1.Clinical characteristics of adult acute myelogenous leukemia in National Institute of Hematology and Bloof Transfusion
Phuong Minh Vu ; Vinh Quang Pham ; Khanh Quoc Bach
Journal of Medical Research 2007;49(3):24-30
Background: In Vietnam, there are increase rate of patients with acute leukemia including acute myelogenous leukemia. The clinical, gender, age as well as morphological characteristics of cells have prognostic significance about response to treatment and survival time of patients. Objectives: (1) To describe the distribution of acute myelogenous leukemia types by FAB standard in 'National Institute of Hematology and Blood Transfusion. (2) To describe the clinical characteristics of patients with acute myelogenous leukemia. Subjects and methods: The study included 67 patients diagnosed acute myelogenous leukemia by FAB standard without chemotherapy in 'National Institute of Hematology and Blood Transfusion. Results and conclusions: The median age: 35.55 \xb1 13.46, sex: 53% male, 47% female. Ratio of M0, M1, M2, M3, M4, M5, M6, M7 was 1, 10, 19, 18, 30, 13, 6, 1 %, respectively. 100% of these patients presented with anemia, 57 % with hemorrage, 46 % with fever. Lymphadenopathy was presented in 61 %, hepatomegaly was presented in 27% and spleenomegaly was presented in 9%. 53% of the patients had more bleeding was M3. Lymphadenopathy, hepatospleenomegaly had most frequently seen in the patients of M4 and M5 type. \r\n", u'\r\n', u'
Leukemia
;
Myeloid
;
Acute/ immunology
;
Hematology
2.Evaluationg effects of protective ventilation for patients with Acute Lung Injury (ALI) or acute Respiratory Distress Syndrome (ARDS)
Minh Quang Pham ; Khoa Manh Chu ; Tu Huu Nguyen
Journal of Medical Research 2008;54(2):45-50
Background: Although there are many advances in the treatment of Acute Respiratory Distress Syndrome (ARDS), the mortality rate is still high (40%-60%). The new strategy \u2018protective ventilation\u2019 helped to lower the fatality rate and shortening the duration of mechanical ventilation in comparison with traditional modes. However, there is controversy about the effects of protective ventilation. Objectives: (1) To estimate the change of arterial blood gas and hemodynamic in the first 48hrs in the patients suffering from ALI or ARDS under protective ventilation. (2) To discover the disadvantages of this ventilation mode. Subjects: 30 ALI and ARDS patients (22 males and 8 females) treated at ICU, Viet Duc Hospital between April 2005 and October 2005. Method: Prospective and self-control study. Protective ventilation was applied for these patients. Artery blood gas, hemodynamic and disadvantages of protective ventilation were monitored during first 48hrs. Results: Protective ventilation significantly lowers airway pressure (p < 0.001). There was no change of PaCO2 (p > 0.05), and PaO2 was improved clearly after 12hrs of ventilation (p < 0.05). There were no significant changes of mean arterial pressure, heart rate and central venous pressure. 83.3% patients needed a high dose of sedation during protective ventilation. Conclusion: Protective ventilation lowered airway pressure, improved PaO2 and had no hemodynamic effect. However, patients required a high dose of sedation during this mode of ventilation.
Protective ventilation
;
acute lung injury
;
acute respiratory distress syndrome
3.Application PCR technique for analysis of fusion gene transcripts in the acute myelogenous leukemia
Phuong Minh Vu ; Vinh Quang Pham ; Hoa Khanh Bach ; Cuong Quoc Nguyen ; Phuong Minh Nguyen
Journal of Medical Research 2007;51(4):30-35
Background: In recent years, Vietnam has applied four methods (morphology, cell chemistry, immune marker classification, cyto genetic) in diagnosis and used multi-chemotherapy in treatment for acute myelogenous leukemia (AML)\r\n', u'Objectives: To initially determine some fusion gene transcripts in the acute myelogenous leukemia patients by applying PCR technique. Subject and method: The study included 19 patients with acute myelogenous leukemia treated in National Institute of Hematology and Blood Transfusion and Bachmai Hospital from April 2007 to August 2007. RNA were extracted from leukemic cells and PCR for AML1/ETO, CBFP/MYH11, PMR/RARa fusion transcript was done. Results: Number of male patients was 6 (32%), female patients was 13 (68%). The average age of these patients was 32.67 \xb113.62. There were three M4, M4eo patients with AML1/ETO gene (accounting for 16%), two M2, M4 patients with CBF/MYH1 gene and type F of genetic modification accounting for 11%), two M3 patients with PMR/RAR\u03b1 and Bcr3 of genetic modification (accounting for 11%). Conclusion: Results of the study did not differ significantly from other researches in the world. This study showed the need of applying the PCR technique in determining fusion gene transcript together with traditional cyto-genetic method.\r\n', u'\r\n', u'
Leukemia
;
Myeloid
;
Acute/ blood
;
pathology
;
complications
;
Polymerase Chain Reaction
4.Study PML/RAR alpha fusion gene on 21 patients diagnosed with acute promyelocytic leukemia (AML \u2013 M3)
Phuong Minh Vu ; Vinh Quang Pham ; Hoa Khanh Bach ; Nhung Thi Hong Le ; Dung Thi My Tran ; Phuong Minh Nguyen
Journal of Medical Research 2008;58(5):18-24
Background: In Vietnam, there are a number of studies on the application of ATRA in treating acute promyelocytic leukemia (AML \u2013 M3) but they have still faced with certain difficulties. Objectives: (1). Study PML/RAR alpha fusion gene on the patients diagnosed with AML \u2013 M3. (2). Study the index of hematology of the PML/RAR alpha positive group. Subject and Method: 21 patients with acute promyelocytic leukemia (M3) were studied. All patients were examined with morphology, coagulation and cytogenetic tests and RNA were extracted from leukemic cells and PCR for PML/RAR alpha fusion transcript. Result and conclusion: PML/RAR alpha positive in 67% including 4 patients which were not discovered t(15; 17) by cytogenetic technique. Rates of three subtype (bcr1, bcr2 and bcr3) of PML/RAR alpha were 7 patients (50%), 3 patients (21,5%) and 4 patients (28,5%), respectively. WBC and bone marrow cells of PML/RAR alpha positive group were 5.08+/-3.87 and 155.82+/-106.21. D \u2013 Dimer level was 1954.89+/-1575.28; 93% of patients in the PML/RAR alpha positive group had DIC.
Acute promyelocytic leukemia
;
M3
;
PML/RAR alpha
5.Research on AML1/ETO fusion gene on 76 patients diagnosed with acute myelogenous leukemia
Phuong Minh Vu ; Vinh Quang Pham ; Hoa Khanh Bach ; Nhung Thi Hong Le ; Dung Thi My Tran ; Phuong Minh Nguyen
Journal of Medical Research 2008;59(6):10-16
Background: Chromosome mutation type t(8;21) has quite a high frequency in acute myelogenous leukemia, which accounted for about 15% among adult patients. From 2001, the WHO has a new classification for acute myelogenous leukemia based on genetic mutations. Form had AML1/ETO were arranged into genetic mutation group with better prognosis and ability to fully recover after chemotherapy with a high dose of cytarabin. Objective: Study AML1/ETO fusion gene on the patients diagnosed with Acute Myelogenous Leukemia (AML), as well as the clinical features and some haematologic parameters of the AML1/ETO positive group. Subject and methods: 76 patients with AML were treating in the National Institute of Hematology & Blood Transfusion and the Department of Hematology & Blood Transfusion of Bach Mai Hospital from April 2007 to July 2008. These patients were studied for clinical examination, morphology and RNA were extracted from leukemic cells and PCR for AML1/ETO fusion transcript was performed. Results and conclusions: The incidence of AML1/ETO positive in the AML patients was 24%. The incidence of AML1/ETO positive in AML-M2 was 28%. In the AML1/ETO positive group: median age was 26.94+/-9.22; rate of severe anemia, hemorrhage, fever, infection, hepatomegaly, splenomegaly, lymphadenopathy and gum hypertrophy was 44%, 33%, 28%, 11%, 44%, 28%, 17% and 6%, respectively. Median hemoglobin, WBC, platelet, bone marrow cell count, % blast in peripheral blood and in bone marrow was 84.41+/-28.97 g/l, 29.42+/-31.36 g/l, 42.12+/-33.83 g/l, 215.93+/-134.42 g/l, 56.21+/-26.58% and 65.14+/-16.12%, respectively.
acute myelogenous leukemia
;
AML1/ETO fusion gene
6.Rare Complication of Strongyloidiasis in Vietnam: A Case of Venous Thromboembolism and Duodenal Obstruction
Tien Huynh MANH ; Khanh Quoc Le TRAN ; Phat Tan HO ; Man Minh VO ; Thong Quang PHAM ; Thong Duy VO
The Korean Journal of Gastroenterology 2023;81(6):270-275
Strongyloidiasis, a chronic helminth infection caused by the parasitic nematode Strongyloides stercoralis, has various clinical manifestations. Although rare, duodenal obstructions and venous thromboembolism are possible complications of strongyloidiasis.This paper presents the case of a 47-year-old Vietnamese male with a history of right lower limb edema, anorexia, nausea, vomiting, diarrhea, and abdominal discomfort lasting for four months. Venous Doppler ultrasound detected a thrombus in the right femoral vein, while an abdominal CT scan revealed a mass lesion suggestive of a lower bile duct tumor. Esophageogastroduodenoscopy showed a friable duodenal cap mucosa with multiple ulcers and edematous mucosa of the second part of the duodenum that caused a partial lumen obstruction. The final histological examination of the biopsy specimen revealed chronic duodenitis with larvae consistent with Strongyloides stercoralis. The patient was treated with Ivermectin for two weeks and anticoagulation therapy for three months. After treatment and a six-month follow-up, the patient's gastrointestinal symptoms and leg swelling resolved completely. This is the first documented case of a patient in Vietnam with strongyloidiasis who presented with venous thromboembolism and duodenal obstruction. (Korean J Gastroenterol 2023;81:270-275)
7.Atypical Toxocara canis-Induced Hepatic Visceral Larva Migrans: Diagnostic Challenges and Literature Review
Tien Manh HUYNH ; Khanh Quoc Le TRAN ; Trung Hoang DINH ; Man Minh VO ; Thong Quang PHAM ; Thong Duy VO
The Korean Journal of Gastroenterology 2024;83(6):247-252
Toxocariasis, a zoonotic infection transmitted by Toxocara canis (from dogs) and Toxocara cati (from cats) larvae, poses rare but severe risks to humans. We present a case of hepatic visceral larva migrans (VLM) caused by Toxocara canis in a 21-year-old male with a history of close contact with a pet dog. Initial symptoms and imaging findings mimicked a pyogenic liver abscess. The initial laboratory investigations revealed neutrophilia and elevated levels of IgE. Despite broad-spectrum antibiotics, persistent fever prompted further investigation. Subsequent serological testing for Toxocara antibodies and histopathological analysis of liver tissue demonstrating eosinophil infiltrates and Charcot-Leyden crystals led to a confirmed diagnosis of a liver abscess caused by Toxocara canis. Serological testing for Toxocara antibodies and histopathological analysis of liver tissue confirmed a Toxocara canis-induced liver abscess. Albendazole treatment yielded significant clinical improvement. This case highlights the necessity of considering toxocariasis in liver abscess differentials, particularly in high-seroprevalence regions like Vietnam. Relying solely on serological tests may be insufficient, emphasizing the need for corroborative evidence, including invasive procedures like liver biopsy, for accurate hepatic toxocariasis diagnosis.
8.Pancreaticoduodenectomy with superior mesenteric artery first-approach combined total meso-pancreas excision for periampullary malignancies:A high-volume single-center experience with short-term outcomes
Thanh Khiem NGUYEN ; Ham Hoi NGUYEN ; Tuan Hiep LUONG ; Kim Khue DANG ; Van Duy LE ; Duc Dung TRAN ; Van Minh DO ; Hong Quang PHAM ; Hoan My PHAM ; Thi Lan TRAN ; Cuong Thinh NGUYEN ; Hong Son TRINH ; Yosuke INOUE
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):59-69
Background:
s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape.
Methods:
We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated.
Results:
The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%.
Conclusions
The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.
9.Pancreaticoduodenectomy with superior mesenteric artery first-approach combined total meso-pancreas excision for periampullary malignancies:A high-volume single-center experience with short-term outcomes
Thanh Khiem NGUYEN ; Ham Hoi NGUYEN ; Tuan Hiep LUONG ; Kim Khue DANG ; Van Duy LE ; Duc Dung TRAN ; Van Minh DO ; Hong Quang PHAM ; Hoan My PHAM ; Thi Lan TRAN ; Cuong Thinh NGUYEN ; Hong Son TRINH ; Yosuke INOUE
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):59-69
Background:
s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape.
Methods:
We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated.
Results:
The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%.
Conclusions
The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.
10.Pancreaticoduodenectomy with superior mesenteric artery first-approach combined total meso-pancreas excision for periampullary malignancies:A high-volume single-center experience with short-term outcomes
Thanh Khiem NGUYEN ; Ham Hoi NGUYEN ; Tuan Hiep LUONG ; Kim Khue DANG ; Van Duy LE ; Duc Dung TRAN ; Van Minh DO ; Hong Quang PHAM ; Hoan My PHAM ; Thi Lan TRAN ; Cuong Thinh NGUYEN ; Hong Son TRINH ; Yosuke INOUE
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(1):59-69
Background:
s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape.
Methods:
We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated.
Results:
The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%.
Conclusions
The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.