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정두용,강동혁,정해도,이주용,김도경,하지수,전진형(Jin Hyung Jeon),조강수 대한비뇨의학회 2023 Investigative and Clinical Urology Vol.64 No.3
The oncologic outcomes of cytoreductive prostatectomy (CRP) in oligometastatic prostate cancer (OmPCa) are still controversial. Therefore, we conducted a systematic review and meta-analysis on the oncologic outcome of CRP in OmPCa. OVID-Medline, OVID-Embase, and Cochrane Library databases were searched to identify eligible studies published before January 2023. A total of 11 studies (929 patients), 1 randomized controlled trial (RCT) and 10 non-RCT studies, were included in the final analysis. RCT and non-RCT were further analyzed separately. End points were progression-free-survival (PFS), time to castration-resistant prostate cancer (CRPCa), cancer-specific-survival (CSS) and overall-survival (OS). It was analyzed using hazard ratio (HR) and 95% confidence intervals (CIs). In PFS, in RCT, HR=0.43 (CIs=0.27–0.69) was shown statistically significant, but in non-RCTs, HR=0.50 (CIs=0.20–1.25), there was no statistical difference. And, in time to CRPCa was statistically significant in the CRP group in all analyses (RCT; HR=0.44; CIs=0.29–0.67) (non-RCTs; HR=0.64; CIs=0.47–0.88). Next, CSS was not statistically different between the two groups (HR=0.63; CIs=0.37–1.05). Finally, OS showed better results in the CRP group in all analyses (RCT; HR=0.44; CIs=0.26–0.76) (non-RCTs; HR=0.59; CIs=0.37–0.93). Patients who received CRP in OmPCa showed better oncologic outcomes compared to controls. Notably, time to CRPC and OS showed significantly improved compared with control. We recommend that experienced urologists who are capable of managing complications consider CRP as a strategy to achieve good oncological outcomes in OmPCa. However, since most of the included studies are non-RCT studies, caution should be exercised in interpreting the results.
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정두용,홍창희,임영재,이용승,김상운,한상원 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.2
Purpose: To evaluate changes in differential renal function (DRF), as a functional outcome, in children who underwent redo pyeloplastyfor management of failed pyeloplasty and to examine the factors that affect functional outcomes. Materials and Methods: Between January 2002 and November 2010, a total of 18 patients who underwent redo pyeloplasty forpersistent ureteropelvic junction obstruction after failed pyeloplasty were enrolled in this study. We assessed perioperative factorsand evaluated changes in renal cortical thickness (RCT), renal function, and hydronephrosis by use of serial ultrasound and diureticrenography. Results: The mean follow-up period was 44.83±28.86 months. After redo pyeloplasty, prevention of further functional deteriorationwas observed in only 12 of the 18 patients. After dividing the patients according to this observation, we discovered significantdifferences in both change in DRF (dDRF) and change in RCT (dRCT) (difference between before and after initial pyeloplasty)between the two groups (p<0.001). Additionally, we noted a significant positive correlation between dRCT and dDRF. All patientsshowed improvements in hydronephrosis grade and relief of symptoms compared with before redo pyeloplasty. Conclusions: Redo pyeloplasty should be considered in cases of failed pyeloplasty to preserve renal function and obtain relieffrom symptoms. If patients show severe deterioration of DRF or a decrease in RCT after initial pyeloplasty, preservation of DRF inthese patients after redo pyeloplasty could be difficult. Therefore, redo pyeloplasty should be performed before severe deteriorationof DRF or decrease in RCT.
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Feasibility and Efficacy of Intermediate-Supine Percutaneous Nephrolithotomy: Initial Experience
정두용,이주영,Kyu Hyun Kim,최재혁,조강수 전남대학교 의과학연구소 2014 전남의대학술지 Vol.50 No.2
We evaluated the feasibility and efficacy of intermediate-supine percutaneous nephrolithotomy(PCNL) in patients with renal calculi. Fifteen patients were included inthis study. The intermediate-supine operative position was modified by using a 1-L salinebag below the ipsilateral upper flank. A nephrostomy and stone extraction wereperformed as usual. After completion of the stone removal, a nephrostomy tube wasused when necessary according to the surgeon’s decision. If there was no significantbleeding or renal pelvic injury, tubeless PCNL was performed. The mean stone sizewas 5.48±5.69 cm2, the mean operative time was 78.93±38.72 minutes, and the meanhospital stay was 2.60±1.29 days. Tubeless PCNL was performed in 13 cases (86.7%),and retrograde procedures were simultaneously performed without a change of positionin 2 patients (ureteroscopic ureterolithotomy in one patient and transurethralplacement of an occlusion catheter in one patient). There were two complications accordingto the Clavien-Dindo classification (Grade I in one patient and Grade II in onepatient). The success rate was 80.0% and the complete stone-free rate was 73.3%. Threepatients with a significant remnant stone were also successfully managed with additionalprocedures (one patient underwent a second-look operation, and the remainingtwo patients were treated with shock wave lithotripsy). In the treatment of renal calculi,intermediate-supine PCNL may be a safe and effective choice that offers several advantageswith excellent outcomes. Thus, a prospective study with a larger population isneeded to verify our outcomes.
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정두용 건국대학교 의과학연구소 1996 건국의과학학술지 Vol.5 No.-
Although the definition of fetal macrosomia is variable by many authors, the delivery of the fetus weighing 4,000g or more brings many dangerous obstetrical and neonatal complications including shoulder dystocia, birth canal injuries, postpartum bleeding, voiding difficulty in the mother and brachial plexus inju(???)ry, humerus & clavicular fracture, meconium aspiration syndrome, hypoglycemia, and pneumothorax etc. in the neonate that lead to the increse in perinatal morbidity and mortality rate. The author studied 115 cases of women who gave birth to the large babies weighing more tan 4,000g among 4,151 cases of total deliveries in Kon-Kuk University Hospital during past 4 years from Jan., 1, 1992 to Dec., 31, 1995 with the brief review of literatures. The results were as follows. 1. The number and incidence of macrosomia weighing 4,00g or more was 115 and 2.77%, and those of macrosomia weighing more than 4,500g was 9 and 0.22% of total deliveries. 2. The man birthweight of the 115 cases of macrosomia was 4,210±20g. 3. The mean age of the mothers who gave birth to the macrosomia was 27.82±0.37 year and the age distribution of the mother was highest in the 25∼29 year group. 4. There was no tendency of the increase in the incidence of macrosomia as the parity increases. 5. The mean gestational age in the macrosomia group was 40.41±0.13wks and this was statistically significant from that of normal birthweight group(39.26±0.14잔). 6. The results of postpartum oral GTT were abnormal in 11 cases (9.6%) and this is not significant from that of normal birthweight group. 7. The mean weights of the mother who gave birth to the macrosomia and normal birthweight baby were 58.03±0.78Kg and 51.65±0.71Kg and this difference was statistically significant(P<0.05). The mean bodyweight at term in both groups were 71.99±0.78Kg and 64.29±0.74Kg, and also this difference was statistically significant(P<0.05). The mean weight gain during pregnancy in both groups were 13.91±0.41Kg and 12.66±0.38Kg, and the difference was statistically significant, too(P<0.05). 8. 12 women (17.9%) of multiparous macrosomia group had the previous history of delivering macrosomia. 9. Male to female ratio was 259:100 in the macrosomia group and this was quite significant from that of normal birthweight group(105:100). 10. 55 patients (47.8%) of the macrosomia group and 43 patients (37.4%) of the normal birthweight group were delivered by cesarean section and this difference was not statistically significant. 11. The indications for cesarean section in the macrosomia group were in the order of large baby (59.2%), previous cesarean section (20.3%), and fetal distress(11.1%). 12. The most common maternal antepartum complication was anemia(18.2%). And others were pregnancy induced hypertension(5.2%) and diabetes mellitus(2.6%). 13. The mean hemoglobin concentrations at delivery were 10.88±0.13g/dL in the macrosomia group and this was not statistically significant from that of normal birthweight group. 14. The most common intra and postpartum maternal complication was urinary tract infection(17.4%). And others were birth canal laceration(7.0%) and postpartum bleeding(6.1%). 15. The 1 minute and 5 minute Apgar scores in macrosomia group were quite significant from those of normal birthweight group(P<0.05). 16. Neonatal complications in macrosomia were severely depressed infant(1.7%), cephalhematoma(0.9%), brachial plexus injury(0.9%) and clavicularfracture(0.9%). There was no perinatal death in the macrosomia group.
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정두용 건국대학교 1995 學術誌 Vol.39 No.2
This study is a clinical and laboratory analysis of the effects of hepatitis B infection in pregnancy on the fetuses, neonates and infants. All pregnant women admitted for delivery to department of Obstetrics and Gynecology, Kon Kuk University Hospital from Jan., 1, 1992 to Dec.,31, 1993 were screened for hepatitis B viral markers such as anti-HBc and anti-HBs. The women who showed positivity for HBsAg were further studied for other viral markers including- HBeAg, anti-HBe, anti-HBc, IgG & IgM. The babies born to the HBsAg positive mothers were treated within 12 hours of birth with HBIG. They also received three doses of HBVax at birth mild one each at 1 and 2 months after birth. After 6 to 8 months of age, the efficacies of active and passive immunizations were tested. The results were as follows : The prevalence rate of HBsAg in the pregnant women was 3.5%. The prevalence rate was highest in the 30 to 39 years old age group, which was 5.4%. The positive rate of HBeAg among HBsAg positive mothers were 50%. The positive rate of anti-HBc among HBsAg positive mothers were 95%. The effects of HB infection on pregnancy outcome were as following : preterm delivery, 3.5 % ; premature rupture of membrane, 14% ; fetal distress, 4.6%. There was no significant effects on the birthweight of the babies born to the HBsAg positive mothers. Male babies were much more than female born to the HBsAg positive mothers. (M/F=53/33=1.6) One infant among 7 who were tested for HBsAg was found to be in acute HB infection despite the immunization.
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