6.Comparative analysis of recurrence rates between intravesical gemcitabine and bacillus Calmette–Guérin induction therapy following transurethral resection of bladder tumors in patients with intermediate- and high-risk bladder cancer: A retrospective multicenter study
Joongwon CHOI ; Kyung Hwan KIM ; Hyung Suk KIM ; Hyun Sik YOON ; Jung Hoon KIM ; Jin Wook KIM ; Yong Seong LEE ; Se Young CHOI ; In Ho CHANG ; Young Hwii KO ; Wan SONG ; Byong Chang JEONG ; Jong Kil NAM
Investigative and Clinical Urology 2024;65(3):248-255
Purpose:
This study investigated the efficacy of intravesical gemcitabine as an alternative to bacillus Calmette–Guérin (BCG) therapy.
Materials and Methods:
Data were retrospectively collected across seven institutions from February 1999 to May 2023. Inclusion criteria included patients with intermediate- or high-risk non-muscle invasive bladder cancer (NMIBC) who underwent transurethral resection of bladder tumors (TURBT) and received at least four sessions of intravesical gemcitabine or BCG induction therapy. Patient characteristics, complete remission (CR), occurrence, and progression rates were compared.
Results:
In total, 149 patients were included in this study (gemcitabine, 63; BCG, 86). No differences were apparent between the two groups in baseline characteristics, except for the follow-up period (gemcitabine, 9.2±5.9 months vs. BCG, 43.9±41.4 months, p<0.001). There were no consistent significant differences observed between the two groups in the 3-month (gemcitabine, 98.4% vs. BCG, 95.3%; p=0.848), 6-month (94.9% vs. 90.0%, respectively; p=0.793) and 1-year CR rates (84.2% vs. 83.3%, respectively;p=0.950). Also, there was no significant statistical difference in progression-free survival between the two groups (p=0.953). The occurrence rates of adverse events were similar between the groups (22.2% vs. 22.1%; p=0.989); however, the rate of Clavien– Dindo grade 2 or higher was significantly higher in the BCG group (1.6% vs. 16.3%, respectively; p<0.001).
Conclusions
Intravesical gemcitabine demonstrated efficacy comparable to BCG therapy for the first year in patients with intermediate- and high-risk NMIBC. However, long-term follow-up studies are warranted.
7.Experimental Study on Transverse-Axis Neovascularization of Acellular Dermal Matrix Using Platelet-Rich Plasma
Hyung Suk YI ; Ho Young IM ; Jin Hyung PARK ; Yoon Soo KIM ; Sun-Ju OH ; Hong Il KIM
Journal of Wound Management and Research 2024;20(1):29-35
Background:
Acellular dermal matrices (ADMs) have shown promise in promoting tissue regeneration; however, their integration in challenging cases with limited vertical-axis neovascularization remains difficult. This study investigates whether clinically meaningful transverse-axis neovascularization is identified in ADM engraftment and whether this can be further accelerated by platelet-rich plasma (PRP).
Methods:
ADM and PRP-soaked ADM were implanted into New Zealand rabbits, and histological analysis was performed at different periods to compare neovascularization.
Results:
Histological analysis revealed that among 32 biopsy sites, there was transverse-axis neovascularization with an average length of 606.89 μm. When divided into two groups for assessing the impact of PRP on transverse-axis neovascularization, the extent of such neovascularization was measured as 582.99 μm in the control group and 630.79 μm in the experimental group. However, there was no statistically significant difference between the two groups (P=0.693).
Conclusion
The results of the present study indicate that achieving meaningful transverse-axis neovascularization in implanted ADMs remains a challenge, warranting further investigation into ADM structure and vertical-axis neovascularization.
8.Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Ki-Hyun KIM ; Hyung Ku CHON ; Tae Jun SONG ; Dong Won AHN ; Eaum Seok LEE ; Yun Nah LEE ; Yoon Suk LEE ; Tae Joo JEON ; Chang Hwan PARK ; Kwang Bum CHO ; Dong Wook LEE ; Jin-Seok PARK ; Seung Bae YOON ; Kwang Hyung CHUNG ; Jin JIN ; Miyoung CHOI
Korean Journal of Pancreas and Biliary Tract 2024;29(4):144-156
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that requires abundant clinical experience and endoscopic skills, and can lead to various complications, some of which may progress to life-threatening conditions. With expanding indications and technological advancements, ERCP is widely utilized, enhancing procedural accessibility. However, without proper quality management, the procedure can pose significant risks. Quality management in ERCP is essential to ensure safe and successful procedures and meet societal demands for improved healthcare competitiveness. To address these concerns, the Korean Pancreatobiliary Association has developed a Korean-specific ERCP quality indicator reflecting domestic medical environments and realities. Initially, based on a review of foreign ERCP quality indicators and related literatures, key questions were formulated for five preprocedural items, three intra-procedural items, and four post-procedural items. Descriptions and recommendations for each item were selected through peer evaluation. The developed Korean-specific ERCP quality indicator was reviewed by external experts based on the latest evidence and consensus in this fields. This Korean-specific indicator is expected to significantly contribute to improving ERCP quality in Korea, as it is tailored to local needs.
9.Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea
Ki-Hyun KIM ; Hyung Ku CHON ; Tae Jun SONG ; Dong Won AHN ; Eaum Seok LEE ; Yun Nah LEE ; Yoon Suk LEE ; Tae Joo JEON ; Chang Hwan PARK ; Kwang Bum CHO ; Dong Wook LEE ; Jin-Seok PARK ; Seung Bae YOON ; Kwang Hyung CHUNG ; Jin LEE ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(3):111-122
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that requires abundant clinical experience and endoscopic skills, and can lead to various complications, some of which may progress to life-threatening conditions. With expanding indications and technological advancements, ERCP is widely utilized, enhancing procedural accessibility. However, without proper quality management, the procedure can pose significant risks. Quality management in ERCP is essential to ensure safe and successful procedures and meet societal demands for improved healthcare competitiveness. To address these concerns, the Korean Society of Pancreatobiliary Endoscopy has developed a Korean-specific ERCP quality indicator reflecting domestic medical environments and realities. Initially, based on a review of foreign ERCP quality indicators and related literatures, key questions were formulated for five pre-procedural items, three intra-procedural items, and four post-procedural items. Descriptions and recommendations for each item were selected through peer evaluation. The developed Korean-specific ERCP quality indicator was reviewed by external experts based on the latest evidence and consensus in this fields. This Korean-specific indicator is expected to significantly contribute to improving ERCP quality in Korea, as it is tailored to local needs.
10.One-Year Results of Ear Reconstruction with 3D Printed Implants
Mijung KIM ; Yun Jung KIM ; Young Seok KIM ; Tai Suk ROH ; Eun-Ju LEE ; Jin-Hyung SHIM ; Eun Hye KANG ; Min Ji KIM ; In Sik YUN
Yonsei Medical Journal 2024;65(8):456-462
Purpose:
External ear reconstruction has been a challenging subject for plastic surgeons for decades. Popular methods using autologous costal cartilage or polyethylene still have their drawbacks. With the advance of three-dimensional (3D) printing technique, bioscaffold engineering using synthetic polymer draws attention as an alternative. This is a clinical trial of ear reconstruction using 3D printed scaffold, presented with clinical results after 1 year.
Materials and Methods:
From 2021 to 2022, five adult patients with unilateral microtia underwent two-staged total ear reconstruction using 3D printed implants. For each patient, a patient-specific 3D printed scaffold was designed and produced with polycaprolactone (PCL) based on computed tomography images, using fused deposition modeling. Computed tomography scan was obtained preoperatively, within 2 weeks following the surgery and after 1 year, to compare the volume of the normal side and the reconstructed ear. At 1-year visit, clinical photo was taken for scoring by two surgeons and patients themselves.
Results:
All five patients had completely healed reconstructed ear at 1-year follow-up. On average, the volume of reconstructed ear was 161.54% of that of the normal side ear. In a range of 0 to 10, objective assessors gave scores 3 to 6, whereas patients gave scores 8 to 10.
Conclusion
External ear reconstruction using 3D printed PCL implant showed durable, safe results reflected by excellent volume restoration and patient satisfaction at 1 year postoperatively. Further clinical follow-up with more cases and refinement of scaffold with advancing bioprinting technique is anticipated. The study’s plan and results have been registered with the Clinical Research Information Service (CRIS No. 3-2019-0306) and the Ministry of Food and Drug Safety (MFDS No.1182).

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