전이성 신세포암에서 장기적 예후를 가질 수 있는 적절한 치료 방안

최돈경(Don-Kyoung Choi),서성일(Seong Il Seo) 대한비뇨기종양학회 2013 대한비뇨기종양학회지 Vol.11 No.2

Recent developments in the treatment of metastatic renal cell carcinoma (mRCC) will be discussed, with emphasis on data published over the past year. With recent improvements in the prognosis for patients with metastatic renal cell carcinoma (mRCC), focus is now shifting towards maximizing clinical benefit from targeted therapies. To achieve this goal, a number of factors which impact on treatment selection and outcomes need to be considered when treating patients with mRCC, such as the optimal sequence of targeted therapies. Futhermore, despite the absence of data from Phase III trials, available evidence suggests that some patients may benefit substantially from cytoreductive nephrectomy (CRN) in the era of targeted therapy. Results of ongoing and planned clinical trials, coupled with advances in the understanding of the underlying biology of RCC, are likely to contribute towards even greater improvements in the prognosis for patients with mRCC in the near future. The purpose of this review is to analyze and weigh the efficacy data available for the drugs approved for metastatic renal cell carcinoma and to suggest the best therapy based on the multiplicity of features of each patient in relation to the main characteristics of each agent.

아날로그 주파수공용통신 시스템과 디지털 주파수공용통신 시스템간의 양립성 분석에 관한 연구

김은철(Eun Cheol Kim),서성일(Sung Il Seo),류충상(Chung Sang Ryu),오성백(Seong Taek Oh),김진영(Jin Young Kim) 한국통신학회 2007 한국통신학회 학술대회논문집 Vol.2007 No.11

라만 스펙트럼 고속 검색 알고리즘

고대영(Koh, Daeyoung),백성준(Baek, Seong-Joon),박준규(Park, Jun-Qyu),서유경(Seo, Yu-Gyeong),서성일(Seo, Sung-Il) 한국산학기술학회 2015 한국산학기술학회논문지 Vol.16 No.5

최근에 라만스펙트럼에 대한 고속 검색 방법은 많은 관심을 받아왔다. 지금까지 가장 간단하고 널리 사용되는 방법은 주어진 스펙트럼과 데이터베이스 스펙트라 사이의 유클리드 거리를 계산하고 비교하는 방법이다. 하지만 고차원 데이터의 속성으로 검색의 문제는 그리 간단하지 않다. 가장 큰 문제점중의 하나는 검색 방법에 있어서 연산량이 많아 계산 시간이 너무 오래 걸린다는 것이다. 이러한 문제점을 극복하기 위해, 코드워드의 MPS(Mean Pyramids Search)와 PDS(Partial Distortion Search)을 사용하는 알고리즘이 현재 이미지 코딩 분야에서 고속 검색 알고리즘으로 널리 사용되고 있다. 하지만 이 방법은 1차원 데이터의 경우에는 적합하지 않다. 본 논문에서 우리는 라만 스펙트럼 데이터에 적합한 3가지 새로운 방법 의 고속 검색 알고리즘을 제안한다. 이 방법은 벡터의 두 개의 주요한 특징으로 평균과 분산을 사용하여 후보가 될 수 없는 많은 코드워드를 계산하지 않으므로 연산량을 줄이고 계산 시간을 줄여준다. 실험은 1DMPS+PDS와 비교하여 1DMPS Sort+PDS는 42.8%, 1DMPS Sort+PDS는 48.6%, 1DMPS Sort with Sorted Variance+PDS는 55.2%의 성능향상을 보였다. 실험 결과는 제안된 알고리즘이 고속 검색에 적합함을 확인시켜 준다. The problem of fast search for raman spectrum has attracted much attention recently. By far the most simple and widely used method is to calculate and compare the Euclidean distance between the given spectrum and the spectra in a database. But it is non-trivial problem because of the inherent high dimensionality of the data. One of the most serious problems is the high computational complexity of searching for the closet codeword. To overcome this problem, The fast codeword search algorithm based on the mean pyramids of codewords is currently used in image coding applications. In this paper, we present three new methods for the fast algorithm to search for the closet codeword. the proposed algorithm uses two significant features of a vector, mean values and variance, to reject many unlikely codewords and save a great deal of computation time. The Experiment results show about 42.8-55.2% performance improvement for the 1DMPS+PDS. The results obtained confirm the effectiveness of the proposed algorithm.

계층적 트리 구조를 이용한 라만스펙트럼 판별 성능 개선

박준규(Park, Jun-Qyu),백성준(Baek, Seong-Joon),서유경(Seo, Yu-Gyeong),서성일(Seo, Sung-Il) 한국산학기술학회 2014 한국산학기술학회논문지 Vol.15 No.8

본 논문에서는 라만스펙트럼의 효과적인 판별을 위해 계층 트리 구조로 클래스를 그룹화 하는 방식을 제안하였다. 실험데이터로는 28종 화학물질의 라만 스펙트럼을 준비하였고 잡음제거, 정규화 등의 전처리 수행하였다. 다음으로 사전 실험을 통해 서로 간에 분류오류를 발생시키는 물질들을 그룹화 하여 계층 구조의 클래스를 구성하였고, 각각의 상위, 하위 클래스에 PCA(principal component analysis) 특징추출과 MAP(maximum a posteriori probability) 방식의 분류실 험을 수행하였다. 실험 결과에 의하면 계층 구조의 클래스를 적용한 경우 평균 2.7개의 특징을 사용하여 분류가 100% 이루 어짐을 확인할 수 있었다. 계층 구조를 적용하지 않는 기존의 방식에서 6개의 특징을 사용할 때 동일한 분류결과를 보였음 을 감안해 보면, 제안한 방식이 전체 계산 복잡도의 측면에서 훨씬 뛰어남을 알 수 있다. 따라서 제안한 방식이 실제 응용에 보다 적합하다고 할 수 있다. This paper proposes a method in which classes are grouped as a hierarchical tree structure for the effective classification of the Raman spectra. As experimental data, the Raman spectra of 28 chemical compounds were obtained, and pre-treated with noise removal and normalization. The spectra that induced a classification error were grouped into the same class and the hierarchical structure class was composed. Each high and low class was classified using a PCA-MAP method. According to the experimental results, the classification of 100% was achieved with 2.7 features on average when the proposed method was applied. Considering that the same classification rates were achieved with 6 features using the conventional method, the proposed method was found to be much better than the conventional one in terms of the total computational complexity and practical application.

전립선암 환자의 비만도가 임상병리학적 인자 및 생화학적 재발에 미치는 영향

유창희(Changhee Yoo),조진선(Jin Seon Cho),송채린(Cheryn Song),서성일(Seong Il Seo),변석수(Seok-Soo Byun),권태균(Tae Gyun Kwon),김형진(Hyung Jin Kim),정태영(Tae Young Jung),정병하(Byung Ha Chung),황태곤(Tae-Kon Hwang),이강현(Kang Hyun 대한비뇨기종양학회 2009 대한비뇨기종양학회지 Vol.7 No.3

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.

한국 전립샘암 데이터베이스를 활용한 근치적 전립샘절제술 후 생화학적 재발 예측

유성혜 ( Sung Hye Yu ),최문주 ( Mun Joo Choi ),이선정 ( Sun Jung Lee ),김청수 ( Choung Soo Kim ),서성일 ( Seong Il Seo ),변석수 ( Seok Soo Byun ),정창욱 ( Chang Wook Jeong ),박용현 ( Yong Hyun Park ),홍준혁 ( Jun Hyuk Hong ),최인 한국보건정보통계학회(구 한국보건통계학회) 2019 한국보건정보통계학회지 Vol.44 No.1

Objectives: As the surgical techniques are developed such as adopting robotic surgery etc. It has been reduced postoperative side effects such as urinary incontinence and sexual dysfunction etc., but also remain constant risk of recurrence after the treatment. It is very important to figure out the predictive factors, whichincreasing the probability of long-term survival, by Analyzing the progression of the disease according to biochemical recurrence (BCR). This study aims to figure out the influential predictive factors on BCR by using Korean Prostate Cancer Registry (KPCR) database, which constructedwith providing data from Korean manifold, because of therecurrence-free survival rates are reported to vary according to geographical location and race. Methods: KPCR database consists 7,394 patients’ data which collected from six medical institutions, and final analysis was conducted with 5,119 patients’ data which collected from December 2003 to December 2014. Statistical analysis was conducted with the multivariable Cox proportional hazard regression models to figure out the correlation of clinical factors which affect BCR. The biochemical recurrence free survival rate (BCR-FS) was calculated using with Kaplan-Meier method. Results: The 5 year BCR occurred in 23.6% (1,209 patients). As a result of the recurrence rate, prostate specific antigen (PSA) value ≥20.1 ng/mL was 49.3%, the clinical T3 stage was 40.4%, Gleason score ≥8 was 54.4%, Gleason score 7 was 21.8%. The mean duration of BCR was 20.7 months and the strongest predictor of BCR was Gleason scoreand PSA value ≥20.1 ng/mL. Conclusions: It has been verified that, Gleason scores and PSA value are the most influential factors for biochemical recurrence after radical prostatectomy. These results will be helpful fordetermining the treatment direction in postoperative follow-up and able to contribute to improving survival outcome in the future.

Prognostic Significance of Systemic Inflammatory Response in Patients with Synchronous and Metachronous Metastatic Renal Cell Carcinoma Receiving First-Line Tyrosine Kinase Inhibitors

Joongwon Choi(최중원),Tae Jin Kim(김태진),Hyun Hwan Sung(성현환),Hwang Gyun Jeon(전황균),Byong Chang Jeong(정병창),Seong Soo Jeon(전성수),Hyun Moo Lee(이현무),Han Yong Choi(최한용),Minyong Kang(강민용),Seong Il Seo(서성일) 대한비뇨기종양학회 2019 대한비뇨기종양학회지 Vol.17 No.3

Purpose: To determine whether systemic inflammatory response (SIR), particularly platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), has different prognostic role between patients with metastatic renal cell carcinoma (mRCC) receiving first-line tyrosine kinase inhibitors (TKI). Materials and Methods: We retrospectively reviewed 547 patients with mRCC who were diagnosed and treated with a first-line TKI between 2007 and 2015. The primary endpoint was overall survival (OS) and secondary endpoint was progression-free survival (PFS). We evaluated differences in survival outcomes according to SIR and identified predictors of OS and PFS. Results: In synchronous mRCC, patients with a higher PLR had significantly worse OS and PFS. Moreover, a higher NLR was also associated with both worse OS and PFS in these patients. However, PLR was not associated with either OS or PFS in metachronous mRCC patients. While metachronous mRCC patients with a higher NLR had worse OS compared to those with lower NLR, there was no difference in PFS according to the status of NLR. On multivariate analysis, PLR was identified as predictive factor for OS (hazard ratio [HR], 1.55) as well as PFS (HR, 1.39) in patients with synchronous mRCC, but not in patients with metachronous mRCC. Additionally, higher NLR was also remained as predictive factor of both OS (HR, 1.83) and PFS (HR, 1.57) in patients with synchronous mRCC. Conclusions: Our study indicates that simple biomarkers of SIR, particularly PLR and NLR, can be more useful predictors of survival outcomes in patients with synchronous mRCC rather than metachronous mRCC.

임상적으로 유의미한 전립선암의 예측 향상을 위한 Prostate Health Index와 PI-RADS Version 2 조합의 유용성

송완(Wan Song),이충언(Chung Un Lee),정재훈(Jae Hoon Chung),강민용(Minyong Kang),성현환(Hyun Hwan Sung),전황균(Hwang Gyun Jeon),정병창(Byong Chang Jeong),서성일(Seong Il Seo),전성수(Seong Soo Jeon),이현무(Hyun Moo Lee) 대한비뇨기종양학회 2022 대한비뇨기종양학회지 Vol.20 No.2

Purpose: To evaluate the performance of combining prostate health index (PHI) and Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) for detection of clinically significant prostate cancer (csPCa). Materials and Methods: We retrospectively reviewed patients who underwent prostate biopsy for elevated prostate-specific antigen (PSA) ≥2.5 ng/mL and/or abnormal digital rectal examination. Serum markers for PSA, free PSA (fPSA), and [-2] proPSA (p2PSA) were measured, and PHI was calculated as ([p2PSA/fPSA]×[PSA]<SUP>1/2</SUP>). Multiparametric magnetic resonance imaging was performed using a 3.0T scanner and scored using PI-RADSv2. csPCa was defined as either grade group (GG) ≥2 disease or GG1 cancer detected in >2 cores or >50% of positive on biopsy. Univariable and multivariable logistic regression modelling, along with receiver-operating characteristic (ROC) curve analysis was used to predict the probability of csPCa. Results: Of the total 358 patients, 159 (44.4%) were diagnosed with csPCa. On univariable analysis, age, PSA density (PSAD), PHI and PI-RADSv2 were associated with csPCa. The area under the ROC curve (AUC) of baseline model incorporating age and PSAD was 0.663. The AUC of combining PHI and PI-RADSv2 to baseline model was higher than that of PHI alone to baseline model (0.884 vs. 0.807, p<0.0001) and PI-RADSv2 alone to baseline model (0.884 vs. 0.846, p=0.0002), respectively. If biopsy was restricted to patients with PI-RADS 5 as well as PI-RADS 3 or 4 and PHI ≥27, 36.0% of unnecessary biopsy could be avoided at the cost of missing 4.7% of csPCa. Conclusions: The combination of PHI and PI-RADSv2 to baseline model incorporating age and PSAD had higher accuracy for detection of csPCa compared with PHI or PI-RADSv2 alone.

신장암에 대한 부분 신절제술 활용 경향 분석

신승제(Seung Jea Shin),김형준(Hyung Joon Kim),고광진(Kwang Jin Ko),성현환(Hyun Hwan Sung),전황균(Hwang Gyun Jeon),정병창(Byong Chang Jeong),서성일(Seong Il Seo),이현무(Hyun Moo Lee),최한용(Han Yong Choi),전성수(Seong Soo Jeon) 대한비뇨기종양학회 2015 대한비뇨기종양학회지 Vol.13 No.3

Purpose: Partial nephrectomy has a similar oncologic outcome to radical nephrectomy while reducing cardiac and metabolic morbidity. However, previous studies reported that partial nephrectomy had been underutilized. The purpose of this study is to analyze trends in the use of partial nephrectomy in Korea and evaluate which individual factors and hospital factor influenced the operative approach. Materials and Methods: Using URO-PDS database, 11560 patients underwent nephrectomy for renal cell carcinoma between 2006 and 2010 were identified. International Classification of Disease (ICD-9) diagnosis codes were applied to target subject of interest. Logistic regression was applied to identify determinants of partial nephrectomy. Results: Over the study period, the proportion of partial nephrectomies has steadily increased from 9.4% in 2006 to 30.4% in 2010 (p<0.001). Deviation of utilization in partial nephrectomy has been observed based on the area (p<0.001) and type of surgery (p<0.001). Individual of younger age, as well as male, were more likely to be treated with partial nephrectomy (p<0.001 for each). Furthermore, Patient treated at hospitals with higher nephrectomy volume were more prone to be treated with partial nephrectomy (p<0.001 for each). Conclusions: Partial nephrectomies have been increasingly performed over the study period but are still underutilized.