Diagnostic Value of Thallium-201 Scan in The Thyroid Nodule / 대한내분비학회지

To investigate diagnostic value of Thallium 201(T1-201) thymid scan in differentiating malignant nodule from benign, 135 patients with thyroid nodule were evaluated with Tl-201 thyroid scan, fine needle aspiration(FNA), clinical characteristics and laboratory data. Each had histological diagnosis after thyroidectomy. Tl-201 scan had a sensitivity of 67.3% and a specificity of 66.3% and FNA had sermitivity of 46.9% and specificity of 100% in predicting malignancy. As the size of thyroid nodule and age of patient incteases, diagnostic value of 11-201 thyroid scan was improved. In the thyroid nodules larger then 3cm, sensitivity, specificity and negative predictive value were 100%, 70% and 100%, reqectively. By cornbining Tl-201 throid scan and FNA, sensitivity had 91.8%. From the data we conclude that Tl-201 thyroid scan is valuable with adjuvant diagnostic method in differentiating malignant fmm benign thyroid nodule and treatment planning.

589 Cases of Endoscopic Ultrasound Diagnosis in Upper Gastrointestinal Tract and Pancreaticobiliary System Diseases / 대한소화기내시경학회지

Endoscopic ultrasonography (EUS)-a combination of endoscopy a.nd ultrasonography was one of the most useful tools for diagnosis of digestive system diseases. This technique was known to be very effective in the assessment of depth of invasion in gastric cancer and in pancreatico-biliary diseases. We performed EUS in 589 patients with upper gastrointestinal and pancreatico-biliary tract lesion prior to surgery for past 22 months and examined the diagnostic accuracy of EUS, respectively. The results were compared to surgical histology in esophagus and stomach cancer,to concordance witb endoscopic retrograde cholangiopancreatography(ERCP) results for pancreaticobiliary diseases. 1) In 589 patients diagnosed with EUS, the mean age of the patients was 55.9 years with a male to female ratio of 1.7: 1. 2) Patients were divided into three groups; post-upper gastrointestinal endoscopy, post ERCP and undiagnosed with other diagnostic tools. 3) Among post-upper gastrointestinal endoscopy, 64 cases were operated due to esophageal and gastric cancer and then compared to surgical histology. After compared, EUS accuracy on depth of invasion was 78.1% and sensitivity and specificity on lymph node metastasis in gastric cancer were 76.9% and 74.3%, respectively. 4) In post-ERCP cases, EUS results were compared to ERCP results and then concordance rate was 95.4%. 5) In undiagnosed cases, EUS was performed and results were reported.

Prophylactic Endoscopic Variceal Ligation Compared with Endoscopic Variceal Ligation for Bleeding Esophageal Varices / 대한소화기내시경학회지

Endoscopic Variceal Ligation(EVL) was developed as an alternative to endoscopic injection sclerotherapy(EIS) for decreasing of complication rate. This new technique involves placement of small elastic O-rings around the variceal channels in the distal esophagus. To evaluate the efficacy of EVL for treatment of the acute bleeding esophagea1 varices and the efficacy of prophylactic EVL, we compared EVL in 88 patients who had recently bled from esophageal varices(Group 1) and prophylactic EVL in 45 patients with large size(Grade 2 or 3 or 4) and red color sign on endoscopic finding who had not previously had upper gastrointestinal bleeding(Group 2). Also, we compared prophylactic EVL group(Group 2) and control group(Group 3) who did not performed EVL. At the time of treatment 28.4%(25/88) of patients had active bleeding. They were all treated acutely with EVL and repeated treatment for the long-term goal of variceal eradication. Initial hemostatic efficacy of EVL for acute bleeding varices was 92%(23/25). Varices were eradicated or reduced to Grade 1 in 68%(17/2S). Early mortality rate within 2 weeks was 8%(2/25). Among patients who had eradicated or reduced to Grade 1 varices by repeated EVL sessions, over a mean follow-up of 11 months there was no difference between Group 1 and Group 2 in recurrent rate(49.1%(27/63) vs. 46.8% (15/32)), rebleeding rate(10.9'Yo (6/55) vs. 9.3% (3/32)), rebleeding interval(average 75 days vs, 83.6 days). There was significant difference between prophylactic EVL group and con- trol group in bleeding rate(9.3%(3/~32) vs. 43.7%(14/32))~(p<0.05). Three patients(6.6%) died in prophylactic EVL group, two from ligation site bleeding of esophageal varix, one from hepatic failure. In conclsion, EVL is an effective method for treatment of acute bleeding esophageal varices with repeated sessions. Although prophylactic EVL can be used to prevent bleeding by eradication with lower initial morbidity are necessary because of EVL-related complications.