1.Safety and Efficacy of Venous Coil-Embolization of Type IIa Pelvic Arteriovenous Malformations
Lyo Min KWON ; Sang Yub LEE ; Young Soo DO ; Kwang Bo PARK ; Jun Gon KIM ; Shin-Seok YANG ; Dong-Ik KIM
Korean Journal of Radiology 2025;26(3):239-245
Objective:
To evaluate the safety and efficacy of coil embolization of venous segments in patients with Type IIa pelvic arteriovenous malformations (AVMs).
Materials and Methods:
A retrospective study was performed on 13 patients (median age, 43 years, range 20–62 years, 7 males) who underwent transvenous coil embolization for Type IIa pelvic AVM (characterized by multiple arterioles shunting to focal venous segments of a single draining vein) without the use of additional liquid embolic agents from March 2017 to February 2023. Treatment outcomes were analyzed based on clinical evaluations, post angiography findings, and follow-up CT.
Results:
Fourteen procedures were performed on 13 patients. Except in one patient, all treatments were completed in a single session. Transvenous access was employed in 10 procedures, whereas direct puncture was used in four sessions. The embolization procedures used an average of 55.7 ± 58.5 coils (range, 7–238) and lasted an average of 127.3 ± 39.5 minutes.The technical success rate was 92.9% (of 13/14). All patients reported symptom improvement. Follow-up CT scans showed complete occlusion of the AVM without recurrence in ten of the 13 patients. There was one minor adverse event: a small retroperitoneal hemorrhage, likely related to direct puncture, which resolved spontaneously. No other adverse events were observed.
Conclusion
Coil embolization of the draining vein segment, without the use of additional liquid embolic agents is a safe and effective method for managing Type IIa pelvic AVM.
2.Safety and Efficacy of Venous Coil-Embolization of Type IIa Pelvic Arteriovenous Malformations
Lyo Min KWON ; Sang Yub LEE ; Young Soo DO ; Kwang Bo PARK ; Jun Gon KIM ; Shin-Seok YANG ; Dong-Ik KIM
Korean Journal of Radiology 2025;26(3):239-245
Objective:
To evaluate the safety and efficacy of coil embolization of venous segments in patients with Type IIa pelvic arteriovenous malformations (AVMs).
Materials and Methods:
A retrospective study was performed on 13 patients (median age, 43 years, range 20–62 years, 7 males) who underwent transvenous coil embolization for Type IIa pelvic AVM (characterized by multiple arterioles shunting to focal venous segments of a single draining vein) without the use of additional liquid embolic agents from March 2017 to February 2023. Treatment outcomes were analyzed based on clinical evaluations, post angiography findings, and follow-up CT.
Results:
Fourteen procedures were performed on 13 patients. Except in one patient, all treatments were completed in a single session. Transvenous access was employed in 10 procedures, whereas direct puncture was used in four sessions. The embolization procedures used an average of 55.7 ± 58.5 coils (range, 7–238) and lasted an average of 127.3 ± 39.5 minutes.The technical success rate was 92.9% (of 13/14). All patients reported symptom improvement. Follow-up CT scans showed complete occlusion of the AVM without recurrence in ten of the 13 patients. There was one minor adverse event: a small retroperitoneal hemorrhage, likely related to direct puncture, which resolved spontaneously. No other adverse events were observed.
Conclusion
Coil embolization of the draining vein segment, without the use of additional liquid embolic agents is a safe and effective method for managing Type IIa pelvic AVM.
3.Safety and Efficacy of Venous Coil-Embolization of Type IIa Pelvic Arteriovenous Malformations
Lyo Min KWON ; Sang Yub LEE ; Young Soo DO ; Kwang Bo PARK ; Jun Gon KIM ; Shin-Seok YANG ; Dong-Ik KIM
Korean Journal of Radiology 2025;26(3):239-245
Objective:
To evaluate the safety and efficacy of coil embolization of venous segments in patients with Type IIa pelvic arteriovenous malformations (AVMs).
Materials and Methods:
A retrospective study was performed on 13 patients (median age, 43 years, range 20–62 years, 7 males) who underwent transvenous coil embolization for Type IIa pelvic AVM (characterized by multiple arterioles shunting to focal venous segments of a single draining vein) without the use of additional liquid embolic agents from March 2017 to February 2023. Treatment outcomes were analyzed based on clinical evaluations, post angiography findings, and follow-up CT.
Results:
Fourteen procedures were performed on 13 patients. Except in one patient, all treatments were completed in a single session. Transvenous access was employed in 10 procedures, whereas direct puncture was used in four sessions. The embolization procedures used an average of 55.7 ± 58.5 coils (range, 7–238) and lasted an average of 127.3 ± 39.5 minutes.The technical success rate was 92.9% (of 13/14). All patients reported symptom improvement. Follow-up CT scans showed complete occlusion of the AVM without recurrence in ten of the 13 patients. There was one minor adverse event: a small retroperitoneal hemorrhage, likely related to direct puncture, which resolved spontaneously. No other adverse events were observed.
Conclusion
Coil embolization of the draining vein segment, without the use of additional liquid embolic agents is a safe and effective method for managing Type IIa pelvic AVM.
4.Tuberculous and Malignant Pleural Effusions With Adenosine Deaminase Levels of 40–70 IU/L: Trends in New Cases Over Time and Differentiation Between Groups
Jaehee LEE ; Jongmin PARK ; Jae Kwang LIM ; Ji Eun PARK ; Yong Hoon LEE ; Sun Ha CHOI ; Hyewon SEO ; Seung Soo YOO ; Shin Yup LEE ; Seung-Ick CHA ; Jae Yong PARK ; Chang Ho KIM
Journal of Korean Medical Science 2025;40(13):e35-
Background:
The diagnosis of tuberculous pleural effusion (TPE) often relies on pleural fluid adenosine deaminase (ADA) levels. The diagnostic utility of ADA, however, is influenced by the prevalence of tuberculosis (TB) in local populations. Malignant pleural effusion (MPE) cases can exhibit moderately elevated ADA levels comparable to those seen in TPE. As population aging potentially impacts ADA levels, global TB incidence is decreasing whereas the burden of malignancy is on the rise. Consequently, epidemiological shifts and temporal changes in ADA distribution complicate the differential diagnosis between TPE and MPE when ADA levels are within the 40–70 IU/L range. Nonetheless, data specific to this subset are scarce.
Methods:
This retrospective study included consecutive patients aged > 18 years with confirmed TPE and MPE, spanning from 2012 to 2023. ADA levels in pleural fluid were categorized into three groups: < 40 IU/L, 40–70 IU/L, and > 70 IU/L. The study examined annual trends in the frequency of new cases and ADA level distributions over time and identified discriminating factors between TPE and MPE in cases with ADA levels of 40–70 IU/L.
Results:
In total, 297 TPE and 369 MPE cases were included in this study. Over the study period, the frequency of TPE progressively declined, while that of MPE increased. In the most recent four-year period, new TPE and MPE cases with ADA levels of 40–70 IU/L occurred at comparable numbers. Multivariable analysis identified pleural fluid carcinoembryonic antigen (CEA) levels and the number of focal pleural nodules as independent predictors for MPE. Specifically, the presence of either CEA levels > 15.7 ng/mL or more than eight pleural nodules yielded the highest diagnostic accuracy with a sensitivity of 88%, specificity of 100%, and an area under the curve of 0.95.
Conclusion
The differential diagnosis between TPE and MPE with pleural ADA levels of 40–70 IU/L has become increasingly critical due to evolving epidemiological patterns and ADA distribution changes over time. Pleural fluid CEA levels and the characteristics of pleural nodules may offer valuable guidance in distinguishing between TPE and MPE within this diagnostic gray zone.
5.Tuberculous and Malignant Pleural Effusions With Adenosine Deaminase Levels of 40–70 IU/L: Trends in New Cases Over Time and Differentiation Between Groups
Jaehee LEE ; Jongmin PARK ; Jae Kwang LIM ; Ji Eun PARK ; Yong Hoon LEE ; Sun Ha CHOI ; Hyewon SEO ; Seung Soo YOO ; Shin Yup LEE ; Seung-Ick CHA ; Jae Yong PARK ; Chang Ho KIM
Journal of Korean Medical Science 2025;40(13):e35-
Background:
The diagnosis of tuberculous pleural effusion (TPE) often relies on pleural fluid adenosine deaminase (ADA) levels. The diagnostic utility of ADA, however, is influenced by the prevalence of tuberculosis (TB) in local populations. Malignant pleural effusion (MPE) cases can exhibit moderately elevated ADA levels comparable to those seen in TPE. As population aging potentially impacts ADA levels, global TB incidence is decreasing whereas the burden of malignancy is on the rise. Consequently, epidemiological shifts and temporal changes in ADA distribution complicate the differential diagnosis between TPE and MPE when ADA levels are within the 40–70 IU/L range. Nonetheless, data specific to this subset are scarce.
Methods:
This retrospective study included consecutive patients aged > 18 years with confirmed TPE and MPE, spanning from 2012 to 2023. ADA levels in pleural fluid were categorized into three groups: < 40 IU/L, 40–70 IU/L, and > 70 IU/L. The study examined annual trends in the frequency of new cases and ADA level distributions over time and identified discriminating factors between TPE and MPE in cases with ADA levels of 40–70 IU/L.
Results:
In total, 297 TPE and 369 MPE cases were included in this study. Over the study period, the frequency of TPE progressively declined, while that of MPE increased. In the most recent four-year period, new TPE and MPE cases with ADA levels of 40–70 IU/L occurred at comparable numbers. Multivariable analysis identified pleural fluid carcinoembryonic antigen (CEA) levels and the number of focal pleural nodules as independent predictors for MPE. Specifically, the presence of either CEA levels > 15.7 ng/mL or more than eight pleural nodules yielded the highest diagnostic accuracy with a sensitivity of 88%, specificity of 100%, and an area under the curve of 0.95.
Conclusion
The differential diagnosis between TPE and MPE with pleural ADA levels of 40–70 IU/L has become increasingly critical due to evolving epidemiological patterns and ADA distribution changes over time. Pleural fluid CEA levels and the characteristics of pleural nodules may offer valuable guidance in distinguishing between TPE and MPE within this diagnostic gray zone.
6.Tuberculous and Malignant Pleural Effusions With Adenosine Deaminase Levels of 40–70 IU/L: Trends in New Cases Over Time and Differentiation Between Groups
Jaehee LEE ; Jongmin PARK ; Jae Kwang LIM ; Ji Eun PARK ; Yong Hoon LEE ; Sun Ha CHOI ; Hyewon SEO ; Seung Soo YOO ; Shin Yup LEE ; Seung-Ick CHA ; Jae Yong PARK ; Chang Ho KIM
Journal of Korean Medical Science 2025;40(13):e35-
Background:
The diagnosis of tuberculous pleural effusion (TPE) often relies on pleural fluid adenosine deaminase (ADA) levels. The diagnostic utility of ADA, however, is influenced by the prevalence of tuberculosis (TB) in local populations. Malignant pleural effusion (MPE) cases can exhibit moderately elevated ADA levels comparable to those seen in TPE. As population aging potentially impacts ADA levels, global TB incidence is decreasing whereas the burden of malignancy is on the rise. Consequently, epidemiological shifts and temporal changes in ADA distribution complicate the differential diagnosis between TPE and MPE when ADA levels are within the 40–70 IU/L range. Nonetheless, data specific to this subset are scarce.
Methods:
This retrospective study included consecutive patients aged > 18 years with confirmed TPE and MPE, spanning from 2012 to 2023. ADA levels in pleural fluid were categorized into three groups: < 40 IU/L, 40–70 IU/L, and > 70 IU/L. The study examined annual trends in the frequency of new cases and ADA level distributions over time and identified discriminating factors between TPE and MPE in cases with ADA levels of 40–70 IU/L.
Results:
In total, 297 TPE and 369 MPE cases were included in this study. Over the study period, the frequency of TPE progressively declined, while that of MPE increased. In the most recent four-year period, new TPE and MPE cases with ADA levels of 40–70 IU/L occurred at comparable numbers. Multivariable analysis identified pleural fluid carcinoembryonic antigen (CEA) levels and the number of focal pleural nodules as independent predictors for MPE. Specifically, the presence of either CEA levels > 15.7 ng/mL or more than eight pleural nodules yielded the highest diagnostic accuracy with a sensitivity of 88%, specificity of 100%, and an area under the curve of 0.95.
Conclusion
The differential diagnosis between TPE and MPE with pleural ADA levels of 40–70 IU/L has become increasingly critical due to evolving epidemiological patterns and ADA distribution changes over time. Pleural fluid CEA levels and the characteristics of pleural nodules may offer valuable guidance in distinguishing between TPE and MPE within this diagnostic gray zone.
7.Safety and Efficacy of Venous Coil-Embolization of Type IIa Pelvic Arteriovenous Malformations
Lyo Min KWON ; Sang Yub LEE ; Young Soo DO ; Kwang Bo PARK ; Jun Gon KIM ; Shin-Seok YANG ; Dong-Ik KIM
Korean Journal of Radiology 2025;26(3):239-245
Objective:
To evaluate the safety and efficacy of coil embolization of venous segments in patients with Type IIa pelvic arteriovenous malformations (AVMs).
Materials and Methods:
A retrospective study was performed on 13 patients (median age, 43 years, range 20–62 years, 7 males) who underwent transvenous coil embolization for Type IIa pelvic AVM (characterized by multiple arterioles shunting to focal venous segments of a single draining vein) without the use of additional liquid embolic agents from March 2017 to February 2023. Treatment outcomes were analyzed based on clinical evaluations, post angiography findings, and follow-up CT.
Results:
Fourteen procedures were performed on 13 patients. Except in one patient, all treatments were completed in a single session. Transvenous access was employed in 10 procedures, whereas direct puncture was used in four sessions. The embolization procedures used an average of 55.7 ± 58.5 coils (range, 7–238) and lasted an average of 127.3 ± 39.5 minutes.The technical success rate was 92.9% (of 13/14). All patients reported symptom improvement. Follow-up CT scans showed complete occlusion of the AVM without recurrence in ten of the 13 patients. There was one minor adverse event: a small retroperitoneal hemorrhage, likely related to direct puncture, which resolved spontaneously. No other adverse events were observed.
Conclusion
Coil embolization of the draining vein segment, without the use of additional liquid embolic agents is a safe and effective method for managing Type IIa pelvic AVM.
8.Tuberculous and Malignant Pleural Effusions With Adenosine Deaminase Levels of 40–70 IU/L: Trends in New Cases Over Time and Differentiation Between Groups
Jaehee LEE ; Jongmin PARK ; Jae Kwang LIM ; Ji Eun PARK ; Yong Hoon LEE ; Sun Ha CHOI ; Hyewon SEO ; Seung Soo YOO ; Shin Yup LEE ; Seung-Ick CHA ; Jae Yong PARK ; Chang Ho KIM
Journal of Korean Medical Science 2025;40(13):e35-
Background:
The diagnosis of tuberculous pleural effusion (TPE) often relies on pleural fluid adenosine deaminase (ADA) levels. The diagnostic utility of ADA, however, is influenced by the prevalence of tuberculosis (TB) in local populations. Malignant pleural effusion (MPE) cases can exhibit moderately elevated ADA levels comparable to those seen in TPE. As population aging potentially impacts ADA levels, global TB incidence is decreasing whereas the burden of malignancy is on the rise. Consequently, epidemiological shifts and temporal changes in ADA distribution complicate the differential diagnosis between TPE and MPE when ADA levels are within the 40–70 IU/L range. Nonetheless, data specific to this subset are scarce.
Methods:
This retrospective study included consecutive patients aged > 18 years with confirmed TPE and MPE, spanning from 2012 to 2023. ADA levels in pleural fluid were categorized into three groups: < 40 IU/L, 40–70 IU/L, and > 70 IU/L. The study examined annual trends in the frequency of new cases and ADA level distributions over time and identified discriminating factors between TPE and MPE in cases with ADA levels of 40–70 IU/L.
Results:
In total, 297 TPE and 369 MPE cases were included in this study. Over the study period, the frequency of TPE progressively declined, while that of MPE increased. In the most recent four-year period, new TPE and MPE cases with ADA levels of 40–70 IU/L occurred at comparable numbers. Multivariable analysis identified pleural fluid carcinoembryonic antigen (CEA) levels and the number of focal pleural nodules as independent predictors for MPE. Specifically, the presence of either CEA levels > 15.7 ng/mL or more than eight pleural nodules yielded the highest diagnostic accuracy with a sensitivity of 88%, specificity of 100%, and an area under the curve of 0.95.
Conclusion
The differential diagnosis between TPE and MPE with pleural ADA levels of 40–70 IU/L has become increasingly critical due to evolving epidemiological patterns and ADA distribution changes over time. Pleural fluid CEA levels and the characteristics of pleural nodules may offer valuable guidance in distinguishing between TPE and MPE within this diagnostic gray zone.
9.Safety and Efficacy of Venous Coil-Embolization of Type IIa Pelvic Arteriovenous Malformations
Lyo Min KWON ; Sang Yub LEE ; Young Soo DO ; Kwang Bo PARK ; Jun Gon KIM ; Shin-Seok YANG ; Dong-Ik KIM
Korean Journal of Radiology 2025;26(3):239-245
Objective:
To evaluate the safety and efficacy of coil embolization of venous segments in patients with Type IIa pelvic arteriovenous malformations (AVMs).
Materials and Methods:
A retrospective study was performed on 13 patients (median age, 43 years, range 20–62 years, 7 males) who underwent transvenous coil embolization for Type IIa pelvic AVM (characterized by multiple arterioles shunting to focal venous segments of a single draining vein) without the use of additional liquid embolic agents from March 2017 to February 2023. Treatment outcomes were analyzed based on clinical evaluations, post angiography findings, and follow-up CT.
Results:
Fourteen procedures were performed on 13 patients. Except in one patient, all treatments were completed in a single session. Transvenous access was employed in 10 procedures, whereas direct puncture was used in four sessions. The embolization procedures used an average of 55.7 ± 58.5 coils (range, 7–238) and lasted an average of 127.3 ± 39.5 minutes.The technical success rate was 92.9% (of 13/14). All patients reported symptom improvement. Follow-up CT scans showed complete occlusion of the AVM without recurrence in ten of the 13 patients. There was one minor adverse event: a small retroperitoneal hemorrhage, likely related to direct puncture, which resolved spontaneously. No other adverse events were observed.
Conclusion
Coil embolization of the draining vein segment, without the use of additional liquid embolic agents is a safe and effective method for managing Type IIa pelvic AVM.
10.The Moderating Effect of Resilience on the Relationship Between the Relevance to Victims With Post-Trauma Psychiatric Symptoms of Community Residents After Seoul Halloween Crowd Crush
Se Youl KIM ; Sra JUNG ; Mi Yeon LEE ; Kang-Seob OH ; Young-Chul SHIN ; Dong-Won SHIN ; Junhyung KIM ; Eun Soo KIM ; Sun Wook JUNG ; Kwang-yeol LEE ; Nahyun OH ; Sung Joon CHO ; Sang-Won JEON
Psychiatry Investigation 2024;21(11):1183-1192
Objective:
This study aimed to examine the psychiatric impact of the Seoul Halloween crowd crush on individuals related to the victims compared to the general population. It also explores the moderating effect of resilience on the relationship between trauma exposure and psychiatric symptoms.
Methods:
In total, 2,220 participants completed various post-incident questionnaires (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Hwa-byung symptom scale, post-traumatic stress disorder checklist for DSM-5, and Brief Resilience Scale) 30 days after the incident. Moderation analyses were conducted using the PROCESS macro in the statistical package for the social sciences.
Results:
Individuals related to the victims exhibited higher symptom severity and a greater risk for clinically significant levels of depression, anxiety, anger, and post-traumatic stress disorder (PTSD) (odds ratio=3.28, 3.33, 1.51, and 4.39 respectively). The impact of relevance to victims on anxiety and PTSD symptoms was moderated by resilience, with a stronger effect observed for individuals with low resilience (β=3.51, 95% confidence interval [CI] 2.78–4.24 for anxiety and β=14.53, 95% CI 12.43–16.63 for PTSD) than for those with high resilience (β=1.69, 95% CI 0.72–2.65 for anxiety and β=8.33, 95% CI 5.56–11.09 for PTSD).
Conclusion
When related to the victims, it was found that not only PTSD, but also depression, anxiety, and anger could intensify. Resilience emerged as a potential buffer against these adverse effects, emphasizing its significance in mitigating the psychiatric impact of community trauma.

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