Malignant biliary or pancreatic duct stricture is dilatated using dilatating catheter or balloon catheter but a high grade stricture is difficult to dilate by general dilatating methods. Using Soehendra stent retriever is an effective method for exchanging an impacted stent. Recently, high grade malignant biliary strictures have been dilatated by Soehendra stent retriever. We report 3 cases of successful biliary drainage in high grade malignant biliary strictures using 7 Fr Soehendra stent retriever.
Catheters ; Constriction, Pathologic* ; Drainage* ; Pancreatic Ducts ; Stents*

PURPOSE: To evaluate the clinical utility of the teleradiology system using the information super highway communication network. MATERIALS AND METHODS: Two radiologists selected 101 cases of pneumothorax and 20 cases ofmiliary tuberculosis. There were scanned and transmitted to our hospital at a speed of 640 Kbps and displayed on avideo monitor with a resolution of 1280 pixels/line x 1024 lines. Four radiologists divided into three groups :read the images group A read the images without image processing ; group B read the images with image processing, group C read the radiographic films on the view box. The authors compared sensitivity and specificity between thegroups and checked their statistical significance using the Chi-square test. According to the location of thepleural line, we divided the pneumothorax into four types : continve on this live type 1, pleural line confined tothe apex ; type 2, to the upper half ; type 3, to the lower half ; type 4, to the upper through lower half. We then compared sensitivity between the Three groups. RESULTS: In the pneumothorax group, the average sensitivity of group A, B and C was 79%, 90% and 96%, and average specificity was 99%, 99% and 94%, respectively. There were statistically significant differences in seasitivity between group A and B and between group B and C (p<0.017). There were no statistically significant difference in specificity between group A and B or between group B and C.In the miliary tuberculosis group, the average sensitivity of group A, B and C was 73%, 78% and 90%, and average specificity was 95%, 95% and 100%, respectively. With regard to sensitivity and specificity, there was no statistically significant difference between group A and B or between group B and C but there was a statistically significant difference between group A and C (p<0.017). According to the location of the pneumothorax, for alltypes, the sensitivity of group A was less than that of group B and group B was less than that of group C. CONCLUSION: All groups showed reduced observer performance in the detection of pneumothorax and miliary tuberculosis when reading a transmitted image on the monitor-workstation compared with reading conventional radiographs on the view box. To improve the clinical utility of the teleradiology system, a higher resolution workstation and adequate image processing are required.
Pneumothorax* ; Sensitivity and Specificity ; Teleradiology* ; Tuberculosis ; Tuberculosis, Miliary* ; X-Ray Film

PURPOSE: With the emergence of next-generation sequencing (NGS) technology, profiling a wide range of genomic alterations has become a possibility resulting in improved implementation of targeted cancer therapy. In Asian populations, the prevalence and spectrum of clinically actionable genetic alterations has not yet been determined because of a lack of studies examining high-throughput cancer genomic data. MATERIALS AND METHODS: To address this issue, 1,071 tumor samples were collected from five major cancer institutes in Korea and analyzed using targeted NGS at a centralized laboratory. Samples were either fresh frozen or formalin-fixed, paraffin embedded (FFPE) and the quality and yield of extracted genomic DNA was assessed. In order to estimate the effect of sample condition on the quality of sequencing results, tissue preparation method, specimen type (resected or biopsied) and tissue storage time were compared. RESULTS: We detected 7,360 non-synonymous point mutations, 1,164 small insertions and deletions, 3,173 copy number alterations, and 462 structural variants. Fifty-four percent of tumors had one or more clinically relevant genetic mutation. The distribution of actionable variants was variable among different genes. Fresh frozen tissues, surgically resected specimens, and recently obtained specimens generated superior sequencing results over FFPE tissues, biopsied specimens, and tissues with long storage duration. CONCLUSION: In order to overcome, challenges involved in bringing NGS testing into routine clinical use, a centralized laboratory model was designed that could improve the NGS workflows, provide appropriate turnaround times and control costs with goal of enabling precision medicine.
Academies and Institutes ; Asian Continental Ancestry Group ; DNA ; Humans ; Korea ; Methods ; Paraffin ; Point Mutation ; Precision Medicine ; Prevalence