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Chung, Jae-Seung,Son, Nak Hoon,Lee, Sang Eun,Hong, Sung Kyu,Jeong, Chang Wook,Kwak, Cheol,Kim, Hyeon Hoe,Hong, Sung Hoo,Kim, Yong June,Kang, Seok Ho,Chung, Jinsoo,Kwon, Tae Gyun,Hwang, Eu Chang,Byun, The Korean Academy of Medical Sciences 2018 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.33 No.43
<P><B>Background</B></P><P>To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD).</P><P><B>Methods</B></P><P>We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I–II and stage III. Kidney function, and survival outcomes were compared between groups.</P><P><B>Results</B></P><P>We included 1,756 patients with CKD I–II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I–II disease (99.4% vs. 96.5%, respectively, <I>P</I> = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, <I>P</I> = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I–II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122–0.840; <I>P</I> = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086–1.172; <I>P</I> = 0.117).</P><P><B>Conclusion</B></P><P>PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III.</P>
Comparison of Synchronous and Metachronous Primary Carcinomas of the Bladder and Prostate
Ho Seok Chung,Young Ho Seo,Seung Il Jung,Eu Chang Hwang,Taek Won Kang,Dong Deuk Kwon 대한비뇨기종양학회 2017 대한비뇨기종양학회지 Vol.15 No.1
Purpose: The incidence of multiple primary malignant neoplasms increases with age. An unforeseen finding is the high number of prostate and bladder cancers pairs. Of prostate and bladder cancers pair as first primary and second primary cancers and vice versa, we investigated the differences in clinicopathological features between synchronous and metachronous primary carcinomas of the bladder and prostate. Materials and Methods: Fifty-three patients diagnosed with dual prostate and bladder cancer in a 12-year period (2004–2015) excluding cases with incidental prostate cancer after radical cystectomy were reviewed. Enrolled patients were divided into 3 groups according to cancer development (group I, synchronous cancer; group II, prostate cancer with metachronous bladder cancer; group III, bladder cancer with metachronous prostate cancer). Each group was compared according to clinicopathological features. Results: Median age was 72 years (range, 54–83 years). Groups I, II, and III comprised 29 (54.7%), 8 (15.1%), and 16 patients (30.2%), respectively. Age, prostate-specific antigen, tumor stage, grade, multifocality of bladder tumor, and treatment modality did not show statistical differences between groups. However, group III showed a lower prostate cancer stage (National Comprehensive Cancer Network anatomic stage; p=0.009) and had low-risk of prostate cancers (p=0.025). Conclusions: Bladder tumor showed no differences in the clinicopathological features between synchronous and metachronous primary carcinomas. However, metachronous prostate cancer showed better clinicopathological features of prostate cancer. It is important for clinicians to counselling and decision making in clinical situations.
Byun, Seok-Soo,Hwang, Eu Chang,Kang, Seok Ho,Hong, Sung-Hoo,Chung, Jinsoo,Kwon, Tae Gyun,Kim, Hyeon Hoe,Kwak, Cheol,Kim, Yong-June,Lee, Won Ki Hindawi Publishing Corporation 2016 BioMed research international Vol.2016 No.-
<P><I>Background</I>. The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in nonmetastatic renal cell carcinoma (non-mRCC) is controversial, although NLR has been established as a prognostic factor in several cancers. The objective of our study was to assess the prognostic significance of preoperative NLR in non-mRCC, based on a large, multicenter cohort analysis.<I> Methods</I>. Totally, 1,284 non-mRCC patients undergoing surgery were enrolled from six institutions between 2000 and 2014. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were calculated, and the prognostic significance of NLR was evaluated.<I> Results</I>. Patients with higher NLR had larger tumors (<I>p</I> < 0.001), higher T stage (<I>p</I> < 0.001), worse Eastern Cooperative Oncology Group performance status (<I>p</I> < 0.001), worse symptoms (<I>p</I> = 0.003), sarcomatoid differentiation (<I>p</I> = 0.004), and tumor necrosis (<I>p</I> < 0.001). The 5-year RFS and CSS rates were significantly lower in patients with high NLR than in those with low NLR (each <I>p</I> < 0.001). Multivariate analysis identified NLR to be an independent predictor of RFS and CSS (each <I>p</I> < 0.05). Moreover, predictive accuracy of multivariate models for RFS and CSS increased by 2.2% and 4.2%, respectively, with NLR inclusion.<I> Conclusions</I>. Higher NLR was associated with worse clinical behavior of non-mRCC. Also, NLR was a significant prognostic factor of both RFS and CSS.</P>
Leukemoid Reaction, a Rare Paraneoplastic Syndrome in Urothelial Cell Carcinoma
Ho Seok Chung,Bo Sung Shin,Ho Song Yu,Eu Chang Hwang,Sun-Ouck Kim,Sung Il Jung,Taek Won Kang,Dong Deuk Kwon,Kwangsung Park 대한비뇨기종양학회 2015 대한비뇨기종양학회지 Vol.13 No.3
A leukemoid reaction is usually associated with malignancies of the lung, stomach, and thyroid. In contrast, urothelial cell carcinoma is rarely associated with leukemoid reactions, with few cases reported over the past 30 years. Here, we describe a patient with urothelial cell carcinoma who exhibited a leukemoid reaction. The patient had an elevated white blood cell count and experienced a rapid and aggressive clinical course, terminating in death. For urothelial cell carcinoma patients exhibiting a leukemoid reaction, removal of the inciting tumor is the definitive treatment. However, considering the aggressive nature of these tumors, if the patient is unsuitable for radical surgical management, palliative chemotherapy should be considered.
Kim, Myung Soo,Chung, Ho Seok,Hwang, Eu Chang,Jung, Seung Il,Kwon, Dong Deuk,Hwang, Jun Eul,Bae, Woo Kyun,Park, Jae Young,Jeong, Chang Wook,Kwak, Cheol,Song, Cheryn,Seo, Seong Il,Byun, Seok-Soo,Hong, KOREAN ACADEMY OF MEDICAL SCIENCE 2018 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.33 No.51
<P><B>Background</B></P><P>To evaluate survival outcomes and prognostic factors for overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received sunitinib (SU) and pazopanib (PZ) as first-line therapy in real-world Korean clinical practice.</P><P><B>Methods</B></P><P>Data of 554 patients with mRCC who received SU or PZ at eight institutions between 2012 and 2016 were retrospectively reviewed. Based on the targeted therapy, the patients were divided into SU (n = 293) or PZ (n = 261) groups, and the clinicopathological variables and survival rates of the two groups were compared. A multivariable Cox proportional hazard model was used to determine the prognostic factors for OS.</P><P><B>Results</B></P><P>The median follow-up was 16.4 months (interquartile range, 8.3–31.3). Patients in the PZ group were older, and no significant difference was observed in the performance status (PS) between the two groups. In the SU group, the dose reduction rate was higher and the incidence of grade 3 toxicity was more frequent. The objective response rates were comparable between the two groups (SU, 32.1% vs. PZ, 36.4%). OS did not differ significantly between the two groups (SU, 36.5 months vs. PZ, 40.2 months; log-rank, <I>P</I> = 0.955). Body mass index, Eastern Cooperative Oncology Group PS > 2, synchronous metastasis, poor Heng risk criteria, and liver and bone metastases were associated with a shorter OS.</P><P><B>Conclusion</B></P><P>Our real-world data of Korean patients with mRCC suggested that SU and PZ had similar efficacies as first-line therapy for mRCC. However, PZ was better tolerated than SU in Korean patients.</P>
Effects of anti-asthma therapy on dyspnea perception in acute asthma patients
Choi, Inseon S.,Chung, Se-Woong,Han, Eu-Ryeong,Lim, Jeong-Hwan,Cho, Jeong-Seon,Lee, Yoon-Cheol,Cho, Seok,Jang, An-Soo Bailliere Tindall,in association with the British 2006 Respiratory medicine Vol.100 No.5
<P><B>Summary</B></P><P>Blunted perception of dyspnea may predispose patients to fatal asthma attacks. To examine whether this impaired perception of dyspnea in patients with acute asthma could be corrected by anti-asthma therapy, the medical records of 104 consecutive asthma patients who had been hospitalized as a result of asthma attacks were analyzed retrospectively. During the course of treatment with conventional asthma medications, the forced expiratory volume in 1s (FEV<SUB>1</SUB>) and the Borg scale-based dyspnea perception scores during breathing through an inspiratory muscle trainer were measured at least twice. The baseline Borg score measured just before discharge was significantly lower than from that measured initially, regardless of improvement in FEV<SUB>1</SUB>. In contrast, the Borg score at the highest resistance (HR; 3.12±0.26 vs. 5.03±0.53; <I>P</I><0.01) and the HR-induced ΔBorg score (1.68±0.20 vs. 4.47±0.54, <I>P</I><0.001) were increased significantly in the Poor Perceivers (Borg score ⩽ 5 at HR and HR-induced ΔBorg score ⩽3). Patient age (<I>r</I>=0.363, <I>P</I><0.001), blood eosinophil counts (<I>r</I>=−0.285, <I>P</I><0.01), and serum total IgE levels (<I>r</I>=−0.213, <I>P</I><0.05), but not FEV<SUB>1</SUB>, were significantly related to the effect of the treatment on the HR-induced ΔBorg scores. These findings suggest that anti-asthma treatments decrease dyspnea even without a concomitant improvement in lung function and correct the impaired perception of inspiratory resistive load in acute asthma, and that age and allergy influence the effect of treatment on impaired perception.</P>
( Ji Hae Lee ),( Jung Min Bae ),( Eu Seok Chung ),( Hanmi Chung ),( Sae Mi Park ),( Ju Hee Lee ),( Hee Jin Jeon ),( Seung Jun Hwang ),( Gyong Moon Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: The Immunologically privileged autologously cultured dermal fibroblasts of diabetic mouse may have same or better functions than normally working fibroblasts or stem cells, and previous reports showed similar functioning abilities of diabetic dermal fibroblasts compared with that of normal origin. Objectives: We would like to show that immunologically privileged autologously sampled and cultured dermal fibroblasts might show better clinical and histological, immunohistochemical results than allogeneic mesenchymal stem cells in cell transplantation therapy for diabetic skin ulcers. Methods: Every mouse was given surgery which procedure resulted in 6 mm identical full thickness wound in both back area, and A group mouse were injected allogeneic normal stem cells in right-sided wounds with left sided wounds untreated (normal control). Simultaneously, B group mouse were injected autologous diabetic fibroblasts in right-sided wounds with left sided wounds untreated (normal control). Results: Compared with bare diabetic wounds and groups of diabetic wounds treated with allogeneic stem cells as control groups, autologous fibroblasts-transplanted diabetic wounds showed better wound healing with better, faster dermal granulation tissue regeneration and vascularization than allogeneic stem cell treated wounds. Conclusion: Immunologically privileged autologous dermal fibroblasts may be good therapeutics in nonhealing chronic, diabetic skin ulcers.
Lim Do Gyeong,Lee Ho Yeon,Chung Ho Seok,Hwang Eu Chang,Jung Seung Il,Kwon Dong Deuk 대한요로생식기감염학회 2023 Urogenital Tract Infection Vol.18 No.3
Purpose: Emerging evidence has suggested that prior or concurrent antibiotic (ATB) use may be associated with a poor response to immune checkpoint inhibitors (ICIs) in patients with some solid tumors. This study examined the effects of ATB use on the oncological outcomes of patients receiving ICIs for mUC. Materials and Methods: Patients receiving ICIs for mUC between 2018 and 2020 were assessed retrospectively. Those with over three cycles of atezolizumab or pembrolizumab were included. ATB use, defined as ≥ three days within 60 days before or three months after ICI administration, was compared between groups for oncological outcomes. Results: Thirty-one patients were examined. The ATB-use and no-ATB-use groups consisted of 15 (48.4%) and 16 patients (51.6%), respectively. The ATB-use group showed a lower disease control rate (56.3% vs. 13.3%, p=0.023) than the no-ATB-use group. The objective response rate in the ATB-use group was lower than the no-ATB-use group, but the difference was statistically insignificant (43.7% vs. 13.3%, p=0.113). The ATB-use group had shorter progression-free survival (median three vs. six months, log-rank p=0.045) and shorter overall survival (median three vs. 14 months, log-rank p=0.023) than the no-ATB-use group. The most commonly used antibiotics were fluoroquinolones (46.7%), cephalosporins (40.0%), non-cephalosporin beta-lactams (6.7%), and nitrofurantoin (6.7%). Conclusions: ATB may be associated with poorer oncological outcomes in patients with mUC who received ICI therapy. Hence, further research will be needed to understand the relationship between the modulation of ATB-related dysbiosis and gut microbiota composition with the oncological outcomes in patients with mUC.
( Jihae Lee ),( Jung Min Bae ),( Eu Seok Chung ),( Sae Mi Park ),( Ju Hee Lee ),( Hee Jin Jeon ),( Gyong Moon Kim ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2
Background: Basal carcinomas are well known skin malignancy and frequently associated with sun exposure that may be associated with subclinical cancerization. Objectives: We did research about the sunclinical cancerization marker, Notch, in cutaneous basal cell carcinomas. Methods: Recently surgically removed basal cell carcinomas were clinicopathologically reviewed, and Notch immunohistochemical stains were done. Results: Basal cell carcinomas showed much decreased expressions of Notch marker than normal areas. Assessment of Notch marker showed subclinical cancerization previously. Conclusion: Subclinical cancerization might be another related pathogenesis of basal cell carcinomas and further correlated pathways of basal cell carcinoma-Notch markers will be interesting for the perspectives of new topical anticancer therapeutics challenge.