1.Does Preoperative Bladder Compliance Affect Long-Term Functional Outcomes after Laser Prostatectomy?
Sangjun YOO ; Hyeon JEONG ; Hwancheol SON ; Seung-June OH ; Jae-Seung PAICK ; Min Chul CHO
The World Journal of Men's Health 2023;41(3):734-742
Purpose:
We assessed the effects of preoperative bladder compliance on the long-term functional outcomes, especially focused on postoperative storage symptom changes, after laser prostatectomy.
Materials and Methods:
From January 2008 to March 2014, 1,608 men who underwent laser prostatectomy, including holmium laser enucleation or photo-vaporization of the prostate, were included in the analysis. We divided patients into 3 groups according to bladder compliance on a baseline urodynamic study: <12.5, 12.5–25, ≥25 mL/cmH2O. A multivariable analysis was performed to determine the impact of bladder compliance on changes in long-term functional outcomes after laser prostatectomy.
Results:
Bladder compliance was less than 12.5 mL/cmH2O in 50 (3.1%), 12.5–25 mL/cmH2O in 232 (14.4%) patients. As bladder compliance decreased, the baseline International Prostate Symptom (IPSS) total score and storage sub-score were increased; the voiding sub-score remain unchanged. At postoperative 12 and 36 months, absolute improvements in the IPSS total score and storage sub-score were higher in <12.5 mL/cmH2O group compared to other groups, although those were equivalent at postoperative 1 months. On the multivariable analysis, decreased bladder compliance <12.5 mL/cmH2O was significantly associated with superior improvement in storage sub-score at postoperative 36 months, although it was not associated with voiding sub-score.
Conclusions
In patients with preoperative bladder compliance <12.5 mL/cmH2O, storage symptoms could be further improved at 36 months after laser prostatectomy compared to others. Thus, laser prostatectomy could be a considerable treatment option for patients with severely decreased bladder compliance.
2.A Nationwide Study of Differences in Surgical Treatment Rates and Oncological Outcomes for Prostate Cancer according to Economic Status and Region
Sangjun YOO ; Sohee OH ; Min Chul CHO ; Hwancheol SON ; Hyeon JEONG
Cancer Research and Treatment 2023;55(2):652-658
Purpose:
We investigated the effects of economic status (classified based on insurance type and residential area) on oncological outcomes of prostate cancer using a nationwide database. We additionally investigated oncological outcomes based on economic status and residential area in patients who underwent surgical treatment.
Materials and Methods:
The study included 75,518 men with newly diagnosed prostate cancer between 2009 and 2018 in whom oncological outcomes were investigated based on economic status and residential area. Among the 75,518 men with prostate cancer, the data of 29,973 men who underwent radical prostatectomy were further analyzed. Multivariate analysis was performed to determine the effects of economic status and residential area on postoperative oncological outcomes.
Results:
Among the 75,518 patients with prostate cancer, 3,254 (4.31%) were medical aid beneficiaries. The 5-year overall survival rates were 81.2% and 64.8% in the health insurance and medical aid groups, respectively. Radical prostatectomy was more common in the health insurance group, and surgical intervention was significantly affected by the residential area. Among patients who underwent surgery, 5-year androgen deprivation therapy–free and overall survival were better in the health insurance group. Multivariate analysis showed that insurance type and residential area were significantly associated with the androgen deprivation therapy–free and overall survival after adjustment for other variables.
Conclusion
Economic status and residential area were shown to affect not only treatment patterns but also post-diagnosis and postoperative oncological outcomes. Political support for early diagnosis and appropriate treatment of prostate cancer is warranted for medically vulnerable populations.
3.Postoperative major bleeding risk in patients using oral antiplatelets and/or anticoagulants after laparoscopic gastric cancer surgery
Chami IM ; Young Suk PARK ; Sa-Hong MIN ; So Hyun KANG ; Sangjun LEE ; Eunju LEE ; Mira YOO ; Duyeong HWANG ; Sang-Hoon AHN ; Yun Suhk SUH ; Do Joong PARK ; Hyung-Ho KIM
Annals of Surgical Treatment and Research 2023;104(2):80-89
Purpose:
The use of antiplatelet and/or anticoagulant therapies has become common. In rare cases, these therapies may increase the risk of dangerous postoperative bleeding. We investigated the association of antiplatelets and/or anticoagulants with postoperative major bleeding risk in laparoscopic gastric cancer surgery.
Methods:
We retrospectively enrolled 3,663 gastric cancer patients (antiplatelet/anticoagulant group, 518; control group, 3,145) who had undergone laparoscopic surgery between January 2012 and December 2017. To minimize selection bias, 508 patients in each group were matched using propensity score matching (PSM) method. The primary outcome was postoperative major bleeding. Secondary outcomes were intraoperative, postoperative transfusion and early complications.
Results:
After PSM, postoperative major bleeding occurred in 10 (2.0%) and 3 cases (0.6%) in the antiplatelets/ anticoagulants and control groups, respectively (P = 0.090). Intraoperative and postoperative transfusions were not significantly different between 2 groups (2.4% vs. 1.4%, P = 0.355 and 5.5% vs. 4.3%, P = 0.469). Early complications developed in 58 (11.4%) and 43 patients (8.5%) in the antiplatelets/anticoagulants and control groups, respectively (P = 0.142). The mean amounts of intraoperative and postoperative transfusions were not significantly different between the groups (366.67 ± 238.68 mL vs. 371.43 ± 138.01 mL, P = 0.962; 728.57 ± 642.25 mL vs. 508.09 ± 468.95 mL, P = 0.185). In multivariable analysis, male (P = 0.008) and advanced stage (III, IV) (P = 0.024) were independent significant risk factors for postoperative major bleeding.
Conclusion
Preoperative antiplatelets and/or anticoagulants administration did not significantly increase the risk of postoperative major bleeding after laparoscopic gastric cancer surgery.
4.Urologic malignancies that cause hematuria
Sung Jin KIM ; Myungchan PARK ; Sangjun YOO
Journal of the Korean Medical Association 2023;66(6):363-373
Hematuria, characterized by red blood cells in the urine, is a clinical symptom that demands an immediate investigation for potential urologic cancers, particularly in cases of gross hematuria. This study seeks to comprehensively review various urologic malignancies causing hematuria, such as urothelial carcinoma, renal cell carcinoma, and prostate ductal carcinoma. The review is anchored on the current urologic clinical guidelines and published literature.Current Concepts: Gross hematuria commonly signifies urologic cancer, with approximately 20% of gross hematuria cases and 5% of microscopic hematuria cases associated with a urologic cancer diagnosis. Cystoscopy and imaging studies of the upper urinary tract are recommended in patients presenting with gross hematuria, with urine cytology as a potential supplementary test. Conversely, in the presence of microscopic hematuria only, it is advisable to conduct appropriate tests while considering variables such as patient age. When hematuria occurs alongside antithrombotic drug administration, it is crucial not to forego appropriate testing due to the antithrombotic medication. Hematuria is a prevalent symptom of bladder cancer, renal cancer, and urothelial carcinoma; it can also be present in patients with prostate ductal carcinoma.Discussion and Conclusion: In instances of no urinary tract infection or other discernible cause of hematuria, a consultation with a urologist is recommended, irrespective of the patient’s age. When dealing with patients with urologic cancer, an early diagnosis is a critical factor influencing patient prognosis. Therefore, enhanced attention and a deeper understanding of urologic cancers that can precipitate hematuria are necessary.
5.A Survey on the Quality of Life of Prostate Cancer Patients in Korean Prostate Cancer Patients Association
Yun-Sok HA ; Kwang Taek KIM ; Wook NAM ; Hongzoo PARK ; Sangjun YOO ; Chan Ho LEE ; Ho Seok CHUNG ; Woo Suk CHOI ; Jiyoun KIM ; Jaeeun SHIN ; Jeong Hyun KIM ; Cheol KWAK
Korean Journal of Urological Oncology 2022;20(4):265-272
Purpose:
We aimed to collect opinions on the diagnostic experiences and quality of life profiles for men with prostate cancer in Korea as part of the “Blue Ribbon Campaign” of the Korean Urological Oncology Society.
Materials and Methods:
Korean Urological Oncology Society conducted an online survey of 212 prostate cancer patients belonging to the Prostate Cancer Patient Association. A survey on diagnostic experience and quality of life based on Expanded Prostate Cancer Index Composite 26 Short Form were conducted.
Results:
About half of all respondents (50.5%) answered, “I experienced symptoms of urine leakage more than once a week,” during the last four weeks, 85% of the respondents said their sexual function level was “weak,” and 64.2% said, “very weak.” When asked about the level of erectile dysfunction, 58 percent of the respondents answered, “I never had an erection when I wanted one.” Of the respondents, 47.1% of men said that clinical stage at initial presentation was prostate cancer stage 3–4 and 99.1% of the respondents hoped that the prostate-specific antigen (PSA) test would be included in the national cancer screening.
Conclusions
Through this survey of patients, we were able to confirm the difficulties of the low quality of life currently experienced by prostate cancer patients and what they want to do with prostate cancer treatment. All patients are eager to include a PSA test in the national cancer screening so that prostate cancer can be detected early and patients can receive proper treatment at an appropriate time.
6.The Korea Cohort Consortium: The Future of Pooling Cohort Studies
Sangjun LEE ; Kwang-Pil KO ; Jung Eun LEE ; Inah KIM ; Sun Ha JEE ; Aesun SHIN ; Sun-Seog KWEON ; Min-Ho SHIN ; Sangmin PARK ; Seungho RYU ; Sun Young YANG ; Seung Ho CHOI ; Jeongseon KIM ; Sang-Wook YI ; Daehee KANG ; Keun-Young YOO ; Sue K. PARK
Journal of Preventive Medicine and Public Health 2022;55(5):464-474
Objectives:
We introduced the cohort studies included in the Korean Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies.
Methods:
We mainly focused on the characteristics of individual cohort studies from the KCC. We developed “PROFAN”, a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated.
Results:
The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102.
Conclusions
We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.
7.Investigation of Information Acquisition Channel for Prostate Cancer High-Risk Group
Yun-Sok HA ; Kwang Taek KIM ; Wook NAM ; Hongzoo PARK ; Sangjun YOO ; Chan Ho LEE ; Ho Seok CHUNG ; Woo Suk CHOI ; Jiyoun KIM ; Jaeeun SHIN ; Jeong Hyun KIM ; Cheol KWAK
Korean Journal of Urological Oncology 2021;19(3):174-182
Purpose:
The survey was conducted on Korean men to examine information acquisition channel for prostate cancer high risk group as part of the “Blue Ribbon Campaign” of the Korean Urological Oncology Society.
Materials and Methods:
An online survey of 500 men aged 50 years old or older was completed to query investigation of the status of prostate cancer awareness and information acquisition from February 4 to February 9, 2021.
Results:
Most men in their 50s and older are well aware that prostate cancer can also occur in young men in their 40s, so the rate of misunderstanding of the timing of prostate cancer screening after their 60s is very low. Two-thirds of all respondents (67.2%) were also confirmed that prostate cancer had no initial symptoms and was not included in the national cancer screening. Seventy-five percent of people look up information on their own in case of suspected prostate cancer, and 51.6% seek out knowledge on their own to prevent prostate cancer. Of the respondents, 27.4% of men contacted prostate cancer-related information within the past year, and the percentage of people contacted through ‘Internet/Phone,’ ‘People Around’ and ‘Television’ was high. The most trusted channel among prostate cancer information channels was ‘medical professionals,’ but the experience rate was not high, and the channel with high experience rate and reliability was shown as ‘television.’
Conclusions
Much effort is still needed to understand the information acquisition behavior of Korean men and to improve awareness of early screening for prostate cancer.
8.Multilayered Cell Sheets of Cardiac Reprogrammed Cells for the Evaluation of Drug Cytotoxicity
Sung Pil KWON ; Seuk Young SONG ; Jin YOO ; Han Young KIM ; Ju-Ro LEE ; Mikyung KANG ; Hee Su SOHN ; Seokhyoung GO ; Mungyo JUNG ; Jihye HONG ; Songhyun LIM ; Cheesue KIM ; Sangjun MOON ; Kookheon CHAR ; Byung-Soo KIM
Tissue Engineering and Regenerative Medicine 2021;18(5):807-818
BACKGROUND:
Various cell-culture systems have been used to evaluate drug toxicity in vitro. However, factors that affect cytotoxicity outcomes in drug toxicity evaluation systems remain elusive. In this study, we used multilayered sheets of cardiac-mimetic cells, which were reprogrammed from human fibroblasts, to investigate the effects of the layer number on drug cytotoxicity outcomes.
METHODS:
Cell sheets of cardiac-mimetic cells were fabricated by reprogramming of human fibroblasts into cardiacmimetic cells via coculture with cardiac cells and electric stimulation, as previously described. Double-layered cell sheets were prepared by stacking the cell sheets. The mono- and double-layered cell sheets were treated with 5-fluorouracil (5-FU), an anticancer drug, in vitro. Subsequently, apoptosis and lipid peroxidation were analyzed. Furthermore, effects of cardiacmimetic cell density on cytotoxicity outcomes were evaluated by culturing cells in monolayer at various cell densities.
RESULTS:
The double-layered cell sheets exhibited lower cytotoxicity in terms of apoptosis and lipid peroxidation than the mono-layered sheets at the same 5-FU dose. In addition, the double-layered cell sheets showed better preservation of mitochondrial function and plasma membrane integrity than the monolayer sheets. The lower cytotoxicity outcomes in the double-layered cell sheets may be due to the higher intercellular interactions, as the cytotoxicity of 5-FU decreased with cell density in monolayer cultures of cardiac-mimetic cells.
CONCLUSION
The layer number of cardiac-mimetic cell sheets affects drug cytotoxicity outcomes in drug toxicity tests.The in vitro. cellular configuration that more closely mimics the in vivo configuration in the evaluation systems seems to exhibit lower cytotoxicity in response to drug.
9.Multilayered Cell Sheets of Cardiac Reprogrammed Cells for the Evaluation of Drug Cytotoxicity
Sung Pil KWON ; Seuk Young SONG ; Jin YOO ; Han Young KIM ; Ju-Ro LEE ; Mikyung KANG ; Hee Su SOHN ; Seokhyoung GO ; Mungyo JUNG ; Jihye HONG ; Songhyun LIM ; Cheesue KIM ; Sangjun MOON ; Kookheon CHAR ; Byung-Soo KIM
Tissue Engineering and Regenerative Medicine 2021;18(5):807-818
BACKGROUND:
Various cell-culture systems have been used to evaluate drug toxicity in vitro. However, factors that affect cytotoxicity outcomes in drug toxicity evaluation systems remain elusive. In this study, we used multilayered sheets of cardiac-mimetic cells, which were reprogrammed from human fibroblasts, to investigate the effects of the layer number on drug cytotoxicity outcomes.
METHODS:
Cell sheets of cardiac-mimetic cells were fabricated by reprogramming of human fibroblasts into cardiacmimetic cells via coculture with cardiac cells and electric stimulation, as previously described. Double-layered cell sheets were prepared by stacking the cell sheets. The mono- and double-layered cell sheets were treated with 5-fluorouracil (5-FU), an anticancer drug, in vitro. Subsequently, apoptosis and lipid peroxidation were analyzed. Furthermore, effects of cardiacmimetic cell density on cytotoxicity outcomes were evaluated by culturing cells in monolayer at various cell densities.
RESULTS:
The double-layered cell sheets exhibited lower cytotoxicity in terms of apoptosis and lipid peroxidation than the mono-layered sheets at the same 5-FU dose. In addition, the double-layered cell sheets showed better preservation of mitochondrial function and plasma membrane integrity than the monolayer sheets. The lower cytotoxicity outcomes in the double-layered cell sheets may be due to the higher intercellular interactions, as the cytotoxicity of 5-FU decreased with cell density in monolayer cultures of cardiac-mimetic cells.
CONCLUSION
The layer number of cardiac-mimetic cell sheets affects drug cytotoxicity outcomes in drug toxicity tests.The in vitro. cellular configuration that more closely mimics the in vivo configuration in the evaluation systems seems to exhibit lower cytotoxicity in response to drug.
10.Investigation of Information Acquisition Channel for Prostate Cancer High-Risk Group
Yun-Sok HA ; Kwang Taek KIM ; Wook NAM ; Hongzoo PARK ; Sangjun YOO ; Chan Ho LEE ; Ho Seok CHUNG ; Woo Suk CHOI ; Jiyoun KIM ; Jaeeun SHIN ; Jeong Hyun KIM ; Cheol KWAK
Korean Journal of Urological Oncology 2021;19(3):174-182
Purpose:
The survey was conducted on Korean men to examine information acquisition channel for prostate cancer high risk group as part of the “Blue Ribbon Campaign” of the Korean Urological Oncology Society.
Materials and Methods:
An online survey of 500 men aged 50 years old or older was completed to query investigation of the status of prostate cancer awareness and information acquisition from February 4 to February 9, 2021.
Results:
Most men in their 50s and older are well aware that prostate cancer can also occur in young men in their 40s, so the rate of misunderstanding of the timing of prostate cancer screening after their 60s is very low. Two-thirds of all respondents (67.2%) were also confirmed that prostate cancer had no initial symptoms and was not included in the national cancer screening. Seventy-five percent of people look up information on their own in case of suspected prostate cancer, and 51.6% seek out knowledge on their own to prevent prostate cancer. Of the respondents, 27.4% of men contacted prostate cancer-related information within the past year, and the percentage of people contacted through ‘Internet/Phone,’ ‘People Around’ and ‘Television’ was high. The most trusted channel among prostate cancer information channels was ‘medical professionals,’ but the experience rate was not high, and the channel with high experience rate and reliability was shown as ‘television.’
Conclusions
Much effort is still needed to understand the information acquisition behavior of Korean men and to improve awareness of early screening for prostate cancer.

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