OBJECTIVE: To determine an ideal stimulation site of the medial antebrachial cutaneous nerve (MACN) using ultrasound measurement and to compare the efficiency of the new stimulation site with the conventional stimulation site on the nerve conduction study. METHODS: Both arms of 15 healthy participants were measured using ultrasound. The MACN was identified in the transverse view at each 0, 2, 4, 6, and 8 cm proximal sites from the medial epicondyle, and the distances to the median nerve and to the skin from the MACN were measured. The ideal stimulation site should be located at the level which can give the shortest distance from the skin and the longest distance from the median nerve in terms of volume conduction. To confirm the efficiency of the ideal site, we measured the amplitude of the MACN conduction study at the ideal site against one at the 4 cm proximal to the medial epicondyle (conventional site). RESULTS: The ultrasound showed the ideal stimulation site for the MACN could be the elbow crease line. However, the nerve conduction study revealed that the amplitudes of the MACN were significantly larger at the 4 cm proximal to the medial epicondyle compared with ones at the ideal site. CONCLUSION: The ideal stimulation site based on the ultrasound did not permit better stimulation site for the nerve conduction study of the MACN compared with the conventional site. Careful adjustment of the stimulation site on the basis of this study would contribute to an accurate conduction study of the MACN.
Arm ; Elbow ; Median Nerve ; Neural Conduction ; Skin ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Flow-mediated brachial artery vasoactivity has been proposed as a noninvasive means for assessing endothelial function. The present study is designed to assess the influence of aging on endothelial function and when vasoactivity developed initially, peaked. MATERIALS AND METHOD: We measured brachial artery diameter for 60 seconds continuously using 7.5 MHz ultrasound following 5 minutes of lower arm occlusion in 22 normal volun-teers (young group: 10 volunteers, 26.5+/-1.9 years; old group: 12 volunteers, 55.9+/-3.3 years). After sublingual administration of 0.6 mg nitroglycerine, 240 seconds continuously. And then we measure vasoactivity every 3 seconds. RESULTS: Flow-mediated vasodilation (FMD) was started earlier in young group (24.3+/-2.8 sec; old group 28.8+/-3.6 sec, p=0.017). After release of occlusion, peak vasoacitivity time was at 35.5+/-4.7 seconds and peak vasoactivity was 8.4+/-1.7% in young group (old group 6.9+/-1.5%, p=0.099). Endothelial independent vasodilation (EID) was started at 80.7+/-13.3 seconds after sublingual nitroglycerine in young group (vs 80.0+/-19.0 sec), peaked at 177.5+/-16.9 seconds (vs 171.3+/-13.8 sec). Peak vasoactivity was higher in young group (19.1+/-3.1%; old group 15.9+/-2.5%, p=0.033). CONCLUSION: We conclude that 1) Aging has influence on endothelial function about initiating time of vasoactivity as well as peak vaso- activity. 2) FMD can be measured around 50 seconds after release of brachial artery occlusion and EID at 180 seconds after application of sublingual nitroglycerine. 3) The initiating time of vasoactivity (under 30 seconds) can be used for evaluation of endothelial function.
Administration, Sublingual ; Aging* ; Arm ; Brachial Artery ; Nitroglycerin ; Ultrasonography* ; Vasodilation ; Volunteers

Pilomatricoma is an uncommon benign skin neoplasm arising from the hair matrix. The radiologic features of this uncommon tumor have occasionally been described in the literature however, to the best of our knowledge, there have been no reports in Korea on the sonographic and MR imaging findings of pilomatricoma involving the upper arm. In this article, we describe the imaging findings of a case of pilomatricoma involving the upper arm, with the emphasis being placed on the sonographic and MR imaging findings and a review of the literature.
Arm* ; Hair ; Korea ; Magnetic Resonance Imaging* ; Pilomatrixoma* ; Skin Neoplasms ; Ultrasonography*

OBJECTIVE: To determine which mode of ultrasonography (US), among the conventional, spatial compound, and tissue-harmonic methods, exhibits the best performance for the detection of Implanon(R) with respect to generation of posterior acoustic shadowing (PAS). MATERIALS AND METHODS: A total of 21 patients, referred for localization of impalpable Implanon(R), underwent US, using the three modes with default settings (i.e., wide focal zone). Representative transverse images of the rods, according to each mode for all patients, were obtained. The resulting 63 images were reviewed by four observers. The observers provided a confidence score for the presence of PAS, using a five-point scale ranging from 1 (definitely absent) to 5 (definitely present), with scores of 4 or 5 for PAS being considered as detection. The average scores of PAS, obtained from the three different modes for each observer, were compared using one-way repeated measure ANOVA. The detection rates were compared using a weighted least square method. RESULTS: Statistically, the tissue harmonic mode was significantly superior to the other two modes, when comparing the average scores of PAS for all observers (p < 0.00-1). The detection rate was also highest for the tissue harmonic mode (p < 0.001). CONCLUSION: Tissue harmonic mode in uS appears to be the most suitable in detecting subdermal contraceptive implant rods.
Adult ; Analysis of Variance ; Arm/*ultrasonography ; *Contraceptive Agents, Female ; *Desogestrel ; Female ; Foreign Bodies/*ultrasonography ; Humans ; Middle Aged ; Ultrasonography/*methods

5p deletion syndrome, also known as Cri-du-Chat syndrome, is a chromosomal abnormality caused by a deletion in the short arm of chromosome 5. Clinical features of 5p deletion syndrome are difficult to identify prenatally by ultrasound examination, thus most cases of 5p deletion syndrome have been diagnosed postnatally. Here, we report eight cases of 5p deletion syndrome diagnosed prenatally, but were unable to find common prenatal ultrasound findings among these cases. However, we found that several cases of 5p deletion syndrome were confirmed prenatally when karyotyping was performed on the basis of abnormal findings in a prenatal ultrasound scan. Hence, it is necessary to carefully perform prenatal ultrasonography for detection of rarer chromosomal abnormalities as well as common aneuploidy.
Aneuploidy ; Arm ; Chromosome Aberrations ; Chromosomes, Human, Pair 5 ; Cri-du-Chat Syndrome* ; Karyotyping ; Prenatal Diagnosis* ; Ultrasonography ; Ultrasonography, Prenatal

OBJECTIVE: To investigate the shoulder disease patterns for the table-tennis (TT) and archery (AR) wheelchair athletes via ultrasonographic evaluations. METHODS: A total of 35 wheelchair athletes were enrolled, made up of groups of TT (n=19) and AR (n=16) athletes. They were all paraplegic patients and were investigated for their wheelchair usage duration, careers as sports players, weekly training times, the Wheelchair User's Shoulder Pain Index (WUSPI) scores and ultrasonographic evaluation. Shoulders were divided into playing arm of TT, non-playing arm of TT, bow-arm of AR, and draw arm of AR athletes. Shoulder diseases were classified into five entities of subscapularis tendinopathy, supraspinatus tendinopathy, infraspinatus tendinopathy, biceps long head tendinopathy, and subacromial-subdeltoid bursitis. The pattern of shoulder diseases were compared between the two groups using the Mann-Whitney and the chi-square tests RESULTS: WSUPI did not significantly correlate with age, wheelchair usage duration, career as players or weekly training times for all the wheelchair athletes. For the non-playing arm of TT athletes, there was a high percentage of subscapularis (45.5%) and supraspinatus (40.9%) tendinopathy. The percentage of subacromial-subdeltoid bursitis showed a tendency to be present in the playing arm of TT athletes (20.0%) compared with their non-playing arm (4.5%), even though this was not statistically significant. Biceps long head tendinopathy was the most common disease of the shoulder in the draw arm of AR athletes, and the difference was significant when compared to the non-playing arm of TT athletes (p<0.05). CONCLUSION: There was a high percentage of subscapularis and supraspinatus tendinopathy cases for the non-playing arm of TT wheelchair athletes, and a high percentage of biceps long head tendinopathy for the draw arm for the AR wheelchair athletes. Consideration of the biomechanical properties of each sport may be needed to tailor specific training for wheelchair athletes.
Arm ; Athletes* ; Bursitis ; Head ; Humans ; Pilot Projects* ; Shoulder Pain ; Shoulder* ; Sports ; Tendinopathy ; Ultrasonography ; Wheelchairs*

BACKGROUND AND OBJECTIVES: Endothelial dysfunction is an early change in the process of atherosclerosis. To evaluate endothelial function, expensive and specialized medical devices like high-resolution vascular ultrasound are necessary. Therefore, we sought to compare this atherosclerotic parameter of endothelial function using the inexpensive and simple method of peripheral pulse arrival time (PPAT) measurement. SUBJECTS AND METHODS: Before and after meals, we measured PPAT and flow-mediated vasodilation (FMD). Resting PPAT in both arms was measured with a PPAT device that was designed by the authors. Hyperemic effect was tested in both arms after raising the blood pressure to 250 mmHg for 5 minutes by using a blood pressure cuff, after which the cuff was released to 0 mmHg. PPAT was measured within the first 1 minute to observe the hyperemic response. FMD was measured in the same process by 7 MHz high-resolution ultrasound in the left brachial artery. The percent change was calculated from the baseline value and that of the hyperemic response. RESULTS: In low-fat diet, PPAT change was not different (3.8% vs. 4.7%, p>0.05). In high-fat diet, PPAT tended to be shorter, but without statistical significance (4.8% vs. 2.7%, p>0.05). In low-fat diet, the change of FMD was not different (11.7% vs. 11.4%, p>0.05). In high-fat diet, there was a significant difference in FMD (11.4% vs. 6.5%, p<0.05). CONCLUSION: The PPAT measurement could be a method for evaluating endothelial function, but is less sensitive than flow-mediated vasodilation.
Arm ; Atherosclerosis ; Blood Pressure ; Brachial Artery ; Diet, Fat-Restricted ; Diet, High-Fat ; Meals ; Ultrasonography ; Vasodilation

The authors have used a B-mode real-time sector scanner and a 10-MHz probe for measurement of the skin thickness at 21 different sites in healthy Koreans. Subjects consisted of 35 adults(17 males, 18 females) who were divided into three age groups .' young(20 39 years, 12 subjects), middle-aged(40 59 years, 13 subjects), and old(over 60 years, 10 subjects). The results were as follows. 1, The measurements of the skin thickness in examined sites varied from 1.99 to 4.59 milimeters . flexor aspect of the upper arm, dorsum of the hand, extensor aspect of the forearm and flexor aspect of the forearm were thinner, and heel, upper back, metatarsus were thicker than other sites. 2, The skin thickness in males was generally thicker than that in females '. cheek, extensor aspect of the thigh were highly significantly thicker (p<0.01), and chest, upper back, lower back, flexor aspect of the upper arm and extensor aspect of the lower leg were significantly thicker(p< 0.05) in males than in females, 3. The skin was thickest in the old age groups.
Arm ; Cheek ; Female ; Forearm ; Hand ; Heel ; Humans ; Leg ; Male ; Metatarsus ; Skin* ; Thigh ; Thorax ; Ultrasonography*

BACKGROUND: Fascial free flaps have been widely used for reconstruction of the hand because they are thin. However, studies reporting objective data regarding the advantages of this approach are lacking. Thus, we report our experience with such flaps. METHODS: Forty-five cases of fascial free flaps between November 2006 and March 2014 were reviewed. Nine cases involving reconstructed dorsal or lateral defects were included. Four anterolateral thigh fascial free flaps and 5 lateral arm fascial free flaps were examined. Maximal flap contour was assessed by measuring reconstructed tissue thickness at the central area from the surface of the skin to below the bone in a vertical manner using ultrasonography and X-ray data. Contralateral regions were examined in the same manner and a comparative analysis was performed. A questionnaire survey regarding aesthetic satisfaction was also administered. RESULTS: All reconstructed parts had a thicker contour than the contralateral side. The average relative percentage of reconstructed tissue thickness was found to be 152% using ultrasonography and 143% using X-ray imaging. According to the aesthetic satisfaction survey, the average rate of satisfaction for patients was 62%, and satisfaction with the flap contour was 72%. CONCLUSIONS: Using a fascial free flap, the reconstructed tissue was approximately 1.5× as thick as the contour of the normal side, which led to positive responses regarding aesthetic satisfaction.
Arm ; Fascia ; Free Tissue Flaps* ; Hand* ; Humans ; Patient Satisfaction ; Skin ; Thigh ; Thinness ; Ultrasonography

OBJECTIVE: To evaluate the usefulness of ultrasonography as a follow-up tool for evaluating the effects of complex decongestive physiotherapy (CDPT) in breast cancer-related lymphedema (BCRL). METHODS: Twenty patients with BCRL were enrolled in this study. All patients had undergone therapy in the CDPT program for 2 weeks. Soft tissue thickness of both the affected and unaffected upper limb was measured before and after CDPT. The measurements were taken at 3 points (the mid-point between the medial and lateral epicondyles at the elbow level, 10 cm proximal and 10 cm distal to the elbow) with and without pressure. We then calculated the compliance of soft tissue before and after CDPT. Circumferences of both the affected and unaffected upper limb were also measured before and after CDPT at the 3 defined points. RESULTS: After 2 weeks of the CDPT program, the circumference and soft tissue thickness of the unaffected upper limb did not significantly change. In the affected upper limb, the circumference was significantly reduced in the 3 point, when compared with measurements taken prior to treatment. Additionally, soft tissue thickness was significantly reduced at the elbow and 10 cm proximal to the elbow. After CDPT, compliance at each of the 3 points had increased, but this trend was not significantly different. CONCLUSION: Our results showed that arm circumference and ultrasonography-derived soft tissue thickness was useful as a way of assessing therapeutic effects of CDPT.
Arm ; Breast* ; Compliance ; Elbow ; Follow-Up Studies ; Humans ; Lymphedema* ; Ultrasonography ; Upper Extremity