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전립선염 증상지수를 이용한 전립선염 증상의 규모와 삶의 질에 미치는 영향
변석수,강대희,유근영,박수경,곽철,조문기,이종욱,김현회,Byun, Seok-Soo,Kang, Dae-Hee,Yoo, Keun-Young,Park, Sue-Kyung,Kwak, Cheol,Jo, Moon-Ki,Lee, Chong-Wook,Kim, Hyeon-Hoe 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.4
Objectives : To determine the prevalence of prostatitis symptoms in the general population by questionnaire survey and to measure the effect of prostatitis symptoms on quality of life(QOL). Materials & Methods : A cross sectional community-based epidemiologic study was performed on 2,034 men, living in the Seoul metropolitan area using stepwise random sampling. Out of 2,034 interviewees, 1,356 men who were older than 40 and provided sufficient information were selected for this study. The questionnaires were completed by well trained interviewers. Contents of the questionnaires included demographic data, the Prostatitis Symptom Index(PSI), the International Prostate Symptom Score(IPSS), a general health questionnaire section and a sexual health questionnaire section. The PSI was composed of a sum of the scores from three questions about dysuria, penile pain and perineal pain and it ranged 0 to 12. Incidence of prostatitis symptoms was defined by a score of 4 or more and the reference group was defined as consisting of those with a score of 3 or less. The rate of incidence of prostatitis symptoms was assessed according to age and the difference of QOL between the prostatitis symptoms group and the reference group. Results : The overall positive rate of prostatitis symptoms measured by the PSI, in men older than 40, living in the Seoul metropolitan area, was 4.5%(61/1,356), adjusted to 4.8% by the relative proportion of this age group in the general population of the Seoul metropolitan area as compared to Korea and the World. The proportion of the group with prostatitis symptoms assessed by the PSI did not increase with age although the proportion of participants with moderate to severe lower urinary tract symptoms (LUTS) did increase with age. The group with prostatitis symptoms suffered from a much greater incidence of LUTS compared to the reference group (p<0.05). The QOL scores of the IPSS, and the general health and sexual health status of the group with prostatitis symptoms, were worse than those of the reference group.(p<0.05). Conclusions : The positive rate of prostatitis symptoms in men older than 40, living in the Seoul metropolitan area, was 4.8% and it didn't increase with age. The general QOL of the group with prostatitis symptoms was much worse than that of the reference group.
정창욱(Chang Wook Jeong),변석수(Seok-Soo Byun),이은식(Eunsik Lee),이상은(Sang Eun Lee),정병하(Byung Ha Chung),최영득(Young Deuk Choi),최한용(Han Yong Choi),이현무(Hyun Moo Lee),안한종(Hanjong Ahn),황태곤(Tae-Kon Hwang),이강현(Kang Hy 대한비뇨기종양학회 2013 대한비뇨기종양학회지 Vol.11 No.3
Purpose: Previously, Seoul National University (SNU) prostate cancer (PC) stage calculator was developed to predict the pathological stage of clinically localized PC after radical prostatectomy (RP) in Korean men. We evaluated its generalizability and compared their clinical values with 2013 Partin tables by Korean multicenter cohort. Materials and Methods: Evaluated cohort consisted of 2,607 patients who had clinical stages T1c-T3a PC and were treated with RP at 14 institutions in Korea. After excluding 262 cases with prior hormone or radiation therapy and 604 cases with missing data, 1,741 cases were analyzed. Predictive accuracy was evaluated using the area under the receiver operating characteristic curve (AUC). The agreement between the predicted values with observed outcome was assessed with calibration plot. SNU PC stage calculator was compared with 2013 Partin tables applying to this cohort using DeLong method and decision curve analysis. Results: The accuracies of SNU PC stage calculator was all higher than those of 2013 Partin tables to predict organ-confined disease (0.755 vs. 0.711, p<0.001), extraprostatic extension (0.743 vs. 0.665, p<0.001), seminal vesicle invasion (0.833 vs. 0.764, p<0.001), and lymph node metastasis (0.842 vs 0.760, p=0.019). The observed outcomes were well calibrated with their predicted values by the calculator. Decision curve analyses demonstrated higher net benefits of SNU PC stage calculator compared with 2013 Partin tables.
Cis-platin 내성 방광암세포주에 대한 Trichostatin A의 항암효과 분석
박지현(Jihyun Park),변석수(Seok-Soo Byun),이정은(Jeong Eun Lee),오종진(Jong Jin Oh),이상철(Sang Chul Lee),홍성규(Sung Kyu Hong),윤철용(Cheol Yong Yoon),이은식(Eunsik Lee),이상은(Sang Eun Lee) 대한비뇨기종양학회 2011 대한비뇨기종양학회지 Vol.9 No.2
Purpose: To determine anti-tumor effect of a histone deacetylase (HDAC) inhibitor, trichostatin A (TSA) in cis-platin resistant human bladder cancer cells (T24R2). Materials and Methods: T24 bladder cancer cell line and T24R2 were exposed to escalating dose of TSA and tumor cell proliferation was examined by CCK-8 assay. To evaluate the changes in cell cycle and apoptosis, flow cytometry was used and clonogenic assay was performed. Expression of p21WAF1/CIP1, cIAP1, XIAP, Bcl-2, and Bax were analyzed by Western blot. Results: Acute TSA administration (0.1-2μM for 24-72hours) suppressed tumor cell proliferation in a time- and dose-dependent manner (p<0.05) in all two bladder tumor cell lines. TSA induced G1 phase cell cycle arrest in both bladder cell lines and higher-fraction of sub-G1 (apoptotic portion) with 0.5μM in T24R2. A significant decrease in colony number was seen with the TSA treatment in the two cell lines. Western blot analysis revealed up-regulated p21 and bax, and down-regulated bcl-2, cIAP1 and xIAP with the increasing concentrations of TSA in both cell lines. Conclusions: Our results suggest anti-tumor effect of TSA in inhibiting bladder cancer growths and its potential role as an agent for treating cisplatin-resistant bladder cancer.
전립선암으로 근치적 전립선적출술을 받은 한국인의 특징과 예후
김대성(Dae Sung Kim),변석수(Seok-Soo Byun),이상은(Sang Eun Lee),이은식(Eunsik Lee),최한용(Han Yong Choi),정병하(Byung Ha Chung),최영득(Young Deuk Choi),안한종(Hanjong Ahn),황태곤(Tae-Kon Hwang),이강현(Kang Hyun Lee),김원재(Wun-Jae Ki 대한비뇨기종양학회 2010 대한비뇨기종양학회지 Vol.8 No.1
Purpose: There is a great difference between the prostate cancer in Asian men compared to Western men. We evaluated the clinicopathologic features and prognosis of Korean men with prostate cancer who underwent radical prostatectomy. Materials and Methods: We reviewed retrospectively the clinicopathologic parameters including age, preoperative PSA, stage, Gleason score and so on in 2,783 men underwent radical prostatectomy in 14 institutions. Of 2,783 men, patients with prior radiotherapy, neoadjuvant treatment, suspicious lymph node invasion, distant metastasis and treatment failure were excluded. We evaluated recent change in clinical parameters. 2,081 men with localized prostate cancer were analyzed for the biochemical recurrence-free survival rates. Results: Proportion of patients with serum PSA of less than 10ng/ml were 38.9% in 1999. However the proportion were 68.6% in 2008. The 5-year overall biochemical recurrence-free survival rate (BCR-FS) was 48%. The 5-year BCR-FS according to the preoperative serum PSA, biopsy Gleason score, pathologic T stage, margin positivity had the lower level than Western series. Conclusions: The proportion of patients with serum PSA <10ng/ml were increased in Korean men with prostate cancer. However, the BCR-FS had the lower level than Western men. Therefore, we must consider that the prostate cancer in Korean men have a unfavorable prognosis compared with Western men.
오종진(Jong Jin Oh),변석수(Seok-Soo Byun) 대한비뇨기종양학회 2010 대한비뇨기종양학회지 Vol.8 No.3
Although nephron sparing surgery is the current standard management of small renal masses (SRM), active surveillance is an option in selected patients. The natural history of SRM still remains to be elucidated. Initial size and tumor growth rate seem to predict the risk of malignancy in retrospective studies, even though a proportion of SRM with absent or slow growth can express significant malignant behavior. Biologic markers to predict the tumor biology also need to be investigated in the future. At present, active surveillance of SRM should only be considered in selected patients with poor candidate for surgery.
다기관 한국 전립샘 암 등록(KPCR) 데이터베이스를 이용한 근치적 전립샘 절제술의 수술 결과 비교
유성혜 ( Sung Hye Yu ),최문주 ( Mun Joo Choi ),김청수 ( Choung-soo Kim ),서성일 ( Seong Il Seo ),정창욱 ( Chang Wook Jeong ),변석수 ( Seok-soo Byun ),이지열 ( Ji Youl Lee ),홍준혁 ( Jun Hyuk Hong ),최인영 ( In Young Choi ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.3
목적: 전립샘암은 한국 남성에서 발병률이 급격히 증가하는 추세이다. 국소 전립샘암의 표준 치료로 근치적 전립샘 절제술이 시행되고 있으며 수술 기법은 개복, 복강경 그리고 로봇 수술로 나뉜다. 여러가지 수술 기법은 삶의 질, 경제적 측면, 수술 및 예후의 결과에서 차이가 있다. 이에 저자는 다기관 한국 전립샘 암 등록(KPCR) 데이터베이스를 이용하여 국소 전립샘 암 수술을 시행한 환자들의 결과와 예후에 대한 결과를 비교하고자 한다. 방법: KPCR 데이터베이스에는 5개 의료기관에서 수집한 6,032명의 데이터가 수집되어 있고 데이터의 무결성 보장을 위해 데이터 표준화 및 품질 관리를 시행하였다. KPCR 데이터베이스로부터 분석에 필요한 데이터를 추출하였다. 추출된 데이터는 2006년 1월부터 2011 년 12월까지 수집된 3,262명으로 최종 분석을 시행하였다. 이 데이터를 이용하여 수술 기법에 따른 국소 전립샘 암 환자의 인구학적 특성, 수술 결과 및 예후에 대해 분석하였다. 통계 분석방법은 one-way ANOVA, chi-square test, post-hoc 분석을 실시하였다. 무재발 생존율 분석을 위해 Kaplan-Meier와 multivariable Cox proportional hazard regression model을 통해 분석을 실시하였다. 결과: 분석 결과, 초기 전립샘 특이 항원치의 평균 값은 10.30 ng/mL이었다. 총 환자의 56.7%는 임상 병기 T2를, 43.3%는 병기 T1을 가지고 있었고 환자의 64.4%는 글리슨 스코어가 7 이상이었다. 절제면 양성률의 결과는 개복수술이 33.6%, 복강경 수술이 27.0%, 로봇수술이 28.8%로 나타났다(p <0.001). 로봇수술은 수술 후 합병증 및 예상 출혈량 결과에서 우수한 결과를 나타냈다. 5년 생화학 무 재발 생존율은 전체 환자에서 77.0%의 결과를 보였고 세 수술 기법은 임상 결과에 있어서 차이가 없었다. 또한 Cox 회귀분석 결과 세 수술기법은 생존율에 영향을 미치지 않았다. 결론: 본 연구결과는 국소 전립샘 암 환자의 예후와 특성을 설명한다. KPCR 데이터베이스를 통한 본 결과는 환자와 의료진의 올바른 의사 결정에 도움을 줄 것이라는 것을 보여준다. Objectives: Prostate cancer, commonly is rapidly increasing the incidence of prostate cancer among Korean men. Primary treatment of localized prostate cancer involves radical prostatectomy, and surgery techniques are divided into the abdominal, laparoscopic, and robotic surgery. Different surgical techniques differ in quality of life, economic aspect, and outcome of surgery and prognosis. Therefore we compared the outcomes and prognosis of patients who underwent surgery for localized prostate cancer using the multicenter Korean Prostate Cancer Registry (KPCR) database. Methods: The KPCR database collected data of 6,032 patients from five medical institutions, and data standardization and quality management were performed to ensure data integrity. We extracted data necessary for analysis from the KPCR database. We analyzed data for 3,262 patients during the period from January 2006 to December 2011. The demographic characteristics, surgical outcomes, and prognosis of patients with localized prostate cancer were analyzed. All statistical analyses were performed using one-way ANOVA, chi-square test, and post-hoc analysis. We used the Kaplan-Meier method and multivariable Cox proportional hazard regression model for biochemical recurrence-free survival rate (BCR-FS) analysis. Results: The analysis results showed that the average initial prostate specific antigen value was 10.30 ng/mL. A total of 56.7% of the patients had clinical stage T2, 43.3% had stage T1, and 64.4% of the patients had a Gleason score of more than 7. The rate of positive surgical margin was radical retropubic prostatectomy, laparoscopic radical prostatectomy, robotic-assisted laparoscopic radical prostatectomy (RALP) as 33.6%, 27% and 28.8%, respectively (p<0.001). The RALP gave excellent results for postoperative complication, and estimated blood loss (EBL). The 5-year overall BCR-FS was 77.0%, and the three surgical techniques did not differ in clinical outcomes. Cox regression analysis showed that the surgical technique did not affect the biochemical recurrence rate. Conclusions: Our study describes the characteristics of patients with localized prostate cancer and their prognosis. These results indicate that patients and medical staff can rely on information from the KPCR database for decision-making.