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고영휘,문기학,이성원,김세웅,양대열,문두건,정우식,오경진,현재석,류지간,박현준,박광성 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.1
Purpose: A nationwide survey was conducted of Korean urologists to illustrate physicians’perceptions and real practical patterns regarding Peyronie disease (PD). Materials and Methods: A specially designed questionnaire exploring practice characteristicsand attitudes regarding PD, as well as patient satisfaction with each treatmentmodality, was e-mailed to 2,421 randomly selected urologists. Results: Responses were received from 385 practicing urologists (15.9%) with a mediantime after certification as an urologist of 12 years. Regarding the natural course, 87%of respondents believed that PD is a progressive disease, and 82% replied that spontaneoushealing in PD occurred in fewer than 20% of patients. Regarding diagnosis ofPD, the methods used were, in order, history taking with physical examination (98%),International Index of Erectile Function questionnaires (40%), intracavernous injectionand stimulation (35%), and duplex sonography (28%). Vitamin E was most preferredas an initial medical management (80.2%), followed by phosphodiesterase-5 inhibitors(27.4%) and Potaba (aminobenzoate potassium, 20.1%). For urologists who administeredintralesional injection, the injected agent was, in order, corticosteroid(72.2%), verapamil (45.1%), and interferon (3.2%). The most frequently performed surgicalprocedure was plication (84.1%), followed by excision and graft (42.9%) and penileprosthesis implantation (14.2%). Among the most popular treatments in each modality,the urologists’ perceptions regarding the suitability of treatment and patient satisfactionwere significantly different, favoring plication surgery. Conclusions: The practice pattern of urologists depicted in this survey is in line withcurrently available Western guidelines, which indicates the need for development offurther local guidelines based on solid clinical data.
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고영휘,김병훈,권세윤,정현진,하윤수,김연주,김현태,이준녕,김정현,김태환 대한비뇨의학회 2023 Investigative and Clinical Urology Vol.64 No.2
Purpose: To identify changes in prostate cancer (PCa) risk-stratification during the last two decades in Korea, where the social perception of PCa was limited due to a relatively low incidence but has recently been triggered by the rapidly increasing incidence of benign prostate hyperplasia. Materials and Methods: Retrospective data of patients who had received a diagnosis of PCa in a single Korean province (Daegu-Gyeongsangbuk) at all seven training hospitals in the years 2003, 2007, 2011, 2015, 2019, and 2021 were subjected to analysis. Changes in PCa risk-stratification were investigated with respect to serum prostate-specific antigen (PSA), Gleason score (GS), and clinical stage. Results: Of the 3,393 study subjects that received a diagnosis of PCa, 64.1% had high-risk disease, 23.0% intermediate, and 12.9% low-risk disease. The proportion diagnosed with high-risk disease was 54.8% in 2003, 30.6% in 2019, but then increased to 35.1% in 2021. The proportion of patients with high PSA (>20 ng/mL) steadily decreased from 59.4% in 2003 to 29.6% in 2021, whereas the proportion with a high GS (>8) increased from 32.8% in 2011 to 34.0% in 2021, and the proportion with advanced stage disease (over cT2c) increased from 26.5% in 2011 to 37.1% in 2021. Conclusions: In this retrospective study, conducted in a single Korean province, high-risk PCa accounted for the largest proportion of newly registered Korean PCa patients during the last two decades and increased in the early 2020s. This outcome supports the adoption of nationwide PSA screening, regardless of current Western guidelines.
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고영휘,채지윤,정승민,강재일,안홍재,Hyung Woo Kim,강성구,장훈아,천준,김제종,이정구 대한배뇨장애요실금학회 2010 International Neurourology Journal Vol.14 No.4
Purpose: Although post-void residual urine (PVR) is frequently utilized clinically in patients with benign prostatic hyperplasia (BPH), mainly because of its procedural simplicity, its role as a clinical prognostic factor, predictive of treatment goals, is still under much dispute. We investigated the predictive value of PVR for BPH-related clinical events including surgery, acute urinary retention (AUR), and admission following urinary tract infection (UTI). Methods: From January to June of 2006, patients over 50 years of age who were diagnosed with BPH for the first time at the outpatient clinic and were then treated for at least 3 years with medications were enrolled in this study. The variables of patients who underwent surgical intervention for BPH, had occurrences of AUR, or required admission due to UTI (Group 1, n=43) were compared with those of patients who were maintained with medications only (Group 2, n=266). Results: Group 1 had a significantly higher PVR, more severe symptoms, and a larger prostate at the time of the initial diagnosis in both the univariate and the multivariate analysis. In the 39 patients who underwent BPH-related surgery, although there was a significant change in Qmax at the time of surgery (mean, 13.1 months), PVR and the symptom score remained unchanged compared with the initial evaluation. In the receiver-operating characteristic curve analysis, the area under the curve of Group 1 was in the order of prostate volume (0.834), PVR (0.712), and symptom score (0.621). When redivided by arbitrarily selected PVR cutoffs of 50 mL, 100 mL, and 150 mL, the relative risk of clinical BPH progression was measured as 3.93, 2.61, and 2.11. Conclusions: These data indicate that, in the symptomatic Korean population, increased PVR at baseline is a significant indicator of BPH-related clinical events along with increased symptom score or prostate volume.
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항생제 Fluoroquinolones의 약동학 및 약력학에 관한 최신 정보
고영휘,송필현 대한요로생식기감염학회 2015 Urogenital Tract Infection Vol.10 No.1
The ultimate goal of antimicrobial treatment is to decrease the morbidity and mortality related to infection. Maximizing these outcomes requires an understanding of the complex interactions between the drug administered, the host, and the infecting pathogen. Pharmacokinetics, which deals with the disposition of a drug in the body, focuses on such parameters as absorption, distribution, and elimination. Pharmacodynamics more specifically focuses on the interaction between the drug concentration at the site of action over time and the resulting antimicrobial effect. Use of quinolones has increased in vitro activity against several important pathogenic organisms as well as augmented pharmacokinetic parameters. These properties result in enhanced pharmacodynamic characteristics and should improve therapeutic outcomes against selected pathogens. In this article the pharmacokinetics and pharmacodynamic potential of these quinolones, particularly fluoroquinolones, is reviewed.
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고영휘,문두건,문기학 대한남성과학회 2013 The World Journal of Men's Health Vol.31 No.1
Purpose: To evaluate the actual impact of testosterone replacement therapy (TRT) on patients with lower urinary tract symptom (LUTS), without benign prostate hyperplasia (BPH) medication. Materials and Methods: Two hundreds forty-six patients underwent TRT using intramuscular injection of 3 months bases injection of testosterone 100 mg undecanoate over a year. Among them, 17 patients had moderate LUTS with a maximal flow rate of at least 10 ml/s but did not take any BPH-specific medication during TRT. The changes in prostate specific antigen (PSA), International Prostate Symptom Score (IPSS), and uroflowmetery were measured before and after TRT. Results: After TRT, PSA remained unchanged after a year of treatment (p=0.078). Compared with their counterparts (n=229), the patients without BPH medication had similar baseline prostate characteristics in all variables, including prostate volume, IPSS, maximal flow rate, voiding volume, and PSA, except the median amount of residual urine, which was higher in the patients without BPH medication (21 ml vs. 10 ml). In the no-BPH medication group, the total IPSS score was decreased significantly (p=0.028), both in storage symptoms (questionnaire 2, 4, 7) and voiding symptoms (questionnaire 1, 3, 5, 6), while the maximal flow rate and residual urine amount remained unchanged after a year of TRT. During the median follow up of 15.1 months, no patients experienced urinary retention, BPH-related surgery, or admission for urinary tract infection. Conclusions: Over a year of TRT for the no-BPH medication patients with moderate LUTS and maintained a relatively high maximal flow rate and improved both storage and voiding symptoms, without the clinical progression of BPH or rising PSA.
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Host-Pathogen Interactions in Urinary Tract Infections
고영휘,최재영,송필현 대한요로생식기감염학회 2019 Urogenital Tract Infection Vol.14 No.3
Urinary tract infections (UTIs) are classified by the host condition. Uncomplicated infections are caused most commonly by uropathogenic Escherichia coli (UPEC) and affect otherwise healthy people, whereas complicated infections are com-monly caused by species, such as Proteus mirabilis, and affect patients with under-lying difficulties, such as a urinary tract abnormality or catheterization. The outcome of infection caused by these bacteria is dictated by the immune response to the UTI and the host factors that influence the susceptibility to disease. This review focuses on the host pathogen interactions in UTI, including an identification of additional virulence factors and therapeutic or prophylactic targets, particularly by UPEC and P. mirabilis.
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고영휘,최훈,강성구,강석호,박홍석,천준,이정구,김제종,윤덕기 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.1
Purpose: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. Materials and Methods: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). Results: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4±17.7 vs. 151.4±21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7±11.5 vs. 211.2±43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. Conclusions: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications. Purpose: We evaluated the efficacy of parenchymal compression in open partial nephrectomies (OPNs) compared with that of the conventional vascular clamping method. Materials and Methods: OPNs were conducted by means of the parenchymal compression technique at our institution from April 2006. Among these, the operative outcomes of 20 consecutive patients with normal preoperative renal function (Group 1) were matched with those of 20 control patients from the database of previous operations who underwent OPN with a conventional vascular clamping method (Group 2). Results: All preoperative characteristics were similar in both groups. The operative time was significantly higher for Group 2 (132.4±17.7 vs. 151.4±21.4 minutes, p=0.031). Estimated blood loss was slightly higher for Group 2, with marginal statistical significance (173.7±11.5 vs. 211.2±43.8 ml, p=0.06). Histologic examination revealed that over 80% of the tumors in both groups were renal cell carcinomas. For all patients, the pathology results of specimens were negative. Serum creatinine, checked at 1, 3, and 7 days after the operation, was significantly increased in both groups to a similar degree. However, 30 days after surgery, the patterns of serial serum creatinine levels demonstrated statistically significant differences by repeated-measures ANOVA (p<0.001), with a trend of more elevated in Group 2 than in Group 1, although values were within the normal range. No major complications occurred in either group. Conclusions: OPN using the parenchymal compression method had acceptable outcomes in terms of complete tumor control, avoiding warm ischemic time, and minimizing blooding, with good preservation of renal function and minimal complications.
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