303 results on '"Hyun Hwan Sung"'
Search Results
152. PD49-07 PERSISTENT ERECTILE DYSFUNCTION AFTER DISCONTINUATION OF 5-ALPHA REDUCTASE INHIBITOR THERAPY IN RATS DEPENDING ON THE DURATION OF TREATMENT
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Hyun Hwan Sung, Jonghoon Lee, Su Jeong Kang, Mee Ree Chae, InSuk So, Jong Kwan Park, and Sung Won Lee
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Urology - Published
- 2018
153. PD10-01 DOES CURCUMIN PLAY A ROLE IN PROSTATE CANCER SUPPRESSION?: A RANDOMIZED, DOUBLE-BLIND
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Byong Chang Jeong, Hyun Hwan Sung, Hwang Gyun Jeon, Seong Il Seo, Deok Hyun Han, Han Yong Choi, Seong Soo Jeon, Young Hyo Choi, and Hyun Moo Lee
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Oncology ,medicine.medical_specialty ,business.industry ,Urology ,medicine.disease ,030227 psychiatry ,Double blind ,03 medical and health sciences ,Prostate cancer ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Internal medicine ,medicine ,Curcumin ,business ,030217 neurology & neurosurgery - Published
- 2018
154. Prognostic impact of the pretreatment aspartate transaminase/alanine transaminase ratio in patients treated with first-line systemic tyrosine kinase inhibitor therapy for metastatic renal cell carcinoma
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Minyong Kang, Seong Soo Jeon, Hyun Hwan Sung, Seong Il Seo, Jiwoong Yu, Hyun Moo Lee, Byong Chang Jeong, Hwang Gyun Jeon, Han Yong Choi, and Se Hoon Park
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Male ,medicine.medical_specialty ,medicine.drug_class ,Urology ,Population ,030232 urology & nephrology ,Aspartate transaminase ,Antineoplastic Agents ,Gastroenterology ,Tyrosine-kinase inhibitor ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,Republic of Korea ,Biomarkers, Tumor ,Medicine ,Humans ,Aspartate Aminotransferases ,education ,Carcinoma, Renal Cell ,Protein Kinase Inhibitors ,Aged ,Retrospective Studies ,education.field_of_study ,biology ,business.industry ,Hazard ratio ,Cancer ,Alanine Transaminase ,Middle Aged ,Protein-Tyrosine Kinases ,medicine.disease ,Prognosis ,Survival Analysis ,Kidney Neoplasms ,Treatment Outcome ,Alanine transaminase ,ROC Curve ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Metastasectomy ,business ,Follow-Up Studies - Abstract
OBJECTIVES To examine the prognostic role of the pretreatment aspartate transaminase/alanine transaminase or De Ritis ratio in patients with metastatic renal cell carcinoma receiving first-line systemic tyrosine kinase inhibitor therapy. METHODS We retrospectively searched the medical records of 579 patients with metastatic renal cell carcinoma who visited Samsung Medical Center, Seoul, Korea, from January 2001 through August 2016. After excluding 210 patients, we analyzed 360 patients who received first-line tyrosine kinase inhibitor therapy. Cancer-specific survival and overall survival were defined as the primary and secondary end-points, respectively. A multivariate Cox proportional hazards regression model was used to identify independent prognosticators of survival outcomes. RESULTS The overall population was divided into two groups according to the pretreatment De Ritis ratio as an optimal cut-off value of 1.2, which was determined by a time-dependent receiver operating characteristic curve analysis. Patients with a higher pretreatment De Ritis ratio (≥1.2) had worse cancer-specific survival and overall survival outcomes, compared with those with a lower De Ritis ratio (
- Published
- 2017
155. Prognostic factors after salvage radiotherapy alone in patients with biochemical recurrence after radical prostatectomy
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Seong Soo Jeon, Hyun Moo Lee, Byong Chang Jeong, Hyun Hwan Sung, Han Yong Choi, Seong Il Seo, Hwang Gyun Jeon, and Wan Song
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Male ,Biochemical recurrence ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Median follow-up ,medicine ,Humans ,Treatment Failure ,Stage (cooking) ,Aged ,Neoplasm Staging ,Retrospective Studies ,Prostatectomy ,Salvage Therapy ,Proportional hazards model ,business.industry ,Hazard ratio ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,Magnetic Resonance Imaging ,Confidence interval ,Surgery ,Radiation therapy ,030220 oncology & carcinogenesis ,Radiotherapy, Intensity-Modulated ,Radiology ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Objectives To evaluate the oncological outcome and to assess prognostic factors of salvage radiotherapy alone in patients with biochemical recurrence after radical prostatectomy. Methods We reviewed our single institution, prospectively maintained database of 2043 patients who underwent radical prostatectomy between September 1995 and December 2011. In this cohort, 149 patients who developed biochemical recurrence after radical prostatectomy and received salvage radiotherapy alone after pelvic magnetic resonance imaging were included. Three-dimensional conformal radiotherapy or intensity-modulated radiotherapy was delivered with a median dose of 70.0 Gy (66.0–78.0 Gy) or 67.2 Gy (64.8–70.0 Gy). Kaplan–Meier and Cox regression analyses were carried out. Results With a median follow up of 82 months (range 20–153 months), 55 patients (36.9%) failed salvage radiotherapy. The 5-year salvage radiotherapy failure-free probability was 53.6%. On multivariate analysis, pre-salvage radiotherapy prostate-specific- antigen ≥1.0 ng/mL (P = 0.003, hazard ratio 3.592, 95% confidence interval 1.522–8.579), pathological stage ≥T3a (P = 0.004, hazard ratio 2.261, 95% confidence interval 1.290–3.833), pathological Gleason score ≥7 (P = 0.018, hazard ratio 5.501, 95% confidence interval 1.577–21.221), prostate-specific antigen doubling time
- Published
- 2015
156. Effect of Detrusor Overactivity on Functional Outcomes After Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Obstruction
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Hyo Serk Lee, Tae Heon Kim, Won Jin Cho, Kyu-Sung Lee, Hyun Wook You, Hyun Hwan Sung, Jeongyun Jeong, and Wonho Jung
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Male ,medicine.medical_specialty ,Time Factors ,Urology ,Enucleation ,Prostatic Hyperplasia ,Holmium laser ,Urination ,Lasers, Solid-State ,Prostate ,medicine ,Humans ,In patient ,Aged ,Retrospective Studies ,Urinary Bladder, Overactive ,business.industry ,Transurethral Resection of Prostate ,Urinary Bladder Neck Obstruction ,Treatment Outcome ,medicine.anatomical_structure ,Quality of Life ,International Prostate Symptom Score ,Laser Therapy ,Prostatic obstruction ,business ,Symptom score ,Follow-Up Studies - Abstract
Objective To investigate the effect of detrusor overactivity (DO) on functional outcomes after holmium laser enucleation of the prostate (HoLEP). Materials and Methods One hundred ten men with benign prostatic obstruction were evaluated retrospectively. International Prostate Symptom Score, International Continence Society male questionnaire short form, 3-day voiding diary, and uroflowmetry with postvoid residual were evaluated preoperatively and at 3 and 6 months postoperatively. The patients underwent urodynamic study preoperatively and were divided into the DO group (58 of 110, 52.7%) and the non-DO group (52 of 100, 47.3%). Results Patients in the DO group were older than those in the non-DO group (71.4 vs 66.4 years), although prostate volume and degree of obstruction were not significantly different between the 2 groups. All International Prostate Symptom Score and uroflowmetry parameters improved significantly at the 3- and 6-month follow-ups. Storage symptoms in both groups were comparable preoperatively (9.7 vs 8.6); these improved similarly in both groups during follow-up (5.0 vs 4.0, 6-month follow-up). The number of patients taking anticholinergics increased significantly after HoLEP, from a baseline of 17 patients to 49 patients at the 3-month follow-up and 39 at the 6-month follow-up. More patients in the DO group were taking anticholinergics at the end of the follow-up period (48.3% vs 21.2%). Conclusion Although the storage symptoms improved significantly in both groups, a significant number of patients with DO group took anticholinergics after HoLEP. We recommend that surgeons should counsel the possibility of taking anticholinergics in the early postoperative period to the patients with DO at baseline.
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- 2015
157. Clinical significance of prognosis using the neutrophil-lymphocyte ratio and erythrocyte sedimentation rate in patients undergoing radical nephroureterectomy for upper urinary tract urothelial carcinoma
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Hyun Hwan Sung, Byong Chang Jeong, Han Yong Choi, Seong Il Seo, Hwang Gyun Jeon, Hyun Moo Lee, and Seong Soo Jeon
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Lymphocyte ,fungi ,Hazard ratio ,Gastroenterology ,Confidence interval ,Surgery ,medicine.anatomical_structure ,Internal medicine ,Erythrocyte sedimentation rate ,medicine ,Clinical significance ,Stage (cooking) ,business ,Lymph node ,Upper urinary tract - Abstract
Objectives To evaluate the clinical significance of preoperative erythrocyte sedimentation rate (ESR) and neutrophil–lymphocyte ratio (NLR) as prognostic factors in patients undergoing radical nephroureterectomy for upper tract urothelial carcinoma (UTUC). Patients and Methods A total of 410 patients were retrospectively reviewed. An elevated NLR was defined as ≥2.5 and a normal ESR was considered to be in the range of 0–22 mm/h in men and 0–27 mm/h in women. Patients were divided into three groups: those with ESR and NLR in the normal range (group 0, n = 168), those with either elevated ESR or elevated NLR (group I, n = 169), and those with both elevated ESR and elevated NLR (group II, n = 73). Results The median patient age was 64 years and the median follow-up duration was 40.2 months. In all, 35.6 and 41.2% of patients had elevated NLRs and ESRs, respectively. Group II was associated with advanced tumour status in terms of size, grade, stage, lymph node and margin status (P < 0.05). Preoperative ESR (hazard ratio [HR] 1.784, 95% confidence interval [CI] 1.173–2.712), NLR (HR 1.704, 95% CI 1.136–2.556), and prognostic grouping (HR 2.285, 95% CI 1.397–3.737 for group I; HR 2.962, 95% CI 1.719–5.102 for group II) were independent predictors of progression-free survival (PFS) in the multivariate model (P < 0.05). Prognostic grouping was also an independent prognostic factor for cancer-specific survival (CSS) and overall survival (OS). Time-dependent area under the receiver-operating characteristic curves showed that NLR plus ESR had a greater diagnostic value than NLR alone regarding oncological outcomes (P < 0.05). Conclusions Prognostic grouping using ESR and NLR was identified as an independent prognostic marker in patients with UTUC. The addition of ESR improved the prognostic value of NLR alone in predicting oncological outcomes. The combination of preoperative ESR and NLR might be a new prediction tool in patients with UTUC after radical nephroureterectomy.
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- 2014
158. Predictive Factors for Achieving Superior Pentafecta Outcomes Following Robot-Assisted Partial Nephrectomy in Patients with Localized Renal Cell Carcinoma
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Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Seong Il Seo, In-Hyuck Gong, Han Yong Choi, Seong Soo Jeon, Hyun Moo Lee, Hwi Jun Park, and Byong Chang Jeong
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Adult ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Operative Time ,030232 urology & nephrology ,Blood Loss, Surgical ,Renal function ,Comorbidity ,urologic and male genital diseases ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,Renal cell carcinoma ,Medicine ,Humans ,In patient ,Warm Ischemia ,Renal Insufficiency, Chronic ,Carcinoma, Renal Cell ,Neoplasm Staging ,Retrospective Studies ,Surgeons ,business.industry ,Margins of Excision ,Retrospective cohort study ,Perioperative ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Surgery ,Tumor Burden ,Logistic Models ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hypertension ,Multivariate Analysis ,Operative time ,Neoplasm staging ,Female ,business ,Glomerular Filtration Rate - Abstract
To examine the perioperative outcomes following robot-assisted partial nephrectomy (RAPN) in patients with localized renal cell carcinoma (RCC) and to identify the predictors of Pentafecta achievement following RAPN.We retrospectively analyzed the data from 362 patients with RCC who underwent RAPN from 2008 to 2016. The criteria for Pentafecta achievement were defined as the Trifecta [warm ischemic time (WIT) ≤25 minutes, negative surgical margin, and no significant perioperative complications]; with the addition of renal function preservation, including over 90% preservation of the estimated glomerular filtration rate (e-GFR); and no stage upgrade of chronic kidney disease at 1 year after surgery. Multivariate logistic regression analysis was performed to determine the predictors of the Pentafecta outcomes.Among 362 patients, 82.3% (n = 298) had clinical T1a tumors. The median tumor size was 2.9 cm [interquartile range (IQR) = 2.1-3.6] and median nephrometry score was 7 (IQR = 6-8). The median operative time was 220 minutes (IQR = 185-270) and median estimated blood loss was 150 mL (IQR = 100-200). The median WIT was 20 minutes (IQR = 16-26). The overall rate of postoperative complications was 18.8% (n = 68). The rates of Trifecta and Pentafecta achievement were 66.6% (n = 241/362) and 33.9% (n = 121/303), respectively. Notably, the preoperative e-GFR, hypertension, tumor size, L-component of the R.E.N.A.L score, and surgeon's experience were identified as the significant predictors of Pentafecta achievement. Additionally, patients with T1a tumors showed higher rates of Pentafecta achievement (45.7% vs 25.9%) compared with those of patients with T1b tumors. However, there was no significant difference in the Pentafecta accomplishment rates between the transperitoneal and retroperitoneal approaches.In summary, our data highlighted that tumor size and nephrometry score, which are tumor-related factors, as well as the surgeon's experience, a surgeon-related factor, appear to be the critical predictive factors for Pentafecta achievement following RAPN.
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- 2017
159. Prognostic significance of epithelial-mesenchymal transition phenotypes in upper urinary tract urothelial carcinoma
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Ghee Young Kwon, Hyun Hwan Sung, Sang Yun Ha, Junhun Cho, and Seok-Hyung Kim
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Male ,Urologic Neoplasms ,Epithelial-Mesenchymal Transition ,030232 urology & nephrology ,Vimentin ,Pathology and Forensic Medicine ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Antigens, CD ,Medicine ,Humans ,Epithelial–mesenchymal transition ,Urinary Tract ,Upper urinary tract ,Aged ,Retrospective Studies ,Tissue microarray ,biology ,business.industry ,Cadherin ,Carcinoma ,Wild type ,Cell Biology ,Middle Aged ,Cadherins ,Prognosis ,Phenotype ,Tissue Array Analysis ,030220 oncology & carcinogenesis ,biology.protein ,Cancer research ,Immunohistochemistry ,Female ,business - Abstract
Epithelial-mesenchymal transition (EMT) is a process which epithelial cells gain mesenchymal phenotype such as motility and invasiveness. We investigated the role of EMT in upper urinary tract urothelial carcinoma (UTUC). The patient cohort included 93 cases of UTUC treated with radical nephroureterectomy. Tissue microarrays were constructed from formalin-fixed paraffin-embedded tissue blocks. Immunohistochemical staining was performed for E-cadherin, vimentin, and smooth muscle actin to evaluate the EMT status. Interpretation criteria were defined for the staining results and EMT phenotypes were assigned as wild type, incomplete type (loss of E-cadherin and negative for vimentin), and complete type (loss of E-cadherin and positive for vimentin). The loss of E-cadherin and vimentin-expression was observed in 76 (81.7%) and 10 (10.8%) cases, respectively, yielding EMT phenotypes comprised of 17 cases (18.3%) of wild type, 66 cases (71.0%) of incomplete type, and 10 cases (10.8%) of complete types. In survival analyses, wild type showed statistically significant association with longer extra-bladder recurrence free survival (p < .001) and overall survival (p < .001). In multivariate analyses, complete type was an independent prognostic factor for extra-bladder recurrence free survival and overall survival. EMT phenotype based on the combination of EMT-related markers may provide a useful prognostic marker for UTUC patients.
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- 2017
160. A retrospective feasibility study of biweekly, reduced-dose docetaxel in Asian patients with castrate-resistant, metastatic prostate cancer
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Byong Chang Jeong, Hyun Moo Lee, Ji Yun Lee, Hae Su Kim, Hyun Hwan Sung, Seong Il Seo, Han Yong Choi, Ho Yeong Lim, Seong Soo Jeon, Hwang Gyun Jeon, Se Hoon Park, and Su Jin Lee
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Male ,Oncology ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Antineoplastic Agents ,Docetaxel ,urologic and male genital diseases ,Biweekly ,Drug Administration Schedule ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Asian People ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Neoplasm Metastasis ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,business.industry ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Discontinuation ,Prostatic Neoplasms, Castration-Resistant ,Regimen ,Treatment Outcome ,Reproductive Medicine ,030220 oncology & carcinogenesis ,Prednisolone ,Feasibility Studies ,Taxoids ,Castrate-resistant prostate cancer ,business ,Research Article ,medicine.drug - Abstract
Background The aim of this retrospective study was to evaluate the clinical outcomes of reduced dose, biweekly docetaxel chemotherapy for Korean patients with castrate-resistant prostate cancer (CRPC). Methods We retrospectively reviewed the medical records of 48 patients with metastatic CRPC who were treated with a biweekly regimen (intravenous docetaxel 40 mg/m2 on day 1 plus prednisolone 5 mg twice daily) between 2012 and 2015 at Samsung Medical Center (Seoul, Korea). Prior to the adoption of a biweekly regimen in Oct 2013, our institutional standard chemotherapy was docetaxel 75 mg/m2 every 3 weeks for patients with CRPC (n = 24). After Oct 2013, all chemotherapy-naïve patients with CRPC received a 40 mg/m2 biweekly regimen (n = 24). The primary end point was a PSA response, defined as a greater than 50% decline in PSA level from baseline. Results The baseline characteristics of the patients in the two treatment groups were similar. The most common cause of treatment discontinuation was disease progression, which was exhibited by 17 patients (71%) in the 3-weekly group and 20 (75%) in the biweekly group. PSA responses were observed in 12 (50%) and 11 (46%) patients in the 3-weekly and biweekly groups, respectively (p = 0.683). Time to treatment failure (TTTF, 4.5 vs 3.9 months) and time-to-progression (TTP, 5.0 vs 4.2 months) were not significantly different between the 3-weekly and biweekly groups. Conclusions Within the limitations of a retrospective study, the biweekly reduced dose docetaxel regimen was active and well-tolerated in Korean patients with metastatic CRPC.
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- 2017
161. Predictive Factors of Renal Adaptation After Nephrectomy in Kidney Donors
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Ha Young Oh, Jong-Gi Lee, Hyun Hwan Sung, H.R. Jang, W. Huh, S.J. Kim, D.H. Han, Youngha Kim, Dong-Hoon Kim, Hee Jin Kwon, Daejoong Kim, Jeeeun Park, and Sin-Ho Jung
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Urology ,Renal function ,Kidney Volume ,030204 cardiovascular system & hematology ,Kidney ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Living Donors ,Medicine ,Humans ,030212 general & internal medicine ,Postoperative Period ,Renal Insufficiency ,Kidney transplantation ,Aged ,Retrospective Studies ,Transplantation ,medicine.diagnostic_test ,business.industry ,Age Factors ,Retrospective cohort study ,Nephrons ,Middle Aged ,medicine.disease ,Adaptation, Physiological ,Kidney Transplantation ,medicine.anatomical_structure ,Renal physiology ,Angiography ,Tissue and Organ Harvesting ,Regression Analysis ,Surgery ,Female ,business ,Glomerular Filtration Rate - Abstract
Background Despite compensatory hyperfiltration in remaining nephrons following donor nephrectomy, some donors show impaired renal adaptation and low estimated glomerular filtration rate (eGFR). We investigated the factors predicting early renal adaptation after nephrectomy and identified kidney donors at risk of inadequate renal adaptation. Methods A total of 265 living kidney donors from 2010 to 2013 were retrospectively analyzed. Renal function was serially followed for 6 months after the operation. Regression analyses were performed to identify the independent predictors of low eGFR (eGFR Results A total of 148 donors belonged to the low eGFR group, and changes in eGFR (ΔeGFR) at postoperative (PO) 1 day and 1 month were identified as independent predictors of low eGFR. Impaired renal adaptation was related to age, ΔeGFR PO 2–3 days, and ΔeGFR PO 1 month. Early renal adaptation was associated with age, male gender, and residual kidney computerized tomography angiography (CTA) volume. The best sensitivity and specificity were obtained with a cutoff value of ΔeGFR 31 at PO 1 day and 1 month for predicting low eGFR and with a value of ΔeGFR 27 at PO 2–3 days and 1 month for predicting impaired renal adaptation. Conclusions Our study showed that the degree of early renal adaptation determines subsequent renal function in kidney donors. Closer monitoring and management may be required in old or male donors with small residual CTA kidney volume as well as donors with persistent ΔeGFR >27 within 1 month of nephrectomy.
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- 2017
162. MP22-12 POSTOPERATIVE OUTCOME OF CYSTIC RENAL CELL CARCINOMA DEFINED ON PREOPERATIVE IMAGING: A RETROSPECTIVE STUDY
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Taesoo Choi, Jun Phil Na, CHUNG UN LEE, Hyunwoo Chung, SEUNGHEE YUM, Hyun Hwan Sung, Hwang Gyun Jeon, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi, Chan Kyo Kim, and Byong Chang Jeong
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Urology - Published
- 2017
163. Endoscopic management of upper tract urothelial carcinoma: Improved prediction of invasive cancer using a ureteroscopic scoring model
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Seong Soo Jeon, Hyun Moo Lee, Byong Chang Jeong, Hyun Hwan Sung, Han-Yong Choi, Deok Hyun Han, Seong Il Seo, and Hwang Gyun Jeon
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Male ,medicine.medical_specialty ,Pathology ,030232 urology & nephrology ,Urology ,Endoscopic management ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Ureteroscopy ,Medicine ,Humans ,Neoplasm Invasiveness ,Hydronephrosis ,Early Detection of Cancer ,Urine cytology ,Urothelial carcinoma ,Aged ,Retrospective Studies ,Lamina propria ,Invasive carcinoma ,Mucous Membrane ,medicine.diagnostic_test ,business.industry ,Ureteral Neoplasms ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Oncology ,Upper tract ,030220 oncology & carcinogenesis ,Area Under Curve ,Surgery ,Female ,Urothelium ,business - Abstract
The aim of this study was to investigate clinical and ureteroscopic factors considered as important for the prediction of invasive upper tract urothelial carcinoma (UTUC) and establish a model using a new ureteroscopic scoring.We analyzed tumor depth and grade from ureteroscopic biopsies in 172 patients who underwent imaging studies, urine cytology, and radical nephroureterectomy. Invasive UTUC was defined as muscle-invasive or non-organ confined tumors. Ureteroscopic scoring was defined as sum of the risk factors, lamina propria invasion, or presence of a high-grade tumor.In the multivariate analysis, lamina propria invasion was a significant factor associated with an increased risk of invasive UTUC. Positive urine cytology, hydronephrosis, and local invasion on imaging were also significant. Presence of a high-grade tumor was not significant due to interaction with lamina propria invasion (P 0.001). In the ureteroscopic scoring model, the odds ratio of invasive UTUC was significantly related to the ureteroscopic scoring number (30.9% (56/81), 66.7% (14/42), and 83.7% (41/49) according to the sum of risk factors 0 to 2, respectively, (P 0.001). Positive predictive value (PPV) for invasive UTUC was increased in relation to the number of risk factors including urine cytology, hydronephrosis, local invasion on imaging, and any abnormal ureteroscopic finding (lamina propria invasion or presence of high-grade tumors). The PPV gradually increased as follows: 6.3%, 33.3%, 52.1%, 81.6%, to 92.9% for 0 to 4 positive risk factors, respectively (P 0.001).When lamina propria invasion and presence of a high-grade tumor were incorporated, our novel ureteroscopic scoring model was highly predictive of invasive UTUC.
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- 2017
164. Transperitoneal versus retroperitoneal robotic partial nephrectomy: matched-pair comparisons by nephrometry scores
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Seong Il Seo, Hyun Hwan Sung, Byong Chang Jeong, Seol Ho Choo, Seo Yeon Lee, Han Yong Choi, Hwang Gyun Jeon, Hyun Moo Lee, and Seong Soo Jeon
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Adult ,Male ,Nephrology ,medicine.medical_specialty ,Matched-Pair Analysis ,Urology ,medicine.medical_treatment ,Angiomyolipoma ,Operative Time ,Renal function ,Nephrectomy ,Robotic Surgical Procedures ,Internal medicine ,medicine ,Carcinoma ,Adenoma, Oxyphilic ,Humans ,Retroperitoneal space ,Retroperitoneal Space ,Stage (cooking) ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Perioperative ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Laparoscopy ,business - Abstract
The purpose of this study was to compare perioperative outcomes of transperitoneal (TP) and retroperitoneal (RP) robot-assisted partial nephrectomy (RPN) by matched analysis using nephrometry systems. A total of 107 patients who underwent RPN by a single surgeon from December 2008 to June 2012 were analyzed; 57 patients underwent TP RPN and 50 patients underwent RP RPN. Baseline demographic characteristics, perioperative outcomes and changes in renal function were collected by retrospective review of medical records. Matched-pair comparisons were done using RENAL score and C-index. No significant difference was observed between TP and RP RPN in patient age, body mass index, gender, laterality, clinical stage, tumor size, RENAL score or ASA score. The TP RPN had more cystic renal masses (TP vs. RP = 33 vs. 12 %, p = 0.012) and RP RPN had shorter median operation times (150 vs. 120 min, p = 0.015) and shorter mean warm ischemic times (26.2 vs. 22.6 min, p = 0.040) than TP RPN. In the matched-pair analysis, RP RPN showed shorter operation times with similar warm ischemic times. Estimated blood loss and visual analog pain scales showed no significant differences between groups. A total of 12 (11.4 %) postoperative complications occurred, all Clavien class I or II with no significant difference in incidence. Retroperitoneal robot-assisted partial nephrectomy showed shorter operation time and generally equivalent perioperative results to TP RPN. RP RPN is a viable treatment option for treating posterior or lateral renal masses.
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- 2014
165. Increased expression of TRPC4 channels associated with erectile dysfunction in diabetes
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Sung Won Lee, Sung Chul Kam, M. Ko, Hyun Hwan Sung, I. So, S. J. Kang, S. H. Choo, Deok Hyun Han, and Mee Ree Chae
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Male ,medicine.medical_specialty ,Urology ,Endocrinology, Diabetes and Metabolism ,Gene Expression ,Diabetes Mellitus, Experimental ,TRPC6 ,Diabetes Complications ,Rats, Sprague-Dawley ,TRPC1 ,Endocrinology ,TRPC3 ,Erectile Dysfunction ,Diabetes mellitus ,Internal medicine ,Gene expression ,Animals ,Humans ,Medicine ,TRPC ,TRPC Cation Channels ,business.industry ,Penile Erection ,medicine.disease ,Erectile dysfunction ,Reproductive Medicine ,Immunohistochemistry ,business ,Penis - Abstract
In recent reports, an association between altered TRPC channel function and the development of various diabetic complications has drawn the attention of many investigators. The aim of this study was to investigate the expression of TRPC4 channels of corpus smooth muscle (CSM) cells in diabetes, and to evaluate the association between erectile dysfunction (ED) and altered TRPC4 channel function. The expression of TRPC4 in the penile tissue of human, normal and diabetic rat was investigated using RT-PCR, western blotting and immunohistochemistry (IHC). In vivo gene transfer of dominant negative (DN) TRPC4 into the CSM of rat was conducted. In vivo pelvic nerve stimulation was performed to measure erectile function. Expression of TRPC1, TRPC3, TRPC4 and TRPC6 in human and rat CSM tissues was confirmed by RT-PCR, western blot and IHC. In the diabetic rat, the expression levels of mRNA and protein of the TRPC4, and TRPC6 were significantly increased compared to control rats (p < 0.05). The change in TRPC4 expression in the diabetic rats was higher than those of the other TRPC subunits (p < 0.05). The IHC showed that only TRPC4 expression had a higher intensity in the diabetes compared to normal rats (p < 0.05). Gene transfection with TRPC4(DN) into the diabetic rats restored erectile function to levels similar to that of normal controls. Gene expression of TRPC4(DN) in CSM tissue was confirmed by RT-PCR 2 weeks after transfection. This study demonstrated that TRPC4 channel expression increased in the penile CSM cells of diabetic rats. The down-regulation of TRPC4 with DN form restored erectile function in the diabetic rats. The alteration of TRPC4 channel is one of pathophysiology of ED and could be a target for drug development for ED.
- Published
- 2014
166. Efficacy and tolerability of tamsulosin 0.4 mg in Asian patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia refractory to tamsulosin 0.2 mg: A randomized placebo controlled trial
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Sung Won Lee, Hyun Hwan Sung, Jung Jun Kim, Deok Hyun Han, and Seol Ho Choo
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medicine.medical_specialty ,business.industry ,Urology ,Placebo-controlled study ,Placebo ,medicine.disease ,Tolerability ,Lower urinary tract symptoms ,Tamsulosin ,Palpitations ,medicine ,International Prostate Symptom Score ,Alpha blocker ,medicine.symptom ,business ,medicine.drug - Abstract
Objectives To evaluate the efficacy and safety of tamsulosin dose increase to 0.4 mg daily in Asian patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia refractory to tamsulosin 0.2 mg treatment. Methods We carried out a 12-week, single-center, randomized, placebo-controlled trial in 220 patients. Patients treated with 0.2 mg tamsulosin daily without other lower urinary tract symptoms secondary to benign prostatic hyperplasia medication for more than 3 months and refractory to this treatment were enrolled. We defined “refractory” as an International Prostate Symptom Score of 13 or greater and a maximum flow rate of 15 or under despite medication. Patients with a surgical history related to lower urinary tract symptoms secondary to benign prostatic hyperplasia or a postvoid residual of 150 mL or greater were excluded. Eligible patients were randomly assigned to the 0.4 mg group (two tablets of 0.2 mg tamsulosin once daily) or the 0.2 mg group (one tablet of 0.2 mg tamsulosin and one tablet of placebo once daily). International Prostate Symptom Score, maximum flow rate, blood pressure, heart rate, and adverse events were compared between the two groups at 4 weeks and 12 weeks. Results A total of 220 patients were enrolled and analyzed. There were no differences in baseline characteristics between the two groups. After 12 weeks of medication, the International Prostate Symptom Score was not different between the two groups. However, the improvement in maximum flow rate was greater in the 0.4 mg group than the 0.2 mg group (3.0 ± 0.48 mL/s vs −0.25 ± 0.30 mL/s, P
- Published
- 2014
167. Efficacy of Holmium Laser Transurethral Incision of the Prostate in Symptomatic Mild-to-Moderate Benign Prostate Enlargement Based on Preoperative Characteristics
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Yoon Seok, Suh, Kwang Jin, Ko, Tae Heon, Kim, Hyun Hwan, Sung, and Kyu-Sung, Lee
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Adult ,Aged, 80 and over ,Male ,Patient Selection ,Prostate ,Prostatic Hyperplasia ,Lasers, Solid-State ,Organ Size ,Middle Aged ,Urinary Retention ,Urinary Bladder Neck Obstruction ,Postoperative Complications ,Treatment Outcome ,Lower Urinary Tract Symptoms ,Preoperative Period ,Retreatment ,Humans ,Ejaculation ,Aged ,Hematuria ,Retrospective Studies - Abstract
To investigate the efficacy of Holmium laser transurethral incision of the prostate (Ho-TUIP) with preoperative characteristics based on urodynamic parameters.The medical records of 40 consecutive cases of Ho-TUIP in patients unresponsive to medical treatment were retrospectively reviewed. The efficacy of Ho-TUIP was analyzed according to preoperative factors, including urodynamic parameters. Treatment success was confirmed if overall efficacy demonstrated an improvement that was "good or greater" according to the criteria developed by Homma et al. Predictive factors of treatment success were analyzed using logistic regression analysis with demographics, symptom questionnaires, prostate size, and urodynamic parameters. Postoperative complications and Global Response Assessment (GRA) were investigated.Mean age was 60.9 years (range 37-84), mean follow-up period was 36.6 months (range 6.3-114.8), and mean prostate size was 23.5 mL (range 12.7-39.5). All patients underwent medical treatment before Ho-TUIP, and mean medication duration was 50.5 months (range 3.4-140.0). The treatment success rate was 60.0%. Treatment success rates were higher in the bladder outlet obstruction index (BOOI) ≥20 group (n = 26) than in the BOOI20 group (n = 14) (p = 0.003). In logistic regression analysis, BOOI ≥20 was a predictor of treatment success (OR 7.60, 95% CI 1.60-35.90, P = 0.010). Among patients who maintained an active sex life, 77.8% (14/18) reported retrograde ejaculation. In terms of GRA, 81.5% (31/38, two patients expired) of patients improved at the final follow-up.Ho-TUIP is an effective procedure with tolerable complications for the treatment of symptomatic mild-to-moderate BPE in patients with BOOI ≥20 that are unresponsive to medical treatment.
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- 2016
168. Development of Novel Patient-Derived Preclinical Models from Malignant Effusions in Patients with Tyrosine Kinase Inhibitor-Resistant Clear Cell Renal Cell Carcinoma
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Oliver Rath, Byong Chang Jeong, Julia Schueler, Hyun Moo Lee, Se Hoon Park, Woong-Yang Park, Hyun Hwan Sung, Han-Yong Choi, Ghee-Young Kwon, Jeeyun Lee, Jiryeon Jang, Seong Soo Jeon, Seong Il Seo, and Hwang Gyun Jeon
- Subjects
0301 basic medicine ,Cancer Research ,Pathology ,medicine.medical_specialty ,Original article ,medicine.drug_class ,Angiogenesis ,Cell ,lcsh:RC254-282 ,Tyrosine-kinase inhibitor ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Everolimus ,business.industry ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Primary tumor ,In vitro ,Clear cell renal cell carcinoma ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Cancer research ,business ,Tyrosine kinase ,medicine.drug - Abstract
PURPOSE: Although targeting angiogenesis with tyrosine kinase inhibitors (TKIs) has become standard of care in the treatment of clear cell renal cell carcinoma (RCC), resistance mechanism are not fully understood, and there is a need to develop new therapeutic options overcoming them. METHODS AND MATERIALS: To develop a preclinical model that predicts clinical activity of novel agents in 19 RCC patients, we established patient-derived cell (PDC) and xenograft (PDX) models derived from malignant effusions or surgical specimen. RESULTS: Successful PDCs, defined as cells that maintained growth following two passages, were established in 5 of 15 malignant effusions and 1 of 4 surgical specimens. One PDC, clinically refractory to TKIs, was implanted and engrafted in mice, resulting in a comparable histology to the primary tumor. The PDC-PDX model also showed similar genomic features when tested using targeted sequencing of cancer-related genes. When we examined the drug effects of the PDX model, the tumor cells showed resistance to TKIs and everolimus in vitro . CONCLUSION: The results suggest that the PDC-PDX preclinical model we developed using malignant effusions can be a useful preclinical model to interrogate sensitivity to targeted agents based on genomic alterations.
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- 2016
169. Long-term outcomes of primary implantation and revisions of artificial urinary sphincter in men with stress urinary incontinence
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Hyun Hwan Sung, Tae Heon Kim, Yoon Seok Suh, Kyu-Sung Lee, and Kwang Jin Ko
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,Urology ,Urinary Incontinence, Stress ,030232 urology & nephrology ,Urinary incontinence ,Artificial urinary sphincter ,Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Long term outcomes ,Humans ,In patient ,Survival rate ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Medical record ,Middle Aged ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Etiology ,Urinary Sphincter, Artificial ,Neurology (clinical) ,medicine.symptom ,Complication ,business - Abstract
Aims To evaluate long-term outcomes of primary implantation and revisions of artificial urinary sphincter (AUS) in men with stress urinary incontinence (SUI). Methods The medical records of 155 consecutive patients who underwent AMS 800™ implantation from 2003 to 2015 were reviewed. Treatment success (TS) was defined as no need for pads, and social continence (SC) was defined as a need for pad ≤1/day at last follow-up. The efficacy, complication rates, and associated risk factors with reoperation and durability of primary AUS implantation, as well as treatment outcomes following AUS revision were evaluated. Results The median age was 69.0 years (range 27-85), and median follow-up was 45.1 months (range 9-126). The rates of TS and SC were 63.2% and 84.5%, respectively. The reoperation rate of AUS was 26.4%. Non-mechanical failure (70.7%) was a dominant etiology of reoperation. The 5-year device survival rate without reoperation was 67.0%. The immediate TS rates of primary AUS without reoperation (pAUS) and AUS revision without secondary reoperation (rAUS) groups were 88.6% and 79.2% (P = 0.352), respectively. At last follow-up, the SC rate was higher in patients with pAUS (92.1%) than with rAUS (62.5%) (P = 0.001). Conclusions Although there are appreciable rates of reoperation, the AMS 800™ offers high rates of continence in men with SUI. The immediate TS rate was comparable in patients with pAUS and rAUS. At the final follow-up, however, the SC rate was significantly higher in patients with pAUS than with rAUS.
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- 2016
170. Novel predictive models of early death less than one year in patients with metastatic RCC treated with first-line tyrosine kinase inhibitors
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Hyun Moo Lee, Hwang Gyun Jeon, Tae Jin Kim, Hyun Hwan Sung, Byong Chang Jeong, Minyong Kang, Jae Young Joung, Seong Soo Jeon, and Seong Il Seo
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Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,First line ,Early death ,medicine.disease ,Renal cell carcinoma ,Internal medicine ,medicine ,Overall survival ,In patient ,business ,Tyrosine kinase - Abstract
552 Background: Although the IMDC model can provide useful information on overall survival outcomes in patients with metastatic renal cell carcinoma (mRCC), this model maybe invaluable in patients who experience early death less than one year after initial systemic therapy. Here, we aimed to develop a new prognostic model which can predict early death in patients with mRCC receiving first line tyrosine kinase inhibitors (TKI). Methods: We retrospectively evaluated a total of 498 patients treated with first line line TKI among 537 patients with mRCC at our institution. The primary endpoint was the rate of early death within 1 year after first line TKI administration. We selected statistically significant factors predicting early death by performing multiple logistic regression. Modified IMDC model 1 based on existing IMDC model and model 2 composed of new variables were generated. The prediction accuracy was evaluated by calculating the concordance index (C-index). Area under curve (AUC) and net reclassification index (NRI) using ROC curve analysis were used to compare the predictive power between the models. Results: Overall mortality was 59.0% (n = 294) in 498 patients, and early mortality was 19.7% (n = 98) within 1 year after first line TKI administration. The C-index of the IMDC model for early death was 0.655. Five variables were selected: previous nephrectomy, BMI, multiple metastases, previous metastasectomy and serum albumin level. The C-index of the model 1, which includes five new variables plus variables in the IDMC model, is 0.823, showing a significant improvement over the IDMC model. In model 2, hemoglobin and neutrophil levels were added in new five variables, and the C-index was 0.822. For the IMDC model, there was a significant NRI difference in both models 1 and 2, but no significant difference in NRI between models 1 and 2. (-0.0368 [95% CI = -0.1416 - 0.0681]; p = 0.491). Conclusions: In this study, we suggest modified IMDC models for predicting ‘early death less than one year in patients with mRCC treated with first line TKI. These novel models can provide better treatment strategies and counseling in patients with mRCC who were treated by first line TKI.
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- 2019
171. Persistent Erectile Dysfunction after Discontinuation of 5-Alpha Reductase Inhibitor Therapy in Rats Depending on the Duration of Treatment
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Mee Ree Chae, Jong Kwan Park, Jiwoong Yu, Hyun Hwan Sung, Su Jeong Kang, Insuk So, and Sung Won Lee
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Aging ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,lcsh:Medicine ,Stimulation ,5-alpha reductase inhibitors ,lcsh:RC870-923 ,03 medical and health sciences ,5 Alpha-Reductase Inhibitor ,chemistry.chemical_compound ,0302 clinical medicine ,Oral administration ,In vivo ,medicine ,Erectile dysfunction ,Pharmacology (medical) ,030219 obstetrics & reproductive medicine ,business.industry ,Health Policy ,Finasteride ,lcsh:R ,Public Health, Environmental and Occupational Health ,Dutasteride ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Discontinuation ,Psychiatry and Mental health ,Reproductive Medicine ,chemistry ,Original Article ,business - Abstract
Purpose: The current study is aimed to assess whether a longer duration of 5α-reductase inhibitor (5α-RI) exposure was asso-ciated with higher rate of permanent erectile dysfunction (ED) in a rat model. Materials and Methods: Male Sprague-Dawley rats (n=76) were assigned to five groups: (i) normal control group; (ii) dutaste-ride (0.5 mg/rat/d) for 4-weeks group; (iii) dutasteride for 4-weeks plus 2-weeks of resting group; (iv) dutasteride for 8-weeks group; and (v) dutasteride for 8-weeks plus 2-weeks of resting group. In vivo erectile responses to electrical stimulation, and changes of fibrotic factors and smooth muscle/collagen contents in the corpus cavernosum were evaluated in each group. Results: Dutasteride administration for 4 and 8 weeks significantly decreased erectile parameters compared with the control group. Reduced erectile responses were recovered during 2 weeks of drug-free time in the 4-week treatment group, but were not in the 8-week group. Protein levels of fibrosis-related factors transforming growth factor (TGF)-β1, TGF-β2, and p-Smad/Smad (Smad 2/3) in the corpus cavernosum showed no significant change after 4 weeks of dutasteride oral administration, but were enhanced after 8 weeks. Dutasteride markedly decreased smooth muscle content and increased collagen after 4 and 8 weeks of use, but no nuclear size changes; however, neither group showed significant improvement in the smooth muscle to collagen ratio after the rest period. Conclusions: Our study showed that recovery from ED depended on the duration of medication, and administration of dutas-teride for more than 8-weeks in rats could result in irreversible ED even after discontinuation of medication.
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- 2019
172. The role of intracavernosal injection therapy and the reasons of withdrawal from therapy in patients with erectile dysfunction in the era of PDE5 inhibitors
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J. S. Ahn, S. H. Choo, Hyun Hwan Sung, Sung Won Lee, Je-Jong Kim, and Deok Hyun Han
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Male ,medicine.medical_specialty ,Sildenafil ,Urology ,Endocrinology, Diabetes and Metabolism ,Self Administration ,Piperazines ,Sildenafil Citrate ,Injections ,Treatment Refusal ,chemistry.chemical_compound ,Endocrinology ,Patient satisfaction ,Erectile Dysfunction ,Papaverine ,Internal medicine ,medicine ,Humans ,Sulfones ,Alprostadil ,Phentolamine ,Adverse effect ,Libido ,business.industry ,Reason for Treatment ,Penile Erection ,Coitus ,Middle Aged ,Phosphodiesterase 5 Inhibitors ,medicine.disease ,Surgery ,Discontinuation ,Treatment Outcome ,Erectile dysfunction ,Reproductive Medicine ,chemistry ,Patient Satisfaction ,Purines ,business - Abstract
There has been little data regarding the role of intracavernosal injection (ICI) treatment, its discontinuation rate and the reasons of withdrawal in patients with erectile dysfunction (ED) in the era of phosphodiesterase type 5 (PDE5) inhibitors. The aim of this study was to investigate the rate of withdrawal and its associated reasons in patients undergoing ICI therapy. Patients who were prescribed with ICI treatment two times or more were included since the introduction of sildenafil in Korea in 1999. Telephone surveys were performed to evaluate intercourse rates, withdrawal rates and their associated reasons, adverse events and the patients' satisfaction with their sex lives after the ICI treatments. Two hundred and ninety-four men were contacted by telephone. The mean age was 61.8 ± 7.9 years with a follow-up duration of 25.6 ± 32.1 months. At the last follow-up, 79.9% had discontinued the treatment. Most patients had previously failed PDE5 inhibitor treatment prior to the ICI therapy, and more than half had two or more risk factors of ED. Adequate penile rigidity after ICI therapy was restored in 60.2% of patients. The reasons for discontinuation of ICI were poor response (43.1%), inconvenience of use (18.3%), switch to other treatments (10.7%), loss of libido (6.7%), adverse events (5.5%) and return of spontaneous erection (2.8%). Pain was the most common adverse event in the withdrawal group, whereas prolonged erection was most common in the continuing group. Following ICI treatment, PDE5 inhibitors were the most common therapeutic option (63.1%). The overall satisfaction rate regarding sex life was significantly high in the treatment-continuing group. In conclusion, patients on ICI treatment had severe ED and high withdrawal rates in the era of PDE5 inhibitors. The most common reason for treatment discontinuation was poor response. Before initiating ICI treatments, sufficient counselling is necessary.
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- 2013
173. Relationship Between Patient Position and Pain Severity During Shock Wave Lithotripsy for Renal Stones With the MODULITH SLX-F2 Lithotripter: A Matched Case-Control Study
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Seol Ho Choo, Jung Hun Kang, Sung Ho Moon, Hyun Hwan Sung, Sin Woo Lee, and Deok Hyun Han
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medicine.medical_specialty ,business.industry ,Patient positioning ,Case-control study ,Shock wave lithotripsy ,Surgery ,Extracorporeal shockwave lithotripsy ,Pain severity ,mental disorders ,Medicine ,Endourology/Urolithiasis ,Kidney calculi ,Original Article ,Radiology ,business - Abstract
Purpose We evaluated the association between shock wave lithotripsy (SWL)-related pain and patient positioning during SWL. Materials and Methods We retrospectively reviewed the medical records of 162 patients who underwent their first SWL session for single renal stones from May 2010 to August 2011. One hundred thirteen patients underwent SWL in the supine position and 49 did so in the lateral position. To evaluate an unbiased estimation of the positional effect on pain severity during SWL, both groups (supine vs. lateral) were matched according to sex, age, body mass index, stone location, and stone size. Thirty-four patients from each group were selected for analysis. Pain was evaluated with an average visual analogue scale (VAS-avg) and maximum visual analogue scale (VAS-max). Analgesic usage was also compared between the groups. Results All patients (n=34) in the supine group had radio-opaque stones compared with only 47.1% of the patients in the lateral group (n=16). The VAS-avg and VAS-max of the lateral group were significantly lower than those of the supine group (1.2±1.0 and 3.1±1.7 for VAS-avg and 2.5±1.8 and 4.7±1.9 for VAS-max, respectively, p
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- 2013
174. Recent advances in robotic surgery in female urology
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Kyu-Sung Lee, Bong Hee Park, Dong Soo Ryu, and Hyun Hwan Sung
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Laparoscopic surgery ,medicine.medical_specialty ,Urinary Tract Fistula ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,Urinary system ,Female urology ,Surgery ,body regions ,Dissection ,Urinary Fistula ,Medicine ,Robotic surgery ,business ,Laparoscopy - Abstract
Pelvic organ prolapse and lower urinary tract fistulas are two disorders frequently managed in female urology. New techniques have been adapted and improved to decrease morbidity and improve clinical outcomes of these disorders. The adaptation of minimally-invasive approaches for the management of pelvic organ prolapse and lower urinary tract fistulas began with laparoscopy. However, laparoscopic surgery has not gained widespread popularity as a result of the associated technical challenges, such as intracorporeal suturing and pelvic dissection. Robotic surgery has been widely carried out in urological oncology since 2001, and has been widely adapted because of its advantages over conventional laparoscopy for the management of pelvic organ prolapse and lower urinary tract fistulas. The current literature has shown the safety, feasibility and favorable clinical outcomes of robotic surgery for the treatment of these disorders. Robotic surgery in the management of pelvic organ prolapse and lower urinary tract fistula repairs might offer a promising advancement and benefits. However, further long-term data should be followed to assess the durability of this newer, and minimally-invasive approach.
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- 2013
175. Tailoring pharmacotherapy for male lower urinary tract symptoms: A prospective, multicenter, observational trial
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Kyu-Sung Lee, Hyun Hwan Sung, Yoon Seok Suh, Joon Chul Kim, Jong Bo Choi, Yun-Seob Song, and Kwang Jin Ko
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Adult ,Male ,medicine.medical_specialty ,Combination therapy ,030232 urology & nephrology ,Urology ,Muscarinic Antagonists ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Lower Urinary Tract Symptoms ,Republic of Korea ,medicine ,Nocturia ,Humans ,Prospective Studies ,Medical prescription ,Practice Patterns, Physicians' ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Male lower urinary tract ,General Medicine ,Middle Aged ,Treatment Outcome ,030220 oncology & carcinogenesis ,Urological Agents ,Observational study ,International Prostate Symptom Score ,Drug Therapy, Combination ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Objectives The aim of this study was to evaluate the pattern of tailoring and efficacy of several types of pharmacotherapy in male LUTS. Methods Prospectively 404 male subjects were included who were over 40 years old, had at least 3 months symptom duration, and 12 or higher international prostate symptom score (IPSS). Subjects were treated with several types of pharmacotherapy for 6 months and were evaluated with IPSS/QoL at every follow-up. Subjects were subdivided into storage (44%), nocturia (18.5%), and voiding symptom (37.5%) groups according to the most bothersome symptom. Results At 6 months, 188 subjects (46.5%) completed the study. The mean age was 64.2±8.5 years, and symptom duration was 30.6±32.6 months. PSA was 2.98±7.96 ng/mL, and prostate size was 32.8±14.2 cc. IPSS continually decreased from baseline (18.7) to last follow-up (10.8). Combination therapy increased from 33.0% to 52.7% at last follow-up (P=.006). However, there was no difference of IPSS changes between combination and monotherapy groups (P>.05). Only antimuscarinic prescription significantly increased from 15.4% to 28.2% (P=.004). Mean number of visits to the clinic was 3.6±1.3 and the number of treatment changes was 0.31±0.47. The nocturia (0.47±0.51) group changed treatment more than voiding group (0.21±0.41, P=.003). However, the voiding group (−9.4) had significantly more improvement than e storage (−6.4) and nocturia (−7.8) groups (P=.011). Conclusions Male LUTS continually improved over 6 months with customised treatment. Pharmacotherapy for male LUTS should be tailored by symptom type and alteration of symptoms during treatment.
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- 2016
176. Diagnosing bladder outlet obstruction using the penile cuff test in men with lower urinary tract symptoms
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Hyun Hwan Sung, Kyu-Sung Lee, Gyu Ha Ryu, Kwang Jin Ko, Tae Heon Kim, and Yoon Seok Suh
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Male ,medicine.medical_specialty ,Visual analogue scale ,Urology ,030232 urology & nephrology ,Sensitivity and Specificity ,03 medical and health sciences ,Bladder outlet obstruction ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Lower urinary tract symptoms ,Predictive Value of Tests ,parasitic diseases ,Pressure ,Medicine ,Humans ,Prospective Studies ,Adverse effect ,Aged ,Pain Measurement ,business.industry ,Diagnostic Tests, Routine ,Nomogram ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Surgery ,Urinary Bladder Neck Obstruction ,Urodynamics ,Tolerability ,030220 oncology & carcinogenesis ,Cuff ,International Prostate Symptom Score ,Neurology (clinical) ,business ,hormones, hormone substitutes, and hormone antagonists ,Penis - Abstract
Aim The current standard diagnostic test to evaluate bladder outlet obstruction (BOO) is pressure-flow study (PFS). The penile cuff test (PCT) was introduced as a non-invasive alternative to PFS to determine the isovolumetric bladder pressure and also flow rate. The aim of the study was to evaluate the diagnostic accuracy and acceptability of the PCT, compared to those of PFS, in the assessment of BOO in men. Methods A total of 146 consecutive men with an International Prostate Symptom Score (IPSS) >12 and lower urinary tract symptoms (LUTS) for >6 months were included in this single-institution, prospective, diagnostic study. The primary outcome was to evaluate the diagnostic accuracy of PCT. Secondary outcomes included pain severity measured on a visual analog scale (VAS), procedure time, and adverse events. In addition, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were estimated. Results Based on the PFS results, the sensitivity of PCT was 89.7%, the PPV 54.2%, the specificity 71.8%, and the NPV 94.9%. The mean pain VAS for the PFS and PCT were 5.04 ± 2.17 and 1.83 ± 1.98, respectively (P
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- 2016
177. De Ritis Ratio (AST/ALT) as a Significant Prognostic Factor in Patients With Upper Tract Urothelial Cancer Treated With Surgery
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Deok Hyun Han, Byong Chang Jeong, Han Yong Choi, Hwang Gyun Jeon, Hakmin Lee, Young Hyo Choi, Seong Soo Jeon, Hyun Moo Lee, Seong Il Seo, and Hyun Hwan Sung
- Subjects
Male ,medicine.medical_specialty ,Prognostic factor ,Urologic Neoplasms ,Urology ,030232 urology & nephrology ,Kaplan-Meier Estimate ,digestive system ,Nephroureterectomy ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Overall survival ,medicine ,Biomarkers, Tumor ,Urothelial cancer ,Humans ,In patient ,Aspartate Aminotransferases ,Prospective cohort study ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Receiver operating characteristic ,Proportional hazards model ,business.industry ,Alanine Transaminase ,Middle Aged ,Prognosis ,digestive system diseases ,Surgery ,Treatment Outcome ,Oncology ,Upper tract ,030220 oncology & carcinogenesis ,Disease Progression ,Female ,business - Abstract
We investigated the clinical prognostic value of preoperative De Ritis ratio (aspartate aminotransferase [AST]/alanine aminotransferase [ALT]) on postsurgical survival outcomes in patients with upper tract urothelial cancer (UTUC).We retrospectively analyzed the data of 623 patients who underwent radical nephrouretectomy for UTUC. Multivariate regression tests were performed to identify possible associations between adverse pathologic events and AST/ALT. The risk of postoperative progression and survival were tested using Kaplan-Meier analyses and Cox proportional hazards models.According to the receiver operator characteristic curve of AST/ALT for cancer-specific mortality, patients with AST/ALT value ≥1.5 were regarded as the high AST/ALT group, and the remaining patients formed the low AST/ALT group. In Kaplan-Meier analyses, the high AST/ALT group showed worse progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (all P .001). Elevated AST/ALT was associated with higher T stage (hazard ratio [HR], 1.577; 95% confidence interval [CI], 1.077-2.311; P = .033) and higher cellular grade (HR, 1.538; 95% CI, 1.034-2.287; P = .041) in multivariate regression tests. In multivariate Cox analyses, high AST/ALT was revealed as an independent predictor of PFS (HR, 2.335; 95% CI, 1.633-3.340; P .001), CSS (HR, 2.550; 1.689-3.851; P .001), and overall survival (HR, 2.069; 95% CI, 1.409-3.038; P .001).Elevated preoperative AST/ALT was a significant predictor of worse postoperative survival in patients surgically treated for UTUC. Further large prospective studies are needed for better understanding of the prognostic value of preoperative AST/ALT.
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- 2016
178. The effect of contralateral kidney volume on renal function after radical nephroureterectomy: Implications for eligibility for neoadjuvant chemotherapy for upper tract urothelial cancer
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Byong Chang Jeong, Hyun Moo Lee, Seong Il Seo, Hyun Hwan Sung, Seong Soo Jeon, Hwang Gyun Jeon, Wan Song, Deok Hyun Han, and Han Yong Choi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Renal function ,Kidney Volume ,Antineoplastic Agents ,urologic and male genital diseases ,Logistic regression ,Kidney ,Kidney Function Tests ,Nephroureterectomy ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,Humans ,Renal Insufficiency, Chronic ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,Carcinoma, Transitional Cell ,business.industry ,Ureteral Neoplasms ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Neoadjuvant Therapy ,Administration, Intravesical ,Oncology ,Upper tract ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Contralateral kidney ,Female ,Cisplatin ,business ,Tomography, X-Ray Computed ,Kidney disease ,Glomerular Filtration Rate - Abstract
Purpose We investigated the effect of preoperative contralateral kidney (CK) volume on renal function after radical nephroureterectomy (RNU). Methods We reviewed 630 patients who underwent RNU between September 1994 and December 2013. Of these 630 patients, 135 patients with advanced upper tract urothelial cancer were ultimately included. Preoperative CK volume was measured from computed tomography images of the venous phase using a specialized volumetric program. Glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations and checked preoperatively, 7 days, 1, 3, and 12 months postoperatively. Results The mean age at surgery was 62.1 (10.1) years and the mean CKD-EPI GFR was 73.8 (75.5) ml/min/1.73 m 2 . After RNU, new-onset CKD was identified in 69 (51.1%) patients. On multivariate logistic regression analysis, high body mass index (95% CI: 1.08–1.51, P = 0.005), low preoperative CKD-EPI GFR (95% CI: 0.92–0.98, P = 0.037), and low CK volume (95% CI: 0.96–0.99, P ρ = 0.495, P P = 0.001). Conclusions High body mass index, low preoperative CKD-EPI GFR, and low CK volume are significantly associated with new-onset CKD. Therefore, they could be used to identify patients eligible for neoadjuvant chemotherapy in upper tract urothelial cancer.
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- 2016
179. Oncological Outcomes in Patients Treated with Radical Cystectomy for Bladder Cancer: Comparison Between Open, Laparoscopic, and Robot-Assisted Approaches
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Seong Il Seo, Hyun Hwan Sung, Hwang Gyun Jeon, Tae Heon Kim, Hyun Moo Lee, Seong Soo Jeon, Byong Chang Jeong, and Han Yong Choi
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Cystectomy ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Interquartile range ,medicine ,Humans ,Neoplasm Invasiveness ,Laparoscopy ,Survival rate ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Carcinoma, Transitional Cell ,Laparotomy ,Bladder cancer ,medicine.diagnostic_test ,Proportional hazards model ,business.industry ,Retrospective cohort study ,Perioperative ,Middle Aged ,medicine.disease ,Surgery ,Survival Rate ,Treatment Outcome ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Female ,Neoplasm Recurrence, Local ,business - Abstract
To investigate oncological outcomes in patients with muscle-invasive bladder cancer who underwent open radical cystectomy (ORC), laparoscopic radical cystectomy (LRC), or robot-assisted radical cystectomy (RARC).A retrospective analysis was performed on 230 patients who underwent ORC (n = 150), LRC (n = 22), or RARC (n = 58) between September 2009 and June 2012. Perioperative outcomes were compared between the three surgical approaches. The influence of the type of surgical approach on recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using the Kaplan-Meier method, and differences were assessed with the log-rank test. Predictors of RFS, CSS, and OS were also analyzed with a Cox regression model.The median patient age for ORC, LRC, and RARC groups was 68.0 (interquartile range [IQR]: 60.0-73.0), 65.0 (IQR: 62.8-74.0), and 61.5 (IQR: 54.8-72.0) years, respectively (p = 0.017), and the median follow-up duration was 27.9 (IQR: 14.7-47.9), 28.8 (IQR: 15.7-41.8), and 32.0 (IQR: 15.5-45.4) months, respectively (p = 0.955). There was no significant difference in RFS, CSS, and OS according to the surgical approach (p = 0.253, p = 0.431, and p = 0.527, respectively). Subgroup analysis revealed that RFS, CSS, and OS were not significantly different in both subgroups with stage ≤pT2 or ≥pT3. Multivariable Cox regression analyses showed that the surgical approach was not a significant predictor of RFS, CSS, and OS.Our findings indicate that the type of surgical approach is not associated with RFS, CSS, and OS in patients with bladder cancer.
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- 2016
180. MP27-16 IMPACT OF PERI-OPERATIVE BLOOD TRANSFUSION ON ONCOLOGIC OUTCOMES OF PATIENTS UNDERGOING NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA
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Wan Song, Byong Chang Jeong, Chi I Hun Kwon, Hwang Gyun Jeon, Jae Yong Jeong, Hyun Hwan Sung, Kwang Ho Ryu, Hyun Moo Lee, Han Yong Choi, Jae Ho Yoo, Seong Soo Jeon, Heung Jae Park, and Seong Il Seo
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Oncology ,medicine.medical_specialty ,Blood transfusion ,Upper tract ,business.industry ,Urology ,Internal medicine ,medicine.medical_treatment ,medicine ,Perioperative ,business ,Urothelial carcinoma ,Surgery - Published
- 2016
181. MP74-19 DIAGNOSTIC ACCURACY OF NON-INVASIVE PENILE CUFF TEST FOR THE ASSESSMENT OF BLADDER OUTLET OBSTRUCTION COMPARING BY PRESSURE FLOW STUDY IN MEN WITH LOWER URINARY TRACT SYMPTOM
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Kwang Jin Ko, Jae Ho Yoo, Yoon Seok Suh, Hyun Hwan Sung, Kyu-Sung Lee, and Heung Jae Park
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Urology - Published
- 2016
182. MP60-13 URINARY NERVE GROWTH FACTOR AS A POTENTIAL BIOMARKER FOR PREDICTION OF TREATMENT EFFICACY AND RECURRENCE IN OVERACTIVE BLADDER PATIENTS
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Yoon Seok Suh, Hyun-Woo Kim, Kyu-Sung Lee, Heung Jae Park, Joon Chul Kim, Jeongyun Jeong, Jong Bo Choi, Jae Ho Yoo, and Hyun Hwan Sung
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medicine.medical_specialty ,Randomization ,business.industry ,Urology ,Urinary system ,medicine.disease ,Compliance (physiology) ,Blood pressure ,Overactive bladder ,Lower urinary tract symptoms ,Cohort ,Medicine ,Metabolic syndrome ,business - Abstract
INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is a common disease in the United States, with more than 20% prevalence.MetShasbeenshown tohavedetrimental effectson thebladder, including significant lower urinary tract symptoms (LUTS), decreased quality of life, and detrusor underactivity (DU). However, the progression and mechanism of disease are poorly understood. A large animal model for diabetic bladder dysfunction was developed with Ossabaw pigs. It is hypothesized thatMetSaffects thebladder in theOssabawmetabolicpigandpossibly humans by causing DU over time, contributing to LUTS. METHODS: A group of 11 Ossabaw pigs underwent dietary modification consisting of a hypercaloric, atherogenic diet for 10months to induce MetS. This cohort was compared to a group of 5 lean pigs. Urodynamic studies were performed at 7 and 10 months after randomization. Bladder pressure and compliance were used to define detrusor underactivity. RESULTS: MetS was confirmed between the two groups by demonstrating increased body weight in the MetS animals, increased systolic and diastolic blood pressure, fasting serum glucose, total cholesterol, but not triglycerides (Table 1). Eleven Metabolic pigs demonstrated decreased bladder pressure at maximum capacity (28.2 4.6 vs. 63.8 6.5 cmH2O, p1⁄40.001) and increased compliance (67.1 7.9 vs. 22.2 3.2 cc/cmH2O, p
- Published
- 2016
183. MP05-01 THE IMPACT OF CONTRALATERAL KIDNEY VOLUME ON RENAL FUNCTION AFTER RADICAL NEPHROURETERECTOMY: IMPLICATIONS FOR ELIGIBILITY FOR NEOADJUVANT CHEMOTHERAPY FOR UPPER TRACT UROTHELIAL CANCER
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Heung Jae Park, Kwang Ho Ryu, Jae Ho Yoo, Hwang Gyun Jeon, Seong Soo Jeon, Seong Il Seo, Han Yong Choi, Hyun Moo Lee, Chi I Hun Kwon, Byong Chang Jeong, Wan Song, Deok Hyun Han, and Hyun Hwan Sung
- Subjects
Oncology ,medicine.medical_specialty ,Chemotherapy ,business.industry ,Urology ,medicine.medical_treatment ,Renal function ,Upper tract ,Internal medicine ,Contralateral kidney ,Medicine ,Urothelial cancer ,business - Published
- 2016
184. The prevalence of premature ejaculation and its clinical characteristics in Korean men according to different definitions
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Jong Kwan Park, S K Choi, Hyun Hwan Sung, Lee Jh, Hyun Jun Park, S.C. Kam, and Seung Won Lee
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Adult ,Male ,medicine.medical_specialty ,Ejaculation ,Libido ,Urology ,media_common.quotation_subject ,Personal Satisfaction ,Orgasm ,Asian People ,Erectile Dysfunction ,Surveys and Questionnaires ,Republic of Korea ,Premature ejaculation ,Prevalence ,medicine ,Humans ,Premature Ejaculation ,media_common ,Gynecology ,business.industry ,Obstetrics ,Coitus ,Middle Aged ,medicine.disease ,Sexual intercourse ,Sexual Partners ,Sexual dysfunction ,Erectile dysfunction ,Intravaginal ejaculation latency time ,medicine.symptom ,business - Abstract
This study compared the prevalence of premature ejaculation (PE) diagnosed by the PE diagnostic tool (PEDT) score, self-reporting and stopwatch-recorded intravaginal ejaculation latency time (IELT). It examined the characteristics of males diagnosed with PE by each criterion. A questionnaire survey enrolled 2081 subjects from March to October, 2010. Stopwatch-recorded IELT was measured in 1035 of the 2081 subjects. We aimed to determine whether PE has an influence on the frequency and satisfaction of sexual intercourse, the degree of libido/erectile function and the satisfaction. These factors were evaluated according to different definitions of PE to assess whether the definition used yielded differences in the data. The prevalence of PE, based on a PEDT score of ≥11, self-reporting and stopwatch-recorded IELT of ≤1 min was 11.3%, 19.5% and 3%, respectively. The prevalence of PE diagnoses based on PEDT score and self-reporting increased with age, but stopwatch-recorded IELT-based diagnoses did not. Males experiencing PE showed lower levels of libido, erectile function and frequency and satisfaction of sexual intercourse compared with non-PE males. PE males felt that they did not satisfy their partners in terms of the partners' sexual satisfaction and frequency of orgasm, in comparison with non-PE males. PE is a highly prevalent sexual dysfunction in males. Regardless of whether the PE diagnosis was made on the basis of self-reporting, PEDT score or stopwatch-recorded IELT, subjective symptoms were similar among PE males.
- Published
- 2012
185. Chronic Low Dosing of Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction
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Hyun Hwan Sung and Sung Won Lee
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Treatment response ,Udenafil ,business.industry ,Review Article ,Pharmacology ,medicine.disease ,Tadalafil ,Regimen ,Erectile dysfunction ,Pharmacokinetics ,cGMP-specific phosphodiesterase type 5 ,medicine ,Phosphodiesterase 5 inhibitors ,Dosing ,Chronic ,business ,medicine.drug - Abstract
Oral phosphodiesterase type 5 (PDE5) inhibitors have provided non-invasive, effective, and well-tolerated treatments for patients with erectile dysfunction (ED). However, many patients with ED are unresponsive to 'on-demand' PDE5 inhibitors. In addition, the lack of spontaneity and naturalness of the on-demand regimen could be a reason for decreased compliance with PDE5 inhibitors. Recently, tadalafil and udenafil were approved for low-dose daily administration for the treatment of ED. Since the introduction of the concept of daily administration of PDE5 inhibitors, several reports have supported the potential benefits of this therapy for disease modification, improvement of the treatment response in difficult-to-treat populations, spontaneity, and safety, although further research is needed to better address these hypotheses. In this article, we reviewed the daily administration of PDE5 inhibitors in terms of pharmacokinetics, safety, efficacy, and distinct features.
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- 2012
186. Impact of body mass index in Korean patients with renal cell carcinoma
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Seong Soo Jeon, Hyun Moo Lee, Hyun Hwan Sung, Byong Chang Jeong, Seong Il Seo, Seo Yong Park, and Han-Yong Choi
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Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Statistics as Topic ,Subgroup analysis ,Nephrectomy ,Gastroenterology ,Statistics, Nonparametric ,Body Mass Index ,Renal cell carcinoma ,Internal medicine ,Confidence Intervals ,Humans ,Medicine ,Obesity ,Prospective Studies ,Carcinoma, Renal Cell ,Survival analysis ,Aged ,Korea ,business.industry ,Incidence ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,Kidney Neoplasms ,Confidence interval ,Treatment Outcome ,Multivariate Analysis ,Female ,Underweight ,medicine.symptom ,business ,Body mass index - Abstract
The aim of the current study was to examine the impact of preoperative body mass index (BMI) in Korean patients with surgically treated renal cell carcinoma (RCC). From 1994 to 2008, a total of 1,487 patients underwent nephrectomy for RCC. All patients were classified into three groups according to Asian BMI classification by Asia Cohort Consortium
- Published
- 2012
187. The Diagnostic Efficacy of 3-Dimensional Ultrasound Estimated Bladder Weight Corrected for Body Surface Area as an Alternative Nonurodynamic Parameter of Bladder Outlet Obstruction
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Deok Hyun Han, Hyewon Lee, Hyun Hwan Sung, Kyu-Sung Lee, Ha Na Lee, and Young-Suk Lee
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Male ,medicine.medical_specialty ,Body Surface Area ,Urology ,Urinary system ,urologic and male genital diseases ,Bladder outlet obstruction ,Imaging, Three-Dimensional ,Predictive Value of Tests ,Lower urinary tract symptoms ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Ultrasonography ,Body surface area ,Urinary bladder ,business.industry ,Ultrasound ,Organ Size ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Surgery ,Urinary Bladder Neck Obstruction ,medicine.anatomical_structure ,Predictive value of tests ,business - Abstract
We investigated the relationship between ultrasound estimated bladder weight/corrected ultrasound estimated bladder weight and the bladder outlet obstruction index derived from pressure flow study to evaluate its diagnostic efficacy to predict bladder outlet obstruction.A total 193 men older than 50 years with lower urinary tract symptoms were enrolled in this study. Ultrasound estimated bladder weight measurements were made with a 3-dimensional ultrasound system. Corrected bladder weight was defined as ultrasound estimated bladder weight divided by body surface area on data analysis. The study population was classified into obstructed and unobstructed groups (bladder outlet obstruction index 40 or greater and less than 40, respectively). We evaluated the correlation between bladder outlet obstruction and clinical parameters, including bladder weight/corrected bladder weight and the diagnostic accuracy of bladder weight/corrected bladder weight for bladder outlet obstruction.A total of 50 (26%) and 143 patients (74%) were categorized as obstructed and nonobstructed, respectively. Corrected bladder weight, maximum urine flow and the bladder contraction index showed statistically significant differences between the groups. Bladder weight/corrected bladder weight positively correlated with the bladder outlet obstruction index and corrected bladder weight showed a stronger correlation. Corrected bladder weight was significantly increased depending on obstruction severity. When corrected bladder weight was used to diagnose obstruction, sensitivity, specificity, and positive and negative predictive values were 61.9%, 59.8%, 33.8% and 82.6%, respectively, at a 28 gm/m(2) cutoff.Ultrasound estimated bladder weight/corrected ultrasound estimated bladder weight is a statistically significant parameter correlating with bladder outlet obstruction. However, bladder weight/corrected bladder weight alone was insufficient to predict bladder outlet obstruction due to its weak correlation with and low accuracy for diagnosing obstruction.
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- 2011
188. Changeable prognosis and associated prognostic factors for conditional survival estimates in metastatic renal cell carcinoma patients receiving the first-line targeted therapy
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Seong Il Seo, Byong Chang Jeong, Hyun Hwan Sung, Hyun Moo Lee, Han Yong Choi, Minyong Kang, Seong Soo Jeon, Hwang Gyun Jeon, and Se Hoon Park
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Oncology ,Cancer Research ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,medicine.medical_treatment ,First line ,medicine.disease ,Targeted therapy ,Conditional survival ,Renal cell carcinoma ,Internal medicine ,Survivorship curve ,medicine ,Initial treatment ,business ,Survival rate - Abstract
587 Background: Conditional survival (CS) indicates the probability that patient would survive additional periods, given that the patients has previous survivorship after diagnosis or initial treatment. Here, we aim to evaluate the CS probabilities in mRCC patients who underwent targeted therapy with tyrosine kinase inhibitors (TKI) and to identify the significant prognostic factors of the CS over time. Methods: A total of 1,498 mRCC patients receiving 1st line TKI was finally analyzed from Korean multicenter database of mRCC. Kaplan-Meier survival estimates was used to calculate overall and cancer-specific CS rates by using following formula: CS(α│β) = S(α+β)/S(β), where CS(α│β) indicates the likelihood of additional α years survivorship in the person who has already survived for β years after initial diagnosis or treatment, and S(χ) is the actual survival rate. The Cox regression analysis was used to determine the predictors of CS depended on clinicopathological features. Results: We observed that 1, 2, 3, 4, and 5-year conditional cancer-specific survival (CSS) gradually increased as patients who have all additional survivorships after initial treatment, compared to those with baseline survival estimation. Also, 1, 2, 3, 4, and 5-year conditional OS rates also increased after additional 1, 2, 3, 4, and 5 year survivorships following first-line TKI treatment. Furthermore, we found that key predictive factors of OS and CSS were changed over time in multivariate analysis. While several variables, such as BMI, histologic subtypes, pT stage, were identified as prognosticators of CSS at baseline, they were not remained as independent predictors after 1 yr survivorship. Conversely, only previous metastatectomy was determined as a key prognostic factor for conditional OS over time until 4 yr survivorship after initial TKI treatment. Conclusions: Our study offers valuable information for practical survival estimation and relevant predictive factors for patients with mRCC receiving targeted therapy.
- Published
- 2018
189. Comparisons of oncological outcomes and perioperative complications between laparoscopic and open radical nephrectomies in patients with clinical T2 renal cell carcinoma (≥7cm)
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Hyun Hwan Sung, Byong Chang Jeong, Chung Un Lee, Chang Wook Jeong, Hakmin Lee, Seong Soo Jeon, Jae Ho Yoo, Hyun Moo Lee, Seong Il Seo, Han Yong Choi, and Cheol Kwak
- Subjects
Male ,medicine.medical_treatment ,Cancer Treatment ,030232 urology & nephrology ,lcsh:Medicine ,Nephrectomy ,Postoperative Complications ,0302 clinical medicine ,Animal Cells ,Renal cell carcinoma ,Medicine and Health Sciences ,Radical Nephrectomy ,lcsh:Science ,Laparoscopy ,Neurons ,Multidisciplinary ,medicine.diagnostic_test ,Laparoscopic Nephrectomy ,Middle Aged ,Kidney Neoplasms ,Surgical Oncology ,Oncology ,Nephrology ,Renal Cancer ,030220 oncology & carcinogenesis ,Female ,Cellular Types ,Research Article ,Clinical Oncology ,medicine.medical_specialty ,Urology ,Surgical and Invasive Medical Procedures ,Carcinomas ,Olfactory Receptor Neurons ,Urinary System Procedures ,03 medical and health sciences ,Carcinoma ,medicine ,Humans ,Carcinoma, Renal Cell ,Proportional Hazards Models ,Retrospective Studies ,Surgical Excision ,Proportional hazards model ,business.industry ,lcsh:R ,Renal Cell Carcinoma ,Biology and Life Sciences ,Afferent Neurons ,Cancers and Neoplasms ,Postoperative complication ,Retrospective cohort study ,Cell Biology ,Perioperative ,medicine.disease ,Genitourinary Tract Tumors ,Cross-Sectional Studies ,Cellular Neuroscience ,Multivariate Analysis ,lcsh:Q ,Clinical Medicine ,business ,Neuroscience - Abstract
Purpose Although minimal invasive techniques have been widely accepted in contemporary urology, the perioperative outcomes of laparoscopy in patients with clinical T2 renal cell carcinoma (RCC) have not been clearly evaluated. We aimed to compare the outcomes of laparoscopic radical nephrectomy (LRN) with those of open radical nephrectomy (ORN) in patients with clinical T2 RCC. Methods We retrospectively analyzed the data of 835 patients who underwent radical nephrectomy for localized clinical T2 RCC (≥7 cm). The survival rates and postoperative complications were compared between the LRN and ORN groups. Multivariate Cox regression tests were performed to identify the independent predictors of each survival outcome. Results There were 578 (69.2%) subjects in ORN group and 257 (30.8%) in LRN group, respectively. The LRN group showed a significant male predominance (p = 0.013), higher pathological stage (p = 0.02), and higher cellular grade (p = 0.010) compared with the ORN group. No significant differences in progression-free (p = 0.070), cancer-specific (p = 0.472), or overall survival (p = 0.249) were found between the two groups. In the multivariate analysis, the type of surgery did not show any significant associations with all three survival outcomes (all p > 0.2). Furthermore, there was no significant difference in postoperative complication rate between the two groups (p = 0.595). In the subgroup analysis according to tumor histology, no significant relationships were observed between survival outcome and surgery type. Conclusion The LRN and ORN groups showed similar oncological outcomes in patients with clinical T2 RCC. Early postoperative complications were also comparable between LRN and ORN.
- Published
- 2018
190. Prognostic significance of pre- to postoperative dynamics of prognostic nutritional index in patients with renal cell carcinoma who underwent radical nephrectomy
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Seong Soo Jeon, Hyejoo Choi, Byong-Chang Jeong, Seongil Seo, Hyun Hwan Sung, Hwang Gyun Jeon, Minyong Kang, and Hyun-Moo Lee
- Subjects
medicine.medical_specialty ,Index (economics) ,Oncology ,Renal cell carcinoma ,business.industry ,medicine.medical_treatment ,medicine ,In patient ,Hematology ,medicine.disease ,business ,Nephrectomy ,Surgery - Published
- 2017
191. Comparison of the efficacy and safety of tolterodine 2 mg and 4 mg combined with an α-blocker in men with lower urinary tract symptoms (LUTS) and overactive bladder: a randomized controlled trial
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Hyun Hwan Sung, Tae Heon Kim, Soonhyun Yook, Wonho Jung, Yoon Seok Suh, and Kyu-Sung Lee
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Male ,medicine.medical_specialty ,Tolterodine Tartrate ,Urology ,media_common.quotation_subject ,030232 urology & nephrology ,Muscarinic Antagonists ,Urination ,Drug Administration Schedule ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Lower Urinary Tract Symptoms ,Lower urinary tract symptoms ,law ,medicine ,Nocturia ,Humans ,Single-Blind Method ,media_common ,Aged ,Dose-Response Relationship, Drug ,business.industry ,Urinary Bladder, Overactive ,medicine.disease ,Treatment Outcome ,Overactive bladder ,030220 oncology & carcinogenesis ,Delayed-Action Preparations ,Quality of Life ,International Prostate Symptom Score ,Item score ,Drug Therapy, Combination ,Tolterodine ,medicine.symptom ,business ,medicine.drug - Abstract
Objective To evaluate the efficacy and safety of low-dose (2 mg) tolterodine extended release (ER) with an α-blocker compared with standard-dose (4 mg) tolterodine ER with an α-blocker for the treatment of men with residual storage symptoms after α-blocker monotherapy. Patients and Methods The study was a 12-week, single-blind, randomized, parallel-group, non-inferiority trial that included men with residual storage symptoms despite receiving at least 4 weeks of α-blocker treatment. Inclusion criteria were total International Prostate Symptom Score (IPSS) ≥12, IPSS quality-of-life item score ≥3, and ≥8 micturitions and ≥2 urgency episodes per 24 h. The primary outcome was change in the total IPSS score from baseline. Bladder diary variables, patient-reported outcomes and safety were also assessed. Results Patients were randomly assigned to addition of either 2 mg tolterodine ER (n = 47) or 4 mg tolterodine ER (n = 48) to α-blocker therapy for 12 weeks. Patients in both treatment groups had a significant improvement in total IPSS score (−5.5 and −6.3, respectively), micturition per 24 h (−1.3 and −1.7, respectively) and nocturia per night (−0.4 and −0.4, respectively). Changes in IPSS, bladder diary variables, and patient-reported outcomes were not significantly different between the treatment groups. All interventions were well tolerated by patients. Conclusions These results suggest that 12 weeks of low-dose tolterodine ER add-on therapy is similar to standard-dose tolterodine ER add-on therapy in terms of efficacy and safety for patients experiencing residual storage symptoms after receiving α-blocker monotherapy.
- Published
- 2015
192. Multiple cores of high grade prostatic intraepithelial neoplasia and any core of atypia on first biopsy are significant predictor for cancer detection at a repeat biopsy
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Byong Chang Jeong, Hyun Soo Ryoo, Kwang Jin Ko, Sung Won Lee, Seung Jea Shin, Tae Sun Kim, Kyu-Sung Lee, Seong Il Seo, Hyun Hwan Sung, Hwang Gyun Jeon, Seong Soo Jeon, Hyun Moo Lee, Wan Song, Deok Hyun Han, and Han Yong Choi
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Prostate biopsy ,Urological Oncology ,medicine.medical_treatment ,Biopsy ,Urology ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,High-grade prostatic intraepithelial neoplasia ,Prostate neoplasms ,Aged ,Retrospective Studies ,Prostatectomy ,Prostatic Intraepithelial Neoplasia ,Atypical small acinar proliferation ,Intraepithelial neoplasia ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Prostatic Neoplasms ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Prostate-specific antigen ,Prostate neoplasm ,Kallikreins ,Original Article ,Neoplasm Grading ,business ,Precancerous Conditions - Abstract
Purpose: To investigate the differences in the cancer detection rate and pathological findings on a second prostate biopsy according to benign diagnosis, high-grade prostatic intraepithelial neoplasia (HGPIN), and atypical small acinar proliferation (ASAP) on first biopsy. Materials and Methods: We retrospectively reviewed the records of 1,323 patients who underwent a second prostate biopsy between March 1995 and November 2012. We divided the patients into three groups according to the pathologic findings on the first biopsy (benign diagnosis, HGPIN, and ASAP). We compared the cancer detection rate and Gleason scores on second biopsy and the unfavorable disease rate after radical prostatectomy among the three groups. Results: A total of 214 patients (16.2%) were diagnosed with prostate cancer on a second biopsy. The rate of cancer detection was 14.6% in the benign diagnosis group, 22.1% in the HGPIN group, and 32.1% in the ASAP group, respectively (p
- Published
- 2015
193. Diagnostic Ureterorenoscopy Is Associated with Increased Intravesical Recurrence following Radical Nephroureterectomy in Upper Tract Urothelial Carcinoma
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Deok Hyun Han, Seong Il Seo, Hwang Gyun Jeon, Byong Chang Jeong, Hyun Hwan Sung, Seong Soo Jeon, Han Yong Choi, and Hyun Moo Lee
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Medicine ,Kaplan-Meier Estimate ,Preoperative care ,Nephrectomy ,Disease-Free Survival ,Ureter ,Neoplasm Seeding ,Risk Factors ,Preoperative Care ,medicine ,Ureteroscopy ,Humans ,Radical surgery ,lcsh:Science ,Ureteral neoplasm ,Survival rate ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Carcinoma, Transitional Cell ,Multidisciplinary ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Ureteral Neoplasms ,lcsh:R ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Urinary Bladder Neoplasms ,lcsh:Q ,Female ,Neoplasm Recurrence, Local ,business ,Research Article - Abstract
Diagnostic ureterorenoscopy is powerful tool to confirm upper tract urothelial cancer (UTUC). However, URS and associated manipulation may be related to the risk of intravesical recurrence (IVR) following radical nephroureterectomy (RNU). We aimed to investigate whether preoperative ureterorenoscopy would increase IVR after RNU in patients with UTUC. We performed a retrospective analysis of 630 patients who had RNU with bladder cuff excision due to UTUC. Diagnostic URS was performed in 282 patients (44.7%). Patients were divided into two groups according to the URS. Survival analysis and multivariate Cox regression model were performed to address risk factors for the IVR. The interval from URS to RNU was measured. During URS, manipulation such as biopsy and resection was determined. The median age was 64 (IQR 56-72) years with follow-up duration of 34.3 (15.7-64.9) months. Median time from URS to RNU was 16 (0-38) days. The IVR developed in 42.5% (n = 268) patients at 8.2 (4.9-14.7) months. The five-year IVR-free survival rate was 42.6 ± 8.0% and 63.6 ± 6.9% in patients with and without preoperative URS, respectively (P < 0.001). In multivariate analysis, previous history of bladder tumour, extravesical excision of distal ureter, multifocal tumour, and URS (HR, 95% CI; 1.558, 1.204-2.016, P = 0.001) were independent predictors for higher IVR. The IVR rate in patients without manipulation during URS was not different to those with manipulation (P = 0.658). The duration from URS to RNU was not associated with IVR (P = 0.799). Diagnostic URS for UTUC increased IVR rate after RNU. However, the lessening of interval from URS to radical surgery or URS without any manipulation could not reduce the IVR rate.
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- 2015
194. MP62-17 PREDICTIVE FACTORS OF OUTCOME FOLLOWING SALVAGE RADIOTHERAPY ALONE FOR PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY
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Hyun Hwan Sung, Han Yong Choi, Deok Hyun Han, Young Hyo Choi, Seong Il Seo, Joon Hyung Park, Sang Eun Lee, Hyun Moo Lee, Hwang Gyun Jeon, Seong Soo Jeon, Byong Chang Jeong, and Wan Song
- Subjects
Biochemical recurrence ,medicine.medical_specialty ,business.industry ,Proportional hazards model ,Prostatectomy ,Urology ,medicine.medical_treatment ,medicine.disease ,Log-rank test ,Prostate cancer ,medicine ,Analysis of variance ,Stage (cooking) ,business ,Prostate brachytherapy - Abstract
bone or CT scan. Associations were compared by ANOVA and Chi-square. Survival function was estimated by Kaplan Meier method with comparisons by log rank and cox regression proportion hazard rates RESULTS: The 10 and 15 year freedom from Metz and CSS were 97.1 and 94% and 98.2 and 94.6%, respectively. Freedom from Metz and CSS decreased by risk group (table). When high risk patients were stratified by very high risk (Gleason score 8 and PSA > 20 ng/ml) there was no difference in CSS. BED was significantly higher in low risk patients free of Metz (198 vs 176 Gy, p1⁄40.041) and in low (198 vs 172 Gy, p1⁄40.023) and high risk (193 vs 169 Gy, p1⁄40.005) patients not dying from prostate cancer. Cox regression revealed stage (p1⁄40.012, HR 1.45, 95%CI 1.08-1.94), Gleason score (p1⁄40.037, HR 1.40, 95%CI 1.02-1.91) and BED (p1⁄40.044, HR 1.01, 95%CI 1-1.03) as significant for Metz. Cox regression for CSS was significant for stage (p1⁄40.014) and Gleason score (p1⁄40.002). Use of HT, patient age, and PSA did not influence Metz or CSS. CONCLUSIONS: Radiation dose significantly influences metastases and survival following prostate brachytherapy. Unlike studies which report a beneficial effect of HT combined with EBRT in intermediate and high risk disease, no benefit was experienced when radiation doses are high. Those patients with very high risk disease experienced the same high 10 and 15-year CSS as patients without the highest risk features. These positive results also most likely reflect the high BED.
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- 2015
195. PD25-05 CLINICAL CORRELATIONBETWEEN INCIDENTALLY DETECTED BLADDER WALL THICKENING ON COMPUTED TOMOGRAPHY SCAN AND CYSTOSCOPY
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Don Kyoung Choi, Hyun Hwan Sung, Sin Woo Lee, Sang Eun Lee, Hyun Moo Lee, Sae Bin Jung, Seong Il Seo, Byong Chang Jeong, Yong Hyo Choi, Seong Soo Jeon, Joon Hyung Park, Hwang Gyun Jeon, Jae Yong Jeong, and Han-Yong Choi
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,medicine ,Computed tomography ,Thickening ,Radiology ,Cystoscopy ,business - Published
- 2015
196. MP3-14 CHANGES OF THE URINARY NERVE GROWTH FACTOR (NGF) LEVELS AFTER RELIEF OF OBSTRUCTION IN THE PATIENTS WITH SYMPTOMATIC BENIGN PROSTATIC OBSTRUCTION (BPO) USING HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP)
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Tae Heon Kim, Kyu-Sung Lee, Hyun Hwan Sung, Myung-Soo Choo, and Jeongyun Jeong
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Urinary system ,Urine ,medicine.disease ,Bladder outlet obstruction ,Nerve growth factor ,medicine.anatomical_structure ,nervous system ,Overactive bladder ,Prostate ,medicine ,Transrectal ultrasonography ,International Prostate Symptom Score ,business - Abstract
INTRODUCTION AND OBJECTIVES: Urinary NGF levels are increased in the patients with overactive bladder (OAB) and bladder outlet obstruction (BOO). However, the changes of the urinary NGF levels after relief of BOO have been rarely reported. We investigated the changes of urinary NGF levels following HoLEP procedures in the patients with symptomatic BPO. METHODS: We measured urinary NGF levels from the voided urine samples of the patients preoperatively, and rechecked urinary NGF levels at 6-month follow-up period postoperatively. We analyzed the clinical features of the 97 patients with more than 6-mo follow-up data using the prospectively collected database. All patients were evaluated with International Prostate Symptom Score (IPSS), International Continence Society male questionnaire short form (ICS-SF), 3day voiding diary, transrectal ultrasonography, and uroflowmetry with postvoid residual. Urinary NGF level was measured using the enzymelinked immunosorbent assay (ELISA), and total urinary NGF levels were further normalized to the concentration of urinary creatinine. RESULTS: Preoperatively, the urinary NGF and NGF/Cr levels were measured as 93.6 116.3pg/ml and 1.28 1.95, respectively. Patients with more severe storage symptoms showed higher NGF and NGF/Cr levels at the baseline period. However, there was no correlation between these levels and the urodynamic parameters including BOO index (BOOI), bladder contractility index (BCI), maximum cystometric capacity (MCC), and detrusor overactivity (DO). The mean volume of the prostate was 71.9 41.0cc and the mean resected weight was 28.9 27.0g. A significant improvement was achieved in the parameters of IPSS and uroflowmetry at the 6-mo follow-up compared to baseline. Urinary NGF and NGF/Cr levels were decreased significantly at the 6-mo follow-up period from the baseline. However, there was no correlation between the improvement of clinical parameters and the reduction of the NGF and NGF/Cr levels. The changes of the urinary NGF and NGF/Cr levels were not affected by the preoperative urodynamic parameters including BOOI, BCI, MCC, and DO. CONCLUSIONS: In the present study, the urinary NGF and NGF/Cr levels were elevated in the patients with BPO, and decreased significantly after successful relief of obstruction using HoLEP.
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- 2015
197. MP7-04 PREOPERATIVE PREDICTIVE FACTORS OF ENDOSCOPIC MANAGEMENT IN PATIENTS WITH UPPER TRACT UROTHELIAL CANCER
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Seong Il Seo, Hyun Hwan Sung, Sang Eun Lee, Joon Hyung Park, Hyun Moo Lee, Jae Yong Jeong, Jeong Hee Hong, Byong Chang Jeong, Hwang Gyun Jeon, Sin Woo Lee, Seong Soo Jeon, Young Hyo Choi, and Han Yong Choi
- Subjects
medicine.medical_specialty ,Upper tract ,business.industry ,Urology ,medicine ,Urothelial cancer ,In patient ,Radiology ,Endoscopic management ,business - Published
- 2015
198. Effect of the novel BKCa channel opener LDD175 on the modulation of corporal smooth muscle tone
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Chul-Seung Park, Su Jeong Kang, Deok Hyun Han, Mee Ree Chae, Insuk So, Sung Won Lee, Hyun Hwan Sung, Jong Kwan Park, and Seol Ho Choo
- Subjects
Male ,medicine.medical_specialty ,BK channel ,Contraction (grammar) ,Indoles ,Patch-Clamp Techniques ,Urology ,Endocrinology, Diabetes and Metabolism ,Muscle Relaxation ,Vasodilation ,Erectile tissue ,Phenylephrine ,Endocrinology ,Erectile Dysfunction ,Internal medicine ,medicine ,Animals ,Humans ,Benzofurans ,Udenafil ,biology ,Chemistry ,Penile Erection ,Muscle, Smooth ,Iberiotoxin ,Psychiatry and Mental health ,Electrophysiology ,medicine.anatomical_structure ,Reproductive Medicine ,Anesthesia ,Muscle Tonus ,biology.protein ,Rabbits ,medicine.drug - Abstract
Introduction The BKCa channel has been reported to play an important role in erectile function. Recently, novel BKCa channel activator, LDD175, was introduced. Aim This study aims to investigate whether LDD175 relaxes corporal smooth muscle (CSM) via BKCa channel activation. Methods After isolation of CSM strip from a male rabbit model, contraction studies using organ bath was performed. Isolating human tissue and cell cultures, electrophysiological studies were done via whole-cell patch-clamp recording. Main Outcome Measures Vasodilatory effects of LDD175 were evaluated by cumulative addition ranging from 10−7 to 10−4 M in corpus cavernosal strips after precontraction with 10−5 M phenylephrine via organ bath system. Using cultured human CSM cells, patch-clamp recording was performed. Erectile function was measured by in vivo rat cavernous nerve stimulation. Results LDD175 caused an endothelium-independent relaxation of corporal tissues, and this effect was abolished by pretreatment with iberiotoxin. The relaxation effect of 10−4 M LDD175 was greater than that of 10−6 M udenafil (54.0 ± 3.1% vs. 34.5 ± 3.9%, P < 0.05); 10−5 M LDD175 with 10−6 M udenafil caused a greater relaxation effect on strips than 10−5 M LDD175 or 10−6 M udenafil alone (50.7%, 34.1%, vs. 20.7%, respectively, P < 0.001). In patch-clamp recordings, LDD175 increased K+ currents in a dose-dependent manner, and washout of LDD175 or the addition of iberiotoxin fully reversed the increase. Intravenous LDD175 improved erectile function measured by area under the curve (AUC) of the intracavernosal pressure (ICP)/arterial blood pressure (ABP) ratio (1,612.1 ± 135.6 vs. 1,093.7 ± 123.1, P < 0.05). There was no difference between 10 mg/kg LDD175 and 1 mg/kg udenafil regarding maximal ICP, maximal ICP/ABP ratio, and the AUC of the ICP/ABP ratio (P > 0.05). Conclusions LDD175 leads to an endothelium-independent relaxation of erectile tissue, primarily through the opening of BKCa channels. The results suggest that LDD175 might be a new candidate treatment for erectile dysfunction.
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- 2014
199. Preoperative Prognostic Nutritional Index is a Significant Predictor of Survival in Renal Cell Carcinoma Patients Undergoing Nephrectomy
- Author
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Hyun Hwan Sung, Byong Chang Jeong, Don Kyoung Choi, Hwang Gyun Jeon, Han-Yong Choi, Seong Il Seo, Seong Soo Jeon, and Hyun Moo Lee
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,Nutritional Status ,Preoperative care ,Gastroenterology ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Risk Factors ,Internal medicine ,Preoperative Care ,medicine ,Carcinoma ,Humans ,Survival rate ,Carcinoma, Renal Cell ,Neoplasm Staging ,Retrospective Studies ,Proportional hazards model ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Prognosis ,Kidney Neoplasms ,Surgery ,Survival Rate ,Nutrition Assessment ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Multivariate Analysis ,T-stage ,Female ,business ,Follow-Up Studies - Abstract
Preoperative assessment of patients' immunologic and nutritional conditions is required to predict the outcome of patients with malignant tumors. The aim of the current study was to clarify the significance of the prognostic nutritional index (PNI), which simply accounts for immunological and nutritional conditions, in patients with renal cell carcinoma (RCC).We included 1437 patients who underwent nephrectomy for RCC between 1994 and 2008. PNI was calculated using the following formula: 10 × serum albumin concentration (g/dL) + 0.005 × lymphocyte counts (number/mm(2)) in peripheral blood. We examined the correlation of the preoperative PNI value with clinicopathological features. A Cox regression model and the Harrell concordance index with variables only or combined PNI data were used to evaluate the prognostic significance in the T1-4NallMall and T1-4N0M0 groups.The mean preoperative PNI value was 52.7 ± 6.3 (range 27.7-85.3). The mean PNI values were significantly lower in patients with more advanced tumor T stage, regional lymph node metastasis, distant metastases, higher Fuhrman grade, and sarcomatoid differentiation than in patients without such factors (p0.001). Patients with low PNI (51) had poor survival rates compared to those with high PNI in univariate analysis (51, p0.001). Multivariate analysis showed that low PNI was significantly associated with cancer-specific survival (p = 0.026 and p = 0.009) and overall survival (p = 0.013 and p = 0.011) in the T1-4NallMall and T1-4N0M0 groups, respectively, after correcting for other clinicopathological factors.PNI is an independent prognostic factor for predicting survival after nephrectomy in patients with RCC.
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- 2014
200. Diffusion-weighted magnetic resonance imaging for prediction of insignificant prostate cancer in potential candidates for active surveillance
- Author
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Tae Heon Kim, Sin Woo Lee, Seong Il Seo, Byong Chang Jeong, Hyun Hwan Sung, Chan Kyo Kim, Hwang Gyun Jeon, Byung Kwan Park, Jae Yong Jeong, Han Yong Choi, Seong Soo Jeon, and Hyun Moo Lee
- Subjects
Male ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Group B ,Prostate cancer ,medicine ,Effective diffusion coefficient ,Humans ,Radiology, Nuclear Medicine and imaging ,Watchful Waiting ,Neuroradiology ,Aged ,Retrospective Studies ,Prostatectomy ,medicine.diagnostic_test ,business.industry ,Prostatic Neoplasms ,Seminal Vesicles ,Magnetic resonance imaging ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,body regions ,Diffusion Magnetic Resonance Imaging ,Radiology ,business - Abstract
To investigate whether the apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (DW-MRI) could help improve the prediction of insignificant prostate cancer in candidates for active surveillance (AS). Enrolled in this retrospective study were 287 AS candidates who underwent DW-MRI before radical prostatectomy. Patients were stratified into two groups; Group A consisted of patients with no visible tumour or a suspected tumour ADC value > 0.830 × 10-3 mm2/sec and Group B consisted of patients with a suspected tumour ADC value
- Published
- 2014
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