1.A 19F Blake Drain versus a 28F Conventional Drain Following Video-Assisted Thoracoscopic Esophagectomy for Esophageal Cancer: A Comparative Retrospective Study
Hiep Van PHAM ; Tuan Anh NGUYEN ; Thang Manh TRAN
Journal of Chest Surgery 2026;59(1):30-36
Background:
Pleural drainage is essential for preventing and managing respiratory complications after video-assisted thoracoscopic esophagectomy (VATE). Conventional largebore drains often cause significant pain. Small-bore drains (e.g., 19F Blake drains) may reduce discomfort; however, evidence regarding their use in VATE is limited. This study compared drainage effectiveness and pain between 19F Blake drains and conventional 28F drains after VATE for esophageal cancer.
Methods:
This retrospective study included 77 male patients with middle- or lower-third esophageal cancer who underwent VATE with laparoscopic retrosternal tunneling from November 2018 to November 2022. Fifty-five patients received a 28F conventional drain, and 22 received a 19F Blake drain. Outcomes included drainage duration and volume, pain levels (Visual Analog Scale [VAS]), postoperative pneumonia rates, and pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) on postoperative day 3.
Results:
The 19F group reported significantly lower pain scores on postoperative days 1–3 (VAS: 2.95–3.25 vs. 4.07–4.62, p<0.001). Drainage duration and pneumonia rates were similar between groups. The 19F group demonstrated a trend toward higher drainage volume and significantly better preservation of pulmonary function, with smaller declines in FVC (ΔFVC: 0.24±0.20 L vs. 0.63±0.17 L, p<0.001) and FEV1 (ΔFEV1: 0.38±0.25 L vs. 0.58±0.25 L, p=0.02).
Conclusion
19F Blake drains provide similar drainage effectiveness to that of 28F drains, with reduced postoperative pain and better pulmonary function preservation. These findings support the use of 19F Blake drains to improve patient comfort and recovery following VATE.
2.The Thrombectomy Dilemma in Stroke Patients With Active Cancer: To Treat or Not to Treat?
Yohanna KUSUMA ; Mikiya BEPPU ; Beom Joon KIM ; Sung-Chun TANG ; Mikito HAYAKAWA ; Hiroshi YAMAGAMI ; Hiroyuki KAWANO ; Teruyuki HIRANO ; Shinichi YOSHIMURA ; Hamidon BASRI ; Richard LI ; Huy Thang NGUYEN ; Deidre Anne De SILVA ; Keun-Sik HONG ; Jiann-Shing JENG ; Than G. PHAN ; Henry MA ; Bernard YAN ;
Journal of Stroke 2026;28(2):218-227
Endovascular thrombectomy for acute large-vessel occlusion in patients with active cancer remains a difficult clinical decision. Multiple cohort studies and meta-analyses indicate that, when standard imaging and clinical criteria are applied, reperfusion success is high and symptomatic intracranial hemorrhage is broadly comparable with non-cancer populations, arguing against categorical exclusion. At the same time, registries show lower 90-day functional independence and higher 90-day mortality in active-cancer cohorts—effects likely driven by malignancy-related systemic factors and pre-existing functional compromise rather than procedural harm. This narrative review synthesizes efficacy and safety signals, highlights decision-grade outcomes that are seldom reported—early neurological change, performance status around 90 days, and whether systemic anticancer therapy is started or resumed. It sets out a clinical–ethical–economic framework to support selection, consent, and aftercare, including a pragmatic pathway for under-resourced settings based on non-contrast computed tomography (CT) or single-phase CT angiography where advanced perfusion imaging or magnetic resonance imaging are unavailable. We outline an Asia–Pacific collaborative program designed to identify subgroups that may benefit from reperfusion and initiation of active cancer care.
3.Using Low-Speed Rotation in Heparin Immobilization Improved Antithrombogenicity of Tubular Acellular Vascular Scaffolds
Hoang Minh LAM ; Nho Thuan NGUYEN ; My Thi Ngoc NGUYEN ; Quan Minh TO ; Thanh Thi Ngoc NGUYEN ; Thang Quoc BUI ; Ha Le Bao TRAN
Tissue Engineering and Regenerative Medicine 2026;23(1):143-155
BACKGROUND:
Acellular tubular artery scaffolds offer structural support for vascular regeneration but are inherently limited by poor anticoagulant properties, which increases the risk of thrombus formation following implantation. This thrombogenicity remains a major obstacle to their clinical application, particularly in small-diameter vascular grafts.
METHODS:
To address this challenge, the present study investigates the use of the Layer-by-Layer (LbL) assembly technique for heparin immobilization under low-speed rotation. Utilizing a roller tube system, heparin was immobilized onto decellularized scaffolds through electrostatic interactions facilitated by a DHI-based linker. This low-speed rotation LbL approach enhanced the uniformity and stability of heparin deposition compared to traditional static methods. One, 4, 7, 10, 13 deposition cycles were performed to achieve optimal heparin loading, resulting in scaffolds capable of sustained heparin release over 28 days.
RESULTS:
The heparinized scaffolds exhibited an initial burst release (approximately 80%), followed by a sustained phase with 18.24% ± 0.242 remaining to support prolonged anticoagulant activity. Importantly, the modified scaffolds significantly reduced thrombus formation and exhibited minimal hemolytic activity, indicating improved hemocompatibility. In addition to their antithrombotic properties, the scaffolds also promoted endothelial cell adhesion, which is critical for restoring vascular integrity, regulating vascular tone, and maintaining long-term patency.
CONCLUSION
These findings highlight the efficacy of roller-assisted LbL heparinization as a practical and scalable strategy to enhance the blood compatibility of acellular vascular grafts. This method holds considerable promise for addressing thrombogenicity in vascular tissue engineering and advancing the clinical translation of bioengineered vascular constructs.
4.Lessons from the 2024–2025 measles outbreak in southern Viet Nam
Thang Nguyen-Tien ; Hoa Minh Tran ; Anh Vu Le
Western Pacific Surveillance and Response 2026;17(2):64-67
Dong Nai province in southern Viet Nam was among the hardest hit in a measles outbreak in 2024–2025 with over 7000 cases. Our analysis outlines major takeaways for measles control in recommending the need for strengthened surveillance, digital communication and intersectoral collaboration to address immunization gaps and build health system resilience in Viet Nam.
5.Characteristics of RET gene mutations in Vietnamese medullary thyroid carcinoma patients: a single-center analysis
Van Hung PHAM ; Quoc Thang PHAM ; Minh NGUYEN ; Hoa Nhat NGO ; Thao Thi Thu LUU ; Nha Dao Thi MINH ; Trâm ĐẶNG ; Anh Tu THAI ; Hoang Anh VU ; Dat Quoc NGO
Journal of Pathology and Translational Medicine 2025;59(2):125-132
The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.
6.Imaging and Surgical Repair of the Left Pulmonary Venous Anomaly to Coronary Sinus With Small Patent Ductus Arteriosus
Hieu Lan NGUYEN ; Ly Thi Minh NGUYEN ; Tu Ngoc VU ; Luu Tien DOAN ; Thang Duy NGUYEN ; My Thi Ha TRINH
Cardiovascular Imaging Asia 2025;9(2):19-22
A 47-year-old female was admitted with progressive exertional dyspnea and diagnosed with anomalous drainage of the left pulmonary veins into the coronary sinus (CS), combined with an intact interatrial septum and a small patent ductus arteriosus (PDA). Multimodal imaging, including echocardiography, computed tomography, and cardiac catheterization, helps diagnosis, optimal management and monitoring. The patient successfully underwent surgical repair, which involved rerouting the left anomalous pulmonary veins into the left atrium through a surgically created atrial septal defect, while the CS continued to drain into the right atrium and the PDA was closed directly via a transpulmonary approach. The postoperative course was uneventful.
7.Neutrophil-to-lymphocyte-to-albumin ratio as a prognostic marker for mortality in sepsis and septic shock in Vietnam
Nguyen Van Viet THANG ; Le Thi LUYEN ; Nguyen Thi Tuong VI ; Pham Dang HAI
Acute and Critical Care 2025;40(2):244-251
Background:
Sepsis and septic shock are life-threatening global health challenges associated with high mortality rates. Early identification of high-risk patients is critical for improving outcomes. In the present study, the association between the neutrophil-to-lymphocyte-to-albumin ratio (NLAR) and mortality in septic patients was evaluated.
Methods:
A retrospective study was performed at a tertiary hospital in Vietnam. Patients ≥18 years of age diagnosed with sepsis or septic shock based on the Sepsis-3 criteria were included. Exclusion criteria included recent corticosteroid use within 7 days, autoimmune diseases, hematological disorders, and active cancer within 5 years. NLAR was calculated from complete blood counts and albumin levels within the first 24 hours of intensive care unit admission. Receiver operating characteristic (ROC) curves were used to determine the predictive ability of NLAR for in-hospital mortality.
Results:
The present study included 141 patients with a mean age of 72 years. Non-survivors were significantly older with higher rates of mechanical ventilation. NLAR was significantly elevated in non-survivors compared with survivors (0.88 [0.57–1.24] vs. 0.44 [0.28–0.77], P<0.001). In ROC analysis, the area under the curve for NLAR was 0.70 (P<0.001). Using a cutoff value of 0.56, NLAR showed a sensitivity of 77.8% and a specificity of 61.5% for predicting in-hospital mortality.
Conclusions
Elevated NLAR on admission was associated with a higher mortality rate in sepsis patients. NLAR could be used as an early prognostic marker for sepsis mortality.
8.Characteristics of RET gene mutations in Vietnamese medullary thyroid carcinoma patients: a single-center analysis
Van Hung PHAM ; Quoc Thang PHAM ; Minh NGUYEN ; Hoa Nhat NGO ; Thao Thi Thu LUU ; Nha Dao Thi MINH ; Trâm ĐẶNG ; Anh Tu THAI ; Hoang Anh VU ; Dat Quoc NGO
Journal of Pathology and Translational Medicine 2025;59(2):125-132
The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.
9.Characteristics of RET gene mutations in Vietnamese medullary thyroid carcinoma patients: a single-center analysis
Van Hung PHAM ; Quoc Thang PHAM ; Minh NGUYEN ; Hoa Nhat NGO ; Thao Thi Thu LUU ; Nha Dao Thi MINH ; Trâm ĐẶNG ; Anh Tu THAI ; Hoang Anh VU ; Dat Quoc NGO
Journal of Pathology and Translational Medicine 2025;59(2):125-132
The RET gene point mutation is the main molecular alteration involved in medullary thyroid carcinoma (MTC) tumorigenesis. Previous studies in Vietnam mainly consisted of case reports, with limited data on larger sample sizes. In this study, we investigated RET gene mutations in exons 10, 11, and 16 and analyzed clinicopathological features of a series of Vietnamese MTC patients. Methods: We collected 33 tissue samples from patients with MTC and analyzed RET mutations using the Sanger sequencing method. The relationship between hotspot RET mutations (exons 10, 11, 16) and clinicopathological features were investigated. Results: Among the 33 analyzed cases, 17 tumors (52%) harbored RET mutations in exon 10, 11, or 16. A total of 10 distinct genetic alterations were identified, including eight missense mutations and two short indels. Of these, seven were classified as pathogenic mutations based on previous publications, with p.M918T being the most frequent (4 cases), followed by p.C634R (3 cases) and p.C618R (3 cases). Mutations were significantly associated with specific histological patterns, such as the nested/insular pattern (p=.026), giant cells (p=.007), nuclear pleomorphism (p=.018), stippled chromatin (p=.044), and amyloid deposits (p=.024). No mutations were found in germline analyses, suggesting these were somatic alterations. Conclusions: Our results provided the first comprehensive analysis of RET mutations in Vietnamese MTC patients. The most frequent mutation was p.M918T, followed by p.C634R and p.C618R. Mutations in these three exons were linked to specific histopathological features. Information on mutational profiles of patients with MTC will further aid in the development of targeted therapeutics to ensure effective disease management.
10.Academic stress among students in Vietnam: a three-year longitudinal study on the impact of family, lifestyle, and academic factors
Thao Vi TRAN ; Hoang Thuy Linh Nguyen ; Xuan Minh Tri Tran ; Yuri TASHIRO ; Kaoruko SEINO ; Thang Van VO ; Keiko NAKAMURA
Journal of Rural Medicine 2024;19(4):279-290
Objective: Academic stress is associated with mental health disorders, notably depression and anxiety among students. Mitigating stress can decrease the incidence of mental health disorders and improve student well-being. This study explored factors influencing academic stress among secondary school students in Vietnam.Materials and Methods: A three-year longitudinal study was conducted using a self-reported questionnaire with 611 students from four secondary schools in Hue City, Vietnam. Academic stress was evaluated using the Educational Stress Scale for Adolescents (ESSA). Family factors, including the number of siblings and parental educational levels; lifestyle factors, including physical activity and sleep; and academic factors, including grade point average and attending extra classes were evaluated. Linear regression models were used to analyze the associations between the ESSA scores at follow-up and family, lifestyle, and academic factors at baseline.Results: A total of 341 students completed both the baseline and follow-up surveys and answered the questions required for this analysis. The mean ESSA score of 341 students increased from 46.4 ± 7.6 (mean ± SD) to 53.5 ± 10.8, from 2018 to 2021. The multivariate model revealed that the number of siblings, higher father’s educational attainment level, female gender, lower academic scores, and attending extra classes were associated with overall academic stress. In contrast, no associations were observed between the variables of lifestyle, parental concentration, and parental acceptance and overall academic stress.Conclusion: The findings highlight the impact of family factors and study workload on academic stress, emphasizing the need for proper care from family and school to reduce or prevent student academic stress and provide them with a comfortable and healthy learning environment.


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