1.Transcatheter Arterial Embolization for Acute Arterial Extravasation with Hematoma Formation: Classified the Group as Cause and Their Clinical Outcomes
Boram KIM ; Young Min HAN ; Gong Yong JIN
Journal of the Korean Radiological Society 2018;78(2):120-129
PURPOSE:
To present our experience in transcatheter arterial embolization (TAE) for hematoma formation related to variable causes. We analyzed the factors that could affect clinical outcomes.
MATERIALS AND METHODS:
A retrospective study was conducted on 50 patients (24 men, 36 women; mean age, 63.8 years) who were treated for a TAE to control bleeding. Computed tomography (CT) scans showed the formation of hematomas. We classified the patients into three groups depending on the underlying cause of the hematoma i.e., spontaneous, traumatic or iatrogenic groups. We evaluated relevant factors such as sex, age, hematoma size and liquefaction, extravasation on CT, injured artery, onset to procedure time, embolization material, hospital day.
RESULTS:
TAE was successfully performed in all patients. The proportions of patients in the spontaneous, traumatic, and iatrogenic bleeding groups were 36% (18/50), 42% (21/50), and 22% (11/50), respectively. Using the Mann Whitney U test, the international normalized ratio (INR) was statistically different for the spontaneous bleeding group (p = 0.013). In addition, the INR (p = 0.038) and platelet count (p = 0.004) were significant different for the traumatic group. Also, the platelet counts were related to clinical successes (p = 0.046).
CONCLUSION
Based our experience, TAE is a safe and effective treatment option for the management of hematoma formation. Furthermore, the interventional radiologist should consider the cause of hematoma formation in order to perform proper treatment.
2.Reimbursement of Digital Therapeutics: Future Perspectives in Korea
Jin Han JU ; Boram SIM ; Jeongeun LEE ; Jin Yong LEE
Korean Circulation Journal 2022;52(4):265-279
Digital health is rapidly growing worldwide and its area is expanding from wellness to treatment due to digital therapeutics (DTx). This study compared DTx in the Korean context with other countries to better understand its political and practical implications. DTx is generally the same internationally, often categorized as software as a medical device. It provides evidence-based therapeutic interventions for medical disabilities and diseases.Abroad, DTx support entailed state subsidies and fundraising and national health insurance coverage. In the case of national health insurance coverage, most cases were applied to mental diseases. Moreover, in Japan, DTx related to hypertension will possibly be under discussion for national health insurance coverage in 2022. In overseas countries, coverage was decided only when the clinical effects were equivalent to those provided by existing technology, and in the UK, real usage data for DTx and associated evaluations were reflected by national health coverage determination. Prices were either determined through closed negotiations with health insurance operating agencies and manufacturers or established based on existing technology. Concerning the current situation, DTx dealing with various diseases including hypertension are expected to be developed near in the future, and the demand for use and compensation will likely increase. Therefore, it is urgent to define and prepare for DTx, relevant support systems, and health insurance coverage listings. Several support systems must be considered, including government subsidies, science/technology funds, and health insurance.
3.KRAS Mutation Detection in Non-small Cell Lung Cancer Using a Peptide Nucleic Acid-Mediated Polymerase Chain Reaction Clamping Method and Comparative Validation with Next-Generation Sequencing.
Boram LEE ; Boin LEE ; Gangmin HAN ; Mi Jung KWON ; Joungho HAN ; Yoon La CHOI
Korean Journal of Pathology 2014;48(2):100-107
BACKGROUND: KRAS is one of commonly mutated genetic "drivers" in non-small cell lung cancers (NSCLCs). Recent studies indicate that patients with KRAS-mutated tumors do not benefit from adjuvant chemotherapy, so there is now a focus on targeting KRAS-mutated NSCLCs. A feasible mutation detection method is required in order to accurately test for KRAS status. METHODS: We compared direct Sanger sequencing and the peptide nucleic acid (PNA)-mediated polymerase chain reaction (PCR) clamping method in 134 NSCLCs and explored associations with clinicopathological factors. Next-generation sequencing (NGS) was used to validate the results of discordant cases. To increase the resolution of low-level somatic mutant molecules, PNA-mediated PCR clamping was used for mutant enrichment prior to NGS. RESULTS: Twenty-one (15.7%) cases were found to have the KRAS mutations using direct sequencing, with two additional cases by the PNA-mediated PCR clamping method. The frequencies of KRAS mutant alleles were 2% and 4%, respectively, using conventional NGS, increasing up to 90% and 89%, using mutant-enriched NGS. The KRAS mutation occurs more frequently in the tumors of smokers (p=.012) and in stage IV tumors (p=.032). CONCLUSIONS: Direct sequencing can accurately detect mutations, but, it is not always possible to obtain a tumor sample with sufficient volume. The PNA-mediated PCR clamping can rapidly provide results with sufficient sensitivity.
Alleles
;
Carcinoma, Non-Small-Cell Lung*
;
Chemotherapy, Adjuvant
;
Constriction*
;
Humans
;
Lung Neoplasms
;
Peptide Nucleic Acids
;
Polymerase Chain Reaction*
5.Non-small Cell Lung Cancer with Concomitant EGFR, KRAS, and ALK Mutation: Clinicopathologic Features of 12 Cases.
Taebum LEE ; Boram LEE ; Yoon La CHOI ; Joungho HAN ; Myung Ju AHN ; Sang Won UM
Journal of Pathology and Translational Medicine 2016;50(3):197-203
BACKGROUND: Although epidermal growth factor receptor (EGFR), v-Ki-ras2 Kirsten rat sarcoma viral oncogene (KRAS), and anaplastic lymphoma kinase (ALK) mutations in non-small cell lung cancer (NSCLC) were thought to be mutually exclusive, some tumors harbor concomitant mutations. Discovering a driver mutation on the basis of morphologic features and therapeutic responses with mutation analysis can be used to understand pathogenesis and predict resistance in targeted therapy. METHODS: In 6,637 patients with NSCLC, 12 patients who had concomitant mutations were selected and clinicopathologic features were reviewed. Clinical characteristics included sex, age, smoking history, previous treatment, and targeted therapy with response and disease-free survival. Histologic features included dominant patterns, nuclear and cytoplasmic features. RESULTS: All patients were diagnosed with adenocarcinoma and had an EGFR mutation. Six patients had concomitant KRAS mutations and the other six had KRAS mutations. Five of six EGFR-KRAS mutation patients showed papillary and acinar histologic patterns with hobnail cells. Three of six received EGFR tyrosine kinase inhibitor (TKI) and showed partial response for 7-29 months. All six EGFR-ALK mutation patients showed solid or cribriform patterns and three had signet ring cells. Five of six EGFR-ALK mutation patients received EGFR TKI and/or ALK inhibitor and four showed partial response or stable disease, except for one patient who had acquired an EGFR mutation. CONCLUSIONS: EGFR and ALK mutations play an important role as driver mutations in double mutated NSCLC, and morphologic analysis can be used to predict treatment response.
Adenocarcinoma
;
Animals
;
Carcinoma, Non-Small-Cell Lung*
;
Cytoplasm
;
Disease-Free Survival
;
Humans
;
Lymphoma
;
Oncogenes
;
Phosphotransferases
;
Protein-Tyrosine Kinases
;
Rats
;
Receptor, Epidermal Growth Factor
;
Sarcoma
;
Smoke
;
Smoking
6.In-Vitro Study of Urokinase Thrombolysis Following Stereotactic Aspiration of Intracerebral Hematoma
Wonsoo SON ; Jaechan PARK ; Dong-Hun KANG ; Young-Min HAN ; Yeon-Ju CHOI ; Boram OHK
Journal of Korean Neurosurgical Society 2020;63(3):380-385
Objective:
: A consensus regarding the ideal regimen for urokinase (UK) thrombolysis subsequent to stereotactic spontaneous intracerebral hemorrhage aspiration has yet to be established. The purpose of this study is to evaluate the efficacy of UK thrombolysis relative to when the regimen is changed.
Methods:
: Venous blood from 30 heathy volunteers was obtained for this in-vitro study. Various concentrations of UK solution were added to microcentrifuge tubes containing the clotted blood. The efficacy of UK thrombolysis was identified by checking the weight of lysed hematoma following various time intervals with different concentrations of UK solution. Group one, the “3×4” group involved four administrations every 3 hours over 12 hours, and group two, the “6×2” group involved two administrations every 6 hours over 12 hours.
Results:
: More hematoma was lysed in the 3×4 group than the 6×2 group across all concentration levels (however, the differences were only significant between groups at the 500 and 1000 IU concentration levels, p<0.05). There were no significant differences of lysed hematoma among the various UK solution concentrations within groups.
Conclusion
: This study suggests that frequent administrations of UK thrombolysis may result in a greater degree of lysed hematoma in comparison to a higher concentration of UK.
7.Neutrophil-to-lymphocyte ratio predicts early acute cellular rejection in living donor liver transplantation
Boram LEE ; YoungRok CHOI ; Jai Young CHO ; Yoo-Seok YOON ; Ho-Seong HAN
Annals of Surgical Treatment and Research 2020;99(6):337-343
Purpose:
The aim of this study was to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in acute cellular rejection (ACR) after living donor liver transplantation (LDLT).
Methods:
All consecutive patients who underwent ABO-compatible (ABOc) LDLT from September 2014 to December 2017 were retrospectively reviewed. NLR was calculated on 3 occasions; (1) 4 weeks prior to liver transplantation (LT), (2) the day of LT, and (3) the day before liver biopsy.
Results:
Among 66 patients who underwent ABOc LDLT, ACR was identified in 15 patients (22.7%) on protocol liver biopsy performed routinely on the postoperative day 7. There was no significant difference in NLR at 4 weeks prior to LT and the day of LT between no-ACR and ACR group (2.98 ± 1.92 vs. 2.54 ± 1.15, P = 0.433; 17.9 ± 8.31 vs. 20.5 ± 13.4, P = 0.393). However, NLR was significantly lower in ACR group compared to non-ACR group just prior to liver biopsy (5.82 ± 3.42 vs. 18.4 ± 17.2, P = 0.035). NLR tends to decrease 3.5 days before the onset of ACR. The area under the receiver operating characteristic curve for optimal cut-off value of NLR was 6.49, with sensitivity and specificity of 80.4% and 73.3% respectively.
Conclusion
NLR has a potential as a noninvasive predictor of early ACR in ABOc LDLT.
8.Comparison of Monthly Characteristics of Adolescent Suicide Attempts Before, During and After COVID-19
Sujin YOO ; Hanjin CHO ; Boram CHAE ; Han Na KIM ; Ju Yeon JEE ; Ho-Kyoung YOON
Korean Journal of Psychosomatic Medicine 2024;32(2):64-69
Objectives:
:This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic.
Methods:
:From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods.
Results:
:From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before.
Conclusions
:Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.
9.Comparison of Monthly Characteristics of Adolescent Suicide Attempts Before, During and After COVID-19
Sujin YOO ; Hanjin CHO ; Boram CHAE ; Han Na KIM ; Ju Yeon JEE ; Ho-Kyoung YOON
Korean Journal of Psychosomatic Medicine 2024;32(2):64-69
Objectives:
:This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic.
Methods:
:From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods.
Results:
:From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before.
Conclusions
:Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.
10.Comparison of Monthly Characteristics of Adolescent Suicide Attempts Before, During and After COVID-19
Sujin YOO ; Hanjin CHO ; Boram CHAE ; Han Na KIM ; Ju Yeon JEE ; Ho-Kyoung YOON
Korean Journal of Psychosomatic Medicine 2024;32(2):64-69
Objectives:
:This study aimed to investigate the monthly characteristics of suicide attempts among adolescents considering the impact of the COVID-19 pandemic.
Methods:
:From 2018 to 2023, patients who arrived at Korea University Ansan Hospital’s emergency depart-ment following a suicide attempt were categorized by age, with adolescents defined as those aged 18 and below.These patients were then compared across three periods: pre COVID-19, COVID-19 period, and post COVID-19 periods.
Results:
:From January 2018 to December 2023, a total of 3,008 patients who attempted suicide visited the emergency room. Among them, 333 (11.1%) were adolescents. In the overall sample, the proportion of suicide attempts in January increased during the COVID-19 period compared to the pre-COVID-19 period, while the proportion in September decreased. Among adolescents, the proportion of suicide attempts in August decreased after COVID-19 compared to before.
Conclusions
:Our findings highlight a concerning increase in suicide attempts among teenagers, showing a cor-relation with the academic semester after COVID-19 pandemic. Understanding and addressing this trend are paramount for effective suicide risk management strategies moving forward.