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- 저자 : Jeremy Yuen-Chun Teoh (검색결과 3 건)
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The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy
Chi-Hang Yee,Jeremy Yuen-Chun Teoh,Pui-Tak Lai,Vivian Yee-Fong Leung,Winnie Chiu-Wing Chu,Wai-man Lee,Yuk-Him Tam,Chi-Fai Ng 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.2
Purpose: The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods: This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results: From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). Conclusions: Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.
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Peter Ka-Fung Chiu,Jeremy Yuen-Chun Teoh,Wai-Man Lee,Chi-Hang Yee,Eddie Shu-Yin Chan,See-Ming Hou,Chi-Fai Ng 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.5
Purpose: We investigated the extended use of Prostate Health Index (PHI) and percentage of [-2]pro-prostate-specific antigen (%p2PSA) in Chinese men with prostate-specific antigen (PSA) 10–20 ng/mL and normal digital rectal examination (DRE). Materials and Methods: All consecutive Chinese men with PSA 10–20 ng/mL and normal DRE who agreed for transrectal ultrasound (TRUS)-guided 10-core prostate biopsy were recruited. Blood samples were taken immediately before TRUS-guided prostate biopsy. The performances of total PSA (tPSA), %free-to-total PSA (%fPSA), %p2PSA, and PHI were compared using logistic regression, receiver operating characteristic, and decision curve analyses (DCA). Results: From 2008 to 2015, 312 consecutive Chinese men were included. Among them, 53 out of 312 (17.0%) men were diagnosed to have prostate cancer on biopsy. The proportions of men with positive biopsies were 6.7% in PHI<35, 22.8% in PHI 35–55, and 54.5% in PHI>55 (chi-square test, p<0.001). The area under curves (AUC) of the base model including age, tPSA and status of initial/repeated biopsy was 0.64. Adding %p2PSA and PHI to the base model improved the AUC to 0.79 (p<0.001) and 0.78 (p<0.001), respectively, and provided net clinical benefit in DCA. The positive biopsy rates of Gleason 7 or above prostate cancers were 2.2% for PHI<35, 7.9% for PHI 35–55, and 36.4% for PHI>55 (chi-square test, p<0.001). By utilizing the PHI cutoff of 35 to men with PSA 10–20 ng/mL and normal DRE, 57.1% (178 of 312) biopsies could be avoided. Conclusions: Both PHI and %p2PSA performed well in predicting prostate cancer and high grade prostate cancer. The use of PHI and %p2PSA should be extended to Chinese men with PSA 10–20 ng/mL and normal DRE.
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Simone Scarcella,Daniele Castellani,Vineet Gauhar,Jeremy Yuen-Chun Teoh,Carlo Giulioni,Pietro Piazza,Carlo Andrea Bravi,Ruben De Groote,Geert De Naeyer,Stefano Puliatti,Andrea Benedetto Galosi,Alexand 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.6
Purpose: To review safety and efficacy of robotic-assisted simple prostatectomy (RASP) compared to open simple prostatectomy (OP). Materials and Methods: A comprehensive literature search was performed to assess the differences in perioperative course and functional outcomes in patients with benign prostatic hyperplasia and surgical indication. The incidences of complications were pooled using the Cochran–Mantel–Haenszel Method and expressed as odds ratio (OR), 95% confidence interval (CI), and p-values. Perioperative course and functional outcomes were pooled using the inverse variance of the mean difference (MD), 95% CI, and p-values. Analyses were two-tailed and the significance was set at p<0.05. Results: Eight studies were accepted. Meta-analysis showed significantly longer surgical time (MD, 43.72; 95% CI, 30.57–56.88; p<0.00001) with a significantly lower estimated blood loss (MD, -563.20; 95% CI, −739.95 to −386.46; p<0.00001) and shorter postoperative stay (MD, −2.85; 95% CI, −3.72 to −1.99; p<0.00001) in RASP. Catheterization time did not differ (MD, 0.65; 95% CI, −2.17 to 3.48; p=0.65). The risk of blood transfusion was significantly higher in OP (OR, 0.23; 95% CI, 0.17–0.33; p<0.00001). The risk of recatheterization (OR, 1.96; 95% CI, 0.32–11.93; p=0.47), postoperative urinary infections (OR, 0.89; 95% CI, 0.23–3.51; p=0.87) and 30-day readmission rate (OR, 0.96; 95% CI, 0.61–1.51; p=0.86) did not differ. At 3-month follow-up, functional outcomes were similar. Conclusions: RASP demonstrated a better perioperative outcome and equal early functional outcomes as compared to OP. These findings should be balanced against the longer operative time and higher cost of robotic surgery.
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