2.The usefulness of endoscopic ultrasonography for the diagnosis and treatment of pancreatic cystic tumor.
Korean Journal of Medicine 2010;78(3):289-294
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
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Biopsy, Fine-Needle
;
Decision Making
;
Diagnosis, Differential
;
Endosonography
;
Ethanol
;
Paclitaxel
;
Pancreatic Cyst
;
Therapeutic Irrigation
3.The Expanding Role of Contrast-Enhanced Endoscopic Ultrasound in Pancreatobiliary Disease.
Gut and Liver 2015;9(6):707-713
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
4.A case of isolated ACTH deficiency.
Seung Won CHOI ; Ki Up LEE ; Dong Wan SEO ; Ghi Su KIM ; Munho LEE
Journal of Korean Society of Endocrinology 1992;7(4):397-401
No abstract available.
Adrenocorticotropic Hormone*
5.EUS-Guided Antitumor Therapy for Pancreatic Tumors.
Gut and Liver 2010;4(Suppl 1):S76-S81
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
6.A case of the nutcracker syndrome: repair by external stenting procedure
Hong Rae CHO ; Chang Sik CHOI ; Soo Dong BAE ; Dong Wan CHAE ; Kwi Sook SEO ; Sang Hoon BAE
Journal of the Korean Society for Vascular Surgery 1993;9(1):168-173
No abstract available.
Stents
7.Endoscopic Ultrasound-guided Local Therapy of Pancreatic Tumors.
The Korean Journal of Gastroenterology 2015;66(3):154-158
The development of curvilinear EUS has enabled EUS-guided fine-needle aspiration of intra-abdominal mass lesions. With the introduction of interventional EUS, this technology has undergone several modifications in order to be applied to clinical medicine. One of the potential uses of interventional EUS is the EUS-guided local therapy of pancreatic tumors. Various treatment modalities such as fine-needle injection, radiofrequency ablation, photodynamic therapy, laser ablation, and brachytherapy have been tried under EUS guidance. Some of these modalities are being applied clinically. These methods for EUS-guided local therapy of pancreatic tumors will be reviewed in this article.
Animals
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Biopsy, Fine-Needle
;
Catheter Ablation
;
Disease Models, Animal
;
Endosonography
;
Humans
;
Pancreatic Neoplasms/pathology/surgery/*therapy
;
Photochemotherapy
;
Photosensitizing Agents/therapeutic use
8.Comparison Study of Dipyridamole and Dobutamine Stress Echocardiography in Same Patients.
Wan Joo SHIM ; Chang Kyu PARK ; Young Hoon KIM ; Hong Seog SEO ; Dong Joo OH ; Young Moo RO
Korean Circulation Journal 1994;24(2):211-219
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
9.Lipoprotein(a) and Lipoprotein(a) Phenotype in Restenosis after Percutaneous Transluminal Coronary Angioplasty.
Dong Wan SEO ; Jae Joong KIM ; Wonki MIN ; Jae Kwan SONG ; Seong Wook PARK ; Seung Jung PARK ; Jong Koo LEE
Korean Circulation Journal 1995;25(2):439-450
BACKGROUND: The purpose of the study was to investigate prospectively the relation of lipoprotein(a)[Lp(a)],apoproteins and serum lipid parameters to restenosis after percutaneous transluminal coronary angioplasyt(PTCA). METHODS: One hundred and forty-five patients who received successful PTCA were enrolled and their serum levels of lipids, apoproteins and Lp(a) were measured before PTCA. After 6 months of follow-up, the patients were reevaluated for the development of restenosis by coronary angiography, treadmill test or thallium scan. RESULTS: A total 137 patients could be followed. Restenosis occurred in 71 patients(52%). Clinical parameters(e.g. age, sex, hypertension, diabetes, smoking) and angiographic parameters(e.g. lesion site, type and degree of stenosis) were not significantly different between the group without restenosis and the group with restenosis. Lipid parameters and apoproteins were not associated with restenosis. Lp(a) and Lp(a) phenotype analysis showed no significant difference between the two gruops. CONCLUSION: Serum lipid parameters, apoproteins and Lp(a) concentration are not associated with restenosis after PTCA and cannot be used as predictios of restenosis.
Angioplasty, Balloon, Coronary*
;
Apoproteins
;
Coronary Angiography
;
Exercise Test
;
Follow-Up Studies
;
Humans
;
Hypertension
;
Lipoprotein(a)*
;
Phenotype*
;
Prospective Studies
;
Thallium
10.EUS-guided Intervention.
Korean Journal of Gastrointestinal Endoscopy 2010;40(1):1-8
Linear array echoendoscopes were developed in the early 1990s and they have facilitated performing EUS-guided interventional procedures. The introduction of linear array echoendoscopes allows performing fine needle aspiration because the device enables tracing the path of the tip of the needle during puncture procedure. In addition to being very useful for diagnostic purpose, this device enabled us to develop various therapeutic endoscopic procedures. Therapeutic drainage procedures, including EUS-guided bile duct drainage, pancreatic pseudocyst drainage and pancreatic duct drainage, have all been more frequently performed in the last decade. In addition to the acquisition of tissue or fluid, various substances can be delivered into the target areas with EUS, with an example being an EUS-guided celiac plexus neurolysis/block. In this review, we describe the present place and role of interventional EUS in clinical practice.
Bile Ducts
;
Biopsy, Fine-Needle
;
Celiac Plexus
;
Drainage
;
Hypogonadism
;
Mitochondrial Diseases
;
Needles
;
Ophthalmoplegia
;
Pancreatic Ducts
;
Pancreatic Pseudocyst
;
Punctures