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1.
Intestinal Research ; : 208-214, 2017.
Article Dans Anglais | WPRIM | ID: wpr-117644

Résumé

BACKGROUND/AIMS: ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC. METHODS: We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value. RESULTS: For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P=0.029, P=0.000, and P=0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P=1.000, P=0.004, and P=0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P=0.009, P=0.001, respectively). CONCLUSIONS: Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.


Sujets)
Humains , Tumeurs colorectales , Diagnostic , Électrons , Noeuds lymphatiques , Métastase tumorale , Tomographie par émission de positons , Pronostic , Récidive , Sensibilité et spécificité
2.
The Korean Journal of Gastroenterology ; : 202-209, 2016.
Article Dans Anglais | WPRIM | ID: wpr-47256

Résumé

BACKGROUND/AIMS: EUS can detect bile duct stones (BDS) that are undetectable on multidetector computed tomography (MDCT). BDS associated with acute biliary pancreatitis (ABP) are small and tend to be excreted spontaneously. This study evaluated the usefulness of early EUS in patients with ABP and undetectable BDS on MDCT. METHODS: Forty-one patients with ABP and undetectable BDS on MDCT underwent EUS within 24 hours of admission and were diagnosed with BDS, sludge, dilated common bile duct (CBD), or normal CBD. ERCP was performed in patients with BDS, sludge, or clinical deterioration. The diagnostic yield and the effects of early EUS on morbidity, mortality, and the length of hospitalization were evaluated. RESULTS: EUS detected BDS or sludge in 48.8% of patients examined. BDS was the diagnosis in 13 patients, sludge in seven, and neither for 21 patients. ERCP was performed in 20 patients with BDS or sludge, in two patients with coexisting cholangitis, and in one patient with worsening liver function tests. ERCP identified BDS in 12 patients and sludge in seven. No lesions were diagnosed in four patients by ERCP. All patients improved, and the length of hospitalization in patients with ERCP was 9.0 days, without ERCP 7.1 days. Two patients with major complications by ERCP were hospitalized for a prolonged time. CONCLUSIONS: Early EUS may be useful to select patients for therapeutic ERCP in cases of suspected ABP with undetectable BDS on MDCT.


Sujets)
Humains , Conduits biliaires , Cholangiopancréatographie rétrograde endoscopique , Angiocholite , Lithiase cholédocienne , Conduit cholédoque , Diagnostic , Endosonographie , Calculs biliaires , Hospitalisation , Tests de la fonction hépatique , Mortalité , Tomodensitométrie multidétecteurs , Pancréatite , Eaux d'égout
3.
Clinical Endoscopy ; : 239-246, 2015.
Article Dans Anglais | WPRIM | ID: wpr-178049

Résumé

BACKGROUND/AIMS: Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis. METHODS: We compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy. RESULTS: Final diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, two adenomyomas, one paraganglioma, and one neuroendocrine tumor. The diagnostic accuracy of endoscopic imaging or the initial biopsy was identical (67.3%). At least one test was concordant with the final diagnosis in all except two cases. Compared with the final diagnosis, endoscopic imaging tended to show more advanced tumors, whereas the initial biopsy revealed less advanced lesions. The diagnostic accuracy of the initial biopsy was influenced by the type of endoscope used and the final diagnosis, but not by the number of biopsies taken. CONCLUSIONS: Endoscopy has limited accuracy in the diagnosis of ampullary tumors. However, most cases with concordant endoscopic imaging and biopsy results are identical to the final diagnosis. Therefore, in cases where both of these tests disagree, re-evaluation with a side-viewing endoscope after resolution of papillitis is required.


Sujets)
Adénocarcinome , Adénomes , Adénomyome , Biopsie , Diagnostic , Erreurs de diagnostic , Endoscopes , Endoscopie , Tumeurs neuroendocrines , Oedème papillaire , Paragangliome
4.
Korean Journal of Nephrology ; : 403-406, 2010.
Article Dans Coréen | WPRIM | ID: wpr-74989

Résumé

Spontaneous splenic rupture is a rare disease but can cause a life threatening situation. It can occur under a pathological spleen such as infection, neoplastic, infiltrative and inflammatory disease. Although splenectomy is the treatment of choice for splenic rupture, it is uncertain that the effectiveness of non- surgical treatment in the hemodynamically stable patient. We report a case of a 66-year-old male undergoing hemodialysis for 4 years who presented to the emergency department with abdominal pain and distention. Blood pressure was 130/80 mmHg, heart rate was 108 bpm. White blood cell count was 7,130/mm3, hemoglobin was 6.7 g/dL, platelet was 156,000/mm3. PT INR was elevated up to 2.01 because he had taken warfarin due to splenic infarction. Abdominal CT scan revealed hemoperitoneum due to splenic rupture. We performed angiography but there was no active bleeding. We decided conservative management without embolization because of stable condition and increased bleeding risk in operation. He received 6 pints of packed red blood cell transfusion during continuous renal replacement therapy for 24 hours on ICU. He was discharged with complete recovery on the 21st hospital day. We suggest that non-surgical treatment in splenic rupture also could be considered in hemodynamically stable patients with a high risk of postoperative complication.


Sujets)
Sujet âgé , Humains , Mâle , Douleur abdominale , Angiographie , Plaquettes , Pression sanguine , Urgences , Transfusion d'érythrocytes , Rythme cardiaque , Hémoglobines , Hémopéritoine , Hémorragie , Rapport international normalisé , Numération des leucocytes , Moutardes , Maladies rares , Dialyse rénale , Traitement substitutif de l'insuffisance rénale , Rate , Splénectomie , Infarctus splénique , Rupture de rate , Warfarine
5.
Tuberculosis and Respiratory Diseases ; : 288-292, 2010.
Article Dans Coréen | WPRIM | ID: wpr-146749

Résumé

Exogenous lipoid pneumonia occurs rarely in healthy people. In most cases, exogenous lipoid pneumonia is usually caused by aspiration of mineral, vegetable, or animal oil. We report the case of 42-year-old woman, who have experienced lipoid pneumonia after silicon injection into her breast for cosmetic purposes. The patient experienced fever, dyspnea, sputum, and hemoptysis after silicon injection into her breast. Chest computed tomography demonstrated non-segmental distribution of bilateral consolidation in both lung fields. A transbronchial lung biopsy specimen shows foamy microphages in alveolar spaces. Papanicolaous staining of bronchoalveolar lavage fluid showed abundant foamy marcrophages and many neutrophils. With these results, we confirmed lipoid pneumonia was associated with silicon oil injection into breast.


Sujets)
Adulte , Animaux , Femelle , Humains , Biopsie , Région mammaire , Liquide de lavage bronchoalvéolaire , Cosmétiques , Dyspnée , Fièvre , Hémoptysie , Poumon , Mammoplastie , Granulocytes neutrophiles , Pneumopathie infectieuse , Stéatose pulmonaire , Huiles de silicone , Expectoration , Thorax , Légumes
6.
Korean Journal of Medicine ; : 660-663, 2010.
Article Dans Coréen | WPRIM | ID: wpr-162414

Résumé

Macrolides antibiotics synthesized by Streptomyces strains are prescribed widely and seldom produce hypersensitivity reactions, even when administered topically. Consequently, they are considered very safe drugs. We report the case of a 32.year.old woman who developed anaphylactic shock after ingesting erythromycin, which she had taken twice before. The previous exposure to erythromycin, clinical findings, and a positive skin intradermal test with erythromycin (10 mg/mL) support the postulate that anaphylaxis was induced by erythromycin.


Sujets)
Femelle , Humains , Anaphylaxie , Antibactériens , Érythromycine , Hypersensibilité , Tests intradermiques , Macrolides , Peau , Tests cutanés , Streptomyces
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