• Korean Journal of Clinical Laboratory Science
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• v.55 no.3
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• pp.219-226
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• 2023

Transcranial doppler ultrasonography (TCD) applies a low frequency of 2 MHz to measure the blood flow velocity and waveform within the skull. Medical technologists at several hospitals are conducting these examinations, and education is being imparted in many schools and academic societies. However, the skill of the tester is of utmost importance when performing TCD. Technicians who are conducting the procedure for the first time have trouble locating the blood vessels, and some experienced personnel are worried because too many blood vessels are present. Since this procedure does not directly look at and measure blood vessels, there are several limitations and difficulties. Therefore, this study aims to provide some help by introducing precautions and suggestions for TCD technicians conducting the test.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.92-109
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• 2023

In patients with thyroid nodules, ultrasonography (US) has been established as a primary diagnostic imaging method and is essential for treatment decision. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is a pattern-based, US malignancy risk stratification system that can easily diagnose nodules during real-time ultrasound examinations. The 2021 K-TIRADS clarified the US criteria for nodule classification and revised the size thresholds for nodule biopsy, thereby reducing unnecessary biopsies for benign nodules while maintaining the appropriate sensitivity to detect malignant tumors in patients without feature of high risk thyroid cancer. Thyroid radiology practice has an important clinical role in the diagnosis and non-surgical treatment of patients with thyroid nodules, and should be performed according to standard practice guidelines for proper and effective clinical care.

• Childhood Kidney Diseases
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• v.28 no.2
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• pp.74-79
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• 2024

Purpose: To compare the Doppler sonographic findings of the left renal vein (LRV) of children diagnosed with nutcracker syndrome with and without orthostatic proteinuria. Methods: Fifty and 53 consecutive children with and without orthostatic proteinuria, respectively, underwent renal Doppler ultrasonography examinations. The peak velocity (PV) was measured at the hilar portion of the LRV and between the aorta and superior mesenteric artery. Renal Doppler ultrasonography findings and clinical data including urine protein-to-creatinine ratio (UPCR) were compared according to the presence or absence of orthostatic proteinuria. Results: Between the two groups, no significant differences were observed in terms of age or sex. The PV ratio between the aortomesenteric and hilar portions was 7.79±2.65 and 6.32±3.01 in children with and without orthostatic proteinuria, respectively (P=0.009). No significant differences were observed between the two groups in terms of the UPCR in the first morning urine sample. However, the UPCR in the afternoon urine sample was significantly higher in children with orthostatic proteinuria than in those without orthostatic proteinuria (0.49±0.46 mg/mg vs. 0.11±0.04 mg/mg, P<0.001). Furthermore, the PV ratio between the aortomesenteric and hilar portions revealed a positive correlation with the ratio of UPCR of the afternoon to that of first morning urine samples (R=0.21, P=0.034). Conclusions: This study suggests that there can be a significant correlation of the PV ratio between the aortomesenteric and hilar portion of the LRV with orthostatic proteinuria in pediatric patients with nutcracker syndrome.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.1
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• pp.15-20
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• 2010

Purpose: The goal of this study is to find out how useful ultrasonography is in measuring amount of effusion within the knee joint in comparison with physical examination and simple radiography. Materials and Methods: We evaluated total 60 cases which were suspicious for joint effusion. Average age was 61.3 years. The group was consisted of 22 males and 38 females, and 24 obese people and 36 non-obese people. Stroke test and patella floating test were done as physical examination. Amount of joint effusion was classified into 3 groups in simple lateral radiographic view and ultrasonography was used for recheck-up. Results: 39 cases were found positive in stroke test, and patella floating was shown in 20 cases. In simple lateral radiographic view, 47 cases of grade I, 7 cases of grade II and 3 cases of grade III were checked. Average $7.67{\pm}2.90mm$ amount of effusion was checked by ultrasonography. Amount of fluid in stroke test, patella floating test and simple lateral radiographic view showed close correlation with ultrasonography. Gender did not seem to affect physical examination, but strong correlation was found in female in simple radiography. Obese group showed closer relationship with all 3 exams compared with non-obese group. Physical examination was relatively effective with nonobese group, but not with obese group. And it was not easy to measure the amount of fluid with simple radiographic view, but we could obtain objective data from ultrasonography by measuring the amount of effusion dynamically. Conclusion: We concluded that more objective data was obtained with ultrasonography in comparison with physical examinations and simple radiography in the aspect of measuring amount of joint fluid.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.64-68
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• 2000

Objectives: With the recent advances and increasing use of imaging techniques in examination of the neck, the incidence of incidentally discovered thyroid carcinoma has been increasing. This study was carried out to evaluate the clinicopathologic characteristics of incidental thyroid carcinomas and to find optimal therapeutic strategies for these lesions. Materials & Methods: From Jan. 1988 to Aug. 1998, 1,053 patients were operated on for thyroid cancer, of whom 127(12.1%) had incidentally discovered thyroid cancers which were identified during routine health checkups(n=40), diagnostic procedures for unrelated medical conditions(n=39) and mass screening for thyroid cancer(n=48). The preoperative diagnosis was obtained by ultrasound-guided FNAB and the extent of surgery was determined based on frozen section examinations, as well as prognostic factors and gross findings at the time of surgery. Results: There were 6 men and 121 women with a mean age of 45.9 years. Histopathological diagnosis included papillary carcinomas(n=1l9), follicular carcinomas(n=6), poorly differentiated carcinoma(n=l) and medullary carcinoma(n=1). Thirty patients(23.6%) had multifocallesions. The mean diameter of the tumors was 1.1 cm(0.2-3.4 cm). Capsular invasions were found in 53 patients(41.7%) and nodal metastases in 41(32.3%). The surgical procedures used were: 90 less-than total thyroidectomies and 37 total thyroidectomies with central neck node dissection. Lateral neck dissection was added in 5 patients. According to TNM staging, 79 patients(63.2%) were at stage I, 15(12.0%) at stage II, 31(24.8%) at stage III and 0(0.0%) at stage IV. By AMES scoring system, 102 patients(81.6%) were in the low-risk group and 23(18.4%) in the high-risk group. And by MACIS scoring system, 103(86.6%) of 119 papillary thyroid cancer patients were less than 6. Conclusions: The clinicopathological characteristics of incidentally discovered thyroid carcinomas are similar to ordinary thyroid carcinomas. The treatment of choice should be individualized based on the particular clinical situation encountered, as in ordinary thyroid carcinomas.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6411-6414
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• 2014

Background: A dense breast not only reduces the sensitivity of mammography but also is a moderate independent risk factor for breast cancer. The percentage of Western women with fat breast tissue is higher aged 40 years or older. To a certain extent, mammography as a first choice of screening imaging method for Western women of this group is reasonable. Hitherto, the frequency and age distribution of mammographic breast density patterns among Chinese women had not been characterized. The purpose of this study was to investigate the frequency and age distribution of mammographic breast density patterns among a group of Chinese screening women and breast cancer patients in order to provide useful information for age-specific guidelines for breast cancer screening in Chinese women. Methods: A retrospective review of a total of 3,394 screening women between August and December 2009 and 2,527 breast cancer patients between July 2011 and June 2012 was conducted. Descriptive analyses were used to examine the association between age and breast density. The significance of differences of breast density between the screening women and the breast cancer patients was examined using nonparametric tests. Results: There was a significant inverse relationship between age and breast density overall (r=-0.37, p< 0.01). Breast density of the breast cancer patients in the subgroups of 40-49 years old was greater compared with that of the screening women, the same in those aged 50-54 years and in those 55 years old or older, less than in the screening group. Conclusions: With regard to the Chinese women younger than 55 years old, the diagnostic efficiency of breast cancer screening imaging examinations may be potentially improved by combining screening mammography with ultrasound.

• Korean Journal of Community Nutrition
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• v.12 no.3
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• pp.352-360
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• 2007

Several nutrients are known to affect bone mineral density (BMD). However, these nutrients are combined with food intake and dietary patterns and little is known about the association of dietary patterns and BMD. The objective of this study was to investigate the association of dietary patterns with BMD in Korea Genome Epidemiology Study subjects. Among 2,884 women (40-69 yr) recruited at baseline study (2001), 861 subjects with BMD measurements at baseline and a 4-year follow up study (2005) completed the semi-quantitative food frequency questionnaire. BMD was measured by the Quantitative Ultrasound method. One hundred three food items were combined into 17 food groups and 4 dietary patterns were identified by factor analysis. Cluster analysis using factor score classified each subject into one of three dietary pattern groups named 'Rice and kimchi eating' (n = 617), 'Contented eating' (n = 124), and 'Healthy and light eating' (n = 120). The 'Healthy and light eating' group, characterized by higher intake of fruit, vegetables, fish, milk and dairy products, and younger age, more exercise, higher education, and higher income than other groups. The tibia BMD of the 'Healthy and light eating' group was higher than the other groups after adjusting for the age. After the adjustment for the age BMI and exercise, the 'Healthy and light eating' group showed significantly lower odds of tibia osteopenia/osteoporosis risk compared to the 'Rice and kimchi eating' group both at the baseline [OR(95% CI) : 0.50(0.30-0.84)] and follow-up [OR(95% CI) : 0.59(0.36-0.97)] examinations. The dietary pattern with low calorie and high intakes of fruit, vegetables, fish, milk and dairy products may have beneficial effects on BMD in middle-aged women.

• Journal of the Optical Society of Korea
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• v.20 no.5
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• pp.607-613
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• 2016

The pleura is known as an end target organ of exposure to toxic environmental materials such as fine particulate matter and asbestos. Moreover, long-term exposure to hazardous materials can eventually lead to fatal lung disease such as diffuse pleural fibrosis or mesothelioma. Chest computed tomography (CT) and ultrasound are gold standard imaging modalities for detection of advanced pleural disease. However, a diagnostic tool for early detection of pleural reaction has not been developed yet due to difficulties in imaging ultra-fine structure of the pleura. Optical coherence tomography (OCT), which provides cross-sectional images of micro tissue structures at a resolution of 2-10 μm, can image the mesothelium with a thickness of ~100 μm and therefore enables investigation of the early pleural reaction. In this study, we induced the early pleural reaction according to a time sequence after pleurodesis using talc, which has been widely used in the clinical field. The pleural reaction in talc grouped according to the time sequence (1st, 2nd, 4th weeks) showed a significant thickening (average thickness: 45 ± 7.5 μm, 80 ± 10.7 μm, 90 ± 12.5 μm), while the pleural reaction in sham and normal groups showed pleural change from normal to minimal thickening (average thickness: 16 ± 5.5 μm, 17 ± 4.5 μm, 15 ± 6.5 μm, and 12 ± 7.5 μm, 13 ± 2.5 μm, 12 ± 3.5 μm). The measurement of pleural reaction by pathologic examinations was well-matched with the measurement by OCT images. This is the first study for measuring the thickness of pleural reactions using a biophotonic modality such as OCT. Our results showed that OCT can be useful for evaluating the early pleural reaction.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.293-301
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• 2019

Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.379-394
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• 2020

Purpose To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.