Oncological and functional outcomes following robot-assisted laparoscopic radical prostatectomy at a single institution: a minimum 5-year follow-up

( Jun-koo Kang ),( Jae-wook Chung ),( So Young Chun ),( Yun-sok Ha ),( Seock Hwan Choi ),( Jun Nyung Lee ),( Bum Soo Kim ),( Ghil Suk Yoon ),( Hyun Tae Kim ),( Tae-hwan Kim ),( Tae Gyun Kwon ) 영남대학교 의과대학 2018 Yeungnam University Journal of Medicine Vol.35 No.2

Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D’Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (≥T3a) and 26.6% (34/128) had high grade disease (Gleason score ≥8). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ≥8) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

Extra-gastrointestinal Stromal Tumor on the Inner Urinary Bladder Wall

Jun Nyung Lee,Se Yun Kwon,Jeongshik Kim,Ghil Suk Yoon,Eun Sang Yoo,Hyun Tae Kim 대한비뇨기종양학회 2016 대한비뇨기종양학회지 Vol.14 No.1

A gastrointestinal stromal tumor is the most common mesenchymal tumor of the gastrointestinal tract, and is diagnosed on the basis of the combined expression of CD34 and CD117 (C-kit protein). An extragastrointestinal stromal tumor of the urinary bladder is a very rare neoplasm. In this report, we describe a case of an extragastrointestinal stromal tumor originating from the inner surface of the urinary bladder. A 46-year-old man presented with an incident bladder mass, and he was diagnosed with an extragastrointestinal stromal tumor after transurethral resection of the bladder tumor. A tumor on the inner urinary bladder wall is an unusual presentation of an extragastrointestinal stromal tumor. The patient is doing well with no recurrence at 18 months after surgery.

Predictive Factors of De Novo Overactive Bladder After Radical Prostatectomy in Patients With Clinically Localized Prostate Cancer: A Prospective Observational Study

Jun Nyung Lee,Sang Won Kim,Kyeong-Hyeon Byeon,Jae-Wook Chung,Yun-Sok Ha,Seock Hwan Choi,Bum Soo Kim,Hyun Tae Kim,Tae-Hwan Kim,Eun Sang Yoo,Tae Gyun Kwon 대한비뇨기종양학회 2021 대한비뇨기종양학회지 Vol.19 No.2

Purpose: To evaluate the incidence of de novo overactive bladder (OAB) and the factors related to its occurrence following radical prostatectomy (RP) in patients with clinically localized prostate cancer (PCa). Materials and Methods: We prospectively examined 50 patients without OAB who underwent RP for clinically localized PCa in our institution from August 2019 to February 2020. We performed assessments using the International Prostate Symptom Score (IPSS), the Overactive Bladder Symptom Score (OABSS), and uroflowmetry before surgery and 3 months after RP. OAB was defined as a score of 1 or more on the urgency components of the OABSS. Three months after RP, the patients were divided into 2 groups based on the presence of de novo OAB symptoms. We evaluated the patients’ demographics and outcomes after RP according to their de novo OAB grouping. The predictive factors of de novo OAB after RP were analyzed using a multivariate logistic regression model. Results: Of the 50 patients, 22 (44%) had de novo OAB 3 months after RP. The patients in the de novo OAB group were older, had higher preoperative IPSS storage subscores, and had larger volumes of postvoid residual urine on preoperative uroflowmetry than those in the non-de novo OAB group. Multivariate analysis showed that age and preoperative IPSS storage subscores were predictive factors of de novo OAB after RP. Conclusions: De novo OAB was observed in 44% of the patients 3 months after RP. Age and preoperative IPSS storage subscores were predictive factors of de novo OAB following RP.

High Notch1 Expression Correlates with Tumor Stage and Size in Clear Cell Renal Cell Carcinoma

Jun Nyung Lee,So Young Chun,Hyo Jung Lee,Yun-Sok Ha,Hyun Tae Kim,Eun Sang Yoo,Tae Gyun Kwon,Tae-Hwan Kim 대한비뇨기종양학회 2016 대한비뇨기종양학회지 Vol.14 No.3

Purpose: Although the influence of Notch signaling on several types of malignancies has been studied, the role of Notch signaling in clear cell renal cell carcinoma (ccRCC) remains unclear. In this study, we evaluated the levels of Notch1 and Jagged1 and their significance in ccRCC. Materials and Methods: Tumor tissue and matched normal adjacent kidney tissue from 49 ccRCC cases were obtained. The expression of Notch1 and Jagged1 was analyzed using real-time polymerase chain reaction (PCR) and Western blotting. Tissue samples were divided into several groups according to clinicopathological features, and the relative expression of Notch1 and Jagged1 was assessed. Results: Real-time PCR revealed increased Notch1 expression in tumor tissues compared with that in adjacent normal tissues (p=0.044). Based on the pathological stage, a significant difference in Notch1 expression was observed between tumor and normal kidney tissues in pT2 and pT3 ccRCC (pT2, p=0.041; pT3, p=0.001). Notch1 expression in ccRCC relative to that in normal tissue was higher in later-stage ccRCC and larger ccRCC. Notch1 expression showed significant positive correlation with the maximal diameter of the primary renal tumor (mRNA, p<0.001; protein, p=0.001). High Notch1 expression was associated with recurrence and disease-specific death, although the difference was not significant. Jagged1 level was not significantly correlated with any of the factors examined. Conclusions: Notch1 may play a significant role in the tumorigenesis and progression of ccRCC. Notch signaling may be a potential target for chemopreventive or adjuvant therapeutics for ccRCC.

Human Urine-derived Stem Cells Seeded Surface Modified Composite Scaffold Grafts for Bladder Reconstruction in a Rat Model

Lee, Jun Nyung,Chun, So Young,Lee, Hyo-Jung,Jang, Yu-Jin,Choi, Seock Hwan,Kim, Dae Hwan,Oh, Se Heang,Song, Phil Hyun,Lee, Jin Ho,Kim, Jong Kun,Kwon, Tae Gyun The Korean Academy of Medical Sciences 2015 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.30 No.12

<P>We conducted this study to investigate the synergistic effect of human urine-derived stem cells (USCs) and surface modified composite scaffold for bladder reconstruction in a rat model. The composite scaffold (Polycaprolactone/Pluronic F127/3 wt% bladder submucosa matrix) was fabricated using an immersion precipitation method, and heparin was immobilized on the surface via covalent conjugation. Basic fibroblast growth factor (bFGF) was loaded onto the heparin-immobilized scaffold by a simple dipping method. In maximal bladder capacity and compliance analysis at 8 weeks post operation, the USCs-scaffold<SUP>heparin-bFGF</SUP> group showed significant functional improvement (2.34 ± 0.25 mL and 55.09 ± 11.81 µL/cm H<SUB>2</SUB>O) compared to the other groups (2.60 ± 0.23 mL and 56.14 ± 9.00 µL/cm H<SUB>2</SUB>O for the control group, 1.46 ± 0.18 mL and 34.27 ± 4.42 µL/cm H<SUB>2</SUB>O for the partial cystectomy group, 1.76 ± 0.22 mL and 35.62 ± 6.69 µL/cm H<SUB>2</SUB>O for the scaffold group, and 1.92 ± 0.29 mL and 40.74 ± 7.88 µL/cm H<SUB>2</SUB>O for the scaffold<SUP>heparin-bFGF</SUP> group, respectively). In histological and immunohistochemical analysis, the USC-scaffold<SUP>heparin-bFGF</SUP> group showed pronounced, well-differentiated, and organized smooth muscle bundle formation, a multi-layered and pan-cytokeratin-positive urothelium, and high condensation of submucosal area. The USCs seeded scaffold<SUP>heparin-bFGF</SUP> exhibits significantly increased bladder capacity, compliance, regeneration of smooth muscle tissue, multi-layered urothelium, and condensed submucosa layers at the in vivo study.</P>

신장을 침범한 후복막강 악성섬유성조직구종

이준녕(Jun Nyung Lee),예석준(Seok Jun Ye),김재수(Jae Soo Kim),유은상(Eun Sang Yoo),권태균(Tae Gyun Kwon) 대한비뇨기종양학회 2007 대한비뇨기종양학회지 Vol.5 No.2

Oncological and functional outcomes following robot-assisted laparoscopic radical prostatectomy at a single institution: a minimum 5-year follow-up

Kang, Jun-Koo,Chung, Jae-Wook,Chun, So Young,Ha, Yun-Sok,Choi, Seock Hwan,Lee, Jun Nyung,Kim, Bum Soo,Yoon, Ghil Suk,Kim, Hyun Tae,Kim, Tae-Hwan,Kwon, Tae Gyun Yeungnam University College of Medicine 2018 Yeungnam University Journal of Medicine Vol.35 No.2

Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D'Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (${\geq}T3a$) and 26.6% (34/128) had high grade disease (Gleason score ${\geq}8$). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ${\geq}8$) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

한의표준임상진료지침 개발을 위한 수족냉증에 대한 한의사의 인식과 치료현황

이동녕 ( Dong-nyung Lee ),김형준 ( Hyung-jun Kim ),유준상 ( Jun-sang Yu ) 대한한방부인과학회 2017 大韓韓方婦人科學會誌 Vol.30 No.3

Objectives: The purpose of this study were to researched a Korean medicine doctors` recognition about coldness of hands and feet, and developing of korean medicine clinical practice guidelines (CPG) for coldness of hands and feet. Methods: We conducted a questionnaire survey targeting 399 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 1. 86.86% of the respondents agreed about the necessity of CPG for coldness of hands and feet. 2. 84.2% of respondents wanted coding of Korean Standard Classification of Diseases (KCD) on coldness of hands and feet. 3. To diagnosis a coldness of hands and feet, the respondents used a Subjective symptoms (98.5%), Infrared thermographic imaging device (DITI) (26.32%) Heart rate variablity test (HRV) (17.04%), Thermometer (9.77%), Cold stress test (2.76%) 4. Causing of coldness of hands and feet, the respondents considered a constitution or heredity (84.71%), stress (73.66%), lack of exercise (64.91%), irregular eating habits (51.63%), Cold meals (32.83%), depression (31.33%), etc. 5. Treating coldness of hands and feet, the respondents used a herbal medicine (66.85%), acupuncture (70.7%) Pharmacopuncture (23.85%) and moxibustion (60.08%) for 10.91±8.03 week. Conclusions: We researched a Korean Medicine doctors` recognition of CPG, clinical diagnosis, treatment on a coldness of hands and feet, and policy they required.

Impact of Multiple Prostate Biopsies: Risk of Perioperative Complications and Biochemical Recurrence After Radical Prostatectomy

Kyong Min Park(박경민),Jae-Wook Chung(정재욱),Jun-Koo Kang(강준구),Teak Jun Shin(신택준),Se Yun Kwon(권세윤),Hyun Chan Jang(장현찬),Yun-Sok Ha(하윤석),Seock Hwan Choi(최석환),Wonho Jung(정원호),Jun Nyung Lee(이준녕),Byung Hoon Kim 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.1

Purpose: The aim of this study was to analyze the perioperative complications and oncological outcomes of radical prostatectomy (RP) in patients who underwent multiple prostate biopsies. Materials and Methods: A total of 1,112 patients who underwent RP between January 2009 and April 2016 at 4 different centers were included in this study. We divided these patients into 2 groups: patients who underwent only 1st biopsy, and those who underwent 2nd or more repeated biopsies. The association between the number of prior biopsies and perioperative complications and biochemical recurrence (BCR) was analyzed. Results: Of 1,112 patients, 1,046 patients (94.1%) underwent only 1st biopsy, and 66 (5.9%) underwent 2nd or more repeated biopsies. There were no significant differences in preoperative prostate-specific antigen levels, operation times, blood loss volumes, or hospital stay durations (all p>0.05). Patients who underwent multiple prostate biopsies presented with a localized tumor significantly more often (p<0.05). The Gleason score and rate of positive surgical margins were significantly lower in patients with multiple biopsies (all p<0.05). The Cox proportional hazards model analysis indicated that there was no association between the number of prior prostate biopsies and BCR (p>0.05). Kaplan-Meier curve analysis indicated that BCR-free survival rates between the 2 groups were similar (p>0.05). Conclusions: Multiple prostate biopsies are not associated with an increased risk of perioperative complications, adverse pathological outcomes, or higher rates of BCR in patients who have undergone RP.

Role of FLASH in caspase-8-mediated activation of NF-κB: dominant-negative function of FLASH mutant in NF-κB signaling pathway

Jun, Joon-Il,Chung, Chul-Woong,Lee, Ho-June,Pyo, Jong-Ok,Lee, Kee Nyung,Kim, Nam-Soon,Kim, Yong Sung,Yoo, Hyang-Sook,Lee, Tae-Ho,Kim, Eunhee,Jung, Yong-Keun Nature Publishing Group 2005 Oncogene Vol.24 No.4

Caspase-8 is the most receptor-proximal, upstream caspase in the caspase cascade and plays a key role in cell death triggered by various death receptors. Here, we addressed the role of endogenous caspase-8 in tumor necrosis factor (TNF)-α-induced activation of NF-κB. Direct targeting of caspase-8 with siRNA and antisense (AS) approaches abolished TNF-α-induced activation of NF-κB in NIH3T3, HeLa, and HEK293 cells as determined with luciferase reporter gene and cell fractionation assays. Reconstitution of caspase-8-deficient C33A cells with processing-defective (P/D) mutant of caspase-8 sensitized the cells to TNF-α for NF-κB activation. In contrast to wild-type caspase-8, death effector domain mutant replacing Asp73 with Ala (caspase-8 (D73A)) failed to activate NF-κB and to bind FLICE-associated huge protein (FLASH) in vitro and in vivo. Instead, caspase-8 (D73A) mutant bound to caspase-8 and blocked NF-κB activation triggered by TNF-α and caspase-8. In addition, expression of an NF-κB-activating domain-deletion mutant of FLASH or transfection of FLASH AS oligonucleotides abolished TNF-α and caspase-8, but not phorbol 12-myristate 13-acetate, -induced activation of NF-κB. Further, immunoprecipitation assays showed that caspase-8 formed triple complex with TRAF2 and FLASH. Taken together, these results suggest that endogenous caspase-8 mediates TNF-α-induced activation of NF-κB via FLASH.Oncogene (2005) 24, 688–696. doi:10.1038/sj.onc.1208186 Published online 13 December 2004