• Clinical Endoscopy
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• v.57 no.2
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• pp.263-267
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• 2024

Technical failure of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is often attributed to device failure. To rectify this problem, we developed a single-pigtail plastic stent (SPPS) for EUS-GBD. We retrospectively reviewed the cases of four patients who underwent EUS-GBD for acute cholecystitis. To prepare the SPPS, a 7.5-Fr endoscopic nasobiliary drainage tube was cut to an appropriate length. The use of SPPS during EUS-GBD was successful from both technical and clinical standpoints. The SPPS spontaneously detached 57 days after the procedure in patient 4 and 412 days after the procedure in patient 1. Patient 1 developed cholecystitis after 426 days and was managed with antibiotics. The other three patients did not develop any complications after surgery. In conclusion, we designed a new SPPS dedicated to EUS-GBD and established its technical feasibility and clinical effectiveness.

• Journal of Acupuncture Research
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• v.29 no.5
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• pp.177-185
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• 2012

Objectives : The objective of this case report was to observe the effect of musculoskeletal ultrasound-guided acupotomy therapy on common peroneal nerve palsy. Methods : From June, 2010 to September, 2012, 3 patients clinically diagnosed as common peroneal nerve palsy were treated with general oriental medicine therapy (acupuncture, pharmacopuncture, moxibustion, cupping, physical therapy, herbal medication) and acupotomy. Results : The foot drop of the patients was remarkably improved. Conclusions : This study demonstrates that oriental medical treatment with acuputomy therapy hasnotable effect in improving symptoms of common peroneal nerve palsy. As though we had not widly experienced in this treatment, more research is needed.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.6
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• pp.980-982
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• 2012

Metastasis to the pancreas from extra-pancreatic primary cancers are rare; they commonly present as a manifestation of widespread disease and rarely as an isolated mass of the pancreas. Examinations showed a pancreatic tumor infiltrating the pancreas tail portion and an endoscopic ultrasound guided percutaneous biopsy proved that the lesion was metastatic from the lung carcinoma. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastasis are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. This report that patient undergoing chemotherapy for a small cell lung cancer, who 1 year and 3 months later, accidentally diagnosed of solitary pancreas metastasis and confirmed histology by needle biopsy using endoscopic ultrasound.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.52-56
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• 2015

Painful periarticular calcification most commonly occurs within the rotator cuff of the shoulder and rarely around the elbow, hip, foot, and neck. As acute inflammatory reaction develops, severe pain, exquisite tenderness, local swelling, and limitation of motion with pain occur. In case of calcific tendinitis of the shoulder, it can be easily diagnosed according to the symptoms and with x-ray. However, in lesions of the hip, as it is a rare location and usually involves pain in the posterolateral aspect of the thigh, which can simulate radicular pain from a lumbar intervertebral disc, it could be difficult to diagnose. Hence, physicians usually focus on lumbar lesions; therefore, misdiagnosis is common and leads to a delayed management. Here, we report the case of a 30-year-old female patient with calcific tendinitis of the rectus femoris that was successfully managed with ultrasound-guided steroid injection. This study offers knowledge about the rectus femoris calcification.

• Journal of Veterinary Clinics
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• v.35 no.6
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• pp.290-293
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• 2018

Signalment: A dog which had been hit by car a month prior and had been experiencing recurrent pleural chyle effusion was referred to Chung-buk National University Animal Medical Center. The clinical signs included tachypnea and salivation. Results: Ultrasound-guided popliteal lymphography was performed. The computed tomography imaging revealed that the thoracic duct was ruptured and the lymph was leaking into the cranial mediastinal region. After this discovery, thoracic duct ligation was performed. The ultrasound-guided popliteal lymphography was repeated after the surgery. The second computed tomography imaging revealed that the thoracic duct rupture was resolved. Clinical relevance: We identified the etiology of chylothorax through the computed tomographic lymphography and imaged specific leakage areas. After surgery, the computed tomography imgaing confirmed the lymphatic flow modification and the treatment was successful.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.153-158
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• 2018

Posterior interosseus (PI) nerve compression is a rare form of compressive neuropathy. It can cause pain along the radial nerve course and weakness of radial nerve innervating muscles without sensory symptoms. A 65-year-old man visited our institution complaining weakness of finger extension and thumb abduction after 2 times of injections at the right elbow in local clinic. The patient's clinical history and physical examination implied an iatrogenic radial nerve injury caused by the injection. The electrophysiologic study revealed of posterior interosseus neuropathy (PIN) with incomplete conduction block. However, the ultrasound study showed that the PI nerve was compressed by an anechoic cyst. The magnetic resonance imaging also confirmed of a ganglion cyst, not a hematoma. After repeated aspirations and a steroid injection, the electrophysiologic study showed recovery of motor weakness. Despite of the clue which implying an iatrogenic injury, clinician should consider other possibilities such as ganglion cysts and ultrasound guided aspiration and steroid injection could be an effective option for conservative management.

• Journal of the Korean Orthopaedic Association
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• v.54 no.5
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• pp.393-401
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• 2019

The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.

• Clinical Endoscopy
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• v.56 no.2
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• pp.169-179
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• 2023

Background/Aims: This meta-analysis analyzed the effect of an indwelling biliary stent on endoscopic ultrasound (EUS)-guided tissue acquisition from pancreatic lesions. Methods: A literature search was performed to identify studies published between 2000 and July 2022 comparing the diagnostic outcomes of EUS-tissue acquisition (TA) in patients with or without biliary stents. For non-strict criteria, samples reported as malignant or suspicious for malignancy were included, whereas for strict criteria, only samples reported as malignant were included in the analysis. Results: Nine studies were included in this analysis. The odds of an accurate diagnosis were significantly lower in patients with indwelling stents using both non-strict (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.52-0.90) and strict criteria (OR, 0.58; 95% CI, 0.46-0.74). The pooled sensitivity with and without stents were similar (87% vs. 91%) using non-strict criteria. However, patients with stents had a lower pooled sensitivity (79% vs. 88%) when using strict criteria. The sample inadequacy rate was comparable between groups (OR, 1.12; 95% CI, 0.76-1.65). The diagnostic accuracy and sample inadequacy were comparable between plastic and metal biliary stents. Conclusions: The presence of a biliary stent may negatively affect the diagnostic outcome of EUS-TA for pancreatic lesions.

• Clinical Endoscopy
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• v.57 no.4
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• pp.434-445
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• 2024

Pancreatic cystic lesions (PCLs) have increased in prevalence due to the increased usage and advancements in cross-sectional abdominal imaging. Current diagnostic techniques cannot distinguish between PCLs requiring surgery, close surveillance, or expectant management. This has increased the morbidity and healthcare costs from inappropriately aggressive and conservative management strategies. Endoscopic ultrasound (EUS) needle-based confocal laser endomicroscopy (nCLE) allows for microscopic examination and delineation of the surface epithelium of PCLs. Landmark studies have identified characteristics distinguishing various types of PCLs, confirmed the high diagnostic yield of EUS-nCLE (especially for PCLs with an equivocal diagnosis), and shown that EUS-nCLE helps to change management and reduce healthcare costs. Refining procedure technique and reducing procedure length have improved the safety of EUS-nCLE. The utilization of artificial intelligence and its combination with other EUS-based advanced diagnostic techniques would further improve the results of EUS-based PCL diagnosis. A structured training program and device improvements to allow more complete mapping of the pancreas cyst epithelium will be crucial for the widespread adoption of this promising technology.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.81-93
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• 2013

This review was described to investigate the feasibility of using ultrasound as an image tool for interventions of lumbar spine. This article will first provide an overview of lumbosacral spine surface anatomy and sonoanatomy. A detailed understanding of anatomy is critical for interpretation of ultrasound and procedural performance at spine. Fluoroscopy is most commonly used in interventional spine procedures, but radiation exposure is the major concern when obtaining fluoroscopic images. Ultrasound is radiation-free, is easy to use, and can provide real-time images with high accuracy. Also this device can be used in virtually any clinical setting. Ultrasound guidance offers a reliable alternative to fluoroscopy or computed tomography for lumbar interventions and can be safely performed without radiation exposure.