• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7107-7110
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• 2013

Malignant bowel obstruction (MBO), an occasional complication in patients with advanced urological cancer, causes gastrointestinal symptoms such as nausea and vomiting leading to suffering which severely impairs quality of life (QOL). Drug therapy, especially octreotide, a synthetic analog of somatostatin, is reportedly effective in controlling the symptoms of MBO. In the present study, we administered octreotide to urological cancer patients with MBO and evaluated the improvement of subjective symptoms, oral intake, and nasogastric intubation. Fourteen terminally ill urological cancer patients suffering with MBO were included (age range 55-92, 10 male, 4 female). Octreotide was administered at $300{\mu}g/day$ to those patients subcutaneously as a continuous injection. Significant improvements in subjective symptoms were observed in thirteen patients (92.8%), and ten patients (71.4%) were able to resume oral intake. Four patients required nasogastric drainage before the administration of octreotide, but nasogastric intubation was discontinued in all these cases after the use of octreotide. Early initiation of octreotide resulted in better improvement of MBO symptoms, and no adverse event was observed in any of the patients. These results revealed that $300{\mu}g/day$ dose of octreotide is safe and effective for managing gastrointestinal symptoms of terminally ill urological cancer patients with MBO. We also recommend starting the treatment with ocreotide as soon as MBO is diagnosed.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7351-7354
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• 2013

Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.

• The World Journal of Men's Health
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• 제34권2호
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• pp.137-144
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• 2016

Purpose: We compared a transperineal ligation model and a transperitoneal ligation model in male rats to determine which animal model of overactive bladder (OAB) was more useful based on cystometrography, estimations of oxidative stress, and measurements of pro-inflammatory cytokine levels. Materials and Methods: Male rats were randomly divided into three groups (n=15 in each): the control group, the transperineal ligation group, and the transperitoneal ligation group. Four weeks after the ligation procedure, cystometrography was performed and oxidative stress, pro-inflammatory cytokine levels, and histologic changes were evaluated. Oxidative stress was assessed by measuring 8-hydroxy-20-deoxyguanosine and superoxide dismutase, and pro-inflammatory cytokine activity was investigated by measuring levels of interleukin (IL)-6, IL-8, and tumor necrosis $factor-{\alpha}$. Results: The transperineal model led to results similar to those observed for the transperitoneal model, namely (1) increased voiding frequency and reductions in the non-voiding contraction interval and the maximal vesical pressure, (2) increased levels of oxidative stress markers, (3) increased pro-inflammatory cytokine levels, and (4) fibrotic changes in the bladder tissue. Conclusions: We suggest that the transperineal procedure can be used as an alternative OAB model in male rats.

• Journal of Yeungnam Medical Science
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• 제40권4호
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• pp.412-418
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• 2023

Background: The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP). Methods: A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis. Results: Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002-1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022-6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110-4.438; p=0.024). Conclusion: Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

• Journal of Korean Medical Science
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• 제33권43호
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• pp.277.1-277.10
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• 2018

Background: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). Methods: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I-II and stage III. Kidney function, and survival outcomes were compared between groups. Results: We included 1,756 patients with CKD I-II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I-II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I-II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122-0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086-1.172; P = 0.117). Conclusion: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III.

• Journal of Korean Medical Science
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• 제33권51호
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• pp.325.1-325.10
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• 2018

Background: To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice. Methods: Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS. Results: The median follow-up was 16.4 months (interquartile range, 8.3-31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, P = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS. Conclusion: Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.

• 대한비뇨기종양학회지
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• 제16권3호
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• pp.110-118
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• 2018

Purpose: The aim of this study is to confirm the detection rate of transperineal biopsy after multiparametric magnetic resonance imaging (mpMRI) and compared it to that of transrectal biopsy. We also examined the role of mpMRI and the rate of complications for each method. Materials and Methods: In a retrospective study, we analyzed 147 patients who underwent mpMRI before prostate biopsy because of elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings at Korea University Hospital, Seoul, Korea from March 2017 to April 2018. Regions on the mpMRI that were suggestive of prostate cancer were categorized according to the Prostate Imaging-Reporting and Data System (PI-RADS v2). For transperineal biopsy, a 20-core saturation biopsy was performed by MRI-TRUS cognitive or fusion techniques and a 12-core biopsy was performed in transrectal biopsy. Results: Sixty-three and 84 patients were enrolled in transperineal group and transrectal group, respectively. The overall detection rate of prostate cancer in transperineal group was 27% higher than that in transrectal group. Classification according to PI-RADS score revealed a significant increase in detection rate in all patients, as the PI-RADS score increased. Frequency of complications using the Clavien-Dindo classifications revealed no significant differences in the total complications rate, but two patients in transrectal group received intensive care unit care due to urosepsis. Conclusions: Our results confirmed that transperineal biopsy is superior to transrectal biopsy for the detection of prostate cancer. From the complication point of view, this study confirmed that there were fewer severe complications in transperineal biopsy.

• Investigative and Clinical Urology
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• 제59권6호
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• pp.357-362
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• 2018

Purpose: Classic angiomyolipoma (AML) is common benign kidney tumor. However, some studies have claimed that epithelioid angiomyolipoma (EAML) has malignant potential. We compared the patient characteristics and prognosis of EAML and classic AML to demonstrate predicting factors and poorer prognosis of EAML. Materials and Methods: The medical records of 231 patients who were diagnosed with EAML (n=27, 11.7%) or classic AML (n=204, 88.3%), were reviewed. All patients underwent computed tomography (CT) scans before operation or needle biopsy. We assessed the age, sex, tumor size, body mass index, comorbidities, and Hounsfield unit (HU) according to each CT phase. We defined the unfavorable group as patients with recurrence, metastasis and death due to tumor progression. Logistic regression analysis was used to predict EAML. Results: EAML patients were younger (41.2 years vs. 49.1 years, p=0.001), predominantly male (55.6% vs. 28.4%, p=0.005), and had a larger tumor (7.5 cm vs. 4.2 cm, p<0.001). The median pre-contrast HU was not significantly different between EAML and classic AML ($29.9{\pm}23.7$ vs. $14.7{\pm}41.0$, p=0.071). In multivariable analysis, younger age (odds ratio [OR], 0.96; p=0.032), male sex (OR, 3.33; p=0.013), and tumor larger than 4 cm (OR, 3.8; p=0.009) were significant predictive factors. Five patients (18.5%) had unfavorable outcomes, two patients had lymph node metastasis, and three patients had lung metastasis. Conclusions: Patient and tumor characteristics can be helpful in determining the type of AML preoperatively. Younger age, male sex, and larger tumor mass may increase the possibility of diagnosing EAML. EAML has malignant potential and requires careful follow-up.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.192-195
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• 2006

Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.

• 대한생식의학회:학술대회논문집
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• 대한불임학회 1996년도 추계 학술대회 및 정기총회
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• pp.48.2-49
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• 1996