담낭암은 드물지만 치명적인 악성 종양으로 초기에는 증상이 없어 대부분의 담낭암이 늦게 진단되고, 급속하게 인접 장기로 전이되기 때문에 예후가 불량하다. 따라서 담낭암을 조기에 발견하는 경우는 드물고, 담낭담석이나 용종으로 수술적 절제를 시행한 후 우연히 발견되는 때가 대부분이다. 저자들은 급성 무결석 담낭염 환자에서 초음파 내시경을 통해 비교적 조기에 담낭관암을 발견하여 성공적으로 치료할 수 있었던 증례를 경험하였다. 이에 문헌고찰과 함께 보고한다.

The aims of this study were to measure the ultrasonographic biometry of genitalia of the indigenous rams and observe the relationship of biometry on semen parameters. The epididymal volume was significantly reduced (p < 0.01) after semen collection compared with before collection for both left and right part in all rams. The cumulative results showed that although there was no significant difference in length, width and volume of epididymis between before and after semen collection, however the values were lower after collection. The epididymal length was significantly correlated with epididymal volume (p < 0.01), semen motility (p < 0.05) and semen morphology (p < 0.01). Epididymal width was only significantly correlated with epididymal volume (p < 0.01) not with the semen parameters. Epididymal volume had a significant correlation only with semen morphology (p < 0.01).The scrotal circumference had the significant correlation with semen density, mass activity, concentration and motility (p < 0.01). The epididymis had the similar or slightly increased echogenicity as compared to the normal testis. During whole study, some white spots were found on testis which did not affect the semen quantity and quality. Significant variation was observed only for semen concentration and motility among the rams (p < 0.05). The overall normal morphology was 90.5 ± 4.6% with highest percentage of coiled tail abnormalities.

The present study was conducted in a goat farm for pregnancy diagnosis by using vaginal cytology and B-mode real time ultrasound using 5 MHz probe by transabdominal method. Seventeen pregnant does were used for this study. The objective of the study was to determine the earliest day of pregnancy and describe the chronological characteristics of pregnancy from day 22 to day 40 for vaginal cytology and day 25 to day 60 for ultrasonography of gestation. The differences among the average percentage of cell value in different age of pregnancy were significant (p < 0.05). The average percentage of intermediate cells (81.12%) was also significantly (p < 0.05) higher than superficial (9.41%), keratinized (7.10%) and neutrophil (2.61%) on 22-40th days of pregnancy. In case of real time B-mode ultrasonography, the gestational sac was observed only in three does out of seventeen (17.6 %) at 25-30 days whereas the placentomes and heart beat of the foetus were first detected at 31-35 days in six does (35.3%). The foetal leg buds were first visualized at 36-40 days in four does (23.5%) whereas the foetal vertebral column was first observed at 36-40 days of gestation in only three does (17.6%). In conclusion, vaginal cytology and trans-abdominal ultrasonography can be used for detection of early pregnancy in does.

본 연구는 내리막 달리기(downhill running, DR) 후 초음파 영상분석을 이용해 대퇴사두근 무리 (quadriceps group, QG) 내 근손상의 국소화 여부를 검증하고, DR 동안 운동 강도가 운동유발성 근손상 (exercise-induced muscle damage, EIMD) 및 근육 반향세기 변화에 미치는 영향을 규명하려는 목적으로 수행되었다. 규칙적인 신체활동이 없는 건강한 남성 11명이 무작위 교차설계에 따라 서로 다른 강도 [low-intensity DR session(50%HRmax), LDR; high-intensity DR session(70%HRmax), HDR]의 DR 운동을 수행하였다. DR 후 EIMD의 심각성은 혈청크레아틴 키나아제(creatine kinase, CK) 활성 수준 변화와 함께 신경근 기능 지수로서 무릎 신전근의 최대 수의적 등척성 수축(maximal voluntary isometric contraction, MVIC) 및 관절가동범위(range of motion, ROM) 변화를 통해 결정되었다. 회색조 분석을 적용한 근육 반향세 기 평가는 DR에 따른 QG 내 국소 근육별(rectus femoris, RF; vastus lateralis, VL; vastus medialis, VM; vastus intermedius, VI) 손상 양상을 탐지하기 위해 활용되었다. 모든 세션에서 혈청 CK 활성 수준과 VL 및 VM의 근통증 정도는 운동 후 24시간째(RF의 경우 각각 LDR 24시간째와 HDR 48시간째) 최대에 이르렀으며, 혈청 CK 수준에서 운동 강도에 따른 유의한 차이(p<.05)가 나타난 반면 근통증에서 세션 간 통계적 차이는 없었다. 무릎 관절을 이용한 MVIC 및 ROM과 같은 신경근 기능 지표 및 VM을 제외한 모든 QG 근육 반향세기는 운동 직후 극적으로 감소 또는 증가 후 72시간까지 점진적 회복 양상을 나타내었다. 그러나 신경근 기능 지표에서 운동 강도에 따른 통계적 차이는 없었으나 RF 및 VL 반향세기에서 세션 내 및 세션 간 유의한 차이(p<.01)를 나타내었다. 본 연구의 결과로 ECC를 함유한 DR 운동 시 운동 강도는 DOMS 및 신경근 기능 지표에 부분적으로 영향을 미칠 가능성이 있으며, 특히 혈청 CK 수준과 함께 RF 및 VL의 근육 반향세기는 운동 강도의 영향을 직접적으로 반영한다는 사실을 알 수 있다. 또한, 현재 연구결과는 DR동안 ECC를 겪는 QG 내 국소 근육 간 근손상 정도가 다를 수 있으며 초음파 근육 반향세기가 국소 근육의 EIMD 심각성을 차별화할 수 있는 유용한 평가기법임을 뒷받침하고 있다.

Background:Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing.Objective:The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility.Methods:Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels.Results:The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05).Conclusion:These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

목 적 : 간 자기공명영상에서 Screening Dixon, Multi Echo Dixon, High-speed T2-corrected Multi Echo acquisition at 1H MR spectroscopy의 지방간 평가를 초음파 검사와 비교하여 간 자기공명상에서 지방간 평가의 유용성을 알아보고자 하였다. 대상 및 방법 : 2014. 8월~2015. 8월까지 본원을 내원하여 간 자기공명영상 검사를 시행한 환자들 중 검사시행 3개월 전· 후에 초음파 검사를 동시에 시행한 138명(남: 101명, 여: 37명, 평균연령: 60.2세)의 환자를 대상으로 하였다. 연구에 사용 된 MRI 장비는 Magnetom Skyra 3.0T(Siemens Healthcare, Germany)였으며 18ch Body array coil을 이용하여 Screening Dixon, Multi Echo Dixon, High-speed T2-corrected Multi Echo acquisition at 1H MR spectroscopy(이하 HISTO) 기법의 검사를 시행하였다. 초음파 장비는 iu22(Philips healthcare, Netherlands), E9(GE healthcare, America)였으며 C3-5 convex probe를 사용 하였다. 지방간의 분석은 Screening Dixon에서 지방간의 유·무와 Multi Echo Dixon, HISTO 기 법간의 지방간 유무를 각각 비교하였으며 Multi Echo Dixon과 HISTO 기법에서는 지방 함유량에 따라 normal(5% 이하), mild(5~33%), moderate(33~66%), severe(66% 이상)로 나누어 두 기법 간 비교 및 초음파 검사와 비교하여 그 유의성을 SPSS21 통계프로그램을 이용하여 person χ2(카이제곱) 검증하였다. 결 과 : Screening Dixon과 Multi Echo Dixon, Screening Dixon과 HISTO 기법을 비교한 결과, Screening Dixon에서 지 방간을 가진 환자가 가장 많은 것으로 나타났지만 통계적인 차이는 없었으며(p>0.05), Multi Echo Dixon과 HISTO 기법을 normal, mild, moderate, severe 군으로 나누어 비교한 결과 두 기법에서의 유의한 차이는 없는 것으로 나타났다(p>0.05). 반면 Multi Echo Dixon과 초음파, HISTO와 초음파의 각각의 비교에서는 초음파 검사에서 지방간으로 평가되는 환자가 Multi Echo Dixon, HISTO에 비해 많은 것으로 나타났으며(p<0.05), normal 군의 환자가 많이 감소한 반면 moderate, severe군으로 평가되는 환자가 많이 증가하였다. 결 론 : Screening Dixon, Multi Echo Dixon, High-speed T2-corrected Multi Echo acquisition at 1H MR spectroscopy(HISTO)의 지방간 평가를 초음파 검사와 비교한 결과 자기공명영상을 이용한 평가에서는 기법 간에 유의한 차이가 없는 것으로 나타났으나 초음파와 비교에서는 유의한 차이가 있는 것으로 나타났다. 그러나 자기공명영상을 이용한 검사는 간 자기공명영상 검사에서 부가적인 검사로 짧은 시간에 지방간을 정량화 할 수 있다는 장점이 있었다.

MEN1 환자에서 췌장 NET는 30-80% 동반된다. 증상 및 악성 가능성이 있는 경우 수술적 절제가 예후에 중요한 영향을 미친다. 수술이 불가능한 췌장 NET에 대해 EUS-EI를 고 려할 때는 합병증과 불완전 치료 및 재발 가능성에 대한 주 의 깊은 고려가 필요하다.

Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at 60° abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at 60° abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at 60° abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni’s post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.

The aim of this study is to compare measurements of abdominal muscle thickness using ultrasonography imaging (USI) to those using a special transducer head device, during five different trunk stabilization exercises, ultimately to determine which exercise led to the greatest muscle thickness. Thirty eight healthy subjects participated in this cross-sectional study. The five types of trunk stabilization - i.e., a sit-up on the supine, an upper and lower extremity raise with quadruped on the prone, a leg raise in sitting on the ball, trunk rolling on the ball, and balance using sling on the prone position - were each performed with an abdominal draw. The thickness of the abdominal muscle - including the transverse abdominal (TrA), internal oblique (IO), and external oblique (EO) - was measured by USI with a special transducer head device, at rest and then at contraction in each position. Data were analyzed using one-way repeated ANOVA with the level of significance set at =.05. The results were as follows: 1) the TrA thickness was statistically significant (p<.05), whereas the IO and EO thicknesses were not (p>.05); 2) among the five types of trunk stabilization, TrA thickness significantly increased with the balance using a sling in the prone position, (p<.05), whereas no significant difference was noted for the four types of trunk stabilization (p>.05); 3) reliability data showed that there was a high degree of consistency among the measurements taken using the special transducer head device (ICC=.92). In conclusion, the balance using a sling in the prone position was more effective than any of the four other types of trunk stabilization in increasing TrA thickness in healthy subjects.

Anestrus is one of the most important production limiting disorders in dairy buffaloes and its underlying causes have been a current topic of studies. The objectives of this study were to explore the causes of anestrus in buffaloes with the application of ultrasonography. Two examinations were performed by transrectal ultrasonography at 12 days apart in buffalo cows that were not seen in oestrus at 60 or more days postpartum. As high as 54.5% buffaloes had silent ovulation and 45.5% suffered from the true anestrus with ovarian dysfunction. The duration of anestrus after calving was 60～90, 91～120, 121～180 and 181～365 days in 27%, 32%, 18% and 23% buffalo cows, respectively. Treatment with prostaglandin of cyclic buffalo cows with a corpus luteum (72.7%) resulted in higher estrous rate as compared with close observation of estrus (23.1%) by the farmer (p=0.021). Acyclic buffalo cows without any corpus luteum on ovaries were successfully treated with gonadotropin releasing hormone (70%), resulting in higher estrous detection rate than those treated with a vitamin-mineral mixture (20%) (p=0.035). In conclusion, poor heat detection due to silent ovulation is the most important cause of apparent anoestrus in buffaloes; however the percentage of the true anestrous is also quite high in postpartum buffaloes.

Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.

The reliability of the thickness measurement of the lumbar multifidus (LMD using real-time ultrasonography (US) was determined in only the superficial fiber of the lumbar multifidus (SM). However, previous studies have not examined the reliability of the deep fiber of the LM (DM). The purpose of this study was to determine the intrarater and the interrater reliability of the thickness measurements of DM using US. Eleven heathy males participated in the study. The thickness of the DM was measured with an US in the prone position. Reliability was examined using intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and the Bland and Altman plot. ICC(3,1) was used to calculate the interrater reliability of the thickness measurement of DM using the values from both the first and second test sessions. Additionally, ICC(3,1) was used to calculate the intrarater reliability of the measurements over two days using the measurements obtained in test session 1 and lest session 2. The results of this study were as follows: 1) the ICC(3,1) value for interrater reliability was .94 in the first test session, and .93 in the second test session. 2) the ICC(3,1) values for intrarater reliability of the measurements over two days was .90 in both the first examiner and the second examiner. The interrater reliability and interrater reliability of the DM measurements, obtained via the US protocol used in this research was excellent. Therefore, we conclude that the thickness measurement of the DM obtaioned from the US protocol used in this research would be useful for clinician assessment of the thickness of the DM.

Serial ultrasonographic examinations were performed to establish a prediction table of parturition date in pregnant Maltese, Yorkshire Terrier, Shih-tzu and Miniature Schnauzer bitches. The inner chorionic cavity diameter and fetal head diameter in 45 pregnant bitches were converted retrospectively based on the day of parturition. The data of inner chorionic cavity diameter obtained from Day-44 to Day-25 and fetal head diameter obtained from Day-25 to Day-1 were used to compile a equations of prediction of parturition date. The 70 pregnant bitches with unknown mating time were examined to assess an accuracy of the equations established in this study. And these results were applied to the prediction of parturition date and compared to actual parturition date. The accuracy for parturition date within 0, 1, and 2 days interval using the equations of prediction of parturition date were 64.3%, 22.8% and 12.8%, respectively. The overall accuracy of prediction table of parturition day based on the ICCD and HD was 100% accurate within 2 days. Therefore, the prediction table seems to be a useful tool of the prediction of parturition day in practice.

Serial ultrasonographic examinations were daily performed from 15 days after ovulation until parturition to determine the growth curve of gestational structures in pregnant Maltese, Yorkshire terrier, Shih-tzu, and Miniature Schnauzer bitches, respectively. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. The inner chorionic cavity diameter were significantly and linearly relative to gestational age especially days 20 to 40, and the fetal head diameter were significantly and linearly relative to gestational age especial1y day 40 to parturition. These results indicate that inner chorionic cavity diameter were the most accurate for estimating gestational age before day 38 of gestation and the fetal head diameter were after day 38 of gestation.

Serial ultrasonographic examinations were daily performed from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures in pregnant 10 Maltese, 10 Yorkshire Terrier, 15 Shih-tzu, and 10 Miniature Schnauzer bitches, respectively. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0ng/ml. The gestational length was (range: ) days and the geatational length was no statistically significant difference among bitches (p>0.05). The initial detection of the extra-fetal structures were; gestational sac at days , zonary placenta at days , yolk sac membrane at days , yolk sac tubular shape at days , and amniotic membrane at days , respectively. The time of the first detection of the extra-fetal structures were no statistically significant difference among bitches (p>0.05). The initial detection of the fetal structures were; embryo initial detection at days , heartbeat at days , embryo bipolar shape , fetal movement at days , limb buds at days , stomach at days , urinary bladder at days , skeleton at days , and kidney at days , respectively. The the time of the first detection of the fetal structures were no statistically significant difference among bitches (p>0.05). These results indicate the evaluation of the time of first detection and ultrasonographic characteristics of the gestational structures might be useful for pregnancy diagnosis, estimating fetal age, embryonic resorption, fetal monster, abnormal fetal growth and fetal viability, respectively.

본 연구는 도축된 제주마의 난소를 이용하여 초음파 유도난포란 채취 기술을 확립하고자 난소, 난포 및 황체의 크기를 초음파상과 육안적 측정치를 비교하고자 하였다. 초음파상 측정치와 caliper를 이용한 실제 크기의 측정치 비교에서는 통계학적 차이는 보이지 않았다. 배란 직전의 난포를 조사한 결과, 초음파상에서 관찰한 것은 난소 한 개 당 평균 0.83개와 평균 크기는 2.86 m였으며, 육안으로 관찰된 것은 난소 한 개 당 평균 0.75개와 평균 크기는

전국 65개 시군에 소재하는 착유우 20두 이상 규모의 760개 목장에서 85,983두를 대상으로 초음파 번식 검진 및 치료를 실시하여 다음과 같은 결과를 얻었다. 번식 검진우 85,983두 중 난소 질병이 40,399(47.0 %)로 가장 많았으며 자궁 질병 11,912두(13.9%), 임신 및 임신기 사고가 26,587두(30.9%), 난소나 자궁의 유착이 172두(0.2%), 프리마틴 8두(0.01%)그리고 분만 후 50일 이내로서 정상적인 발정