No abstract available.
Gallbladder ; Gallbladder Neoplasms

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

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

No abstract available.
Adrenocorticotropic Hormone*

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.
Stents

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

Hepatolithiasis is common in east Asia, but rare in the Western world. Recently, epidemiologic study on Korea gallstone disease showed that the portion of patients with hepatolithiasis among total gallstone patients is 14.1%. Hepatolithiasis is the cause of recurrent cholangitis and it is that risk factor of liver abscess, hepatic failure, or sepsis. Also, biliary cirrhosis and cholangiocarcinoma were developed from hepatolithiasis. The incidence of cholangiocarcinoma associated with hepatolithiasis is about 2.4~10% . We present three cases of unresectable cholangiocarcinoma diagnosed after removal of hepatolithiases by percutaneous transhepatic cholangioscopy.
Cholangiocarcinoma* ; Cholangitis ; Far East ; Gallstones ; Humans ; Incidence ; Korea ; Liver Abscess ; Liver Cirrhosis, Biliary ; Liver Failure ; Risk Factors ; Sepsis ; Western World

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

No abstract available.
Pulmonary Blastoma*