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Usefulness of transcatheter arterial embolization for eighty-three patients with secondary postpartum hemorrhage:Focusing on difference in angiographic findings

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World Journal of Clinical Cases 2023年第15期11卷 3471-3480页

作者： Bong Man Kim Gyeong Sik Jeon Min jeong Choi Nam-Soo Hong Department of Radiology Dankook University HospitalDankook University College of MedicineCheonan-si 31116Chungcheongnam-doSouth Korea Department of Radiology CHA Bundang Medical CenterCollege of MedicineCHA UniversitySeongnam-si 13496Gyeonggi-doSouth Korea Department of Preventive Medicine School of MedicineKyungpook National UniversityDaegu 41944South Korea

BACKGROUND Transcatheter arterial embolization(TAE)has been widely used as an effective and a safe treatment method and was often used as an alternative to the surgical management,but there are limited studies on the efficacy and the safety for patients undergoing their secondary postpartum hemorrhage(PPH).AIM To evaluate the usefulness of TAE for secondary PPH focusing on the angiographic findings.METHODS We conducted a research from January 2008 to July 2022 on all 83 patients(mean:32 years,range:24-43 years)presented with secondary PPH and they were treated with TAE in two university hospitals.The medical records and angiography were retrospective reviewed in order to evaluate the patients’characteristics,delivery details,clinical status and peri-embolization management,angiography and embolization details,technical/clinical success and complications.The group with active bleeding sign and the group without it were also compared and analyzed.RESULTS On angiography,46(55.4%)patients showed active bleeding signs such as contrast extravasation(n=37)or pseudoaneurysm(n=8)or both(n=1),and 37(44.6%)patients showed non-active bleeding signs such as only spastic uterine artery(n=2)or hyperemia(n=35).In the active bleeding sign group there were more multiparous patients,low platelet count,prothrombin time prolongation,and high transfusion requirements.The technical success rates were 97.8%(45/46)in active bleeding sign group and 91.9%(34/37)in non-active bleeding sign group,and the overall clinical success rates were 95.7%(44/46)and 97.3%(36/37).An uterine rupture with peritonitis and abscess formation occurred to one patient after the embolization,therefore hysterostomy and retained placenta removal were performed which was a major complication.CONCLUSION TAE is an effective and a safe treatment method for controlling secondary PPH regardless of angiographic findings.

关键词： Postpartum hemorrhage Angiography Transcatheter arterial embolization Pseudoaneurysm Nbutylcyanoacrylate

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Embolization of pancreatic arteriovenous malformation:A case report

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World Journal of Clinical Cases 2020年第8期8卷 1471-1476页

作者： So Yeon Yoon Gyeong Sik Jeon Shin Jae Lee Dae Joong Kim Chang Il Kwon Mi Hyun Park Department of Radiology CHA Bundang Medical CenterCollege of MedicineCHA UniversitySeongnam-si 13496Gyeonggi-doSouth Korea Department of Radiology Research Institute of Radiological ScienceYongin Severance HospitalYonsei University College of MedicineYongin-si 17046South Korea Department of Internal Medicine Digestive Disease CenterCHA Bundang Medical CenterCollege of MedicineCHA UniversitySeongnam-si 13496Gyeonggi-doSouth Korea Department of Radiology Dankook University HospitalChungcheongnam-do 31116South Korea

BACKGROUND Pancreatic arteriovenous malformation(AVM)is a rare disease with a number of different reported treatment methods,but there are as yet no established or definite treatments for the disease.CASE SUMMARY A 43-year-old man visited the hospital due to periumbilical pain.The patient underwent imaging study and laboratory testing for evaluation of cause.Pancreatic AVM associated with pancreatitis was suspected on computed tomography and magnetic resonance imaging.The patient was diagnosed with pancreatic AVM with pancreatitis on imaging study and angiography.Transcatheter arterial embolization with various embolic materials was performed.Follow-up computed tomography scan revealed progressive regression of AVM and improvement of pancreatitis.At two-year follow-up,the patient showed no recurrence of symptom or pancreatitis.CONCLUSION Transcatheter arterial embolization can be considered an effective treatment modality for selective cases of pancreatic AVM.

关键词： Pancreas Arteriovenous malformation Pancreatitis Pancreatic pseudocyst Embolization Therapeutic Case report

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边缘区淋巴瘤晚期患者R-CVP后利妥昔单抗维持治疗的Ⅱ期研究:一项改善淋巴瘤生存协会(CISL)的研究

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癌症 2020年第3期39卷 118-128页

作者： Sung Yong Oh Won Seog Kim Jin Seok Kim Seok Jin Kim Dok Hyun Yoon Deok‑Hwan Yang Won sik Lee Hyo Jung Kim Ho‑Young Yhim Seong Hyun jeong Jong Ho Won Suee Lee Jee Hyun Kong Sung‑Nam Lim Jun Ho Ji Kyung A.Kwon gyeong‑Won Lee Jae Hoon Lee Ho Sup Lee Ho‑Jin Shin Cheolwon Suh Department of Internal Medicine Dong-A University HospitalBusan 49201Republic of Korea Department of Medicine Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351Republic of Korea Division of Hematology Department of Internal MedicineYonsei University College of MedicineSeoul 03722Republic of Korea Department of Oncology Asan Medical CenterUniversity of Ulsan College of MedicineSongpa‑guSeoul 05505Republic of Korea Department of Hematology‑Oncology Chonnam National University Hwasun HospitalHwasun 58128Republic of Korea Department of Hematology Busan Paik HospitalInje University College of MedicineBusan 04511Republic of Korea Department of Internal Medicine Hallym University Sacred Heart HospitalHallym University College of MedicineAnyang 14068Republic of Korea Department of Internal Medicine Chonbuk National University HospitalJeonju 54907Republic of Korea Department of Hematology‑Oncology Ajou University School of MedicineSuwon 16499Republic of Korea Department of Internal Medicine Soonchunhyang University Seoul HospitalSoonchunhyang University College of MedicineSeoul 04401Republic of Korea Division of Hematology‑Oncology Department of Internal MedicineWonju Severance Christian HospitalYonsei University College of MedicineWonju 26426Republic of Korea Department of Internal Medicine Haeundae Paik HospitalInje University College of MedicineBusan 48108Republic of Korea Division of Hematology and Oncology Department of Internal MedicineSamsung Changwon HospitalSungkyunkwan University School of MedicineChangwon 51353Republic of Korea Division of Hematology‑Oncology Department of Internal MedicineDongnam Institute of Radiological and Medical SciencesBusan 46033Republic of Korea Division of Hematology‑Oncology Department of Internal MedicineGyeongsang National University HospitalGyeongsang National University College of MedicineJinju 52727Republic of Korea Department of Internal Medicine Gachon University Gil Medical CenterIncheon 21565Republic of

背景与目的利妥昔单抗是一种靶向CD20的单克隆抗体,在治疗边缘区淋巴瘤(marginal zone lymphoma,MZL)中可以单药或联合化疗使用,可提高缓解率和生存率,但治疗后仍可能会复发。因此,仍需探索如何延长MZL患者的缓解期的治疗方案。这项多... 详细信息

背景与目的利妥昔单抗是一种靶向CD20的单克隆抗体,在治疗边缘区淋巴瘤(marginal zone lymphoma,MZL)中可以单药或联合化疗使用,可提高缓解率和生存率,但治疗后仍可能会复发。因此,仍需探索如何延长MZL患者的缓解期的治疗方案。这项多中心、单臂、开放标签的Ⅱ期研究评估了对一线R-CVP(rituximab,cyclophosphamide,vincristine,and prednisolone;利妥昔单抗、环磷酰胺、长春新碱和泼尼松龙)治疗有反应的Ⅲ–Ⅳ期CD20阳性MZL患者进行利妥昔单抗维持治疗2年的生存率。本研究旨在明确R-CVP后利妥昔单抗维持治疗的策略是否有进一步研究的价值。方法在利妥昔单抗维持治疗之前,Ⅲ–Ⅳ期MZL患者应接受6–8周期的R-CVP一线治疗。每个周期为3周,第1 d静脉输注利妥昔单抗(375 mg/m^2)、环磷酰胺(750 mg/m^2)和长春新碱(1.4 mg/m^2;最大2 mg),第1–5 d口服泼尼松龙(100 mg)。对R-CVP治疗达到完全缓解(complete response,CR)、部分缓解(part response,PR)或疾病稳定(stable response,SD)的患者进行利妥昔单抗维持治疗,每8周静脉注射利妥昔单抗375mg/m^2,直到12个周期。主要终点为无进展生存期(progression-free surviva,PFS),次要终点为总生存期(overall survival,OS)和治疗安全性。结果共纳入47例患者,其中45(96%)例接受了利妥昔单抗维持治疗。15(33%)例患者有淋巴结MZL。在进行R-CVP一线治疗后,分别有20(44%)例、22(49%)例和3(7%)例的患者达到了CR、PR和SD。中位随访38.2个月后,患者的3年PFS率为81%。在利妥昔单抗维持治疗期间,R-CVP治疗后有6例PR和1例SD患者获得CR。LDH升高和B症状是PFS的重要预后因素(P=0.003),3年OS率为90%。利妥昔单抗维持治疗的耐受性良好,常见的治疗性不良事件为感觉性神经病(18%)、肌痛(13%)、疲劳(9%)和中性粒细胞减少(9%)。结论一线R-CVP治疗后利妥昔单抗维持治疗在Ⅲ–Ⅳ期MZL患者中不仅表现出较好的PFS,而且药物毒性反应评价良好。

关键词：边缘区淋巴瘤晚期利妥昔单抗环磷酰胺长春新碱维持多中心开放标签生存

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Multiple z-Score Based Method for Noninvasive Prenatal Test Using Cell-Free DNA in Maternal Plasma

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Open Journal of Genetics 2017年第1期7卷 1-8页

作者： Hyuk Jung Kwon Amit Goyal Heesu Im Kichan Lee Seon Young Yun Yoon Hee Kim Sungjong Lee Mi-gyeong Lee Hyuna Lee Reena Garg Boram Park Soyoung Choi Joungsu Joo Jin-sik Bae Min-jeong Kim Min Seob Lee Sunghoon Lee EONE-DIAGNOMICS Genome Center Co. Ltd. Inchon Korea

Objective: To improve the detecting accuracy of chromosomal aneuploidy of fetus by non-invasive prenatal testing (NIPT) using next generation sequencing data of pregnant women’s cell-free DNA. Methods: We proposed the multi-Z method which uses 21 z-scores for each autosomal chromosome to detect aneuploidy of the chromosome, while the conventional NIPT method uses only one z-score. To do this, mapped read numbers of a certain chromosome were normalized by those of the other 21 chromosomes. Average and standard deviation (SD), which are used for calculating z-score of each sample, were obtained with normalized values between all autosomal chromosomes of control samples. In this way, multiple z-scores can be calculated for 21 autosomal chromosomes except oneself. Results: Multi-Z method showed 100% sensitivity and specificity for 187 samples sequenced to 3 M reads while the conventional NIPT method showed 95.1% specificity. Similarly, for 216 samples sequenced to 1 M reads, Multi-Z method showed 100% sensitivity and 95.6% specificity and the conventional NIPT method showed a result of 75.1% specificity. Conclusion: Multi-Z method showed higher accuracy and robust results than the conventional method even at low coverage reads.

关键词： Cell-Free DNA z-Score Multiple Thresholds Coefficient of Variance Noninvasive Prenatal Testing NIPT

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Phase Ⅱ study of R-CVP followed by rituximab maintenance therapy for patients with advanced marginal zone lymphoma:consortium for improving survival of lymphoma(CISL)study

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Cancer Communications 2019年第1期39卷 526-535页

作者： Sung Yong Oh Won Seog Kim Jin Seok Kim Seok Jin Kim Dok Hyun Yoon Deok-Hwan Yang Won sik Lee Hyo Jung Kim Ho-Young Yhim Seong Hyun jeong Jong Ho Won Suee Lee Jee Hyun Kong Sung-Nam Lim Jun Ho Ji Kyung A.Kwon gyeong-Won Lee Jae Hoon Lee Ho Sup Lee Ho-Jin Shin Cheolwon Suh Department of Internal Medicine Dong-A University HospitalBusan 49201Republic of Korea Department of Medicine Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351Republic of Korea Division of Hematology Department of Internal MedicineYonsei University College of MedicineSeoul 03722Republic of Korea Department of Oncology Asan Medical CenterUniversity of Ulsan College of MedicineSongpa-guSeoul 05505Republic of Korea Department of Hematology-Oncology Chonnam National University Hwasun HospitalHwasun 58128Republic of Korea Department of Hematology Busan Paik HospitalInje University College of MedicineBusan 04511Republic of Korea Department of Internal Medicine Hallym University Sacred Heart HospitalHallym University College of MedicineAnyang 14068Republic of Korea Department of Internal Medicine Chonbuk National University HospitalJeonju 54907Republic of Korea Department of Hematology-Oncology Ajou University School of MedicineSuwon 16499Republic of Korea Department of Internal Medicine Soonchunhyang University Seoul HospitalSoonchunhyang University College of MedicineSeoul 04401Republic of Korea Division of Hematology-Oncology Department of Internal MedicineWonju Severance Christian HospitalYonsei University College of MedicineWonju 26426Republic of Korea Department of Internal Medicine Haeundae Paik HospitalInje University College of MedicineBusan 48108Republic of Korea Division of Hematology and Oncology Department of Internal MedicineSamsung Changwon HospitalSungkyunkwan University School of MedicineChangwon 51353Republic of Korea Division of Hematology-Oncology Department of Internal MedicineDongnam Institute of Radiological and Medical SciencesBusan 46033Republic of Korea Division of Hematology-Oncology Department of Internal MedicineGyeongsang National University HospitalGyeongsang National University College of MedicineJinju 52727Republic of Korea Department of Internal Medicine Gachon University Gil Medical CenterIncheon 21565Republic of

Background:The response rate and survival improvement for rituximab,a CD20-targeting monoclonal antibody,have been demonstrated in marginal zone lymphoma(MZL)as monotherapy and in combination with chemotherapeutic regimens,yet relapses still occur despite treatment completion.Thus,extending the period of remission in MZL patients remains an essential goal.This multicenter,single-arm,open-label phase II study evaluated the survival efficacy of 2 years of rituximab-maintenance therapy in patients with stage III-IV CD20-positive MZL who had responded to first-line R-CVP(rituximab,cyclophosphamide,vincristine,and prednisolone).The objective of this study was to determine whether rituximab maintenance following R-CVP warrants further investigation.Methods:Prior to rituximab-maintenance therapy,patients received 6-8 cycles of first-line R-CVP therapy for stage III-IV MZL.Rituximab(375 mg/m^(2)),cyclophosphamide(750 mg/m^(2)),and vincristine(1.4 mg/m^(2);maximum 2 mg)were administered via an intravenous infusion on day 1 of each 3-week cycle,while oral prednisolone(100 mg)was given on days 1-5 of each 3-week cycle.The patients who achieved complete response(CR),partial response(PR),or stable disease(SD)to R-CVP treatment,were prescribed rituximab-maintenance therapy which was administered intravenously at a dose of 375 mg/m^(2) every 8 weeks for up to 12 cycles.The primary endpoint was progression-free survival(PFS).Secondary endpoints were overall survival(OS)and treatment safety.Results:47 patients were enrolled,of whom,45(96%)received rituximab-maintenance treatment.Fifteen(33%)patients had nodal MZL.Following R-CVP first-line therapy,20(44%),22(49%),and 3(7%)patients achieved CR,PR,and SD,respectively.After a median follow-up of 38.2 months,their observed 3-year PFS rate was 81%.During the rituximab-maintenance,6 PR and 1 SD patients achieved CR following the administration of R-CVP.Elevated LDH and the presence of B symptoms were found to be significant prognostic factors for PFS(P=0.003)and demonstrated a 3-year O

关键词： Marginal zone Lymphoma Advanced stage Rituximab Cyclophosphamide Vincristine Maintenance Multicenter Open label Survival

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