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Song, Cheryn,Doo, Chin Kyung,Hong, Jun-Hyuk,Choo, Myung-Soo,Kim, Choung-Soo,Ahn, Hanjong Williams and Wilkins Co 2007 The Journal of urology Vol.178 No.1
<P><B>Purpose</B></P><P>We investigated how the preoperatively estimated integrity of pelvic floor muscles related to the recovery of continence after radical prostatectomy.</P><P><B>Materials and Methods</B></P><P>A total of 94 patients underwent magnetic resonance image of the prostate and urodynamic studies before undergoing radical prostatectomy and evaluation of voiding symptoms before, and 3 and 6 months after surgery. Incontinence was defined as any unwanted urine leakage. On the magnetic resonance image the thickness of the levator ani and pelvic diaphragm, and prostate volume were measured to correlate with continence status.</P><P><B>Results</B></P><P>Incontinence was noted in 41.5% and 15.9% of the patients at 3 and 6 months, respectively. Recovery of continence 3 months after RP was related to the thickness of the pelvic diaphragm on sagittal imaging (p = 0.017), the ratio of the levator ani on the axial image to prostate volume (p = 0.047), functional urethral length (p = 0.007) and incontinence before surgery (p = 0.009). Recovery at 6 months was related to neurovascular bundle sparing (p = 0.013) and marginally to the pelvic diaphragm on sagittal imaging (p = 0.059). On multivariate analysis the pelvic diaphragm on sagittal imaging (HR 2.455, 95% CI 0.894–6.739, p = 0.008) and the ratio of the levator ani on the axial image to prostate volume (HR 1.886, 95% CI 0.952–3.736, p = 0.011) significantly predicted continence at 3 months, while at 6 months only the pelvic diaphragm on sagittal imaging showed a significant relationship (p = 0.024).</P><P><B>Conclusions</B></P><P>Pelvic diaphragm thickness and the ratio of levator ani thickness to prostate volume are independent factors predictive of post-prostatectomy incontinence. Patients with better developed pelvic floor muscles, especially in relation to the size of the prostate, can be expected to achieve earlier recovery of continence after radical prostatectomy.</P>
Song, Cheryn,Lee, Jungmin,Hong, Jun Hyuk,Choo, Myung-Soo,Kim, Choung-Soo,Ahn, Hanjong Blackwell Publishing Ltd 2010 BJU INTERNATIONAL Vol.106 No.5
<P>Study Type – Diagnostic (exploratory cohort)Level of Evidence 2b</P><P>OBJECTIVE</P><P>To investigate and compare changes in the bladder function after radical prostatectomy (RP) and to correlate changes in subjective voiding symptoms with the observed changes in function.</P><P>PATIENTS AND METHODS</P><P>In 72 patients who had RP between 2003 and 2004, we serially evaluated urodynamic studies (UDS) before RP and at 3, 6 and 36 months afterward. The short-form International Continence Society-<I>male</I> symptom questionnaire was also repeated at corresponding periods. Changes in bladder contraction and storage function after RP were compared for changes in subjective symptoms.</P><P>RESULTS</P><P>On serial UDS, there were reductions in maximum cystometric capacity, maximum detrusor pressure and maximum urethral closure pressure (MUCP) at 3 months, after which all remained relatively unchanged. On the questionnaire, the voiding symptom domain score improved (8.04 to 4.82, <I> P</I> < 0.001) while the storage domain score significantly and progressively worsened, beginning from 3 months (2.25 to 3.78, <I> P</I>= 0.04), resulting in an unchanged overall urinary symptom-related quality of life at 3 years. The incidence of detrusor overactivity increased from 37.5% before RP, to 45.8% at 3 months and 51.4% at 3 years. At 3 years, a recurring postvoid residual urine volume was the cause of the deterioration in the voiding symptom domain score, while a prominent reduction in MUCP resulted in a deterioration in the storage symptom score.</P><P>CONCLUSIONS</P><P>There is a reduction in bladder capacity, detrusor and sphincteric activity immediately after RP, stabilizing thereafter but remaining significantly reduced at 3 years. Although voiding symptoms improved in most men, the significant deterioration in storage symptoms, which might be attributed to sphincteric incompetence in addition to increased detrusor overactivity, became a source of overall urinary bother in the long term.</P>
Myungsun Shim,Cheryn Song,Jintaek Park,Minkyu Kang,Moo-Song Lee,Jongwon Kim,Hanjong Ahn 대한비뇨기종양학회 2014 대한비뇨기종양학회지 Vol.12 No.1
Purpose: We aimed to identify the relationship between the serum testosterone (TS) axis and the clinically localized prostate cancer and to evaluate the changes in hormone concentrations after radical prostatectomy (RP). Materials and Methods: Blood samples were drawn from 699 patients with prostate cancer before and after RP, without hormone or radiation therapy, and from 700 age-matched healthy men between 7:00 and 9:00 A.M., and their serum concentrations of total TS and sex hormone-binding globulin (SHBG) were measured. Results: Patients with prostate cancer had lower mean SHBG (55.8±22.0 vs. 61.4±24.2 nmol/L) and higher mean free TS (FT) (7.1±2.5 vs. 6.3±2.6 ng/dl), bioavailable TS (BAT) (158.2±55.2 vs. 138.1±56.5 ng/dl), and free TS index (FTI) (31.3±12.0 vs. 27.1±11.6) than healthy controls (all, p<0.001), while total TS did not differ. Following RP, patients with prostate cancer showed significant increases in SHBG (65.6±26.3 vs. 56.3±21.6 nmol/L) and subsequent decreases in FT (6.4±4.4 vs. 7.2±2.5 ng/dl), BAT (138.2±50.3 vs. 158.7±55.3 ng/dl), and FTI (26.5±11.1 vs. 31.2±11.7) (all, p<0.001), whereas total TS remained unchanged. Preoperative SHBG concentration was significantly lower in patients with pathologic Gleason score (GS) <7 than in those with GS ≥7 (p<0.001). SHBG was an independent predictor of pathologic GS <7 (p=0.003), along with preoperative prostatic specific antigen (PSA) concentration and biopsy GS. Conclusions: Prostate cancer influences the sex hormonal axis, modulating SHBG concentration and increasing the utilization of bioactive TS.
Hyunji Ahn,Mi-Sun Yum,Han Na Jang,Cheryn Song,Tae-Sung Ko 대한소아신경학회 2019 대한소아신경학회지 Vol.27 No.4
Purpose: The aim of this study was to evaluate the efficacy and tolerability of everolimus, an oral mammalian target of rapamycin (mTOR) inhibitor, for the treatment of tuberous sclerosis complex (TSC) manifestations. Methods: A retrospective analysis was conducted using an in-house research database with the keywords “tuberous sclerosis AND everolimus.” Twenty patients were treated with everolimus for TSC from 2013 to February 2019. Results: The mean age of the 20 patients was 25.6 years (range, 0 to 57), and the average duration of everolimus treatment was 87.6 weeks (range, 0 to 290). Everolimus was given with a usual daily dosage of 5 to 10 mg (mean, 7.1) or 0.0625 to 0.5 mg for neonates. Twelve patients were prescribed everolimus for more than 1 year for kidney angiomyolipoma (AML). Two of those patients (16.7%) experienced reductions of >50% in tumor size, and four patients (33.3%) experienced reductions of 25% to 50%. The four patients who were prescribed everolimus for subependymal giant cell astrocytoma (SEGA) had 25% to 50% reductions. Neonates with cardiac rhabdomyoma showed significant tumor reduction with everolimus, but their tumors exhibited rebound size increases after treatment was halted. Of the three patients with intractable seizures, one patient became seizure-free, and two patients had >50% reductions. Overall, everolimus therapy was well tolerated. Conclusion: Everolimus, an mTOR inhibitor, was effective for seizure control and size reduction of kidney AML, SEGA, and cardiac rhabdomyoma tumors in patients with TSC. However, clinicians should also be aware of the adverse event profile of everolimus.
2021 대한비뇨기종양학회 신암연구회 Consensus Statement: 전이성 신세포암의 종양감축 신적출술
이찬호,강민용,곽철,김성한,김정권,박재영,서성일,서일영,서준교,송완,Song Cheryn,육형동,이상철,이형호,정진수,정창욱,조정기,최창일,추설호,한준현,Hwang Eu Chang,김미소,김찬(Chan Kim),최석환,홍성후 대한비뇨기종양학회 2022 대한비뇨기종양학회지 Vol.20 No.3
Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC).Materials and Methods: A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC.Results: The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority.Conclusions: In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.
Choi Changil,Kang Minyong,Seo Seong Il,Suh Jungyo,Song Cheryn,Chung Jinsoo,Kim Sung Han,Park Jae Young,Hwang Eu Chang,Jeong Chang Wook,Kwak Cheol,Kim Jung Kwon,Hong Sung-Hoo 대한의학회 2024 Journal of Korean medical science Vol.39 No.3
Background: We sought to identify prognostic risk factors for one year recurrence in patient with renal cell carcinoma (RCC) after partial or radical nephrectomy. Methods: We performed a retrospective study of 1,269 patients with RCC after partial or radical nephrectomy and diagnosed recurrence using Korean Renal Cancer Study Group (KRoCS) database between January 1991 and March 2017. Recurrence-free survival (RFS), and overall survival (OS) were calculated using the Kaplan–Meier method and multivariate Cox regression analysis were performed to evaluate independent prognostic factors for recurrence Results: The median patient age was 56 years and median follow-up period was 67 months. Multivariable analysis demonstrated BMI greater than or equal to 23 and less than 30 (vs. BMI less than 23, hazard ratio [HR]: 0.707, P = 0.020) reduced recurrence one year postoperatively. Eastern Cooperative Oncology Group performance status (ECOG PS) greater than or equal to 1 (vs. ECOG PS 0, HR: 1.548, P = 0.007), high pathological T stage (pT2 vs. pT1, HR: 2.622, P < 0.001; pT3 vs. pT1, HR: 4.256, P < 0.001; pT4 vs. pT1, HR: 4.558, P < 0.001), and tumor necrosis (vs. no tumor necrosis, HR: 2.822, P < 0.001) were independent predictive factors for early recurrence within one year in patients with RCC. Statistically significant differences on RFS and OS were found among pathological T stages (pT2 vs. pT1; pT3 vs. pT1; pT4 vs. pT1, all P < 0.001). Conclusion: This large multicenter study demonstrated ECOG PS greater than or equal to 1, high pathological T stage, tumor necrosis and BMI less than 23 were significant prognostic risk factors of early recurrence within one year in patients with RCC who underwent nephrectomy.