1.Uncommon Cause: Lateral Band Subluxation Unveiled by Ultrasound in Finger Snapping Diagnosis
Kyung Hwan CHO ; Dong yuk LEE ; Jaeki AHN ; Yongbum PARK ; Suyeon KIM
Clinical Pain 2024;23(2):105-108
Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.
2.Trimodal Therapy in the Treatment of Muscle-Invasive Bladder Cancer
Journal of Urologic Oncology 2024;22(3):256-267
This review examines the evolution, clinical efficacy, and future directions of trimodal therapy (TMT) as a bladder-preserving treatment option for muscle-invasive bladder cancer. A nonsystematic literature search was conducted on PubMed in October 2024 using the following keywords: “muscle invasive bladder cancer,” “bladder preservation,” “trimodal therapy,” “chemoradiotherapy,” and “radiation therapy.” Papers published between 2000 and 2024 were included, and original articles, reviews, and editorials written in English were selected. Relevant studies were organized and cited in the analysis. TMT, which consists of transurethral resection of the bladder tumor, chemotherapy, and radiotherapy, demonstrated comparable oncologic outcomes to radical cystectomy (RC) in terms of 5-year overall survival (36%–74%) and cancer-specific survival (50%–82%). Long-term data from multiple studies indicate that TMT can preserve bladder function while maintaining acceptable survival rates. The recent integration of immune checkpoint inhibitors with TMT shows promise, further improving tumor control and expanding the eligible patient population. However, standardized protocols and long-term follow-up data are still lacking. TMT serves as an effective alternative to RC in selected patients, offering similar oncologic outcomes while preserving quality of life. Further research is needed to establish standardized protocols and to refine patient selection criteria to optimize treatment outcomes.
3.Uncommon Cause: Lateral Band Subluxation Unveiled by Ultrasound in Finger Snapping Diagnosis
Kyung Hwan CHO ; Dong yuk LEE ; Jaeki AHN ; Yongbum PARK ; Suyeon KIM
Clinical Pain 2024;23(2):105-108
Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.
4.Uncommon Cause: Lateral Band Subluxation Unveiled by Ultrasound in Finger Snapping Diagnosis
Kyung Hwan CHO ; Dong yuk LEE ; Jaeki AHN ; Yongbum PARK ; Suyeon KIM
Clinical Pain 2024;23(2):105-108
Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.
5.Trimodal Therapy in the Treatment of Muscle-Invasive Bladder Cancer
Journal of Urologic Oncology 2024;22(3):256-267
This review examines the evolution, clinical efficacy, and future directions of trimodal therapy (TMT) as a bladder-preserving treatment option for muscle-invasive bladder cancer. A nonsystematic literature search was conducted on PubMed in October 2024 using the following keywords: “muscle invasive bladder cancer,” “bladder preservation,” “trimodal therapy,” “chemoradiotherapy,” and “radiation therapy.” Papers published between 2000 and 2024 were included, and original articles, reviews, and editorials written in English were selected. Relevant studies were organized and cited in the analysis. TMT, which consists of transurethral resection of the bladder tumor, chemotherapy, and radiotherapy, demonstrated comparable oncologic outcomes to radical cystectomy (RC) in terms of 5-year overall survival (36%–74%) and cancer-specific survival (50%–82%). Long-term data from multiple studies indicate that TMT can preserve bladder function while maintaining acceptable survival rates. The recent integration of immune checkpoint inhibitors with TMT shows promise, further improving tumor control and expanding the eligible patient population. However, standardized protocols and long-term follow-up data are still lacking. TMT serves as an effective alternative to RC in selected patients, offering similar oncologic outcomes while preserving quality of life. Further research is needed to establish standardized protocols and to refine patient selection criteria to optimize treatment outcomes.
6.Uncommon Cause: Lateral Band Subluxation Unveiled by Ultrasound in Finger Snapping Diagnosis
Kyung Hwan CHO ; Dong yuk LEE ; Jaeki AHN ; Yongbum PARK ; Suyeon KIM
Clinical Pain 2024;23(2):105-108
Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.
7.Trimodal Therapy in the Treatment of Muscle-Invasive Bladder Cancer
Journal of Urologic Oncology 2024;22(3):256-267
This review examines the evolution, clinical efficacy, and future directions of trimodal therapy (TMT) as a bladder-preserving treatment option for muscle-invasive bladder cancer. A nonsystematic literature search was conducted on PubMed in October 2024 using the following keywords: “muscle invasive bladder cancer,” “bladder preservation,” “trimodal therapy,” “chemoradiotherapy,” and “radiation therapy.” Papers published between 2000 and 2024 were included, and original articles, reviews, and editorials written in English were selected. Relevant studies were organized and cited in the analysis. TMT, which consists of transurethral resection of the bladder tumor, chemotherapy, and radiotherapy, demonstrated comparable oncologic outcomes to radical cystectomy (RC) in terms of 5-year overall survival (36%–74%) and cancer-specific survival (50%–82%). Long-term data from multiple studies indicate that TMT can preserve bladder function while maintaining acceptable survival rates. The recent integration of immune checkpoint inhibitors with TMT shows promise, further improving tumor control and expanding the eligible patient population. However, standardized protocols and long-term follow-up data are still lacking. TMT serves as an effective alternative to RC in selected patients, offering similar oncologic outcomes while preserving quality of life. Further research is needed to establish standardized protocols and to refine patient selection criteria to optimize treatment outcomes.
8.Changes in Treatment After Gallium-68 Prostate-Specific Membrane Antigen-11 Positron Emission Tomography/Computed Tomography in Patients With Prostate Cancer: A Retrospective Case Series Study
Si Hyun KIM ; Chang Wook JEONG ; Minh-Tung DO ; Jang Hee HAN ; Seung-Hwan JEONG ; Hyeong Dong YUK ; Ja Hyeon KU ; Hyeon Hoe KIM ; Gi Jeong CHEON ; Cheol KWAK
Journal of Urologic Oncology 2024;22(2):157-165
Purpose:
The use of gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (Ga-68 PSMA-11 PET/CT) is becoming increasingly common among men with prostate cancer (PCa). However, it remains uncertain which patients will derive the most benefit, and there is a scarcity of real-world data regarding its impact on altering treatment plans. This study investigated which patients would most benefit from Ga-68 PSMA-11 PET/CT, focusing on detection rates and changes in treatment strategies, drawing from a single-center experience.
Materials and Methods:
In total, 230 men with PCa who underwent Ga-68 PSMA-11 PET/CT between November 2021 and August 2022 were included in this retrospective study. The patients were classified into 5 groups based on their disease status: group 1, further work-up for high-risk localized PCa; group 2, de novo metastatic PCa; group 3, biochemical recurrence after definitive treatment; group 4, castration-resistant PCa; group 5, others. The positivity rate, positive lesions, predictive value of lymph node metastases, comparison with conventional images, and treatment changes after Ga-68 PSMA-11 PET/CT were analyzed in each group.
Results:
Of the 230 patients, 40 (17.4%), 20 (8.7%), 77 (33.5%), 76 (33.0%), and 17 (7.4%) were classified into groups 1–5, respectively. Ga-68 PSMA-11 PET/CT showed lesions in 74.8% of patients, and the optimal cutoff value for PSA was 1.99 ng/mL. Lesions not observed on conventional imaging were found in 62 patients (33.2%). In 38 patients (13.5%), treatment was changed due to Ga-68 PSMA-11 PET/CT.
Conclusions
These real-world data suggest that Ga-68 PSMA-11 PET/CT may be clinically useful for various disease conditions, as substantial stage migration and subsequent treatment changes occur in men with PCa. However, the prognostic impact of this modality remains unclear; thus, a well-designed prospective study is needed to address this issue.
9.Intramedullary Spinal Cord Hemorrhage Associated with Monoparesis after Transforaminal Cervical Epidural Steroid Injection
Mi Rim SUH ; Yongbum PARK ; Seok Hyeon LEE ; Dong Yuk LEE ; Jaeki AHN
Clinical Pain 2022;21(2):109-113
Transforaminal cervical epidural steroid injection (TFCESI) is widely used as conservative treatment for cervical radiculopathy, but severe complications associated with this procedure have been reported. This report was the first case of intramedullary spinal cord hemorrhage following TFCESI. A 67-year-old woman presented with weakness and sensory disturbance in left upper extremity after TFCESI. Cervical magnetic resonance imaging revealed intramedullary spinal cord hemorrhage accompanied by myelopathy at the C2∼C5 level. The patient was administered intravenous methylprednisolone daily (1,000 mg/8 hours) for 5 days and was subsequently transferred to the Department of Rehabilitation Medicine for rehabilitation therapy. A month later, the patient’s neurological impairment partially improved. Although TFCESI is rarely associated with major complications, physicians should be cautious when performing the procedure, and remain mindful of the potentially serious complications.
10.2021 Consensus Statements on the Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma From the Korean Renal Cancer Study Group (KRoCS)
Chan Ho LEE ; Minyong KANG ; Cheol KWAK ; Sung Han KIM ; Jung Kwon KIM ; Jae Young PARK ; Seong Il SEO ; Ill Young SEO ; Jungyo SUH ; Wan SONG ; Cheryn SONG ; Hyeong Dong YUK ; Sangchul LEE ; Hyung Ho LEE ; Jinsoo CHUNG ; Chang Wook JEONG ; Jung Ki JO ; Chang Il CHOI ; Seol Ho CHOO ; Jun Hyun HAN ; Eu Chang HWANG ; Miso KIM ; Chan KIM ; Seock Hwan CHOI ; Sung-Hoo HONG
Korean Journal of Urological Oncology 2022;20(3):151-162
Purpose:
The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC).
Materials and Methods:
A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC.
Results:
The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority.
Conclusions
In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.

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