임상적으로 확인되지 않는 양성 요세포검사의 대처법

최석환(Seock Hwan Choi),권태균(Tae Gyun Kwon) 대한비뇨기종양학회 2012 대한비뇨기종양학회지 Vol.10 No.3

Urine cytology is one of the key screening and surveillance methods in the management of patients with urothelial tumors. Urine cytology usually shows high specificity and low sensitivity. Therefore, positive cytology is generally considered as a precursor of the urothelial malignancy even if there is no clinical confirmation. Clinically unconfirmed positive urine cytology refers to the condition that the result of urine cytology is repeatedly positive but the malignancy cannot be identified with the imaging study or cystoscopy. Based upon current reports, most patients with clinically unconfirmed positive urine cytology will eventually be identified with the recognizable tumors. In the present study cohort, the most common site of malignancy was the bladder. In this article, we address the systematic approach to evaluation and management of clinically unconfirmed positive urine cytology with the literature review.

전립선암 선별검사로서 PSA의 유용성

최석환(Seock Hwan Choi),권태균(Tae Gyun Kwon) 대한비뇨기종양학회 2013 대한비뇨기종양학회지 Vol.11 No.1

The rapid and widespread use of prostate-specific antigen (PSA) screening into clinical field was based on the assumption that PSA may increase the chance of earlier detection and cure of prostate cancer with minimal harms. In US, the introduction of PSA testing nearly doubled the lifetime risk of receiving a diagnosis of prostate cancer. However, many studies reported that PSA screening also can increase overdiagnosis and subsequent overtreatment. To evaluate the value of PSA screening on prostate cancer mortality, numerous studies have been conducted with contradictory results. Moreover, most of them were not randomized, controlled study. Recently, early results of two large, randomized, controlled trials of screening have published. A European study showed a modest decrease in prostate-cancer mortality, whereas a United States study showed no decrease in prostate-cancer mortality. Considering these inconsistent results of trials, men considering prostate-cancer screening should be informed about the potential benefits and harms of screening and early treatment. In this article, we address the current status and value of PSA screening with the review of the literature on PSA screening for prostate cancer.

국내 전이성 투명세포 신장암 환자의 1차 표적치료제 동향: Sunitinib과 Pazopanib, 다기관 연구

최민수(Minsu Choi),신택준(Teak Jun Shin),김병훈(Byung Hoon Kim),김천일(Chun Il Kim),이경섭(Kyung Seop Lee),최석환(Seock Hwan Choi),김현태(Hyun Tae Kim),김태환(Tae-Hwan Kim),권태균(Tae Gyun Kwon),고영휘(Young Hwii Ko),하윤수(Yoon Soo 대한비뇨기종양학회 2022 대한비뇨기종양학회지 Vol.20 No.2

Purpose: There have been few reports on comparison between sunitinib and pazopanib as first-line targeted therapy in Korean metastatic clear cell renal cell carcinoma (ccRCC). We sought to analyze the treatment trends of metastatic ccRCC by comparing the effects and adverse events of sunitinib and pazopanib. Materials and Methods: Data of 357 metastatic RCC patients who received the sunitinib or pazopanib as the first-line targeted therapy from the Daegyeong Oncology Study Group database was obtained and analyzed. Among these patients, patients who only clear cell type was confirmed after needle biopsy or nephrectomy were included, and patients who underwent target therapy for less than 3 months were excluded. Results: Of 251 patients who met the inclusion criteria, sunitinib and pazopanib group were identified in 156 (62%) and 95 patients (38%), respectively. Pazopanib group was older (66 years vs. 61 years, p=0.001) and more symptomatic (65% vs. 52%, p=0.037) and had more patients with Karnofsky performance status <80 (20% vs. 11%, p=0.048) and fewer number of organ metastases (p=0.004) compared to sunitinib group. There was no significant difference in disease control rate (88.5% vs. 87.3%, p=0.744), the median progression-free survival (19 months vs. 15 months, p=0.444) and overall survival (25 months vs. 19 months, p=0.721) between sunitinib and pazopanib. The most common grade 3/4 adverse events with sunitinib and pazopanib were anemia (5%) and hand-foot syndrome (3%), respectively. There was no significant difference between sunitinib and pazopanib in number of patients who experienced grade 3/4 adverse events (15% vs. 11%, p=0.275). However, there were more patients who discontinued treatment due to only adverse events in sunitinib group compared to pazopanib group (12% vs. 3%, p=0.020). Conclusions: In Korean metastatic ccRCC, pazopanib tended to be used in patients with poorer health status compared to sunitinib. Sunitinib and pazopanib had no significant difference in treatment effect and survival, but pazopanib had more tolerable adverse events.

병원 수술실 내 의료진 호흡영역에서의 수술연기 농도분포 수치해석

이정호(Lee, Jung Ho),최동희(Choi, Dong Hee),최석환(Choi, Seock Hwan),강동화(Kang, Dong Hwa) 한국건축친환경설비학회 2017 한국건축친환경설비학회 논문집 Vol.11 No.1

Recent studies have revealed that surgical smoke emitted during laparoscopy surgery would contain hazardous contaminants. The objective of this study is to predict surgical smoke’s concentration in surgical staff‘s breathing zone in a hospital operating room, in order to estimate the potential inhalation risk of surgical smoke. To predict the surgical smoke’s concentration in the surgeon’s breathing zone, CFD (computational fluid dynamics) simulation was conducted with smoke emission scenarios including various smoke emission velocities, temperatures, and locations. The results showed that the discharge temperature of the smoke was insignificant effects on surgical smoke’s concentration distribution in the surgical staff’s breathing zone, while the discharge velocity significantly effects on the surgical smoke’s concentration distribution. When the surgical smoke emission velocity was 10 m/s with 32℃ of temperature, the highest normalized concentration was found to be 15.1x10<SUP>-3</SUP> at the surgeon 1 breathing zone, and 0.1x10<SUP>-3</SUP> at the surgeon 2 breathing zone. In addition, the benzene mass concentration in the breathing zone was estimated and compared with the reference concentration suggested by CalEPA.

Serum Testosterone Level Can Be Predictive Factor for Upstaging in Clinically Localized Prostate Cancer

Soon Oh Kwon(권순오),Kyeong-Hyeon Byeon(변경현),Jae-Wook Chung(정재욱),Yun-Sok Ha(하윤석),Seock Hwan Choi(최석환),Bum Soo Kim(김범수),Hyun Tae Kim(김현태),Tae-Hwan Kim(김태환),Eun Sang Yoo(유은상),Ghil Suk Yoon(윤길숙),Jun Nyung L 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.2

Purpose: To determine an appropriate surgical technique, it is important to predict pathological results for patients with clinically localized prostate cancer (PCa) eligible for nerve-sparing radical prostatectomy (NSRP). Several studies have highlighted that serum testosterone level was associated with aggressive features of PCa. Therefore, we analyzed factors, including serum testosterone, to predict upstaging and upgrading after surgery for patients with clinically localized PCa eligible for NSRP. Materials and Methods: We retrospectively evaluated patients who underwent radical prostatectomy (RP) between January 2015 and May 2018 at our institution. Patients with Gleason grade group 1 or 2 on biopsy, prostate-specific antigen<10, and ≤clinical/radiologic stage T2 were included in this study. Upstaging and upgrading were defined as pathological stage≥T3a and Gleason grade group≥3, respectively. We evaluated the patients’ demographics and outcomes according to upstaging and upgrading after surgery. Predictive factors for upstaging and upgrading were analyzed using a multivariate logistic regression model. Results: Of 108 patients included in the study, upstaging and upgrading after surgery were observed in 24 (22.2%) and 36 (33.3%), respectively. Low serum testosterone level, small prostate size, and positive core number≥3 on biopsy were identified as predictive factors for upstaging in multivariate analysis. Although serum testosterone was associated with upgrading in univariate analysis, only clinical/radiologic stage and biopsy Gleason grade group were observed as predictive factors for upgrading in multivariate analysis. Conclusions: Serum testosterone level was identified as a predictive factor for upstaging after RP for clinically localized PCa eligible for NSRP.

Impact of Multiple Prostate Biopsies: Risk of Perioperative Complications and Biochemical Recurrence After Radical Prostatectomy

Kyong Min Park(박경민),Jae-Wook Chung(정재욱),Jun-Koo Kang(강준구),Teak Jun Shin(신택준),Se Yun Kwon(권세윤),Hyun Chan Jang(장현찬),Yun-Sok Ha(하윤석),Seock Hwan Choi(최석환),Wonho Jung(정원호),Jun Nyung Lee(이준녕),Byung Hoon Kim 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.1

Purpose: The aim of this study was to analyze the perioperative complications and oncological outcomes of radical prostatectomy (RP) in patients who underwent multiple prostate biopsies. Materials and Methods: A total of 1,112 patients who underwent RP between January 2009 and April 2016 at 4 different centers were included in this study. We divided these patients into 2 groups: patients who underwent only 1st biopsy, and those who underwent 2nd or more repeated biopsies. The association between the number of prior biopsies and perioperative complications and biochemical recurrence (BCR) was analyzed. Results: Of 1,112 patients, 1,046 patients (94.1%) underwent only 1st biopsy, and 66 (5.9%) underwent 2nd or more repeated biopsies. There were no significant differences in preoperative prostate-specific antigen levels, operation times, blood loss volumes, or hospital stay durations (all p>0.05). Patients who underwent multiple prostate biopsies presented with a localized tumor significantly more often (p<0.05). The Gleason score and rate of positive surgical margins were significantly lower in patients with multiple biopsies (all p<0.05). The Cox proportional hazards model analysis indicated that there was no association between the number of prior prostate biopsies and BCR (p>0.05). Kaplan-Meier curve analysis indicated that BCR-free survival rates between the 2 groups were similar (p>0.05). Conclusions: Multiple prostate biopsies are not associated with an increased risk of perioperative complications, adverse pathological outcomes, or higher rates of BCR in patients who have undergone RP.