the required flap volume ($1.2{\times}1.05{\times}$the weight of the resected mastectomy tissue). The TRAM flap was transferred vertically so that zone III was located on the upper side, and zone II was trimmed in the sitting position after vascular anastomosis. We compared the estimated flap width of zone II (=X) with the actual flap width of zone II. Results X was similar to the actual measured width. Accurate volume replacement with the TRAM flap resulted in good symmetry in all cases. Conclusions The volume of a free TRAM flap can be straightforwardly estimated preoperatively using the method presented here, with ultrasound, ruler, and simple calculations, and this technique may help reduced the time required for precise flap tailoring.

• Journal of Veterinary Clinics
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• v.34 no.4
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• pp.229-233
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• 2017

The object of the present study was to compare abnormal serum canine pancreas-specific lipase results and pancreatic ultrasonographic findings in dogs with pancreatitis. Pancreatitis is a common disease in dogs that is difficult to diagnose. The noninvasive diagnostic procedures, including a serum canine pancreatic-specific lipase (cPL) test and ultrasonographic changes in the pancreas, can be considered for the diagnosis of canine pancreatitis in clinical practice. A retrospective study was performed to assess pancreatitis in dogs. Forty client-owned dogs were suspected to have pancreatitis, which was confirmed by abnormal serum SNAP cPL results. Abdominal ultrasound examinations were also performed. The present study investigated the distribution of clinical signs associated with pancreatitis, and the dogs were divided into two groups: group 1 (clinical signs compatible with pancreatitis; n = 30) and group 2 (no clinical signs; n = 10). Based on this study, an abnormal result on the SNAP cPL assay can still present as a normal pancreas through an ultrasonographic examination, and a normal health status can identify the status of pancreatic ultrasonographic abnormal lesions. Therefore, for dogs with suspected pancreatitis, it is important to repeat an ultrasonographic evaluation. There is no significant difference between clinical symptoms and ultrasonographic changes in the pancreas.

• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.355-358
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• 2011

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful, safe diagnostic modality for evaluating mediastinal and hilar lymphadenopathy. We report a 51-year-old male who presented with a left renal mass and multiple pleural masses without lung parenchymal lesions. The pleural masses were thought to be metastatic tumors or malignant mesothelioma. The patient underwent two percutaneous needle biopsies of the pleural mass, but the specimens were insufficient for a histopathological diagnosis. Because one pleural mass was adjacent to the right main bronchus, we decided to perform EBUS-TBNA for the pleural mass. As a result, sufficient core tissue was obtained with no complications, and the histopathological findings were consistent with metastatic papillary renal cell carcinoma. To our knowledge, this is the first case of using EBUS-TBNA for a pleural mass.

• KIPS Transactions on Software and Data Engineering
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• v.4 no.7
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• pp.297-300
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• 2015

In medical ultrasonography, transit time and contrast enhancement patterns are considered as important parameters to analyze liver diseases. In many recent researches, time-intensity curves(TIC) have been used for calculating the transit time of the contrast agents. However, the intensity curve may include the variations which are caused by the micro-bubble effect of contrast agents. In this paper, we propose a complementary approach to diagnostic parameter extraction which utilizes a density information as well as the intensity data. The proposed technique improves the accuracy in extraction of the transit time and velocity of contrast agents for detection and characterization of focal liver lesions. Through the experiments using a set of clinical data, we show that the proposed methods can improve the reliability of the parametric image data.

• The Korean Journal of Pain
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• v.33 no.1
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• pp.48-53
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• 2020

Background: The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade. Methods: This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination. Results: The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection. Conclusions: The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.