진행성 요로상피암에서 Gemcitabine과 Cisplatin 병합 화학요법의 효용성

김상훈(Sang Hoon Kim),이승주(Seung-Ju Lee),이지열(Ji Youl Lee),조수연(Su Yeon Cho),김세웅(Sae Woong Kim),이충범(Choong Bum Lee),조대행(Dae Haeng Cho),강성학(Sung Hak Kang),황태곤(Tae Kon Hwang),조용현(Yong-Hyun Cho) 대한비뇨기종양학회 2004 대한비뇨기종양학회지 Vol.2 No.2

골밀도 향상을 위한 대체 요법으로 칼슘/마그네슘 복합체의 효능

신동호,이동섭,션 리,김세웅,Shin, Dongho,Lee, Dong Sup,Lee, Sean S.,Kim, Sae Woong 한국식품영양학회 2022 韓國食品營養學會誌 Vol.35 No.5

The medicines for treating osteoporosis currently in use have minor to severe side effects, and can be financially burdensome. Thus, there is a need for prevention and alternative supplement that is relatively inexpensive, and can be easily consumed daily as an alternative dietary therapy. In this study, bone marrow density of the spine and femur of osteoporosis patients were checked before and after consuming complex composed of calcium and magnesium, considered to be the core of bone mineral content. November 2017-November 2021, patients with T-score of less than -2.5 or -1.0 < T-score < -2.5 with history of fractures or recent fractures were enrolled. The data of 60 patients who orally administered Ionized Cal/Mag^TM Complex were reviewed retrospectively, and it was significantly confirmed that the average value of T-score was up-regulated by 0.5. Additionally, the cumulative dose was observed to have a positive effect, on the improvement of BMD in the 2nd Lumbar and Femur neck. It is expected that better results will be achieved if use of the supplement is continued.

Capsaicin-Induced Apoptosis in MBT-2 Murine Bladder Tumor Cells and Bladder Wall Penetration Effect of the Nano-Encapsulated Capsaicin in Rabbit

Shin Jay Cho(조신제),Hyong Woo Moon(문형우),Woong Jin Bae(배웅진),Yong-Hyun Park(박용현),U-Syn Ha(하유신),Sung-Hoo Hong(홍성후),Sae Woong Kim(김세웅),Ji Youl Lee(이지열) 대한비뇨기종양학회 2019 대한비뇨기종양학회지 Vol.17 No.3

Purpose: In this study, we attempted to characterize capsaicin’s effects with regard to the apoptosis of murine bladder cancer cells (MBT-2) as well as the pharmacodynamics of nano-encapsulated capsaicin formulation for intravesical instillation. Materials and Methods: We assessed the viability of the MBT-2 cells via MTT staining, agarose gel electrophoresis, and flow cytometric apoptosis analysis. Intravesical reagents were instilled into 3 groups of male white New Zealand rabbits. Instillation agents were nano-encapsulated capsaicin dissolved in saline, capsaicin dissolved in saline, and capsaicin dissolved in dimethyl sulfoxide (DMSO). We also determined the pharmacokinetics of urine, plasma, and bladder tissue after intravesical capsaicin instillation. Results: Capsaicin treatment was determined to reduce cell viability in a time- and dose-dependent manner. The capsaicin concentrations in the urine of the rabbits decreased in each of the treatment groups, but we noted a more profound reduction of capsaicin concentration in the nano-encapsulated capsaicin group. Plasma concentrations were definitely lower as compared with the levels measured in the bladder tissue and urine. We noted distinctive differences in patterns of concentration change between the capsaicin with normal saline solution (NSS) or DMSO and the nano-encapsulated capsaicin groups. The concentration of nano-encapsulated capsaicin in the tissue appeared to increase directly with tissue depth. Conclusions: Our results show that capsaicin can induce apoptosis in MBT-2 cells, as well as the excellent permeation properties of nano-encapsulated capsaicin. Treatment with intravesical capsaicin may be a promising alternative therapeutic modality for the treatment of bladder cancer.

임상적으로 무의미한 전립선암의 선별을 위한 자기공명영상 기반의 노모그램 개발

성재우(Jae Woo Sung),신동호(Dongho Shin),박용현(Yong Hyun Park),조혁진(Hyuk Jin Cho),하유신(U-Syn Ha),홍성후(Sung-Hoo Hong),이지열(Ji Youl Lee),김세웅(Sae Woong Kim) 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.3

Purpose: Various predictive tools have been developed to predict insignificant prostate cancer (PCa) for active surveillance, however, these models cannot reflect all the refinements of current medicine. Thus, we aimed to develop a novel model to predict clinically insignificant PCa incorporating these factors. Materials and Methods: We developed a novel nomogram to predict the probability of insignificant PCa (total tumor volume less than 2.5 cm3, index tumor volume less than 1.3 cm3, organ confined disease and no Gleason pattern 4 or 5) using preoperative data of 790 Korean patients who underwent radical prostatectomy. To evaluate the predictive accuracy, the area under the receiver operating characteristic curve (AUC) was calculated. Next, the predicted probability versus the actual probability was compared. This examination was performed by calibration plotting using 1,000 bootstrap resamples. Results: Of the 790 patients, 668 (84.6%) had clinically significant PCa, and 122 (15.4%) had insignificant PCa. We developed a novel predictive model for clinically insignificant PCa using clinical stage less than T2a, biopsy Gleason sum less than 7, ratio of positive biopsy cores less than 10%, neutrophil-to-lymphocyte ratio, and multiparametric magnetic resonance imaging (mpMRI) visibility, which discriminated patients with clinically insignificant PCa from those with significant PCa with an AUC of 0.9135 (95% confidence interval, 0.9127–0.9143). The calibration plot showed a well-calibrated prediction that had little over- or underestimation. Conclusions: We proposed a novel predictive model for insignificant PCa to more accurately select patients for active surveillance using the results from mpMRI and prebiopsy laboratory marker.

하대정맥 혈전을 동반한 신장에 발생한 원시신경외배엽종양

손동완(Dong Wan Sohn),이병희(Byung Hee Lee),정조운(Jo Un Jung),이준하(Jun Ha Lee),최현섭(Hyun Sop Choe),김세웅(Sae Woong Kim),이연수(Youn Soo Lee),조용현(Yong Hyun Cho) 대한비뇨기종양학회 2006 대한비뇨기종양학회지 Vol.4 No.4

요로감염증 환자의 치료에서 메로페넴(Meropenem)과 이미페넴/실라스타틴(Imipenem/Cilastatin)의 임상효과 및 안정성

김세웅,이승주,이지열,조용현,신완식,윤문수 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.1

목적 :메로페넴은 실라스타틴을 복합투여하지 않아도 되는 새로운 계열의 카바페넴계 항생물질이다. 요로감염 치료에 있어서의 메로페넴의 효과와 안전성을 평가하기 위하여 기존의 카바페넴계 항생물질인 이미페넴/실라스타틴과 동시에 비교임상실험을 실시하였다. 방법 : 본 임상시험은 전향적, 무작위 방법을 통하여 시행하였다. 1996년 10월부터 1998년 2월까지 가톨릭대학교 의과대학 부속 성모병원 및 울산대학교 외과대학 부속 중앙병원 비뇨기과에 입원한 신우신염과 복잡성방광염 환자 115명을 대상으로 하였고, 연속적 무작위 배정방법을 통하여 메로페spa군 58명과 이미페넴/실라스타틴군 57명으로 분류하였다. 두가지 약제는 모두 0.5 g을 12시간 간격으로 정맥주사 하였고, 평균 투약기간은 4일 (3-8일) 이었다. 임상효과, 세균학적 평가 및 부작용을 비교 관찰하였다. 결과 : 총 67명의 환자가 시험을 완료하여 평가가 가능하였고, 이 중 메로페넴군은 34명이었고, 이미페넴/실라스타틴군은 33명이었다. 증상의 치료 및 개선을 임상적 유효성이 있는 경우로 하였을 때, 메로페넴투여군은 34례중 32례 (94.1%)에서, 이미페넴/실라스타틴투여군은 33례중 29례 (87.9%)에서 유효율을 보였다. 세균학적 평가에서 메로페넴 투여군은 34례중 32례 (94.1%)에서, 이미페spa/실라스타틴투여군은 33례중 29례 (87.9%)에서 세균학적 소실율을 보였다. 세균학적 재발 은 각각 4명과 7명이 나타났고, 재감염은 메로페넴군은 나타나지 않았지만, 이미페넴/실라스타틴군은 2명이 나타났다. 임상효과와 세균학적 평가에서는 두 약제간의 통계학적 차이는 없었다. 부작용은 메로페spa투여군 56례중 1례 (1.8%)에서, 이미페넴/실라스타틴투여군 53례중 1례 (1.9%)에서 나타났으며, 임상검사치 이상은 메로페넴투여군 45례중 10례 (22.2%)에서, 이미페넴 실라스타틴투여군 44례중 8례 (18.2%)에서 나타났으나 전체적으로 특별히 문제가 된 증례는 없었다. 결론 :결론적으로 메로페spa은 신우신염 및 복잡성방광염과 같은 요로감염에 대하여 이미페넴/실라스타틴과 동등한 효과를 나타내는 유용한 약제라고 생각된다. Background : Metopenem is the first of a new class carbapenems which may be administered without cilastatin. The clinical study was carried out to assess efficacy and safety of metopenem in the treatment of urinary tract infections, in comparison to imipenem/cilastatin. Methods : This was a controlled, two-center, prospective, randomized study with two parallel groups. From October 1996 until February 1998, a total of 115 consecutive patients with urinary tract infections, such as pyeolonephritis and complicated cystitis, were randomly allocated into two groups, 58 in the meropenem group and 57 in the imipenem/cilastatin group. Both drugs were administered intravenously, at a dose of 0.5 g every 12 hours. The mean duration of therapy was 4 days (3-8 days) for both treatment. Clinical and bacteriological reponses were assessed at the begining of treatment, during treatment, at the end of treatment, and follow-up (1-2 weeks). Results : A total of 67 patients, 34 of meropenem and 33 of imipenem/cilastatin, were evaluable for response. Overall, a positive clinical response (recovery and improvement) was observed in 32 (94.1%) of 34 patients treated with meropenem and in 29 (87.9%) of 33 patients with imipenem/cilastin and the corresponding eradication rates of the primary pathogens were 32 (94.1%) of 34 patients and 29 (87.9%) of 33 patients, respectively. The microbiological relapse after the treatment completion was recorded in 4 patients treated with meropenem and 7 patients given imipenem/cilastath and superinfections occurred in none and 2 patients, respectively. No statistically significant differences in the clinical or bacteriological outcome were observed between the treatment groups. Both drugs were well tolerated with adverse events considered to be related to therapy being recorded for 1 (1.8%) of 56 patients treated with meropenem and 1 (1.9%) of 53 of those who had been given imipenenjcilastatin. Conclusion : Empirial monotherapy with meropenem was therefore as effective and as well tolerated as that with imipenem/cilastatin for the treatment of urinary tract infections.

최근 5년간 요로감염의 원인균 및 항생제 감수성

김세웅,임필빈,정웅교,이승주,이지열,조용현,윤문수 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.3

배경 : 최근 요로감염 원인균에 대한 내성 증가로 항생제 감수성에 변화를 가져와 요로감염 환자에게 경험적 1차 치료를 위한 항생제 선택에 어려움을 주고 있다. 단순 및 복잡성 요로감염으로 진단 받은 환자들을 대상으로 원인균과 그에 따른 항생제의 감수성을 살펴봄으로써 향후 단순 및 복잡성 요로감염에 대한 항생제의 선택에 도움을 받고자 한다. 대상 및 방법 : 1996년 6월부터 2001년 5월까지 요배양 검사상 요로 감염균이 10^5cfu/ml 이상의 집락이 형성된 200명을 대상으로 해부학적 또는 구조적인 장애 유무에 따라 단순 요로감염 및 복잡성 요로 감염으로 나누어 각각의 원인균과 그에 따른 항생제의 감수성을 후향적으로 분석하였다. 결과 : 복잡성 요로감염의 가장 흔한 원인질환은 신경인성 방광이었다. 단순 요로감염의 가장 흔한 원인균은 E. coli (61.35%)였고 복잡성 요로감염에서는 E. coli 이외의 균이 E. coli 보다 더 흔한 원인균이었다(58.9%). 단순 및 복잡성 오료감염 중 그람 양성균에서는 vancomycin, penicillin 이 높은 감수성을 보인 반면 ciprofloxacin, imipenem이 낮은 감수성을 보였고 그람음성균에서는 amikacin, imipenem이 높은 감수성을 보인 반면 ampicillin, bactrim이 낮은 감수성을 보였다. 결론 : 단순 및 복잡성 요로 감염의 주 원인균으로 그람 음성균주 특히, Ecoli에 의한 감염이 많은 비중을 차지하고 있으나 빈도가 점차적으로 감소하는 추세이다. 또한 병원성 감염 및 도뇨관의 장기 유치에 따른 교대균의 증가, 비병원성 세균의 출현 등으로 인한 E. coli 이외의 기타 그람음성균 및 그람양성균의 증가하는 추세이다. 향후 임상에서 요로감염의 일치 치료제로 많이 사용되고 있는 ampicillin과 bactrim 등의 항생제의 감수성이 낮으므로 사용시 필요하다고 사료된다. Backround : The increasing frequency of failure of urinary tract infections (UTIs) may be due to emerging resistance to commonly prescribed antimicrobials. We studied the causative microorganisms and their antibiotic sensitivities in uncomplicated and complicated UTIs. Methods : We analyzed 219 microorganisms and their antibiotic sensitivities of 200 outpatients who had more than 10^5cfu/ml on urine from June 1996 to May 2001 retrospectively. The patients weredivided into 2 groups, uncomplicated UTI group and commplicated UTI group according to with or without underlying disease. Results : The most common underlying disease of complicated UTI was neurogenic bladder. The most common pathogenic microorganism was Escherichia coli (E. coli) (61.35%) in uncomplicated UTI group but in complicated UTI, non-E, coli(58.9%) was more common than E. coli. In uncomplicated and complicated UTI, vancomycin, penicillin showed relatively higher sensitivity of gram positive organisms, while ciprofloxacin, imipenem showed relatively lower sensitivity, and imipenem, amikacin showed relatively higher sensitivity of gram negative organisms, while bactrim, amipicillin showed relatively lower sensitivity. Conclusion : We consider that gram negative microorgansisms, especially E. coli, is the main cause of UTI. But, we should concern about the increase of gram positive organsms and other gram negative organisms besides E. coli. Bactrim, amipicllin which were prescribed empirically in UTIs, showed relatively lower sensitivity. Regarding tom the choice of adequate drug in the treatment of UTI, it is necessary to consider the change of pathologic microorganisms.

급성 단순하부요로감염증 치료에서 노르플록사신과 루플록사신의 임상효과 및 안전성

김세웅,이지열,이승주,조용현,윤문수 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.1

목적 : 루플록사신은 긴 반감기와 넓은 항균력을 가진 퀴놀론계 항생물질이다. 급성 단순하부요로감염 치료에 있어서의 루플록사신의 효과와 안전성을 평가하기 위하여 기존의 퀴놀론계 항생물질인 노르플록사신과 비교임상시험을 실시하였다. 방법 : 본 임상시험은 전향적, 무작위 방법으로 진행하였으며 1997년 8월부터 1999년 3월까지 가톨릭대학교 의과대학 부속 성모병원 비뇨기과에 내원한 급성 단순하부요로감염 환자 72명을 대상으로 하였다. 연속적 무작위 배정방법을 통하여 루플록사신군 36명과 노르플록사신군 36명이 루플록사신 400㎎을 단회 경구투여 받거나 노르플록사신 400㎎을 12시간 간격으로 3일간 6회 경구투여 받았다. 임상효과, 미생물학적 평가 및 부작용을 비교 관찰하였다. 결과 : 총 64명의 환자가 시험을 완료하여 평가가 가능하였고, 이 중 루플록사신군은 32명이었고, 노르플록사신군은 32명이었다. 증상의 치료 및 개선을 임상적 유효성이 있는 경우로 하였을 때, 루플록사신투여군은 32례중 32예(100%)에서, 노르플록사신투여군은 32례 중 31례(96.9%)에서 만족할 만한 결과를 얻었다. 미생물학적 평가에서 루플록사신투여군은 32례 중 29례(90.6%)에서, 노르플록사신투여군은 32례 중 28례(87.5%)에서 미생물학적 소실을 보였다. 미생물학적 재발은 루플록사신군과 노르플록사신군에서 각각 1례(3.1%)과 2례(6.3%)가 나타났고, 재감염은 각각 2례(6.3%)와 1례(3.1%)가 나타났다. 임상효과와 미생물학적 평가에서는 두 약제간의 통계학적 차이는 없었다. 약물역동학적 검사상 루플록사신은 노르플록사신에 비해 높은 MIC를 갖고 있지만 긴 반감기를 통해 소변내에서 높은 농도와 요 살균력을 유지함을 알 수 있었다. 부작용은 루플록사신투여군 34례 중 5례(14/7%)에서, 노르플록사신투여군 35례 중 1례(2.9%)에서 나타났으며, 대부분의 소화기계통의 이상반응 이었으며, 모두 경증으로 24시간 이내에 소실되었다. 루플록사신투여군 중 2례에서는 경증의 중추신경계의 이상반응이 관찰되었다. 결론 : 결론적으로 루플록사신은 급성 단순하부요로감염에 대하여 1회 투여만으로도 노르플록사신의 3일 투여법과 동등한 효과를 나타내는 유용한 약제라고 생각된다. Background : Rufloxacin is a broad-spectrum quinolone that exhibits a prolonged elimination half-life. The purpose of this study is to evaluate the efficacy and safety of a single dose of rufloxacin, campared with those of a norfloxacin standard treatment. Methods : This was a open. randomized. parallel-group, phase 11 clinical trial. A total of 72 women with acute lower urinary tract infections were included and randomly assigned to one of the treatment regimens: rufloxacin 400㎎ single dose, or norfloxacin 400㎎ b.i.d. for 3 days. Clinical and bacteriological assessments were performed twice at the third day and the seventh or tenth day after inclusion. Results : A total of 64 patients(32 and 32 patients in the rufloxacin and norfloxacin groups, respectively) were considered clinically and bacteriologically evaluable. Overall, a clinical response(recovery and improvement) was observed in 32 (100%) of 32 patients treated with rufloxacin and in 31 (96.95) of 32 patients with norfloxacin. The corresponding eradication rates of the primary pathogens were 90.6%(29/32) and 87.5%(28/32), respectively. The microbiological relapses between the seventh and tenth day were recorded in 1 patient(3.1%) and 2 patients(6.3%) in the rufloxacin and norfloxacin groups, respectively. The superinfections occurred in 2(6.3%) and 1(3.1%) patients, respectively. No statistically significant differences in the clinical or bacteriological outcome were observed between the treatment groups. The pharmacodynamic evaluation showed similar median urine bactericidal titers(UBT) for both treatment groups against initial isolates, despite a higher MIC of rufloxacin than that of norfloxacin. Five patients (14.7%) in the rufloxacin group and 2 patients (5.7%) in the norfloxacin group reported 9 and 4 adverse events, respectively, almost all of them being mild and lasting <24 h. Overall, gastrointestinal reactions were the most frequent adverse events reported. However, 2 patients treated with rufloxacin reported 3 central nervous system adverse events. Conclusion : This study suggests that single dose of rufloxacin treatment is effective and well tolerated as norfloxacin 3-day standard treatment in acute uncomplicated lower urinary tract infections.

최근 3년간 급성 단순 요로감염의 원인균에 따른 항생제 감수성

김세웅,이지열,박왕진,조용현,윤문수 대한감염학회 2000 감염 Vol.32 No.5

방광적출 후 Orthotopic Neobladder와 회장도관문합술 (IlealConduit)을 시행받은 환자들의 삶의 질에 대한 비교

김세웅,이지열,이승주,하재성,이충범,조용현,조대행,윤문수 大韓泌尿器科學會 2000 Korean Journal of Urology Vol.41 No.7