No abstract available.
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Crohn Disease/*complications/*drug therapy ; Female ; Humans ; Intestinal Obstruction/*etiology ; Male

Chronic pancreatitis is an irreversible inflammatory disease of the pancreas characterized by progressive inflammation and fibrosis resulting in loss of exocrine and endocrine function. Chronic pancreatitis is a wide spectrum of fibro-inflammatory disorders of the pancreas that includes calcifying, obstructive, and steroid-responsive form. Chronic pancreatitis without specific comment generally refers to calcifying or obstructive chronic pancreatitis. The well-known traditional causes of chronic pancreatitis are alcohol and smoking. Recently, environmental effects and the importance of genes such as genetic variation or interaction have been highlighted. Computerized tomography or magnetic resonance cholangiopancreatography have been used for diagnosis of chronic pancreatitis. However, endoscopic ultrasound has been recently used for diagnosis, too.
Cholangiopancreatography, Magnetic Resonance ; Diagnosis* ; Fibrosis ; Genetic Variation ; Inflammation ; Pancreas ; Pancreatitis ; Pancreatitis, Chronic* ; Smoke ; Smoking ; Ultrasonography

Endoscopic retrograde cholangiopancreatography (ERCP) is a key endoscopy skill used to diagnose and treat pancreatobiliary diseases. However, its diagnostic use is decreasing in favor of other less invasive methods such as magnetic resonance cholangiopancreatography and endoscopic ultrasound. Alternatively, its use has become more important in the therapeutic area. ERCP trainees must know the anatomy and physiology of the pancreatobiliary system, several key basic skills, and complications of a successful procedure. This article briefly introduces basic ERCP knowledge, techniques, numbers necessary to achieve competency, and complications for new ERCP operators.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangiopancreatography, Magnetic Resonance ; Endoscopy* ; Pancreas ; Physiology ; Ultrasonography

Health care screening is becoming more popular in Korea as more people are interested in well-being and health. However, there are controversies regarding usefulness of screening. Tumor markers are frequently measured in the health care screening. As a result, many patients end up visiting physicians because of incidentally found increased levels of tumor markers. Carbohydrate antigen (CA) 19-9 is the single most useful tumor marker for pancreatic cancer. Although CA 19-9 is useful for predicting prognosis and evaluating treatment response for pancreatic cancer, CA 19-9 is less useful for screening of pancreatic cancer because of low incidence of pancreatic cancer.
Biomarkers ; Biomarkers, Tumor ; CA-19-9 Antigen ; Delivery of Health Care ; Early Detection of Cancer ; Humans ; Incidence ; Korea ; Mass Screening ; Pancreatic Neoplasms ; Prognosis

Pancreatic tumor is one of the most difficult diseases to diagnose and treat because of its anatomical location and characteristics. Recently, there have been several innovative trials on the treatment of pancreatic tumors using endoscopic ultrasound (EUS) because it allows selective access to the difficult to reach target organ along the gastrointestinal tract and can differentiate vessels by color Doppler. Among these trials, several have investigated EUS-guided ethanol lavage with or without paclitaxel for pancreatic cystic tumors. These studies show a 33% to 79% complete resolution rate with a favorable safety profile. Compared to EUS-guided ethanol lavage for pancreatic cystic tumors, EUS-guided radiofrequency ablation is considered a less invasive treatment method for pancreatic cancer. Although there are still several difficulties and concerns about complications, one clinical study reported 72.8% feasibility with favorable safety, and therefore, we anticipate the results of ongoing studies with these new less invasive techniques.
Catheter Ablation ; Endosonography ; Ethanol ; Gastrointestinal Tract ; Paclitaxel ; Pancreatic Cyst* ; Pancreatic Neoplasms ; Therapeutic Irrigation ; Ultrasonography

The role of integrated 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography computed tomography (PET-CT) is uncertain in gallbladder cancer. The aim of this study was to show the role of PET-CT in gallbladder cancer patients. Fifty-three patients with gallbladder cancer underwent preoperative computed tomography (CT) and PET-CT scans. Their medical records were retrospectively reviewed. Twenty-six patients underwent resection. Based on the final outcomes, PET-CT was in good agreement (0.61 to 0.80) with resectability whereas CT was in acceptable agreement (0.41 to 0.60) with resectability. When the diagnostic accuracy of the predictions for resectability was calculated with the ROC curve, the accuracy of PET-CT was higher than that of CT in patients who underwent surgical resection (P=0.03), however, there was no difference with all patients (P=0.12). CT and PET-CT had a discrepancy in assessing curative resection in nine patients. These consisted of two false negative and four false positive CT results (11.3%) and three false negative PET-CT results (5.1%). PET-CT was in good agreement with the final outcomes compared to CT. As a complementary role of PEC-CT to CT, PET-CT tended to show better prediction about resectability than CT, especially due to unexpected distant metastasis.
Adult ; Aged ; Aged, 80 and over ; *Cholecystography ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Gallbladder/pathology/surgery ; Gallbladder Neoplasms/*diagnosis/*surgery ; Humans ; Lymphatic Metastasis/diagnosis ; Male ; Middle Aged ; Neoplasm Staging ; *Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND/AIMS: In recent years, a large number of micro-ribonucleic acids (miRNAs) have been identified as putative prognostic biomarkers for solid cancers because of their role in controlling the expression of oncogenes and tumor suppressor genes. The aim of this study was to verify the utility of miRNA 141 as a prognostic biomarker of biliary tract cancers. METHODS: From June 2010 to June 2012, common bile duct cancer tissue samples and matched noncancerous tissues from the ampulla of Vater were obtained from patients with biliary tract cancer undergoing endoscopic retrograde cholangiopancreatography. Using quantitative real-time polymerase chain reaction assays, we measured the mean relative expression levels of miRNA 141 in both groups of tissues. Overexpression of miRNA 141 was defined as a greater than 2-fold increase in expression levels as determined by the 2−ΔΔCt method. RESULTS: In a cohort of 38 patients with biliary tract cancers (seven gallbladder, 13 hilar, and 18 distal bile duct cancers), 26 patients (68.4%) were male, and the median age was 69.5 (52 to 85) years. Nineteen patients (50%) had undergone R0 resection procedures, including three Whipple operations, seven pylorus-preserving pancreaticoduodenectomies, six bile duct resections, and three extended lobectomies. Among the patients who had undergone R0 resection, the overexpression of miRNA 141 was significantly associated with shorter disease-free survival and a greater risk of angiolymphatic invasion. Among the patients who did not undergo R0 resection, miRNA 141 overexpression was significantly associated with reduced overall survival. CONCLUSIONS: Overexpression of miRNA 141 is an indicator of a poor prognosis in patients with biliary tract cancer, suggesting that miRNA 141 may be a valuable prognostic biomarker of this disease.
Ampulla of Vater ; Bile Ducts ; Biliary Tract Neoplasms* ; Biliary Tract* ; Biomarkers ; Cholangiopancreatography, Endoscopic Retrograde ; Cohort Studies ; Common Bile Duct ; Disease-Free Survival ; Gallbladder ; Genes, Tumor Suppressor ; Humans ; Male ; Methods ; MicroRNAs* ; Oncogenes ; Pancreaticoduodenectomy ; Prognosis ; Real-Time Polymerase Chain Reaction