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Hyun CW, Hwang JY, Yun SW, Park TY, Yoon SG, Kim SB, Noh TI, Kang SG, Kang SH, Cho DH, Shim JS. The association between the severity of erectile dysfunction and left ventricular diastolic dysfunction in patients with and without cardiovascular disease. Investig Clin Urol 2024; 65:165-172. [PMID: 38454826 PMCID: PMC10925735 DOI: 10.4111/icu.20230272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE Erectile dysfunction (ED) is considered a microvascular disorder and serves as an indicator for the potential development of cardiovascular disease (CVD). Although left ventricular diastolic dysfunction (LVDD) reflects early myocardial damage caused by microvascular disorders, the association between ED and LVDD remains poorly elucidated. MATERIALS AND METHODS A cross-sectional study was conducted on 123 patients with ED. They underwent RigiScan, and conventional echocardiography, and attempted International Index of Erectile Function (IIEF) questionnaire. ED severity was evaluated by measuring changes in the penile base circumference and duration of penile rigidity (≥70%) during erection. The early diastolic velocity of mitral inflow (E) and early diastolic velocity of the mitral annulus (e') were measured using echocardiography. The patients were grouped based on the presence of CVD. RESULTS Among 123 patients, 29 had CVD and 94 did not. Patients with CVD exhibited more pronounced ED and more severe LVDD. Associations between increased penile circumference with echocardiographic parameters were more prominent in patients with CVD than in those without CVD (ΔTtop and e' wave, r=0.508 and r=0.282, respectively, p for interaction=0.033; ΔTbase and E/e' ratio, r=-0.338 and r=-0.293, respectively, p for interaction <0.001). In the multivariate linear regression, the increase of penile base circumference was an independent risk factor for LVDD (e', B=0.503; E/e' ratio, B=-1.416, respectively, p<0.001). CONCLUSIONS ED severity correlated well with LV diastolic dysfunction, particularly in the presence of CVD. This study highlighted the potential role of ED assessment as early indicator of CVD development.
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Affiliation(s)
- Chang Wan Hyun
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jae Young Hwang
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong Woo Yun
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Young Park
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Goo Yoon
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung Bin Kim
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Il Noh
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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Noh TI, Shim JS, Kang SG, Cheon J, Pyun JH, Kang SH. Corrigendum: The learning curve for robot-assisted radical cystectomy with total intracorporeal urinary diversion based on radical cystectomy pentafecta. Front Oncol 2023; 13:1185908. [PMID: 37035176 PMCID: PMC10078982 DOI: 10.3389/fonc.2023.1185908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/11/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fonc.2022.975444.].
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Affiliation(s)
- Tae Il Noh
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Ji Sung Shim
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sung Gu Kang
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jun Cheon
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jong Hyun Pyun
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Seok Ho Kang, ; Jong Hyun Pyun,
| | - Seok Ho Kang
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
- *Correspondence: Seok Ho Kang, ; Jong Hyun Pyun,
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Noh TI, Shim JS, Kang SH, Cheon J, Kang SG. Diagnostic performance of transperineal prostate targeted biopsy alone according to the PI-RADS score based on bi-parametric magnetic resonance imaging. Front Oncol 2023; 13:1142022. [PMID: 37035173 PMCID: PMC10080665 DOI: 10.3389/fonc.2023.1142022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/10/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose To compare the diagnostic performance of transperineal targeted biopsy (TB) or systematic biopsy (SB) alone based on combined TB+SB and radical prostatectomy (RP) specimen for detecting prostate cancer (PCa) according to the prostate imaging reporting and data system (PI-RADS) score. Materials and methods This study included 1077 men who underwent transperineal bi-parametric (bp) magnetic resonance imaging (MRI)-ultrasound (US) fusion TB+SB (bpMRI-US FTSB) between April 2019 and March 2022. To compare the performance of each modality (TB, SB, and combined TB+SB) with the RP specimen (as the standard) for detecting PCa and clinically significant PCa (csPCa), receiver operating characteristic (ROC) curves were plotted. Results PCa was detected in 581 of 1077 men (53.9%) using bpMRI-US FTSB. CsPCa was detected in 383 of 1077 men (35.6%), 17 of 285 (6.0%) with PI-RADS 0 to 2, 35 of 277 (12.6%) with PI-RADS 3, 134 of 274 (48.9%) with PI-RADS 4, and 197 of 241 (81.7%) with PI-RADS 5, respectively. The additional diagnostic value of TB vs. SB compared to combined TB+SB for diagnosing csPCa were 4.3% vs. 3.2% (p=0.844), 20.4% vs 5.1% (p<0.001), and 20.3% vs. 0.7% (p<0.001) with PI-RADS 3, 4, and 5, respectively. TB alone showed no significant difference in diagnostic performance for csPCa with combined TB+SB based on RP specimens in patients with PI-RADS 5 (p=0.732). Conclusion A need for addition of SB to TB in patients with PI-RADS 3 and 4 lesions, however, TB alone may be performed without affecting the management of patients with PI-RADS 5.
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Kang HE, Kim SB, Noh TI, Shim JS, Kang SH, Cheon J, Tae JH, Patel VR, Kang SG. Modified apical dissection improves early continence in robot-assisted laparoscopic radical prostatectomy: Comparative study between modified apical dissection and anterior suspension stitch. Investig Clin Urol 2022; 63:639-646. [PMID: 36347553 PMCID: PMC9643732 DOI: 10.4111/icu.20220235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/08/2022] [Indexed: 08/11/2023] Open
Abstract
PURPOSE Recently, the modified apical dissection (MAD) technique in robot-assisted laparoscopic radical prostatectomy (RARP) has shown excellent functional outcomes but has never been rigorously validated at various institutions. This study aimed to evaluate the effect of MAD on early continence and potency compared with the anterior suspension stitch (SS) technique. MATERIALS AND METHODS A total of 100 patients who underwent RARP with SS and 100 who underwent RARP with MAD by a single surgeon were propensity score matched and retrospectively compared for continence and potency recovery at 1 week and 1, 3, 6, 9, and 12 months. RESULTS Continence was reached in 20.6%, 33.3%, 67.2%, 74.1%, 81.1%, and 83.0% of patients in the SS group, compared with 49.2%, 73.3%, 86.8%, 96.6%, 100.0%, and 100.0% in the MAD group at postoperative 1 week and 1, 3, 6, 9, and 12 months, respectively. In the SS group, potency rates were 0.0%, 20.0%, 50.0%, 66.7%, 75.0%, and 83.3%; in the MAD group, the rates were 50.0%, 90.0%, 88.9%, 100.0%, 100.0%, and 100.0%. Recovery of continence was higher in the MAD group within the first 6 months (p=0.005, <0.010, 0.041, 0.016 at 1 week, 1, 3, and 6 months). There were no significant differences in potency recovery rates between the two groups (all p≥0.05). CONCLUSIONS The MAD technique results in earlier recovery of continence compared with the SS technique.
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Affiliation(s)
- Ha Eun Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seung Bin Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Tae Il Noh
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jong Hyun Tae
- Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Vipul R Patel
- Department of Urology, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea.
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Noh TI, Shim JS, Kang SG, Cheon J, Pyun JH, Kang SH. The learning curve for robot-assisted radical cystectomy with total intracorporeal urinary diversion based on radical cystectomy pentafecta. Front Oncol 2022; 12:975444. [PMID: 36330475 PMCID: PMC9623051 DOI: 10.3389/fonc.2022.975444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To analyze the learning curve for robot- assisted radical cystectomy (RARC) with total intracorporeal urinary diversion (ICUD) in terms of both time efficiency and quality of surgery based on radical cystectomy (RC)-pentafecta. Patients and methods We identified 203 consecutive patients who underwent RARC with ICUD of the ileal conduit (IC, 85) and orthotopic neobladder (ONB, 118) performed by a single surgeon between 2011 and 2021. We grouped ten consecutive patients into time-associated blocks according to the operation order. Process efficiency and operation quality were measured based on the surgeon’s console time and attainment/score sum of RC-pentafecta. The overcoming point of the learning curve was defined graphically and statistically. Results The mean follow-up period was 44.5 ± 30.7 months. Of the 203 patients, 109 (53.7%) attained the five criteria of RC-pentafecta (ONB vs IC, 50.6% vs. 55.9%, p = 0.35). The attainment rate and sum of the RC-pentafecta score of the third group were not significantly different from those of all patients (40.0% vs. 53.7%, p = 0.369, 4.00 ± 1.05 vs. 4.41 ± 0.75, p = 0.137, respectively), and the proficiency in operation quality was satisfactory in the third group. The console times continually improved and stabilized after the 140th case (IC, 60; ONB, 80), and the attainment rate and sum of the RC-pentafecta were significantly different between before and after the 140th case (p<0.001). Conclusion A single surgeon’s learning curve for RARC with ICUD and pelvic lymph node dissection (PLND) showed an acceptable level of proficiency after 30 consecutive cases in terms of the operation quality. However, for an expert surgeon, 140 cases were required to reach a plateau in time efficiency and second leap with the RC-pentafecta. RARC with ICUD and PLND can be performed safely without compromising functional outcomes and complications through sharing and transmission of standardized techniques.
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Affiliation(s)
- Tae Il Noh
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Ji Sung Shim
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sung Gu Kang
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jun Cheon
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jong Hyun Pyun
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Seok Ho Kang, ; Jong Hyun Pyun,
| | - Seok Ho Kang
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
- *Correspondence: Seok Ho Kang, ; Jong Hyun Pyun,
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Jin HJ, Shim JS, Kwon TG, Kim TH, Jeon SH, Lee SH, Kang SG, Nam JK, Kim WS, Jeong BC, Oh JJ, Lee SC, Lee JY, Hong SH, Rha KH, Han WK, Ham WS, Lee YG, Lee YS, Park SY, Yoon YE, Ku JH, Kang SH. Gender-related outcomes in robot-assisted radical cystectomy: A multi-institutional study. Investig Clin Urol 2022; 63:53-62. [PMID: 34983123 PMCID: PMC8756158 DOI: 10.4111/icu.20210334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/14/2021] [Accepted: 11/11/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose Robot-assisted radical cystectomy (RARC) optimizes patient recovery and has outcomes comparable with those of open surgery. This study aimed to compare the perioperative and oncologic outcomes of RARC in female and male patients. Materials and Methods A retrospective cohort study of the Korean Robot-Assisted Radical Cystectomy Study Group database from 2007 to 2019 identified 749 patients (111 females and 638 males). Female were matched 1:1 to male by propensity score matching using a logistic regression. We compared perioperative outcomes, oncologic outcomes, and complications between the two groups. Results The female group had comparable perioperative outcomes to the male group in terms of operation time, lymph node yield, positive surgical margin, blood transfusion rate, and hospitalization days. Complication rate and grade were not significantly different between the two groups. The most common complication was infection in female and gastrointestinal complications in male. We compared the 5-year overall, disease-specific, and recurrence-free survival of female and male: 58.2% vs. 68.0% (p=0.495), 75.7% vs. 79.3% (p=0.645), and 40.8% vs. 53.5% (p=0.913), respectively. On multivariable analysis, T stage (>T2), postoperative complications, and positive surgical margin were prognostic factors of poor outcome. Sex was not an independent predictor of the three survivals. Conclusions The current study suggests that RARC in female has comparable perioperative and oncologic outcomes to those in male. The complication rate of RARC in female was comparable to that in male, but the type of complications differed by sex.
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Affiliation(s)
- Hyun Jung Jin
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Hwan Kim
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung Hyun Jeon
- Department of Urology, KyungHee University College of Medicine, Seoul, Korea
| | - Sang Hyub Lee
- Department of Urology, KyungHee University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jong Kil Nam
- Department of Urology, Busan National University Yangsan Hospital, Yangsan, Korea
| | - Wan Suk Kim
- Department of Urology, Inje University Busan Paik Hospital, Busan, Korea
| | - Byung Chang Jeong
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Jin Oh
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Chul Lee
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Hoo Hong
- Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Koon Ho Rha
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Woong Kyu Han
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Ham
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Goo Lee
- Department of Urology, Hallym University School of Medicine, Seoul, Korea
| | - Yong Seong Lee
- Department of Urology, Hallym University School of Medicine, Seoul, Korea
| | - Sung Yul Park
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Eun Yoon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea.
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Shim JS, Tae JH, Noh TI, Kang SH, Cheon J, Lee JG, Patel VR, Kang SG. Toggling Technique Allows Retrograde Early Release to Facilitate Neurovascular Bundle Sparing During Robot-Assisted Radical Prostatectomy: A Propensity Score-Matching Study. J Korean Med Sci 2022; 37:e6. [PMID: 34981681 PMCID: PMC8723890 DOI: 10.3346/jkms.2022.37.e6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/11/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study aimed to present the surgical facilitation of neurovascular bundle (NVB) sparing using the toggling technique (30° lens down/up switching) and to evaluate erectile dysfunction (ED) recovery after robot-assisted radical prostatectomy (RARP). METHODS We assessed 144 patients (group with toggling, n = 72; group without toggling, n = 72) who underwent RARP with bilateral NVB sparing using propensity score matching. Inclusion criteria were ≥ 1 year follow-up and preoperative potency as per the Sexual Health Inventory for Men (SHIM) questionnaire (≥ 17 points). Recovery of ED after RARP was defined as return to baseline sexual function or self-assessment regarding successful intercourse. The subjective surgeon's nerve sparing (SNS) score and tunneling success rates were used to evaluate surgical facilitation. The recovery rate of ED between the groups was analyzed using Kaplan-Meier analysis. RESULTS A better ED recovery trend was confirmed according to the SNS score (R² = 0.142, P = 0.004). In the analysis of NVB sparing ease, the toggling group showed higher SNS scores (on right/left side: P = 0.011 and < 0.001, respectively) and overall tunneling success rates (87% vs. 74%, P = 0.001) than the group without toggling. Overall, ED recovery rates were 82% (59/72) and 75% (54/72) in the groups with and without toggling, respectively, at the 1-year follow-up (P = 0.047), and the toggling group showed a faster ED recovery rate at 3 months (47% vs. 35%, P = 0.013). In a specific analysis of the potent cohort (< 60 years, bilateral full NVB spared, SHIM score ≥ 22), the ED recovery rate reached 87% (14/16) in the toggling group. CONCLUSION The retrograde early release with the toggling technique improves the facilitation of NVB sparing, leading to improved ED recovery.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong Hyun Tae
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Il Noh
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jeong Gu Lee
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Vipul R Patel
- Global Robotics Institute, Florida Hospital-Celebration Health Celebration, University of Central Florida School of Medicine, Orlando, FL, USA
| | - Sung Gu Kang
- Department of Urology, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
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Noh TI, Tae JH, Shim JS, Kang SH, Cheon J, Lee JG, Kang SG. Initial Experience of Single-port Robot-assisted Radical Prostatectomy: A Single Surgeon’s Experience with Technique Description. Prostate Int 2022; 10:85-91. [PMID: 35510077 PMCID: PMC9034298 DOI: 10.1016/j.prnil.2021.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/05/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background With the implementation of da Vinci SP robot platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA), we described our initial experience with the da Vinci SP robot platform (Intuitive Surgical, Inc., Sunnyvale, CA, USA) for single-port robotic-assisted radical prostatectomy (SP-RARP). Methods This retrospective review included 30 consecutive patients with prostate biopsy-confirmed prostate cancer who underwent SP-RARP by a single surgeon between June and November 2020. SP-RARP was performed with a single-incision plus one method, in which the multichannel guide port was inserted directly with an additional assist port. We report our initial experience of perioperative and early functional outcomes. Results The mean operative time (SD), console time (SD), and blood loss were 142.8 (15.1) min, 109.9 (15.7) min, and 133.0 (72.9) mL, respectively. No intraoperative complications or blood transfusions were reported. Of the 30 patients, 21 (70.0%), 7 (23.3%) and 2 (6.7%) had stage pT2, pT3a and pT3b disease, respectively. Positive surgical margins were reported in 5 of the 30 (16.7%) patients in the final pathology report, including 2 of 21 (9.5%) with stage pT2 and 3 of 9 (33.3%) with ≥ pT3. At 12 weeks after SP-RARP, 80.0% of patients had achieved continence and the potency was 46.7%; 8 of 11 (72.7%) had sexual health inventory for men (SHIM) scores ≥ 17 and 6 of 19 (31.6%) had SHIM scores < 17. Conclusions The SP platform for radical prostatectomy was technically safe and feasible. After overcoming the technical learning curve, this platform may provide high-quality outcomes comparable to those of multi-port platforms.
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Noh T, Kang YJ, Shim JS, Kang SH, Cheon J, Lee JG, Kang SG. Single-Port versus Multi-Port Robot-Assisted Radical Prostatectomy: A Propensity Score Matching Comparative Study. J Endourol 2021; 36:661-667. [PMID: 34861794 DOI: 10.1089/end.2021.0660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To compare the perioperative outcomes of patients who underwent single-port (SP) robot-assisted radical prostatectomy (RARP) and those who underwent multi-port (MP)-RARP. METHODS Data on 40 consecutive patients who underwent SP-RARP between June 2020 and February 2021 and 129 who underwent MP-RARP between June 2019 and February 2021 were retrospectively reviewed. Using logistic regression, 31 patients who underwent SP-RARP were matched to 31 patients who underwent MP-RARP (1:1) based on propensity scores. The available perioperative parameters and outcomes were analyzed. RESULTS Compared to MP-RARP, SP-RARP showed no significant differences in perioperative parameters, including the console times (111.0±15.7 vs. 102.6±18.8 minutes, p=0.569), operation time (151.3±15.1 vs. 158.7±20.3 minutes, p=0.863), estimated blood loss (121.1±64.7 vs. 140.5±90.5 mL, p=0.638), positive surgical margins (19.4% in both groups), and 3-month continence (77.4% vs. 83.9%, p=0.563) and potency (45.2% vs. 48.4%, p=0.891) rates. Patients who underwent SP-RARP had lower proportions of complete nerve sparing than those who underwent MP-RARP (SP-RARP vs. MP-RARP in subjective scores: 4.0±0.8 vs. 4.4±0.9, p=0.046; SP-RARP vs. MP-RARP in pathologic score of 5, 35.5% vs. 64.5%, p=0.049; score of 4, 41.9% vs. 19.4%, p=0.038; score of 3, 19.4% vs. 9.7%, p=0.398; score of 2, 3.2% vs. 0.0%, p=0.365; and score of 1, 3.2% vs. 3.2%, p=0.932, respectively). CONCLUSIONS SP-RARP showed lower nerve sparing scores than MP-RARP, the present study suggests that SP-RARP is safe and feasible with comparable short-term functional outcomes as those of MP-RARP.
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Affiliation(s)
- Taeil Noh
- Korea University Anam Hospital, 37997, urology, Department of Urology, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Korea, Seoul, Korea (the Republic of), 02841;
| | - Young Jin Kang
- Korea University College of Medicine and School of Medicine, 36899, Pathology, Seoul, Korea (the Republic of);
| | - Ji Sung Shim
- Korea University College of Medicine and School of Medicine, 36899, Urology, Seoul, Korea (the Republic of);
| | - Seok Ho Kang
- Korea University College of Medicine and School of Medicine, 36899, Urology, Seoul, Korea (the Republic of);
| | - Jun Cheon
- Korea University College of Medicine and School of Medicine, 36899, Seoul, Korea (the Republic of);
| | - Jeong Gu Lee
- Korea University College of Medicine and School of Medicine, 36899, Urology, Seoul, Korea (the Republic of);
| | - Sung Gu Kang
- Korea University College of Medicine and School of Medicine, 36899, Urology, Seoul, Korea (the Republic of);
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Kim J, Shim JS, Han BH, Kim HJ, Park J, Cho IJ, Kang SG, Kang JY, Bong KW, Choi N. Hydrogel-based hybridization chain reaction (HCR) for detection of urinary exosomal miRNAs as a diagnostic tool of prostate cancer. Biosens Bioelectron 2021; 192:113504. [PMID: 34298498 DOI: 10.1016/j.bios.2021.113504] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 12/24/2022]
Abstract
Although urinary exosomal microRNAs (miRNAs) have recently emerged as potential biomarkers, clinical applications are still limited due to their low concentration in small volumes of clinical samples. Therefore, the development of a non-invasive, specific diagnostic tool, along with profiling exosomal miRNA markers from urine, remains a significant challenge. Here, we present hydrogel-based hybridization chain reaction (HCR) for multiplex signal amplification to detect urinary exosomal miRNAs from human clinical samples. We succeeded in identifying small amounts (~amol) of exosomal miRNAs from 600 μL of urine with up to ~35-fold amplification and enhanced detection limits by over an order of magnitude for two miRNA biomarker candidates, hsa-miR-6090 and hsa-miR-3665. Furthermore, we proposed ratiometric analysis without requiring normalization to a reference miRNA and validated the clinical diagnostic potential toward differentiating prostate cancer patients from healthy controls. Our hydrogel-based HCR could serve as a new diagnostic platform for a non-invasive liquid biopsy before burdensome tissue biopsy of various diseases, including prostate cancer screening, complementing the PSA test.
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Affiliation(s)
- Junbeom Kim
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, South Korea; Department of Chemical and Biological Engineering, Korea University, Seoul, 02841, South Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, 02841, South Korea
| | - Bo Hoon Han
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, South Korea; School of Mechanical Engineering, Korea University, Seoul, 02841, South Korea
| | - Hye Jin Kim
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, Kyung Hee University, Seoul, 02447, South Korea
| | - Jaesung Park
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea; School of Interdisciplinary Bioscience and Bioengineering. Pohang University of Science and Technology (POSTECH), Pohang, 37673, South Korea
| | - Il-Joo Cho
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, South Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, South Korea; School of Electrical and Electronics Engineering, Yonsei University, Seoul, 03722, South Korea; Yonsei-KIST Convergence Research Institute, Yonsei University, Seoul, 03722, South Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, 02841, South Korea
| | - Ji Yoon Kang
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, South Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, South Korea
| | - Ki Wan Bong
- Department of Chemical and Biological Engineering, Korea University, Seoul, 02841, South Korea.
| | - Nakwon Choi
- Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, 02792, South Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, South Korea; KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul, 02841, South Korea.
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11
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Shim JS, Noh TI, Ku JH, Lee S, Kwon TG, Kim TH, Jeon SH, Lee SH, Nam JK, Kim WS, Jeong BC, Lee JY, Hong SH, Rha KH, Han WK, Ham WS, Lee YG, Lee YS, Park SY, Yoon YE, Kang SG, Oh JJ, Kang SH. Effect of intraoperative fluid volume on postoperative ileus after robot-assisted radical cystectomy. Sci Rep 2021; 11:10522. [PMID: 34006918 PMCID: PMC8131600 DOI: 10.1038/s41598-021-89806-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/29/2021] [Indexed: 01/15/2023] Open
Abstract
This study aimed to investigate the effect of intraoperative fluid volume on the postoperative ileus (POI) recovery period. A retrospective review of the Korean robot-assisted radical cystectomy database identified 718 patients who underwent robot-assisted radical cystectomy (RARC). Regression analyses were performed to identify the associations between the amount of intraoperative fluid administration (crystalloid/colloid/total), POI period (time to flatus/bowel movements), and length of hospital stay (LOS) after adjusting for covariates. In addition, we analyzed the risk factors for gastrointestinal complications and prolonged POI using a logistic regression model. An increasing volume of the administered crystalloid/total fluid was associated with prolonged POI (crystalloid R2 = 0.0725 and P < 0.0001; total amount R2 = 0.0812 and P < 0.0001), and the total fluid volume was positively associated with the LOS (R2 = 0.099 and P < 0.0001). The crystalloid amount was a risk factor for prolonged POI (P < 0.001; odds ratio, 1.361; 95% confidence interval, 1.133–1.641; P < 0.001). In the context of RARC, increased intravenous fluids are associated with prolonged POI and longer LOS.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Tae Il Noh
- Department of Urology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Sangchul Lee
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Tae-Hwan Kim
- Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung Hyun Jeon
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang Hyup Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jong Kil Nam
- Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Wan Seok Kim
- Department of Urology, College of Medicine, Busan Paik Hospital, Inje University, Busan, Korea
| | - Byong Chang Jeong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Sung Hoo Hong
- Department of Urology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Koon Ho Rha
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Woong Kyu Han
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Sik Ham
- Department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Goo Lee
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Korea
| | - Yong Seong Lee
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sung Yul Park
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Eun Yoon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Jong Jin Oh
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea. .,Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
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12
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Ahn ST, Shim JS, Bae WJ, Kim SW, Kim JJ, Moon DG. Efficacy and Safety of Penile Girth Enhancement Using Hyaluronic Acid Filler and the Clinical Impact on Ejaculation: A Multi-Center, Patient/Evaluator-Blinded, Randomized Active-Controlled Trial. World J Mens Health 2021; 40:299-307. [PMID: 33988002 PMCID: PMC8987147 DOI: 10.5534/wjmh.210007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose We aimed to evaluate the efficacy and safety of penile girth enhancement (PGE) using hyaluronic acid (HA) filler with different physical properties from previous studies. Additionally, we evaluated the clinical impact on ejaculation after PGE. Materials and Methods This was a prospective, patient/evaluator-blinded, randomized, active-controlled, multicenter trial. Patients recruited between December 2017 and March 2018 were randomly assigned to the HA filler or control group (polylactic acid [PLA] filler). Penile girth, satisfaction level, Premature Ejaculation Profile (PEP), and self-estimated intravaginal ejaculation latency time (IELT) were assessed at baseline and at 24 weeks post-injection. Results Sixty-four subjects (32 in each group) completed the trial. The mean increase in girth was 22.74±12.60 mm and 20.23±8.73 mm in the HA and control groups, respectively. Satisfaction level regarding penile appearance and sexual life significantly increased in both groups. There was no statistically significant difference between the groups in terms of increase in penile girth or change in satisfaction level. Both groups showed significant improvements in PEP index scores. Self-estimated IELT also significantly increased in the HA group (from 5.36±3.51 to 7.86±4.73 minutes, p=0.0001) and control group (from 5.23±3.55 to 6.43±4.22 minutes, p=0.021). No serious adverse events (AEs) were reported. Conclusions PGE with HA and PLA fillers resulted in significant enhancement of girth without serious AEs with no significant differences. Furthermore, PGE using filler improved clinical symptoms related to ejaculation.
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Affiliation(s)
- Sun Tae Ahn
- Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Woong Jin Bae
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Je Jong Kim
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
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13
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Kim S, Park S, Cho YS, Kim Y, Tae JH, No TI, Shim JS, Jeong Y, Kang SH, Lee KH. Electrical Cartridge Sensor Enables Reliable and Direct Identification of MicroRNAs in Urine of Patients. ACS Sens 2021; 6:833-841. [PMID: 33284011 DOI: 10.1021/acssensors.0c01870] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Urinary miRNAs are biomarkers that demonstrate considerable promise for the noninvasive diagnosis and prognosis of diseases. However, because of background noise resulting from complex physiological features of urine, instability of miRNAs, and their low concentration, accurate monitoring of miRNAs in urine is challenging. To address these limitations, we developed a urine-based disposable and switchable electrical sensor that enables reliable and direct identification of miRNAs in patient urine. The proposed sensing platform combining disposable sensor chips composed of a reduced graphene oxide nanosheet and peptide nucleic acid facilitates the label-free detection of urinary miRNAs with high specificity and sensitivity. Using real-time detection of miRNAs in patient urine without pretreatment or signal amplification, this sensor allows rapid, direct detection of target miRNAs in a broad dynamic range with a detection limit down to 10 fM in human urine specimens within 20 min and enables simultaneous quantification of multiple miRNAs. As confirmed using a blind comparison with the results of pathological examination of patients with prostate cancer, the sensor offers the potential to improve the accuracy of early diagnosis before a biopsy is taken. This study holds the usefulness of the practical sensor for the clinical diagnosis of urological diseases.
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Affiliation(s)
- Seongchan Kim
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
| | - Sungwook Park
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
| | - Young Soo Cho
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
| | - Younghoon Kim
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
| | - Jong Hyun Tae
- Department of Urology, Korea University, School of Medicine, Seoul 02841, Republic of Korea
| | - Tae Il No
- Department of Urology, Korea University, School of Medicine, Seoul 02841, Republic of Korea
| | - Ji Sung Shim
- Department of Urology, Korea University, School of Medicine, Seoul 02841, Republic of Korea
| | - Youngdo Jeong
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
- Department of HY-KIST Bio-convergence, Hanyang University, Seoul 04763, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University, School of Medicine, Seoul 02841, Republic of Korea
| | - Kwan Hyi Lee
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Seoul 02792, Republic of Korea
- KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul 02841, Republic of Korea
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14
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Noh TI, Hyun CW, Kang HE, Jin HJ, Tae JH, Shim JS, Kang SG, Sung DJ, Cheon J, Lee JG, Kang SH. A Predictive Model Based on Bi-parametric Magnetic Resonance Imaging and Clinical Parameters for Clinically Significant Prostate Cancer in the Korean Population. Cancer Res Treat 2021; 53:1148-1155. [PMID: 33421975 PMCID: PMC8524004 DOI: 10.4143/crt.2020.1068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/31/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study aimed to develop and validate a predictive model for the assessment of clinically significant prostate cancer (csPCa) in men, prior to prostate biopsies, based on bi-parametric magnetic resonance imaging (bpMRI) and clinical parameters. Materials and Methods We retrospectively analyzed 300 men with clinical suspicion of prostate cancer (prostate-specific antigen [PSA] ≥ 4.0 ng/mL and/or abnormal findings in a digital rectal examination), who underwent bpMRI-ultrasound fusion transperineal targeted and systematic biopsies in the same session, at a Korean university hospital. Predictive models, based on Prostate Imaging Reporting and Data Systems scores of bpMRI and clinical parameters, were developed to detect csPCa (intermediate/high grade [Gleason score ≥ 3+4]) and compared by analyzing the areas under the curves and decision curves. RESULTS A predictive model defined by the combination of bpMRI and clinical parameters (age, PSA density) showed high discriminatory power (area under the curve, 0.861) and resulted in a significant net benefit on decision curve analysis. Applying a probability threshold of 7.5%, 21.6% of men could avoid unnecessary prostate biopsy, while only 1.0% of significant prostate cancers were missed. CONCLUSION This predictive model provided a reliable and measurable means of risk stratification of csPCa, with high discriminatory power and great net benefit. It could be a useful tool for clinical decision-making prior to prostate biopsies.
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Affiliation(s)
- Tae Il Noh
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang Wan Hyun
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ha Eun Kang
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyun Jung Jin
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong Hyun Tae
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Deuk Jae Sung
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.,Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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15
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Noh TI, Tae JH, Kim HK, Shim JS, Kang SG, Sung DJ, Cheon J, Lee JG, Kang SH. Diagnostic Accuracy and Value of Magnetic Resonance Imaging-Ultrasound Fusion Transperineal Targeted and Template Systematic Prostate Biopsy Based on Bi-parametric Magnetic Resonance Imaging. Cancer Res Treat 2020; 52:714-721. [PMID: 32054151 PMCID: PMC7373864 DOI: 10.4143/crt.2019.716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/05/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose The purpose of this study was to investigate the diagnostic value of magnetic resonance imaging (MRI)–ultrasound (US) fusion transperineal targeted biopsy (FTB) and fusion template systematic biopsy (FSB) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) (intermediate/high grade [Gleason score ≥ 3+4]) based on bi-parametric MRI (bpMRI). Materials and methods Retrospectively, we analyzed 300 patients with elevated prostate-specific antigen (≥ 4.0 ng/mL) and/or abnormal findings in a digital rectal examination at the Korea University Hospital. All 300 men underwent bpMRI-US fusion transperineal FTB and FSB in the period from April 2017 to March 2019. Results PCas were detected in 158 of 300 men (52.7%), and the prevalence of csPCa was 34.0%. CsPCas were detected in 12 of 102 (11.8%) with Prostate Imaging-Reporting and Data System (PI-RADS) 3, 42 of 92 (45.7%) with PI-RADS 4, respectively; and 45 of 62 (72.6%) men with PI-RADS 5, respectively. BpMRI showed a sensitivity of 95.1% and negative predictive value of 89.6% for csPCa. FTB detected additional csPCa in 33 men (12.9%) compared to FSB. Compared to FTB, FSB detected additional csPCa in 10 men (3.9%). Conclusion BpMRI-US FTB and FSB improved detection of PCa and csPCa. The accuracy of bi-parametric MRI is comparable with that of multi-parametric MRI. Further, it is rapid, simpler, cheaper, and no side effects of contrast media. Therefore, it is expected that bpMRI-US transperineal FTB and FSB could be a good alternative to conventional US-guided transrectal biopsy, which is the current gold standard.
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Affiliation(s)
- Tae Il Noh
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Jong Hyun Tae
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Hyung Keun Kim
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Deuk Jae Sung
- Department of Urology, Korea University School of Medicine, Seoul, Korea.,Department of Radiology, Korea University School of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University School of Medicine, Seoul, Korea
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16
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Kang SG, Shim JS, Onol F, Bhat KRS, Patel VR. Lessons learned from 12,000 robotic radical prostatectomies: Is the journey as important as the outcome? Investig Clin Urol 2020; 61:1-10. [PMID: 31942457 PMCID: PMC6946819 DOI: 10.4111/icu.2020.61.1.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/19/2019] [Indexed: 01/15/2023] Open
Abstract
Robotic radical prostatectomy (RARP) is a standardized treatment for localized prostate cancer, which provides better functional outcomes and similar oncological outcomes compared to open approaches. Here, we share our experience of 12,000 RARPs by describing the outcomes of the procedure in terms of positive surgical margin (PSM), continence, and potency as well as by presenting our detailed surgical technique with recent modifications. On cancer control, the PSM rates were 5.8% and 26.1% in T2 and T3, respectively. On the premise of not compromising oncologic outcomes, a tailored approach to individual patients is essential. Even if an extracapsular extension is suspected, neurovascular bundle (NVB) tailoring can be applied using an anatomical landmark to preserve maximal nerve tissue with a negative margin. We developed a nomogram as a useful tool for deciding the degree of tailoring. For improvements of functional outcomes, we used athermal retrograde early release with a toggling technique, wherein the nerve dissection from the bottom helps with blood loss and allows for smooth NVB releasing. Additionally, we recently performed a new minimal apical dissection/lateral prostatic fascia preservation technique. As a result, our 1-week continence rate was 37% and the 6-week rate was 77.6%. In addition, the potency rates in our study were 69%, 82%, and 92% at 3 months, 6 months, and 1 year, respectively (preoperative Sexual Health Inventory for Men scores >21 & bilateral full nerve spared).
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Affiliation(s)
- Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Fikret Onol
- Global Robotics Institute, Florida Hospital Celebration Health, University of Central Florida School of Medicine, Orlando, FL, USA
| | - K R Seetharam Bhat
- Global Robotics Institute, Florida Hospital Celebration Health, University of Central Florida School of Medicine, Orlando, FL, USA
| | - Vipul R Patel
- Global Robotics Institute, Florida Hospital Celebration Health, University of Central Florida School of Medicine, Orlando, FL, USA
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17
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Shim JS, Kwon TG, Rha KH, Lee YG, Lee JY, Jeong BC, Pyun JH, Kang SG, Kang SH. Do patients benefit from total intracorporeal robotic radical cystectomy?: A comparative analysis with extracorporeal robotic radical cystectomy from a Korean multicenter study. Investig Clin Urol 2019; 61:11-18. [PMID: 31942458 PMCID: PMC6946824 DOI: 10.4111/icu.2020.61.1.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/06/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose This study aimed to compare complications, perioperative parameters, and oncologic outcomes between robot-assisted radical cystectomy (RARC) with extracorporeal urinary diversion (ECUD) and RARC with intracorporeal urinary diversion (ICUD). Materials and Methods Between 2007 and 2017, 362 patients who underwent RARC with ECUD or ICUD at multiple tertiary referral institutions were assessed. The primary endpoints were complication rates. The secondary outcomes were perioperative recovery parameters and oncological outcomes including estimated recurrence-free survival (RFS) and recurrence pattern between the 2 groups. Additionally, the complication rates of 2 expert surgeons with experience of >100 RARCs were analyzed. Results The ICUD group showed lower overall, gastrointestinal, and genitourinary complications (p=0.001, p=0.036, and p=0.036, respectively) than the ECUD group. Concerning perioperative outcomes, the ICUD group had a significantly longer operation time (p=0.002), although recovery parameters such as time to flatus passage, oral intake, and length of hospital stay were significantly shorter in this group (p=0.001, p<0.001, and p<0.001, respectively). There was no difference in oncologic outcomes such as positive margin rate (p=0.944) and 2-year RFS (p=0.496), and in the recurrence pattern between groups. In the comparison of the expert surgeons' complication rates, the major and total complication rates did not show differences (p=0.814 and p=0.102, respectively) while the minor complication rates were lower in the ICUD group (p=0.058). Conclusions This multi-institutional cohort study demonstrated the benefits of the ICUD approach, as indicated by lower complication rates and better recovery parameters, although the oncological results were similar to those of ECUD.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea
| | - Koon Ho Rha
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Goo Lee
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Korea
| | - Ji Youl Lee
- Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byong Chang Jeong
- Department of Urology, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jong Hyun Pyun
- Department of Urology, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
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18
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Tae JH, Pyun JH, Shim JS, Cho S, Kang SG, Ko YH, Cheon J, Lee JG, Kang SH. Oncological and functional outcomes of robot-assisted radical cystectomy in bladder cancer patients in a single tertiary center: Can these be preserved throughout the learning curve? Investig Clin Urol 2019; 60:463-471. [PMID: 31692995 PMCID: PMC6821988 DOI: 10.4111/icu.2019.60.6.463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/04/2019] [Indexed: 11/28/2022] Open
Abstract
Purpose To evaluate the overall and segmental oncological and functional outcome of robot-assisted radical cystectomy (RARC) during the learning curve. Materials and Methods From August 2007 to November 2017, a total of 120 bladder cancer patients were treated with RARC in a single-tertiary hospital. These were divided into three groups of 40 consecutive cases. Overall and subgroup analysis of each group was used to evaluate oncological and functional outcomes throughout the learning curve. Results Among the 120 RARC cases, 42, 73, and 5 patients received extracorporeal urinary diversion (ECUD), intracorporeal urinary diversion (ICUD), and ureterocutaneostomy, respectively. There was a transition from ECUD to ICUD during the learning curve. The positive surgical margin rate was 0.8%. The mean lymph node yield for the standard and extended pelvic lymph node dissection was 12.5 and 30.1, respectively, and increased to 19.8 and 31.2 and further to 20.0 and 37.9, respectively, with each additional series of 40 cases. The 5-year overall survival and 3-year recurrence-free survival rates were 86.6% and 81.4%, respectively. The 1-year daytime continence rate was 75.7%, while the nighttime continence rate was 51.4%. The potency preservation rate was 66.7% (n=8) with or without phosphodiesterase-5 inhibitors (PDE5-I) at 1 year and 33.3% without PDE5-I (n=4). Conclusions RARC results in comparable oncological and functional outcomes to open radical cystectomy. In addition, the oncological and functional outcomes were well maintained throughout the learning curve. ECUD transition to ICUD was safe and did not compromise oncological or functional outcome.
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Affiliation(s)
- Jong Hyun Tae
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Jong Hyun Pyun
- Department of Urology, Kangbuk Samsung Hospital, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Seok Cho
- Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Young Hwii Ko
- Department of Urology, Yeungnam University College of Medicine, Daegu, Korea
| | - Jun Cheon
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
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Kim JH, Shim JS, Kim JW, Doo SW, Bae JH, Lee JH, Song YS, Kim JJ, Moon DG. Molecular and Histologic Evidence of Novel Erectile Dysfunction Rat Model as an Aging Atherosclerosis Model: A Preliminary Study. World J Mens Health 2019; 38:345-352. [PMID: 31385467 PMCID: PMC7308229 DOI: 10.5534/wjmh.190031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/28/2019] [Accepted: 05/07/2019] [Indexed: 11/15/2022] Open
Abstract
Purpose To validate a novel arteriogenic erectile dysfunction (ED) model with atherosclerosis (AS) based on molecular and histologic evidence induced by chronic pelvic ischemia (CPI) and determine effect of phosphodiesterase-5 inhibitor treatment. Materials and Methods Twenty 16-week-old male Sprague–Dawley rats were divided into three experimental groups (Group I, untreated sham-operated rats with regular diet; Group II, CPI with cholesterol diet; Group III, CPI model with cholesterol diet and mirodenafil). Erectile function was accessed using maximum intracavernous pressure (ICP) and ICP/mean arterial pressure (MAP). Molecular changes were examined by western blot analysis using hypoxia inducible factor 1-alpha (HIF-1α), endothelial nitric oxide synthase (eNOS), and transforming growth factor beta-1 (TGF-β1) antibodies. Collagen change was evaluated by Masson's trichrome staining. Results In vivo measurements of ICP and ICP/MAP in Group II were significantly lower than those in Group I (p<0.01). Smooth muscle/collagen ratio in Group II was significantly lower than that in Group I (p<0.05). After treatment with mirodenafil for four weeks, Group III showed significantly higher levels of ICP and ICP/MAP than Group II (p<0.05). Western blot analysis showed that HIF-1α and TGF-β1 levels were significantly higher in Group II whereas eNOS levels were significantly lower in Group II than those in Group I or III. Conclusions A novel arteriogenic ED with AS model is successfully induced by CPI and validated based on molecular and histologic evidences.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jong Wook Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seung Whan Doo
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ju Han Lee
- Department of Pathology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yun Seob Song
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Je Jong Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea.
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Park HS, Shin HB, Woo SH, Jeon SH, Lee SH, Kang SH, Shim JS, Shin DW, Park J. Combined androgen blockade (CAB) versus luteinizing hormone-releasing hormone (LHRH) agonist monotherapy for androgen deprivation therapy. World J Urol 2019; 38:971-979. [PMID: 31187203 DOI: 10.1007/s00345-019-02847-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/06/2019] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Combined androgen blockade (CAB) and luteinizing hormone-releasing hormone (LHRH) agonist monotherapy are commonly used in androgen deprivation therapy (ADT). In this randomized clinical trial, we aimed to compare the two methods of ADT in terms of quality of life (QOL). METHODS Eighty patients who underwent primary ADT for newly diagnosed prostate cancer were randomly assigned to CAB group (Group 1) and LHRH agonist monotherapy group (Group 2). Leuprolide and anti-androgen (bicalutamide 50 mg) were used to minimize the confounding effects caused by medication. QOL was evaluated at baseline, 3 months and 6 months post-ADT using validated EORTC QLQ-C30, PR25, and depression questionnaires. A difference of > 10 points in the EORTC domain scores was defined as 'clinically significant'. RESULTS In the baseline characteristics, there was no significant difference between the two groups. At 3 months after ADT, Group 1 had significantly lower pain scores than Group 2 (p = 0.004), while Group 1 had significantly poorer diarrhea symptom score than Group 2, without clinical significance (p = 0.047). No significant differences were observed in the C30, PR25 domains, and the depression score at 3 months. At 6 months, the QOL scores of all the groups were similar. CONCLUSIONS There was no difference in the patient's QOL, except that CAB group was associated with significantly better pain relief than LHRH agonist monotherapy at 3 months following ADT, which was not sustained thereafter. Our results suggest that the benefit of prolonged (≥ 3 months) CAB is questionable in terms of patients' QOL.
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Affiliation(s)
- Hyun Sik Park
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseoro, Seo-gu, Daejeon, 35233, South Korea
| | - Hyun Bin Shin
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseoro, Seo-gu, Daejeon, 35233, South Korea
| | - Seung Hyo Woo
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseoro, Seo-gu, Daejeon, 35233, South Korea
| | - Seung Hyun Jeon
- Department of Urology, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Sang Hyub Lee
- Department of Urology, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, South Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, South Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Seoul, South Korea
| | - Jinsung Park
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, 95 Dunsanseoro, Seo-gu, Daejeon, 35233, South Korea.
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21
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Abstract
Wnts determine cell polarity, cell proliferation, and cell differentiation during embryogenesis and play an essential role during tooth development initiation and morphogenesis. Wnt/β-catenin signaling has a time-dependent role in development because various signaling molecules that mutually interact are involved in the pathway, and tight regulation of the pathway is essential for normal development. Studies investigating how the Wnt/β-catenin signaling pathway controls the different stages of tooth development are rare. Specifically, the effects of Wnt/β-catenin signaling loss of function on different stages of tooth development are currently unknown. Here, we report the stage-dependent role of Wnt/β-catenin signaling in tooth development. In vivo loss and gain of function of Wnt/β-catenin signaling were implemented through the genetic overexpression of DKK1 with heat shock-inducible transgenic models and the pharmacologic inhibition of β-catenin destruction complex formation in zebrafish, respectively. We demonstrated that transient inhibition of Wnt/β-catenin signaling interrupted tooth development in a stage-dependent manner and conditional activation of Wnt/β-catenin signaling during 4V morphogenesis inhibited the development of 3V. These findings suggest that Wnt/β-catenin signaling plays an important role in the morphogenesis of teeth and the initiation of sequential tooth development in a stage-dependent manner.
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Affiliation(s)
- J S Shim
- 1 Department of Prosthodontics, Korea University Ansan Hospital, Ansan-si, Republic of Korea
| | - B Kim
- 2 Graduate School of Medicine, Korea University, Ansan-si, Republic of Korea
| | - H C Park
- 2 Graduate School of Medicine, Korea University, Ansan-si, Republic of Korea
| | - J J Ryu
- 3 Department of Prosthodontics Korea University Anam Hospital, Seoul, Republic of Korea
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Shim JS, Kim JY, Pyun JH, Cho S, Oh MM, Kang SH, Lee JG, Kim JJ, Cheon J, Kang SG. Comparison of effective teaching methods to achieve skill acquisition using a robotic virtual reality simulator: Expert proctoring versus an educational video versus independent training. Medicine (Baltimore) 2018; 97:e13569. [PMID: 30572458 PMCID: PMC6320110 DOI: 10.1097/md.0000000000013569] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To compare the superiority of teaching methods for acquiring a proficient level of surgical skill in a robotic surgery-naïve individual using a robotic virtual reality simulator. METHODS This study employed a prospective, randomized study design to assess student's learning curve. We divided 45 subjects into 3 groups: those with expert proctoring (group I), those who watched only an educational video (group II), and those with independent training (group III; n = 15 per group). The task used in this study was the Tube 2 and it imitates a vesicourethral anastomosis in robotic prostatectomy. The effects were analyzed by the time to end the task after overcoming the learning curve which is determined by several performance parameters. RESULTS The number of task repetitions required to reach the learning curve plateau was 45, 42, and 37 repetitions in groups I, II, and III, which means that there was continuous improvement in performing the task after 40 repetitions only in groups I and II. The mean time for completing the task during the stabilization period was significantly different between group I and group III and group II and group III, which means that the independent training method was inferior to the other methods (group I vs. group II vs. group III: 187.38 vs. 187.07 vs. 253.47 seconds, P < .001). CONCLUSIONS This study's findings showed that an educational video can be as beneficial as expert proctoring, which implies that the development of a standardized educational video would be worthwhile.
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Tae JH, Shim JS, Jin HJ, Yoon SG, No TI, Kim JY, Kang SH, Cheon J, Kang SG. Initial experience of magnetic resonance imaging/ultrasonography fusion transperineal biopsy: Biopsy techniques and results for 75 patients. Investig Clin Urol 2018; 59:363-370. [PMID: 30402568 PMCID: PMC6215777 DOI: 10.4111/icu.2018.59.6.363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/19/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose The aim of this study is to describe the technique and to report early results of transperineal magnetic resonance imaging and ultrasonography (MRI-US) fusion biopsy. Materials and Methods A total of 75 patients underwent MRI-US fusion transperineal biopsy. Targeted biopsy via MRI-US fusion imaging was carried out for cancer-suspicious lesions with additional systematic biopsy. Detection rates for overall and clinically significant prostate cancer (csPCa) were evaluated and compared between systematic and targeted biopsy. In addition, further investigation into the detection rate according to prostate imaging reporting and data system (PI-RADS) score was done. Results of repeat biopsies were also evaluated. Results Overall cancer detection rate was 61.3% (46 patients) and the detection rate for csPCa was 42.7% (32 patients). Overall detection rates for systematic and targeted biopsy were 41.3% and 57.3% (p<0.05), respectively. Detection rates for csPCa were 26.7% and 41.3%, respectively (p<0.05). The cancer detection rates via MRI fusion target biopsy were 30.8% in PI-RADS 3, 62.1% in PI-RADS 4 and 89.4% in PI-RADS 5. Rates of csPCa missed by targeted biopsy and systematic biopsy were 0.0% and 25.0%, respectively. The cancer detection rate in repeat biopsies was 61.1% (11 among 18 patients) in which 55.5% of cancer suspected lesions were located in the anterior portion. Conclusions Transperineal MRI-US fusion biopsy is useful for improving overall cancer detection rate and especially detection of csPCa. Transperineal MRI-US targeted biopsy show potential benefits to improve cancer detection rate in patients with high PI-RADS score, tumor located at the anterior portion and in repeat biopsies.
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Affiliation(s)
- Jong Hyun Tae
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Hyun Jung Jin
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Sung Goo Yoon
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Tae Il No
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Jae Yoon Kim
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Medical Center, Korea University School of Medicine, Seoul, Korea
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Kim JH, Shim JS, Choi H, Park JY, Kwon SS, Bae JH. Who are suitable for low-dose tamsulosin monotherapy as initial treatment strategy in male patients with lower urinary tract symptoms? Medicine (Baltimore) 2018; 97:e12354. [PMID: 30383623 PMCID: PMC6221650 DOI: 10.1097/md.0000000000012354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study aims to investigate the real indications for low-dose tamsulosin monotherapy for initial treatment.A cross-sectional study was conducted in a total of 1643 patients with lower urinary tract symptoms (LUTS) and with initial low-dose tamsulosin. Initial pretreatment data including the International Prostate Symptoms Score (IPSS), prostate volume, and uroflowmetry data were reviewed. After 8 weeks of treatment, post-treatment IPSS and satisfaction was assessed. Logistic regression analysis was conducted to investigate the pretreatment factors influencing post-treatment satisfaction.Overall satisfaction rate with low-dose tamsulosin as an initial treatment medication was 88.7%. Multivariate analysis revealed that symptom durations, IPSS voiding score, IPSS storage score, and quality of life (QoL) were determinant factors for patient satisfaction. ROC analysis revealed that a urinary score > 10 and symptom duration > 3 years showed satisfaction with a sensitivity of 85.8% and 90.6%, respectively, and specificity of 43.5% and 39.8%, respectively. Whereas, ROC analysis revealed that a storage score > 5 and QoL > 3 showed nonsatisfaction with sensitivity of 84.2% and 39.5%, respectively, and specificity of 43.5% and 45.7%, respectively. Multivariate regression analysis demonstrated that voiding score and storage score had a significant relationship with QoL (unstandardized coefficients: 0.073, 0.145, respectively; P-value: < .001, < .001, respectively).The patient with higher storage scores and higher QoL before treatment could have a higher change of non-satisfaction. Combining treatment with anticholinergics could be considered in these patients.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul
| | - Ji Sung Shim
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan
| | - Hoon Choi
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan
| | - Jae Young Park
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan
| | - Soon-Sun Kwon
- Department of Mathematics, College of Natural Science, Ajou University, Suwon, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan
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Shim JS, Seo HK, Ku JH, Jeong BC, Hong B, Kang SH. Oncologic, Perioperative Outcomes of Female Radical Cystectomy: Results from a Multicenter Study in Korea. Cancer Res Treat 2018; 51:1064-1072. [PMID: 30376708 PMCID: PMC6639238 DOI: 10.4143/crt.2018.515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 10/29/2018] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions. MATERIALS AND METHODS This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral periodwith consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method. RESULTS The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20% of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91% of patients underwent open RC; 80% of patients underwent an ileal conduit; and 83% of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recen-tly. CONCLUSION We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University School of Medicine, Seoul, Korea
| | - Ho Kyung Seo
- Department of Urology, National Cancer Center, Goyang, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University School of Medicine, Seoul, Korea
| | - Byong Chang Jeong
- Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bumsik Hong
- Department of Urology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University School of Medicine, Seoul, Korea
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26
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Shim JS, Noh TI, Kim JY, Pyun JH, Cho S, Oh MM, Kang SH, Cheon J, Lee JG, Kim JJ, Kang SG. Predictive Validation of a Robotic Virtual Reality Simulator: The Tube 3 module for Practicing Vesicourethral Anastomosis in Robot-Assisted Radical Prostatectomy. Urology 2018; 122:32-36. [PMID: 30144481 DOI: 10.1016/j.urology.2018.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To predict actual performance in real surgery when vesicourethral anastomosis (VUA) is performed in patients after Tube 3 module training of robot-naive surgeons. METHODS Forty-five patients were enrolled and divided into 3 groups according to chronological trends (each containing 15 patients). Three robot-naive surgeons in a single center completed VUA in robot-assisted radical prostatectomy (RARP) following robotic virtual reality simulator (RVRS) training. The practicing tool used in robotic virtual reality simulator was Tube 3, which was invented for the dV-Trainer that imitates a VUA in RARP. The effects of performance were investigated by analyzing the number of repetitions and the time required to complete the task until achieving the predetermined proficiency level. RESULTS The targeted time (predetermined proficiency level) for completing tasks of Tube 3 and the number of required task repetitions to achieve the proficiency level were 283.1 s and 36 times, respectively, whereas in actual VUA procedures, the number of required attempts was 24, with an average time of 14.9 minutes. The mean time for completing VUA in real surgery significantly decreased with serial cases among all surgeons (1-15 vs 16-30 vs 31-45 cases, P <.001), as well as comparisons between groups (P <.001). CONCLUSION The Tube 3 module can represent a valuable educational tool for procedure-specific robotic training by bridging the gap between safe acquisition of surgical skills and effective performance during actual VUA in RARP.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Tae Il Noh
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jae Yoon Kim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jong Hyun Pyun
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Seok Cho
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Mi Mi Oh
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jun Cheon
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Je Jong Kim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea.
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Shim JS, Han SH, Jha N, Hwang ST, Ahn W, Lee JY, Ryu JJ. Effect of Irradiance and Exposure Duration on Temperature and Degree of Conversion of Dual-Cure Resin Cement for Ceramic Restorations. Oper Dent 2018; 43:E280-E287. [PMID: 30106334 DOI: 10.2341/17-283-l] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the effects of irradiance and exposure duration on dual-cured resin cements irradiated through ceramic restorative materials. A single light-curing unit was calibrated to three different irradiances (500, 1000, and 1500 mW/cm2) and irradiated to three different attenuating materials (transparent acryl, lithium disilicate, zirconia) with 1-mm thicknesses for 20 or 60 seconds. The changes in irradiance and temperature were measured with a radiometer (or digital thermometer) under the attenuating materials. The degree of conversion (DC) of dual-cure resin cement after irradiation at different irradiances and exposure durations was measured with Fourier transform near infrared spectroscopy. Two-way analysis of variance revealed that irradiance ( p<0.001) and exposure duration ( p<0.001) significantly affected temperature and DC. All groups showed higher DCs with increased exposure times ( p<0.05), but there were no statistically significant differences between the groups irradiated with 1000 mW/cm2 and 1500 mW/cm2 ( p>0.05). Higher-intensity irradiances yielded higher temperatures ( p<0.05), but exposure time did not affect temperature when materials were irradiated at 500 mW/cm2 ( p>0.05).
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Kim SB, Yoon SG, Tae J, Kim JY, Shim JS, Kang SG, Cheon J, Lee JG, Kim JJ, Kang SH. Detection and recurrence rate of transurethral resection of bladder tumors by narrow-band imaging: Prospective, randomized comparison with white light cystoscopy. Investig Clin Urol 2018. [PMID: 29520385 PMCID: PMC5840124 DOI: 10.4111/icu.2018.59.2.98] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the efficacy of narrow-band imaging (NBI) as a diagnostic tool for detecting bladder tumors during cystoscopy compared with white light cystoscopy (WLC). Materials and Methods From December 2013 to June 2017, a randomized prospective study was conducted on 198 patients underwent transurethral resection of bladder tumor by a single surgeon. The patients were divided into two groups according to diagnostic method. In Group I, WLC only was performed. In Group II, NBI was additionally performed after WLC. We analyzed the rate of detection of bladder tumors as a primary endpoint. In addition, we evaluated rates of recurrence in each group. Results There were no significant differences between the two groups in characteristics except hypertension. In the analysis of rates of detection, the probability of diagnosing cancer was 80.9% (114/141) in the WLC group, and the probability of diagnosing cancer using WLC in the NBI group was 85.5% (159/186). After switching from WLC to NBI for second-look cystoscopy in the NBI group, NBI was shown to detect additional tumors with a detection rate of 35.1% (13/37) from the perspective of the patients and 42.2% (27/64) from the perspective of the tumors. The 1-year recurrence-free rate was 72.2% in the WLC group and 85.2% in the NBI group (p=0.3). Conclusions NBI had benefits for detecting tumors overlooked by WLC. Although the difference in the 1-year recurrence-free rate was not statistically significant, our results showed a trend for higher recurrence in the NBI group.
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Affiliation(s)
- Seung Bin Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Sung Goo Yoon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jonghyun Tae
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jae Yoon Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Je Jong Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
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Burton JP, Chanyi RM, Cho JY, Cho KS, Cho MC, Cho YH, Choo MS, Choo SH, Chun FKH, Dancik GM, Dewar M, Fisch M, Ha HK, Ha YS, Hong JH, Hong SH, Hwang EC, Izawa J, Jeon BH, Jeon SH, Jeong BC, Jeong CW, Jeong H, Jung SI, Kang HW, Kang M, Kang SH, Kang SG, Keam B, Kim HS, Kim JH, Kim JH, Kim S, Kim SI, Kim SH, Kim TH, Kim YA, Kluth LA, Ko K, Kwon WA, Lee JW, Lee JY, Lee OJ, Lee RJ, Lee SW, Li F, Lim JS, Liu Y, López de Maturana E, Malats N, Min GE, Moon KC, Oh JJ, Paick S, Park JY, Park JH, Park J, Park SK, Pyun JH, Reid G, Schüttfort VM, Seo HK, Shim JS, Shin JH, Theodorescu D, Woo S, Yang WJ, Yun SJ. List of Contributors. Bladder Cancer 2018. [DOI: 10.1016/b978-0-12-809939-1.00041-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shim JS, Kwon TG, Rha KH, Lee YG, Lee JY, Jeong BC, Kim JY, Pyun JH, Kang SG, Kang SH. Oncologic Outcomes and Predictive Factors for Recurrence Following Robot-Assisted Radical Cystectomy for Urothelial Carcinoma: Multicenter Study from Korea. J Korean Med Sci 2017; 32:1662-1668. [PMID: 28875611 PMCID: PMC5592181 DOI: 10.3346/jkms.2017.32.10.1662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/01/2017] [Indexed: 11/24/2022] Open
Abstract
The aim of our study was to evaluate intermediate-term oncologic outcomes, predictive factors for recurrence, and recurrence patterns in a multicenter series of patients treated with robot-assisted radical cystectomy (RARC) for urothelial carcinoma (UC) of the bladder. Between 2007 and 2015, 346 patients underwent RARC at multiple tertiary referral centers in Korea. Descriptive statistics were used for demographics and perioperative variables. Survival and recurrence were estimated with Kaplan-Meier analysis. Logistic regression models were used to determine predictors of recurrence. Median follow-up was 33 months (interquartile range [IQR], 7-50). The numbers of patients with organ-confined and lymph node (LN)-positive disease were 237 (68.4%) and 68 (19.7%), respectively. LN density (1-20 vs. > 20) was 13.6% and 6.1%, with a median of 17 nodes removed (IQR, 9-23). In logistic regression analysis, type of LN dissection, and pathologic tumor stage were significant predictors of cancer recurrence and death from cancer. Local, distal recurrence and secondary UC occurred in 7 (2.0%), 53 (15.3%), and 4 (1.2%) patients, respectively. The 5-year overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were 78%, 84%, and 73%, respectively. At last follow-up, RFS for extended pelvic LN dissection vs. standard pelvic LN dissection was 70% and 47% (P = 0.038). In addition, at last follow-up, LN density (0 vs. 1-20 vs. over 20) was 67%, 41%, and 29%, respectively (P < 0.001). Patients undergoing RARC in this multi-institutional cohort demonstrated intermediate-term oncologic outcomes, predictive factors for recurrence, and recurrence patterns that were not unusual.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Tae Gyun Kwon
- Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea
| | - Koon Ho Rha
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Goo Lee
- Department of Urology, Hallym University College of Medicine, Chuncheon, Korea
| | - Ji Youl Lee
- Department of Urology, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Byong Chang Jeong
- Department of Urology, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jae Yoon Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jong Hyun Pyun
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Korea.
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Shim JS, Chae JY, Kang SG, Park JY, Bae JH, Kang SH, Park HS, Moon DG, Cheon J, Lee JG, Kim JJ, Oh MM. Can Listening to Music Decrease Pain, Anxiety, and Stress During a Urodynamic Study? A Randomized Prospective Trial Focusing on Gender Differences. Urology 2017; 104:59-63. [PMID: 28257916 DOI: 10.1016/j.urology.2017.02.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/18/2017] [Accepted: 02/22/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effect of listening to music on pain, anxiety, or stress during a urodynamic study (UDS). MATERIALS AND METHODS A total of 74 female and 74 male patients who underwent UDS between March 2013 and October 2013 were prospectively randomized. The patients were divided into 2 groups according to gender (female, n = 74 vs male, n = 74) and into 2 subgroups according to whether they listened to music or not. Music group subjects played their preferred music during UDS. Before and after UDS, all subjects completed the State-Trait Anxiety Inventory (STAI) form and their degree of pain, anxiety, and satisfaction during examination were assessed by the visual analog scale (VAS, 0-10). Basic vital signs were also checked before and after the procedure. RESULTS In the analysis of anxiety, pain, and stress scores, the mean shame, discomfort, and satisfaction scores (VAS) were significantly higher in female patients, whereas the mean score of willingness to retry the procedure was higher in male patients whether listening to music or not (P < .001). In the analysis of differences of STAI total, state anxiety, and trait anxiety, there were no statistical significances between the music group and the no-music group in either gender. CONCLUSION In our study, music during UDS did not reduce anxiety, pain, and stress in either gender. In the analysis focusing on gender difference, female patients showed statistically higher levels of pain, anxiety, and stress scores than male patients whether listening to music or not.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Yun Chae
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Gu Kang
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae Young Park
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hong Seok Park
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jun Cheon
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Je Jong Kim
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Mi Mi Oh
- Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea.
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Abstract
There has been no study reporting on the influence of sleep deprivation on the male reproductive system including sperm quality. In this study, we hypothesized that sleep deprivation could lead to adverse effect on the male reproductive system. The rats were divided into three groups: 1) control (home-cage, n = 10); 2) SD4 (sleep deprivation for 4 days, n = 10); and 3) SD7 (sleep deprivation for 7 days, n = 10). Sleep deprivation was performed by a modified multiple platform method. Sperm quality (sperm motion parameters and counts), hormone levels (corticosterone and testosterone), and the histopathology of testis were evaluated and compared between the three groups. A statistically significant reduction (P = 0.018) was observed in sperm motility in the SD7 group compared to those of the control group. However, there were no significant differences in other sperm motion parameters, or in sperm counts of the testis and cauda epididymis between three groups. Compared with the control group, the SD4 (P = 0.033) and SD7 (P = 0.002) groups exhibited significant increases of corticosterone levels, but significant decreases of testosterone levels were found in the SD4 (P = 0.001) and SD7 (P < 0.001) groups. Seminiferous tubular atrophy and/or spermatid retention was partially observed in the SD4 and SD7 groups, compared with the normal histopathology of the control group. Sleep deprivation may have an adverse effect on the male reproductive system in rats.
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Affiliation(s)
- Ji Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea
| | - Seung Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Hong Seok Park
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Young Sik Kim
- Department of Pathology, Korea University College of Medicine, Seoul, Korea
| | - Chol Shin
- Department of Respiratory Internal Medicine, Korea University College of Medicine, Seoul, Korea.
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Shim JS, Kang SG, Park JY, Bae JH, Kang SH, Park HS, Moon DG, Cheon J, Lee JG, Kim JJ, Oh MM. Differences in Urodynamic Parameters Between Women With Interstitial Cystitis and/or Bladder Pain Syndrome and Severe Overactive Bladder. Urology 2016; 94:64-9. [PMID: 27130264 DOI: 10.1016/j.urology.2016.04.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Sung Gu Kang
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jae Young Park
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Hong Seok Park
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Du Geon Moon
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jun Cheon
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Je Jong Kim
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea
| | - Mi Mi Oh
- Department of Urology, Korea University Medical Center, Seoul, Republic of Korea.
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Shim JS, Kim DH, Bae JH, Moon DG. Effects of Omega-3 Fatty Acids on Erectile Dysfunction in a Rat Model of Atherosclerosis-induced Chronic Pelvic Ischemia. J Korean Med Sci 2016; 31:585-9. [PMID: 27051243 PMCID: PMC4810342 DOI: 10.3346/jkms.2016.31.4.585] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 12/23/2015] [Indexed: 01/29/2023] Open
Abstract
The aim of this study was to investigate whether the omega-3 fatty acids help to improve erectile function in an atherosclerosis-induced erectile dysfunction rat model. A total of 20 male Sprague-Dawley rats at age 8 weeks were divided into three groups: Control group (n = 6, untreated sham operated rats), Pathologic group (n = 7, untreated rats with chronic pelvic ischemia [CPI]), and Treatment group (n = 7, CPI rats treated with omega-3 fatty acids). For the in vivo study, electrical stimulation of the cavernosal nerve was performed and erectile function was measured in all groups. Immunohistochemical antibody staining was performed for transforming growth factor beta-1 (TGF-β1), endothelial nitric oxide synthase (eNOS), and hypoxia inducible factor 1-alpha (HIF-1α). In vivo measurement of erectile function in the Pathologic group showed significantly lower values than those in the Control group, whereas the Treatment group showed significantly improved values in comparison with those in the Pathologic group. The results of western blot analysis revealed that systemically administered omega-3 fatty acids ameliorated the cavernosal molecular environment. Our study suggests that omega-3 fatty acids improve intracavernosal pressure and have a beneficial role against pathophysiological consequences such as fibrosis or hypoxic damage on a CPI rat model, which represents a structural erectile dysfunction model.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Dae Hee Kim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
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Shim JS, Bae JH. Drug Concentration in Rat Plasma, Bladder, and Prostate After Mirodenafil Administration in a Chronic Pelvic Ischemia Model. Urology 2016; 91:244.e1-5. [PMID: 26919966 DOI: 10.1016/j.urology.2016.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 12/28/2015] [Accepted: 02/04/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the distribution of a daily phosphodiesterase type 5 inhibitor dose (mirodenafil) in rat plasma and bladder and prostate tissue in a model of atherosclerosis-induced chronic pelvic ischemia. METHODS Thirty-two 18-week-old male Sprague Dawley rats were divided into two groups. Group I (n = 16) comprised a chronic pelvic ischemia model treated with mirodenafil and group II (n = 16) comprised a sham-operated model also treated with mirodenafil. The mirodenafil concentrations in each organ were measured at specific time points after 14 days of daily mirodenafil administration. The drug distribution ratio of group I to group II of each organ was measured, and the bladder tissue-to-plasma and prostate tissue-to-plasma ratios were calculated. RESULTS The mean drug concentration in the bladder of the rats in group I did not differ significantly from that of group II after mirodenafil administration. In the prostate, the mean drug concentration of group I was significantly higher than that of group II at 1 and 4 hours after drug administration. The drug concentration was higher in the bladder tissue than in the prostate tissue and the bladder tissue-to-plasma ratio was significantly higher than the prostate tissue-to-plasma ratio. CONCLUSION Our results suggest that mirodenafil levels might be sufficient in the target tissue after daily treatment in an ischemia-induced aging model. Considering the difficulties of tissue distribution study in human subjects, the results of this investigation provided meaningful evidence of the application of daily doses of mirodenafil for treating lower urinary tract symptoms in an aging population.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Ansan Hospital, Ansan, Republic of Korea.
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Gabor KA, Charette JR, Pietraszewski MJ, Wingfield DJ, Shim JS, Millard PJ, Kim CH. A DN-mda5 transgenic zebrafish model demonstrates that Mda5 plays an important role in snakehead rhabdovirus resistance. Dev Comp Immunol 2015; 51:298-304. [PMID: 25634485 PMCID: PMC4442029 DOI: 10.1016/j.dci.2015.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/17/2015] [Accepted: 01/21/2015] [Indexed: 05/14/2023]
Abstract
Melanoma Differentiation-Associated protein 5 (MDA5) is a member of the retinoic acid-inducible gene I (RIG-I)-like receptor (RLR) family, which is a cytosolic pattern recognition receptor that detects viral nucleic acids. Here we show an Mda5-dependent response to rhabdovirus infection in vivo using a dominant-negative mda5 transgenic zebrafish. Dominant-negative mda5 zebrafish embryos displayed an impaired antiviral immune response compared to wild-type counterparts that can be rescued by recombinant full-length Mda5. To our knowledge, we have generated the first dominant-negative mda5 transgenic zebrafish and demonstrated a critical role for Mda5 in the antiviral response to rhabdovirus.
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Affiliation(s)
- K A Gabor
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA
| | - J R Charette
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA
| | - M J Pietraszewski
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA
| | - D J Wingfield
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA
| | - J S Shim
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA
| | - P J Millard
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA
| | - C H Kim
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, ME, USA; Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA.
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Shim JS, Choi H, Noh TI, Tae JH, Yoon SG, Kang SH, Bae JH, Park HS, Park JY. The clinical significance of a second transurethral resection for T1 high-grade bladder cancer: Results of a prospective study. Korean J Urol 2015; 56:429-34. [PMID: 26078839 PMCID: PMC4462632 DOI: 10.4111/kju.2015.56.6.429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 04/23/2015] [Indexed: 12/02/2022] Open
Abstract
Purpose This study was designed to estimate the value of a second transurethral resection of bladder tumor (TURBT) procedure in patients with initially diagnosed T1 high-grade bladder cancer. Materials and Methods Between August 2009 and January 2013, a total of 29 patients with T1 high-grade bladder cancer prospectively underwent a second TURBT procedure. Evaluation included the presence of previously undetected residual tumor, changes to histopathological staging or grading, and tumor location. Recurrence-free and progression-free survival curves were generated to compare the prognosis between the groups with and without residual lesions by use of the Kaplan-Meier method. Results Of 29 patients, 22 patients (75.9%) had residual disease after the second TURBT. Staging was as follows: no tumor, 7 (24.1%); Ta, 5 (17.2%); T1, 6 (20.7%); Tis, 6 (20.7%); Ta+Tis, 1 (3.4%); T1+Tis, 1 (3.4%); and ≥T2, 3 (10.3%). The muscle layer was included in the surgical specimen after the initial TURBT in 24 patients (82.7%). In three patients whose cancer was upstaged to pT2 after the second TURBT, the initial surgical specimen contained the muscle layer. In the group with residual lesions, the 3-year recurrence-free survival and 3-year progression-free survival rates were 50% and 66.9%, respectively, whereas these rates were 68.6% and 68.6%, respectively, in the group without residual lesions. This difference was not statistically significant. Conclusions Initial TURBT does not seem to be enough to control T1 high-grade bladder cancer. Therefore, a routine second TURBT procedure should be recommended in patients with T1 high-grade bladder cancer to accomplish adequate tumor resection and to identify patients who may need to undergo prompt cystectomy.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea
| | - Hoon Choi
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea
| | - Tae Il Noh
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Hyun Tae
- Department of Urology, Korea University Anam Hospital, Seoul, Korea
| | - Sung Goo Yoon
- Department of Urology, Korea University Anam Hospital, Seoul, Korea
| | - Seok Ho Kang
- Department of Urology, Korea University Anam Hospital, Seoul, Korea. ; Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea. ; Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Hong Seok Park
- Department of Urology, Korea University College of Medicine, Seoul, Korea. ; Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Jae Young Park
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea. ; Department of Urology, Korea University College of Medicine, Seoul, Korea
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Choi H, Kim JH, Shim JS, Park JY, Kang SH, Moon DG, Cheon J, Lee JG, Kim JJ, Bae JH. Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement. Urol Int 2014; 93:425-30. [DOI: 10.1159/000357626] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/25/2013] [Indexed: 11/19/2022]
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Kim JH, Noh TI, Shim JS, Ham BK, Choi H, Bae JH, Park JY. Primary testicular carcinoid tumour with mature teratoma in undescended testis metastatic to lymph nodes. Can Urol Assoc J 2014; 8:E245-8. [PMID: 24839491 DOI: 10.5489/cuaj.383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We report a case of primary testicular carcinoid tumour with mature teratoma metastatic to the para-aortic lymph node and the lymph node around the left gonadal vein, which was treated with radical orchiectomy, bleomycin, etoposide, and cisplatin chemotherapy, and modified retroperitoneal lymph node dissection. Three days after modified retroperitoneal lymph node dissection, bleomycin induced pneumonitis occurred, which was resolved with steroid administration. The patient is alive without recurrence 31 months after radical orchiectomy.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
| | - Tae Il Noh
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Byeong Kuk Ham
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Hoon Choi
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jae Young Park
- Department of Urology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
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Choi H, Kim JH, Park JY, Shim JS, Bae JH. A modified laparoscopic ureterolithotomy by pulling ureter with Carter-Thomason fascial closure and ureter incision by broken 15th blade. Scand J Surg 2014; 103:195-200. [PMID: 24535434 DOI: 10.1177/1457496913509983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS To evaluate the efficacy and safety of a modified laparoscopic ureterolithotomy for the treatment of upper ureteral stones; this method involved the use of a Carter-Thomason fascial closure device, a broken 15th blade. MATERIAL AND METHODS From February 2009 to December 2012, 38 patients with unilateral upper ureteral stones were examined and classified into 2 groups: one group underwent conventional laparoscopic ureterolithotomy (n = 21) and the other group underwent modified laparoscopic ureterolithotomy (n = 17). The modified laparoscopic ureterolithotomy consisted of the use of a Carter-Thomason fascial closure to extract the black silk along with the nylon tape. The ureter incision was made with a modified instrument consisting of a needle holder with a broken 15th blade tip. RESULTS AND CONCLUSIONS Patient demographics were similar in both groups. No significant differences were detected between the conventional laparoscopic ureterolithotomy and modified laparoscopic ureterolithotomy groups with respect to operating time, estimated blood loss, and stone clearance rates. Drain-indwelling times were significantly shorter in modified laparoscopic ureterolithotomy patients than in conventional laparoscopic ureterolithotomy patients (3.2 ± 1.3 vs 4.7 ± 1.5 days). Hospital stay was significantly lesser in modified laparoscopic ureterolithotomy patients than in conventional laparoscopic ureterolithotomy patients (4.3 ± 1.2 vs 5.2 ± 1.2 days). No differences were detected in the ureteral stent indwelling time for the two groups. The use of the Carter-Thomason fascial closure facilitated ureter handling, and the use of a needle holder with a broken 15th blade tip enabled a sharp and precise ureteral incision. Our method allows early removal of the drain and thus earlier patient discharge.
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Affiliation(s)
- H Choi
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - J H Kim
- Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - J Y Park
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - J S Shim
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - J H Bae
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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Kim JH, Park JY, Shim JS, Lee JG, Moon DG, Yoo JW, Choi H, Bae JH. Comparison of outpatient versus inpatient transurethral prostate resection for benign prostatic hyperplasia: Comparative, prospective bi-centre study. Can Urol Assoc J 2014; 8:E30-5. [PMID: 24454598 DOI: 10.5489/cuaj.1370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We compare the symptomatic relief with urodynamic parameter change and operative safety of the outpatient transurethral resection in saline (TURIS-V) technique with inpatient transurethral resection of the prostate (TURP) for the management of benign prostatic hyperplasia (BPH). METHODS This prospective cohort comparison study enrolled patients who needed BPH surgery. Between January 2010 and June 2011, outpatient TURIS-V was performed at 1 centre and the results of the treatment were compared with inpatient TURP performed at a separate hospital. Preoperative characteristics, including prostate volume, were similar in both groups. Perioperative data and any treatment complications were recorded. The analysis compared postoperative outcomes, including a 6-month postoperative International Prostate Symptom Score (IPSS), a quality of life (QoL) evaluation and a record of any changes in uroflowmetry findings, between the 2 groups. RESULTS In the TURIS-V patient group, 75 patients agreed to be in the study. Of these, 69 ultimately complete the study. In the TURP group, 76 patients agreed and 71 of these completed the study. Both study groups were well-matched for age, IPSS, QoL and uroflowmetry findings. The TURIS-V group experienced both shorter operation times (54.6 vs. 74.8 minutes) and shorter catheterization times (2.2 vs. 4.2 days) when compared to the TURP group. There were comparable improvements in the 6-month postoperative IPSS, QoL, and uroflowmetry findings between the 2 groups. There were also equally low incidence rates of procedural complications. CONCLUSIONS Both TURIS-V and TURP relieve lower urinary tract symptoms in a similar way, with great efficacy and safety. Overall, TURIS-V had shorter operative and catheterization times compared to TURP. Notwithstanding the paper's limitations (non- randomized cohort comparison with possible selection or surgeon bias and small heterogeneous sample size), TURIS-V can be performed safely even in an outpatient setting.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Korea Unversity Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan, Korea
| | - Jae Young Park
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Ji Sung Shim
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Jeong Woo Yoo
- Tower Urology Clinic, Nambusunhwan-ro, Gangnam-gu, Seoul, Korea
| | - Hoon Choi
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea Unversity Ansan Hospital, Korea University College of Medicine, Danwon-gu, Ansan, Korea
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Shim JS, Park YJ, Manaloto ACF, Shin SW, Lee JY, Choi YJ, Ryu JJ. Shear Bond Strength of Four Different Repair Materials Applied to Bis-acryl Resin Provisional Materials Measured 10 Minutes, One Hour, and Two Days After Bonding. Oper Dent 2013. [DOI: 10.2341/13-196-lr1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Chalugun P, Shim JS, Liu JO. Abstract P2-09-18: Identification of synergistic drug combination for HER2 positive breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-09-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer is one of the leading causes of death worldwide. 25-30% of breast cancer has HER2 gene amplification, which tend to give rise to poorly-differentiated and high grade tumor with a higher likelihood of spreading. Currently, trastuzumab and lapatinib are the only two FDA-approved treatments that target HER2 positive breast cancer. However, resistance to both drugs is already reported. Since breast cancer is considered to be one of genetic diseases caused by multiple gene aberrations, we used synergistic drug combination as a strategy to overcome these growth signaling pathway abnormalities. To identify new drug combination with lapatinib, we performed a cell-based screen against a library of clinical drugs of 3,200 compounds. Triptolide, a traditional Chinese medicine emerged from the screen with strong synergistic effect with lapatinib in HER2 positive breast cancer cells. This effect was specific to HER2 positive breast cancer. The whole HER2 signaling pathway was inhibited and more cells underwent apoptosis. Besides, both HER2 protein and mRNA levels were decreased in cells treated with the combination. This drug combination was also effective in breast cancer xenograft models of mice. Together, these findings suggest that both triptolide and lapatinib can be used as a promising drug combination for HER2 positive breast cancer.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-09-18.
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Affiliation(s)
- P Chalugun
- Johns Hopkins School of Medicine, Baltimore, MD
| | - JS Shim
- Johns Hopkins School of Medicine, Baltimore, MD
| | - JO Liu
- Johns Hopkins School of Medicine, Baltimore, MD
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Noh TI, Shin YS, Shim JS, Yoon JH, Kim JH, Bae JH, Moon DG, Park JY. Are hypoechoic lesions on transrectal ultrasonography a marker for clinically significant prostate cancer? Korean J Urol 2013; 54:666-70. [PMID: 24175039 PMCID: PMC3806989 DOI: 10.4111/kju.2013.54.10.666] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 07/05/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the relationship of transrectal ultrasound (TRUS) findings with the pathological characteristics of prostate cancer (PCa). Materials and Methods The study was conducted retrospectively by analyzing the data for 970 patients who underwent prostate biopsies. Gleason scores and other clinical variables were compared between PCa patients with and without hypoechoic lesions on TRUS. Results Of the 970 patients, PCa was diagnosed in 291 (30%). Of these, high-grade PCa (Gleason score of 7 or more) was diagnosed in 190 (65%). The cancer detection rate was higher in patients with hypoechoic lesions (43.9%) than in those without hypoechoic lesions (21.4%, p<0.001). High-grade PCa was detected more often in patients with hypoechoic lesions than in those without hypoechoic lesions (p<0.001). Independent predictors for high-grade PCa by logistic regression analysis included hypoechoic lesions on TRUS and abnormal digital rectal examination findings. Conclusions Patients with PCa who had hypoechoic lesions on TRUS had more aggressive pathological disease than did those without lesions. Therefore, hypoechoic lesions on TRUS could be a marker for clinically significant PCa.
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Affiliation(s)
- Tae Il Noh
- Department of Urology, Korea University Ansan Hospital, Ansan, Korea
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Kim JH, Shim JS, Noh TI, Ahn HJ, Bae JH, Park JY. Concurrent bladder lymphoma and bladder cancer presenting as metastatic bladder cancer. World J Mens Health 2013; 30:141-5. [PMID: 23596602 PMCID: PMC3623523 DOI: 10.5534/wjmh.2012.30.2.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 07/20/2012] [Accepted: 07/26/2012] [Indexed: 11/23/2022] Open
Abstract
Malignant lymphoma of the bladder is a rare lesion, representing approximately 0.2% of the primary lesions and approximately 1.8% of the secondary lesions. A disseminated lymphoma presenting as a bladder mass is an infrequent phenomenon. The authors report the case of a 71-year-old patient with concurrent bladder lymphoma and bladder cancer presenting as metastatic bladder cancer. To the best of our knowledge, this is the first report of concurrent bladder lymphoma and bladder cancer.
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Affiliation(s)
- Jae Heon Kim
- Department of Urology, Soon Chun Hyang University Seoul Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea
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Shim JS, Kim JW, Oh MM, Moon DG. Efficacy of hydrodistention implantation technique in treating high-grade vesicoureteral reflux. Korean J Urol 2012; 53:194-9. [PMID: 22468216 PMCID: PMC3312069 DOI: 10.4111/kju.2012.53.3.194] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2011] [Accepted: 12/30/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose In the endoscopic treatment of vesicoureteral reflux, the relatively high rate of success, the simplicity of the procedure, high patient compliance, and a lack of complications has led to the increased development of injection materials and techniques. We report a method of identifying and maintaining a clear visual field during ureteral and bladder submucosal wall injection of a dextranomer/hyaluronic acid copolymer (Deflux, Oceana, Therapeutics Inc.) by use of the hydrodistention implantation technique (HIT) with the aid of temporary ureteral catheter insertion. Materials and Methods We prospectively reviewed patients with grade IV or V reflux who received an endoscopic injection of Deflux. Reflux grade was evaluated before and after treatment (3 months) by use of voiding cystourethrograms. Conventional sub-trigonal injection (STING) was performed with injection of Deflux underneath the bladder mucosa at the 6 o'clock position. HIT was performed either with hydrodistention or with guidewire insertion. These techniques increase visualization of the intramural portion of the distal ureteral wall. Patients with treatment failures were offered reinjection up to three times. Results Sixty-three patients completed endoscopic injection and follow-up of 3 months. The overall resolution rate for conventional STING was 58%, i.e., 67% for grade IV and 43% for grade V. The overall resolution rate for HIT was 80%, i.e., 93% for grade IV and 66% for grade V. The modified methods showed higher resolution rates for overall cure owing to the success in patients with grade IV reflux (p=0.026). Although the success of grade V treatment was higher with the modified method, the success rate was not statistically significant (p=0.27). Conclusions HIT with the use of either hydrodistention or a guidewire to aid in visualization of the intramural portion of the distal ureter is an effective treatment for high-grade vesico-ureteral reflux.
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Affiliation(s)
- Ji Sung Shim
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
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Lee DY, Park JH, Shin HT, Jang KT, Shim JS. Immunohistochemical study of epithelial markers in longitudinal and transverse sections of the human nail unit. Clin Exp Dermatol 2012; 37:688-9. [PMID: 22369386 DOI: 10.1111/j.1365-2230.2011.04324.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kang DR, Kim C, Hur NW, Shim JS, Shin SC, Suh I. Factors associated with participation in providing buccal cell DNA for a genetic epidemiologic study. Public Health Genomics 2010; 14:127-34. [PMID: 20926846 DOI: 10.1159/000318808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 06/26/2010] [Indexed: 01/09/2023] Open
Abstract
AIMS Our aim was to investigate factors associated with participation in buccal cell DNA collection using a large-scale prospective cohort study. METHODS Of the 183,634 Korea Medical Insurance Corporation (KMIC) prospective cohort study enrollees, 44,773 (36,794 men) were randomly selected. Buccal cell collection kits were mailed and collected from March to September 2004. Epidemiologic characteristics measured at baseline (1990 or 1992) and during follow-up (1998) were compared between respondents and nonrespondents. RESULTS Among the 13,084 (29.2%) respondents, 78.7% submitted usable samples (DNA concentration ≥3 μg). After adjustments for either or both age and family history of chronic disease, participation in men was positively associated with old age, a family history of chronic disease, low subjective health status, and regular exercise, and negatively associated with current smoking status. In women, only old age was associated with participation. Low body mass index (BMI) (<18.5 kg/m(2)), blood pressure, total cholesterol, and fasting blood glucose level were negatively associated with participation in men after adjustments for age and family history of chronic disease, but not in women, except for low BMI. CONCLUSIONS In this study, collecting buccal cell DNA by mailed survey has a low success rate (29%), and there appear to be a nonresponse bias and gender differences in the collection process.
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Affiliation(s)
- D R Kang
- Clinical Trial Center, Severance Hospital, Seoul, Republic of Korea
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Abstract
There were 47 patients with congenital muscular torticollis who underwent operative release. After a mean follow-up of 74 months (60 to 90), they were divided into two groups, one aged one to four years (group 1) and the other aged five to 16 years (group 2). The outcomes were assessed by evaluating the following parameters: deficits of lateral flexion and rotation, craniofacial asymmetry, surgical scarring, residual contracture, subjective evaluation and degree of head tilt. The craniofacial asymmetry, residual contracture, subjective evaluation and overall scores were similar in both groups. However, group 2 showed superior results to group 1 in terms of the deficits of movement, surgical scarring and degree of head tilt. It is recommended that operative treatment for congenital muscular torticollis is postponed until the patient can comply successfully with post-operative bracing and an exercise programme.
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Affiliation(s)
- J S Shim
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 IL-Won Dong, Kang Nam Ku, Seoul 135-710, Korea.
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Kim JY, Kim DI, Do YS, Lee BB, Kim YW, Shin SW, Byun HS, Roh HG, Choo IW, Hyon WS, Shim JS, Choi JY. Surgical treatment for congenital arteriovenous malformation: 10 years' experience. Eur J Vasc Endovasc Surg 2006; 32:101-6. [PMID: 16478673 DOI: 10.1016/j.ejvs.2006.01.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Accepted: 01/02/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We report our 10 years experience of the surgical treatment of congenital arteriovenous malformation (AVM). METHODS We retrospectively reviewed the medical records of 145 patients with AVM who visited Samsung Medical Center in Korea from 1994 to 2003. Among the 145 patients, 21 patients were operated on. Preoperative embolo/sclerotherapy was done in 20 out of the 21 patients. RESULTS The surgically treated AVMs were 13 cases of head and neck lesions, four cases of upper extremity lesions, one case each of back lesion, uterus lesion, lower extremity lesion and multiple site lesions. There were 10 patients with the extratruncular infiltrating type, nine patients with the extratruncular limited type, one patient with a truncular superficial AV fistula and one patient with a mixed type. Fourteen cases were operated on for cosmetic reasons and since they had localized lesions, and five cases were operated on for tissue necrosis. Fourteen cases were cured by a single operation, yet seven cases needed several sessions of operation to cure the AVM or to promote wound healing after surgery. CONCLUSION The surgical treatment of AVM is a challenging issue for vascular surgeons. To minimise the complications related to surgery, a multidisciplinary team approach should be considered.
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Affiliation(s)
- J Y Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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