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      • KCI등재

        Establishment of Prospective Registry of Active Surveillance for Prostate Cancer: The Korean Urological Oncology Society Database

        Jung Gyoohwan,Kim Jung Kwon,Jeon Seong Soo,Chung Jae Hoon,Kwak Cheol,Jeong Chang Wook,Ahn Hanjong,Joung Jae Young,Kwon Tae Gyun,Park Sung Woo,Byun Seok-Soo 대한남성과학회 2023 The World Journal of Men's Health Vol.41 No.1

        Purpose: To establish a prospective registry for the active surveillance (AS) of prostate cancer (PC) using the Korean Urologi-cal Oncology Society (KUOS) database and to present interim analysis. Materials and Methods: The KUOS registry of AS for PC (KUOS-AS-PC) was organized in May 2019 and comprises multiple institutions nationwide. The eligibility criteria were as follows: patients with (1) pathologically proven PC; (2) pre-biopsy prostate-specific antigen (PSA) ≤20 ng/mL; (3) International Society of Urological Pathology (ISUP) grade 1 or 2 (no cribriform pattern 4); (4) clinical T stage ≤T2c; (5) positive core ratio ≤50%; and (6) maximal cancer involvement in the core ≤50%. Detailed longitudinal clinical information, including multi-parametric magnetic resonance imaging and disease-specific out-comes, was recorded. Results: From May 2019 to June 2021, 296 patients were enrolled, and 284 were analyzed. The mean±standard deviation (SD) age at enrollment was 68.7±8.2 years. The median follow-up period was 11.2 months (5.9–16.8 mo). Majority of pa-tients had pre-biopsy PSA ≤10 ng/mL (91.2%), PSA density <0.2 ng/mL2 (79.7%), ISUP grade group 1 (94.4%), single positive core (65.7%), maximal cancer involvement in the core ≤20% (78.1%), and clinical T stage of T1c or lower (72.9%). Fifty-two (18.3%) discontinued AS for various reasons. Interventions included radical prostatectomy (80.8%), transurethral prostatec-tomy (5.8%), primary androgen deprivation therapy (5.8%), radiation (5.8%), and focal therapy (1.9%). The mean±SD time to intervention was 8.9±5.2 months. The reasons for discontinuation included pathologic reclassification (59.6%), patient pref-erence (25.0%), and radiologic reclassification (9.6%). Two (4.8%) patients with pathologic Gleason score upgraded to ISUP grade group 4, no biochemical recurrence. Conclusions: The KUOS established a successful prospective database of PC patients undergoing AS in Korea, named the KUOS-AS-PC registry.

      • KCI등재

        Pattern Analysis of Laser Fiber Degradation According to the Laser Setting: In Vitro Study of the Double-Firing Phenomenon

        Jung Gyoohwan,Lee Seung Min,So Sang Won,Kim Sehwan,Kim Seong Chan,Kwon Ohbin,Song Hyunjae,Choi Min Joo,Cho Sung Yong 대한의학회 2022 Journal of Korean medical science Vol.37 No.38

        Background: It is essential to understand the mechanism of the various causes of laser fiber damage and an ideal method of reducing endoscope damage induced by laser emission in multiple sites. This study classified the different patterns of laser fiber degradation according to laser settings and analyzed the role of cavitation bubbles to find a desirable way of minimizing endoscope damage. Methods: A total of 118 laser fibers were analyzed after 1-,3-, and 5-min laser emission to artificial stones under the settings of 1 J-10 Hz, 1 J-20 Hz, 1 J-30 Hz, and 2 J-10 Hz. Every 3 cm from the fiber tip was marked and examined with a digital microscope and a high-speed camera. The images of the fibers and the movement of cavitation bubbles were taken with a distance of 1 to 5 mm from the gel. Results: Seven types of fiber damage (charring, limited and extensive peeled-off, bumpy, whitish plaque, crack, and break-off ) coincided during laser emission. Damages rapidly increased with emission time > 3 minutes regardless of the laser settings. The damaged lengths covered 5 mm on average, and the fibers at 5-min emission were significantly shorter than others. The fiber durability of 1J-10Hz setting was better than other settings after 3-min laser emission. Backward movement of the cavitation bubbles was found at the 1-mm distance from the gel, and the damaged lengths were longer than the diameters of the cavitation bubbles because of their proximal movement. Conclusion: The damage patterns of the laser fiber tips were classified into seven types. The heat damage around the surface of the laser fiber can be increased according to the highenergy or high-frequency laser setting, a short distance to the stone, a short distance from the tips of flexible ureteroscopes, no cutting laser fiber procedures, and the inappropriate use of irrigation fluid or laser fiber jacket.

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        Experience on Early Urethral Catheter Removal Following Radical Prostatectomy

        Hyeong Dong Yuk,Gyoohwan Jung,Min Young Yoon,Juhyun Park,Sung Yong Cho,Hwancheol Son,Hyeon Jeong 대한비뇨기종양학회 2016 대한비뇨기종양학회지 Vol.14 No.2

        Purpose: To assess outcomes from patients who underwent radical prostatectomy and had their indwelling urinary catheter removed on postoperative day (POD) 4 or 7. Materials and Methods: The medical records of 107 consecutive patients receiving radical prostatectomy (RP), were retrospectively reviewed. Patients were categorized into two groups according to length of catheterization. Group 1 (n=40) had the urethral catheter removed on postoperative day (POD) 4, and group 2 (n=67) had the catheter removed on POD7. Group 1 had urethral catheter removal following no leakage on intraoperative leak testing and POD4 cystography, whilst group 2 exhibited leakage at POD4 and instead had routine POD7 urethral catheter removal if there was evidence of no leakage of POD7 cystography. Incontinence was checked according to the use of protective pad. Results: The mean age of the study population was 67.0 years. acute urinary retension (AUR) following catheter removal occurred in 6 of the cohort (5.6%); 3 patients (7.5%) from group 1 and 3 (4.5%) from group 2 (p=0.669). The overall continence rate was 39.3%, 68.2%, 80.4%, and 91.6% at 1, 3, 6, and 12 months respectively. Importantly, the incontinence recovery pace of group 1 was notably higher than that of group 2 (p=0.001). Neither group exhibited bladder neck contracture. Intraoperative factors influencing the decision to remove catheter at POD4 following RP, are bladder neck reconstruction (OR=3.792, p=0.010) and nerve sparing (OR=6.646, p=0.008). Conclusions: Selective early urethral catheter removal may shorten the length of incontinence recovery, without increasing the risk of AUR and bladder neck contracture.

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