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임주현,정인갑,박종연,유달산,홍범식,홍준혁,안한종,김청수 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.7
Purpose: The objective was to investigate the impact of statin use on prognosis after radical nephroureterectomy for upper urinarytract urothelial carcinoma (UTUC). Materials and Methods: A retrospective review of medical records identified 277 patients who underwent radical nephroureterectomyfor primary UTUC at Asan Medical Center between January 2006 and December 2011. Information on preoperative statinuse was obtained from patient charts in an electronic database. We assessed the impact of statin use on recurrence-free survival(RFS), cancer-specific survival (CSS), and overall survival (OS). Results: Of these 277 patients, 62 (22.4%) were taking statin medications. Compared to the statin nonusers, the statin users wereolder, had a higher body mass index, and had higher rates of cardiovascular disease and diabetes. The 5-year RFS rates of statin usersand nonusers were 78.5% and 72.5%, respectively (p=0.528), the 5-year CSS rates were 85.6% and 77.7%, respectively (p=0.516),and the 5-year OS rates were 74.5% and 71.4%, respectively (p=0.945). In the multivariate analysis, statin use was not an independentprognostic factor for RFS (hazard ratio, 0.47, p=0.056), CSS (hazard ratio, 0.46, p=0.093), or OS (hazard ratio, 0.59, p=0.144) inpatients who underwent radical nephroureterectomy for UTUC. Conclusions: Statin use was not associated with improved RFS, CSS, or OS in the sample population of patients with UTUC.
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Prognosis of Prostate Cancer With Other Primary Malignancies
임주현,유달산,정인갑,홍준혁,안한종,김청수 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.5
Purpose: The objective was to investigate the clinicopathological characteristics and the prognosis of prostate cancer patients affected by other primary malignancies. Materials and Methods: From 1990 to 2008, we retrospectively reviewed the medical records of 1,317 patients who underwent radical prostatectomy (RP) for prostate cancer. We assessed the effect of other primary malignancies on clinicopathological features, biochemical recurrence (BCR)-free survival, cancer-specific survival (CSS), and overall survival (OS). Results: Of 1,317 patients, at least one additional other primary malignancy was detected in 187 patients (14.2%). A comparison of patient groups according to the presence or absence of other primary malignancies showed no significant differences in preoperative serum prostate-specific antigen concentrations, pathological Gleason scores, or pathological staging. Prostate cancer patients with other primary malignancies were older than patients without other primary malignancies (p<0.001). No significant differences in 5-year BCR-free survival (80.2% compared with 77.7%; p=0.656) or CSS (98.9% compared with 98.5%; p=0.733) were found between these groups, respectively. Five-year OS was significantly lower in prostate cancer patients with than in those without other primary malignancies (89.3% compared with 95.4%; p<0.001). Multivariate analysis showed that other primary malignancies diagnosed after RP for prostate cancer were independent predictors of OS (hazard ratio, 4.10; p<0.001) but not of BCR-free survival or CSS. Conversely, other primary malignancies diagnosed before RP for prostate cancer did not independently predict BCR-free survival, OS, or CSS. Conclusions: Prostate cancer prognosis after RP is not dependent on the presence or absence of other primary malignancies. However, other primary malignancies diagnosed after RP for prostate cancer negatively affect OS.
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임주현,박창면,김한권,박종연 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6
Purpose: To compare perioperative outcomes between running and interrupted vesicourethral anastomosis in open radical prostatectomy(RP). Materials and Methods: The medical records of 112 patients who underwent open RP for prostate cancer at our institution from2006 to 2008 by a single surgeon were retrospectively reviewed. Preoperative, intraoperative, and postoperative parameters weremeasured. Results: Of 112 consecutive patients, 62 patients underwent vesicourethral anastomosis by use of the running technique, whereas50 patients underwent anastomosis with the interrupted technique. The groups did not differ significantly in age, body mass index,prostate-specific antigen, prostate volume, or pathologic findings. The intraoperative extravasation rate was significantly lower inthe running group (8.1% vs. 24.0%, p=0.01). The mean anastomosis time was 15.1±5.3 and 19.3±4.6 minutes in the running andinterrupted groups, respectively (p=0.04). The rates of postoperative extravasation were similar for both groups (6.4% vs. 10.0%,p=0.12). The duration of catheterization was significantly shorter in the running group (9.0±3.0 days vs. 12.9±6.4 days, p<0.01). The rate of urinary retention after catheter removal and the rate of bladder neck contracture were not significantly different betweenthe two groups. The rate of urinary continence at 3, 6, 9, and 12 months after RP was also similar in both groups. Conclusions: Both anastomosis techniques provided similar functional results and a similar rate of postoperative urine extravasation. However, running vesicourethral anastomosis decreased the rate of intraoperative extravasation and time for anastomosis,without increasing the risk of urinary retention or bladder neck contracture.
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복압성 요실금의 수술방법인 TOT와 TVT-O의 무작위 전향적 비교 연구
임주현,박영경,김명기 대한배뇨장애요실금학회 2005 International Neurourology Journal Vol.9 No.2
Purpose: The aim of our study was to compare the outcomes of the transobturator vaginal tape (TOT) and tension free vaginal tape obturator inside-out (TVT-O) procedures in patients with stress urinary incontinence. Materials and Methods: Between August 2004 and March 2005, 77 women with stress incontinence were randomly assigned to either TOT (n=36) or TVT-O (n=41). The preoperative evaluation included a careful history taking, physical examination, stress test, a quality of life questionnaire and a comprehensive urodynamic examination. Follow up evaluation was carried out after 1 month, 6 months. Patients assessment was made by a clinical examination in the first 1 month and satisfaction rate expressed and uroflowmetry with postvoid residual urine to compare voiding disorder suggesting bladder outlet obstruction after 6 months. Results: Patient characteristics, preoperative quality of life, and urodynamic evaluation were similar between the 2 groups. Mean operative time was similar between the 2 groups (17 min vs 16 min). The rate of postoperative urinary retention was 8.3% (n=3) in the TOT group and 9.8% (n=4) in the TVT-O group. The cutting of tape was required to treat urinary retention in 2.8% (n=1) of the TOT group and 4.9% (n=2) of the TVT-O group at 14 days after the procedure. The rates of cure (66.7% vs 65.9%), improvement (27.8% vs 29.3%), and failure (5.6% vs 4.9%) were similar for the TOT and TVT-O groups, respectively. In terms of bladder outlet obstruction, no difference were found after TOT and TVT-O. Conclusion: Both procedures are equally a simple, safe and effective treatment for female stress urinary incontinence in terms of rate of cure, operation time and complications. However, further studies and long term follow-up are needed for the complications and cure rate. (J. Korean Continence Society 2005;9:82-87)
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임주현,정남운 가톨릭대학교 사회과학연구소 2003 社會科學硏究 Vol.19 No.-
본 연구는 역기능 완벽주의와 심리적 부적응 사이의 매개변인들의 효과를 경로분석을 통하여 모델 검증하였다. 여기서 매개변인은 사회적 지지 지각과 자기지각으로 이루어진 인지세트와 대처방식으로, Lazarus와 Folkman(1984)이 제안한 적응에 대한 스트레스와 대처 모델(stress and coping model of adjustment)에 근거하여 설정되었다. 기본 경로모델 중 부합도가 충분하지 않은 모형을 단계적으로 수정하여 최종모델을 채택하는 과정을 거쳤다. 그 결과 각각의 수정된 경로모델에서 사회적 지지 지각과 대처방식은 매개변인의 효과를 나타냈으나, 자기 지각은 사회지지 지각과만 유의미한 관계를 나타냈고 매개효과는 나타내지 않았다. 역기능 완벽주의와 우울 모델, 역기능 완벽주의와 불안 모델에서는 한 가지 직접경로와 두 가지 간접경로를 볼 수 있었고, 역기능 완벽주의와 강박 모델에서는 직접경로와 간접경로가 각각 한 가지씩 나타났다. 마지막으로 본 연구가 지니는 의의와 제한점, 그리고 추후 연구를 위한 제안 사항들을 기술하였다. This study was to investigate the effect of mediation variables between perfectionism and psychological maladjustments by verifing path model. Mediation variables are cognitive set including social support perception, self perception and coping strategy based on the Stress and Coping Model of Adjustment by Lazarus and Folkman(1984). The final model was modified repeatedly when fit indexes of base path model were not enough to explain data. The result showed that modification path models were selected about depression, anxiety, obsession-compulsion. As a result, social support perception and coping strategy had an effect on mediation variable. Self perception was related with only social support perception and didn't have an effect on mediation variables. Specifically first, There were one direct path and two indirect paths between perfectionism and depression of psychological maladjustments. Second, There were one direct path and two indirect paths like depression model between perfectionism and anxiety of psychological maladjustments. Third, There were one direct path and indirect path. At the end of this, implications, the limitations of this study and suggestions for future were discussed.
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