No abstract available.
Gallbladder ; Gallbladder Neoplasms

Since its introduction into clinical practice in the 1980s, endoscopic ultrasound (EUS) has been described as a good imaging modality for the diagnosis of pancreatobiliary diseases. However, differential diagnosis of certain lesions based only on B-mode ultrasound images can be challenging. Clinical use of ultrasound contrast agents has expanded the utility of EUS from that of detection to characterization of pancreatobiliary lesions based on the enhancement features of contrast-enhanced EUS (CE-EUS). Current low mechanical index techniques for CE-EUS using second-generation contrast agents have a number of distinct advantages over conventional diagnostic modalities in evaluating pancreatobiliary lesions, including real-time assessment of perfusion pattern, availability, and the absence of exposure to radiation. This article describes the technical aspects of CE-EUS and reviews the expanding indications in pancreatobiliary diseases and further development of this technique.
Biliary Tract Diseases/diagnosis/*ultrasonography ; *Contrast Media ; Diagnosis, Differential ; Endosonography/*methods ; Humans ; Medical Illustration ; Pancreatic Diseases/diagnosis/*ultrasonography

No abstract available.
Adrenocorticotropic Hormone*

Pancreatic cystic lesions are becoming more and more important because of the advancement of various kinds of imaging modalities. Endoscopic ultrasonography is recognized as an indispensible tool for the differential diagnosis of pancreatic cystic tumors. High quality images enable us to identify the presence of septum, mural nodule, wall thickness and other internal details. Fine needle aspiration can give us more information about cystic fluid such as amylase, CEA, and cytology. For the treatment of benign pancreatic cystic tumors, endoscopic ultrasound guided ethanol lavage and/or paclitaxel injections are also tried and shows quite good therapeutic efficacy with minimum complications. The importance of endoscopic ultrasonography for the differential diagnosis and therapeutic decision making can not be overemphasized.
Amylases ; Biopsy, Fine-Needle ; Decision Making ; Diagnosis, Differential ; Endosonography ; Ethanol ; Paclitaxel ; Pancreatic Cyst ; Therapeutic Irrigation

Endoscopic ultrasound (EUS) is a very useful modality for the diagnosis and staging of pancreatic masses. With the advent of EUS-guided fine-needle aspiration technology, this modality has made a tremendous leap from imaging modality to histologic diagnosis and therapeutic intervention. EUS offers high-resolution images of and unparalleled access to the pancreas. After locating the tip of the echoendoscope in the duodenum or stomach, several drugs or local treatment modalities can be delivered directly into the pancreas. EUS-guided ethanol lavage with/without paclitaxel injection has been tested for the treatment of cystic tumors of the pancreas, with complete resolution of cystic tumor being observed in up to 70-80% of patients. Ethanol injection is also performed for the management of solid neuroendocrine tumors of the pancreas. Various type of EUS-guided injection have also been investigated for the treatment of pancreatic cancer. An activated allogenic mixed lymphocyte culture (Cytoimplant) was injected in patients with advanced pancreatic cancer. A replication-deficient adenovirus vector carrying the tumor necrosis factor-alpha gene was also delivered intratumorally by EUS. ONYX-015 is an oncolytic attenuated adenovirus that exhibits replication preferentially in malignant cells, causing cell death, and this has also been injected into pancreatic cancers under EUS guidance. EUS-guided local ablation therapies such as radiofrequency ablation, photodynamic therapy, and brachytherapy are also under investigation. EUS-guided fine-needle injection for various solid or cystic lesions is a rapidly expanding field. This article reviews the various applications of EUS for the treatment of pancreatic tumors.
Adenoviridae ; Biopsy, Fine-Needle ; Brachytherapy ; Cell Death ; Duodenum ; Endosonography ; Ethanol ; Humans ; Immunotherapy ; Lifting ; Lymphocytes ; Neuroendocrine Tumors ; Paclitaxel ; Pancreas ; Pancreatic Neoplasms ; Photochemotherapy ; Stomach ; Therapeutic Irrigation ; Tumor Necrosis Factor-alpha ; Viral Vaccines

No abstract available.
Stents

BACKGROUND: The two most commonly used drugs as a stressor during wtress echocardiography are dipyridamole and dobutamine. The purpose of this study was to compare diagnostic accuracies of dipyridamole and dobutamine stress echocardiography for fixed coronary artery disease and evaluate complications related to the two agents in the same patients. METHODS: 30(M : 5=19 : 11, age=56+/-8.8yr) consecutive patients without history of previous myocardial infarction underwent coronary angiography, dipyridamole and dobutamine stress echocardiography in random order. Dipyridamole was infused up to 0.84mg/Kg for 10 minutes during clinical, ECG and echocardiographic montioring. Dobutamine was infused in dose increments from 5 to 40microg/Kg/min under the same condition. Positive criteria for myocardial ischemia by echocardiography was now regional wall mation abnormatity or worsening of regional wall motion after stress. Significant coronary disease was defined as more than 70% stenosis by coronary angiography. RESULTS: The sensitivity and specificity of both stress echocardiography were same, 82% and 92% respectively. In a single vessel disease the sensitivity of dipyridamole echocardiography was 75% and dobutamine echocardiography was 83% without statistical difference. The correlation of ischemic free time during both stress test was 0.375. During dipyridamole infusion no test was prematurely terminated because of side effects, but 3 patients(10%) developed severe hypertension and ventricular arrytricular arrythmia during dobutamine infusion and test was terminated. CONCLUSION: Thus, by this prospective direct comparison of both stress test, dipyridamole and dobutamine stress echocardiography have similar diagnostic accuracies for the detection of coronary artery disease. But during dobutamine infusion, careful monitoring for hemodynamic changes arrythmia is required for possible serious complications.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Sensitivity and Specificity

PURPOSE: Helicobacter pylori infection is probably acquired in childhood and persists as an asymptomatic infection for decades in most individuals. It is unclear why only a minority of those infected develop a clinical manifestation, even in childhood, such as peptic ulcer disease. H. pylori infection activates local immune responses and causes lymphocyte infiltration in the gastric mucosa. We have previously reported that both T and B cells in the lamina propria play important roles in the local immune response of H. pylori-infected children. The aim of this study was to investigate the association between H. pylori genotypes and gastric mucosal lymphocytes. METHODS: Twenty-five H. pylori-infected children (10 with peptic ulcer disease and 15 with gastritis) were enrolled in this study. We investigated the genotypes (cagA, cagE, vacA, and babA2) and evaluated the association with clinical manifestations, histopathology, and gastric mucosal lymphocytes. RESULTS: The prevalence of cagA, cagE, vacA s1m1, and babA2 was 80%, 60%, 84%, and 88%, respectively. The most prevalent (68%) combination of cagA, vacA, and babA2 genotypes was cagA+/ vacA s1m1+/babA2+. H. pylori genotypes were not associated with clinical manifestations, histopathology, or gastric mucosal lymphocytes. CONCLUSION: There was no association between the cagA, cagE, vacA, or babA2 status and gastric mucosal lymphocytes. The role of the host immune response in relation to H. pylori genotypes and disease potential in children needs further studies.
Asymptomatic Infections ; B-Lymphocytes ; Child ; Gastric Mucosa ; Genotype ; Helicobacter ; Helicobacter pylori ; Humans ; Lymphocytes ; Mucous Membrane ; Peptic Ulcer ; Prevalence

PURPOSE: Use of inappropriate statistical methods may lead to incorrect conclusions and a waste of valuable resources. The goal of this study was to assess the frequency and the types of several common statistical errors in the published articles of the Journal of the Korean Academy of Prosthodontics (JKAP) for a 5-year period. MATERIALS AND METHODS: Of 336 articles in the JKAP published from 2006 to 2010, 255 articles using statistics were reviewed and classified by statistical method and year. The frequency and types of the statistical methods were examined, and the statistical errors were evaluated by the appropriateness of the experimental design, assumption check, independent outcomes, proper sample size and suitable use of statistical method. Statistical guidelines were completed based on the appropriateness. RESULTS: Of the 255 articles using statistics, 193 articles (75.9%) used inferential statistics and 153 articles used SPSS statistical software (60.0%). Of the articles using inferential statistics, the three most frequently used statistical methods were ANOVA (41.5%), t-test (20.0%), and the nonparametric method (16.9%). The average rate of statistical errors was 61.2 percent, similar to the rate reported by several studies completed for the medical journal. CONCLUSION: After the whole analysis of the difference among the groups, post-hoc tests for the pairwise comparisons are required. The optimal sample size calculation is an essential part of this study protocol. To minimize the occurrence of statistical errors, statistical guidelines were developed according to each statistical test procedure and will contribute to the academic improvement in the JKAP.
Prosthodontics ; Research Design ; Sample Size

PURPOSE: The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. MATERIALS AND METHODS: Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0(TM), and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. RESULTS: The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. CONCLUSION: Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.
Bone Density ; Cone-Beam Computed Tomography ; Data Interpretation, Statistical ; Dental Implants ; Molar ; Prostheses and Implants ; Tooth ; Transplants