Prognostic Value of Sex-Hormone Receptor Expression in Non-Muscle-Invasive Bladder Cancer

남종길,박성우,이상돈,정문기 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.5

Purpose: We investigated sex-hormone receptor expression as predicting factor of recurrence and progression in patients with non-muscle invasive bladder cancer. Materialsand Methods: We retrospectively evaluated tumor specimens from patients treated for transitional cell carcinoma of the bladder at our institution between January2006 and January 2011. Performing immunohistochemistry using a monoclonal androgen receptor antibody and monoclonal estrogen receptor-beta antibody on paraffin-embedded tissue sections, we assessed the relationship of immunohistochemistryresults and prognostic factors such as recurrence and progression. Results: A total of 169 patients with bladder cancer were evaluated in this study. Sixty-threepatients had expressed androgen receptors and 52 patients had estrogen receptor beta. On univariableanalysis, androgen receptor expression was significant lower in recurrence rates (p=0.001), and estrogen receptor beta expression was significant higher in progressionrates (p=0.004). On multivariable analysis, significant association was found between androgen receptor expression and lower recurrence rates (hazard ratio=0.500; 95% confidence interval, 0.294 to 0.852; p=0.011), but estrogen receptor beta expression was not significantly associated with progression rates. Conclusion: We concluded that the possibility of recurrence was low when the androgen receptor was expressed in the bladder cancer specimen and it could be the predicting factor of the stage, number of tumors, carcinoma in situ lesion and recurrence.

Torsion of an Indirect Hernia Sac Causing Acute Scrotal Swelling in a Child

남종길,Jae Hyun Ahn,Hyeon Woo Kim,박현준,이상돈,정문기 대한남성과학회 2012 The World Journal of Men's Health Vol.30 No.2

Torsion of a hernia sac is an extremely rare condition that presents as acute scrotum in children. We report a case of a 6-year-old boy who presented with an acute scrotum and was found during surgical exploration to have torsion of an indirect hernia sac associated with hydrocele. Upon scrotal exploration, deterioration of the scrotum due to inflammatory changes was found. A necrotic cyst was recognized within a communicating hydrocele of the scrotum and was twisted at an angle of about 360°. All urologists should be aware of this special condition in the differential diagnosis of acute scrotum.

Surgical Treatment of Inferior Vena Cava Invasion in Patients with Renal Pelvis Transitional Cell Carcinoma by Use of Human Cadaveric Aorta

남종길,문기명,박성우,정문기 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.4

We herein report a case of radical nephroureterectomy and replacement of the inferior vena cava (IVC) with ahuman cadaveric aortic graft for a patient with renal pelvis transitional cell carcinoma associated with IVC infiltration. In advanced disease, radical surgery is essential to achieve long-term survival. This case entails the use of another treatment option among the numerous options currently available for the management of patients with advanced renal cancer associated with IVC invasion.

신세포암 환자에서 부분 신절제술의 치료성적

남종길,차창석,정문기 대한비뇨의학회 2004 Investigative and Clinical Urology Vol.45 No.11

Purpose: Although a radical nephrectomy is the mainstay in the surgical management of renal cell carcinomas, a partial nephrectomy is indicated in certain situations where a radical nephrectomy would render the patients in a state of renal insufficiency. Furthermore, the indications are being expanded to include incidentally found small unilateral renal cell carcinomas with a normal contralateral kidney. Therefore, the outcomes between patients treated with partial and radical nephrectomies for renal cell carcinomas were compared. Materials and Methods: Between January 1997 and March 2004, 171 nephrectomy operations were performed as curative treatments for renal masses at the urooncology department of our hospital. The study group was composed of 93 and 32 cases of radical and partial nephrectomies, respectively, with a final pathologic diagnosis of a renal cell carcinoma. The operations for renal cell carcinomas were performed by the same surgeon. The survival rate, time of local recurrence, complication and outcomes were compared and the records of 125 patients who underwent a nephrectomy for a renal cell carcinoma were retrospectively reviewed. Results: The overall mean postoperative follow-up was 25.9, ranging from 2 to 72 months. All the long-term outcomes of a partial nephrectomy for renal cell carcinoma were comparable to those of a radical nephrectomy, especially for localized renal cell carcinomas. Conclusions: A partial nephrectomy could be a better treatment option for localized renal cell carcinomas in appropriately selected cases with normal contralateral kidneys as well as in the absolute indication, with comparable outcomes to a radical nephrectomy, but the more groups and a long-term follow up are required if a partial nephrectomy is to become the standard operation for localized renal cell carcinoma treatment. (Korean J Urol 2004;45:1100-1105)

Xanthogranulomatous Pyelonephritis in Korean Children

남종길,이상돈,박성우,정문기 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.6

Purpose: Xanthogranulomatous pyelonephritis (XGP) is rare among children. In most cases, XGP is diffusely or focally enlarged, mimicking the neoplastic process. The aim of this study was to examine clinical characteristics and outcomes of Korean children with XGP. Materials and Methods: Fourteen children (9 boys, 5 girls) with XGP were reviewed retrospectively. The cohort included 2 children managed at our institution and 12 children reported in the Korean literature. The patients’ records were reviewed with respect to age at diagnosis, clinical presentation,management method, and other characteristic features. Results: The mean age was 79.4±66.5 months (range 1-168 months). Common clinical presentations included fever (85.7%), abdominal pain (57.1%), and palpable mass (28.6%). Laboratory abnormalities included leukocytosis (57.1%), anemia (57.1%), and pyuria (57.1%). The types of XGP that were diagnosed based on preoperative radiologic studies included the focal form in 9 children and the diffuse form in 5. Thirteen children underwent nephrectomy, and 1 child received conservative medical therapy. Conclusion: The possibility of XGP should be considered if a child is diagnosed with a renal mass, especially if it is a small renal mass associated with fever,leukocytosis, or stone. Nephrectomy is the treatment of choice for the diffuse form, whereas partial nephrectomy or conservative medical therapy may be indicated to manage focal XGP.

The Studer Orthotopic Neobladder: Long-Term (More Than 10 Years) Functional Outcomes, Urodynamic Features, and Complications

남종길,김태남,이상돈,박성우,정문기 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3

Purpose: Radical cystectomy and urinary diversion are the standard treatment for invasive bladder cancer. We analyzed the long-term (>10 years postoperatively) functional outcomes, complications, and urodynamic findings in a single center series of patients who underwent cystectomy and a Studer ileal neobladder substitution. Materials and Methods: A retrospective chart review of 108 Studer pouches constructed during 1990 and 2011 was performed. Data were analyzed in terms of long-term (>10 years) outcomes. Complications, incontinence, voiding difficulties, upper urinary tract changes, overall satisfaction, and urodynamic findings of the reservoir were obtained. Results: We evaluated 19 out of 50 patients who had lived for over 10 years postoperatively. Another 31 patients were not traced: 7 patients died following recurrence, 15 died due to exacerbation of a comorbidity, and 9 patients were lost to follow-up. Concerning complications, 6 patients had an atrophied kidney, 5 patients had moderate hydronephrosis, 5 patients had chronic recurrence of pylelonephritis, and 2 patients had voiding difficulty because of bladder neck stricture due to clean intermittent catheterization. One patient underwent an operation due to intestinal obstruction. Seven patients had incontinence; all 7 patients showed intermittently at night and 2 patients even in waking hours. Maximum bladder capacity was 484.1±119.2 mL, maximum flow rate was 13.6±9.7 mL/sec, and post-void residual urine volume was 146.8±82.7 mL. Conclusion: Long-term outcomes with the Studer orthotopic ileal neobladder have an acceptable complication rate and good functional results. However, potential adverse outcomes such as renal deterioration, dysfunctional voiding should also be considered.

급성 완전 요관폐색 흰쥐모델에서 대측 신장의 HIF-1α, iNOS 및 VEGF 발현에 관한 연구

남종길,이상돈,김병오 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.5

Purpose: To understand the process of hemodynamic change and compensatory hypertrophy of the contralateral kidney in an acute ureteral obstruction(UO), the inducible nitric oxide synthase(iNOS), vascular endothelial growth factor(VEGF) and hypoxia-inducible factor-1α(HIF-1α) expressions in the contralateral kidney were evaluated during the acute stage of unilateral UO in the rat. Materials and Methods: Specimens(kidneys) were aseptically removed from 35 Sprague-Dawley rats(8 weeks old, weight 250-300gm) of the control(0 hours), sham(6, 12 and 24 hours) and experimental groups(UO 6, 12 and 24 hours). The iNOS, VEGF and HIF-1α expressions in the contralateral kidney(total renal tissue, medulla and cortex) were evaluated by immunohistochemical staining. The HIF-1α expression was also evaluated by a Western blot assay. Results: Contrary to the control and sham groups, the iNOS, VEGF and HIF-1α expressions in the contralateral kidney from the immunohistochemical staining increased with time of obstruction, especially in the medulla. The HIF-1α expression in the contralateral kidney by the Western blot assay was increased in all the renal tissue, medulla and cortex compared to those in the control and sham groups. Conclusions: In the contralateral kidneys of rats with UO increased expressions of iNOS, VEGF and HIF-1α may facilitate trophic changes and a compensatory increase in the blood flow.

환측 신우성형술 후 발생한 대측 신우요관이행부협착

남종길,이상돈 대한비뇨의학회 2005 Investigative and Clinical Urology Vol.46 No.7

A contralateral metachronous ureteropelvic junction obstruction (UPJO) following ipsilateral pyeloplasty for a UPJO is rarely reported. We report a case of 47-year-old woman who developed a contralateral metachronous UPJO following uneventful left-sided pyeloplasty for a UPJO.

Performance improvement of multiuser detection using antenna array in CDMA base station

남종길,이원철,Nam, Jong-Gil,Lee, Weon-Chul The Korean Institute of Communications and Informa 2000 韓國通信學會論文誌 Vol.25 No.3

This paper analysis the performance of joint receiving structure consisting of the decorrelating multiuser detection and beamfromenr-RAKE receive for DS-CDMA communication systems. In asynchronous transmission as the number of simultaneous users increase. the capacity of CDMA system becomes severly reduced due to the nonideal orthogonality between user-assigned PN sequences and improper power control. Accordingly, the CDMA receiving system becomes vulnerable to the multiple access interferences and the near-far problem under multipath fading channel environment. To withstand these undesired performance degradations, this paper proposes the new type of multiuser detection which has a form of the hybrid structure of concatenating beamformer-RAKE receiver and decorrelating multiuser detection. the beam former-RAKE receiver performs temporal and spatial diversity combining with alleviating fading effect and suppressing undesired interferences, and the multiuser detection plays a role of making the receiver robust to the near-far problem. Regarding the individual merit on the usage of either multiuser detection or beamformer-RAKE receiver, the hybrid one is expected to produce the enhanced performance in multipath fading CDMA channel. However major drawback of using decorrelating multiuser detection for practical deployment is arised from its computational complexity , which is exponentially increased as more number of users and transmitted symbols involve. To diminish the computational complexity, this paper exploits an efficient block Toeplitz inversion technique using matrix Levinson polynomial will be introduced. And this paper provided the mathematical analysis to show the efficiency of the proposed joint structure under the multipath propagation environment. And results of a series of exhaustive computer simulations are presented in order to demonstrate the overall performance of the proposed hybrid structure in multipath fading CDMA channel.

신우성형술 후 이뇨성 DTPA 신주사 판독 시 신기능에 따른 신기능곡선, 연속 신스캔 영상 및 반감기의 유용성 비교

남종길,이상돈 대한비뇨의학회 2006 Investigative and Clinical Urology Vol.47 No.4