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- 저자 : Mark A. Gromski (검색결과 3 건)
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Recent advances in the diagnosis and manage-ment of chronic pancreatitis
( Chang-il Kwon ),( Jae Hee Cho ),( Sung Hoon Choi ),( Kwang Hyun Ko ),( Temel Tirkes ),( Mark A. Gromski ),( Glen A. Lehman ) 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.2
Chronic pancreatitis is a chronic condition characterized by pancreatic inflam mation that causes fibrosis and the destruction of exocrine and endocrine tissues. Chronic pancreatitis is a progressive disease, and no physiological treatment is available to reverse its course. However, with advances in medical technology, the existing diagnostic and treatment methods for chronic pancreatitis are evolving. Managing patients with chronic pancreatitis is challenging and necessitates a multidisciplinary approach. In this review, we discuss the recent advances in the diagnosis and management of chronic pancreatitis and introduce future alterna tive modalities.
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Ihab I. El Hajj,Howard Wu,Sarah Reuss,Melissa Randolph,Akeem Harris,Mark A. Gromski,Mohammad Al-Haddad 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.6
Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissueacquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguidedsampling of solid lesions and compare it with the historical FNA technique. Methods: Acquire® 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtainedusing Expect® 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independentlyevaluated by two cytopathologists blinded to the formal cytopathological diagnosis. Results: Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantlylower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNAgroups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNBgroup. Two patients developed post-FNB abdominal pain. Conclusions: The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to thoseobtained by FNA, but with fewer passes.
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Endoscopic Management of Post-Polypectomy Bleeding
Aditya Gutta,Mark A. Gromski 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.3
Post-polypectomy bleeding (PPB) is one of the most common complications of endoscopic polypectomy. There are multiple riskfactors related to patient and polyp characteristics that should be considered. In most cases, immediate PPB can be effectively managedendoscopically when recognized and managed promptly. Delayed PPB can manifest in a myriad of ways. In severe delayed PPB,resuscitation for hemodynamic stabilization should be prioritized, followed by endoscopic evaluation and therapy once the patientis stabilized. Future areas of research in PPB include the risks of direct oral anticoagulants and of specific electrosurgical settings forhot-snare polypectomy vs. cold-snare polypectomy, benefits of closure of post-polypectomy mucosal defects using through-the-scopeclips, and prospective comparative evaluation of newer hemostasis agents such as hemostatic spray powder and over-the-scope clips.
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