Comprehensive Review of Effective Application of Questionnaires for Clinical Research on Lower Urinary Tract Symptoms With Translation and Cultural Adaptation to the Korean Language

서준교,오승준,조성용 대한배뇨장애요실금학회 2020 International Neurourology Journal Vol.24 No.4

Lower urinary tract symptoms are highly prevalent and closely related to patients’ quality of life. Clinical research on urologic disease is essential for accumulating evidence on patient management; however, the major obstacle is converting patients’ subjective symptoms to objective parameters. The optimal application of well-developed and validated questionnaires is vital in achieving objectivity and minimizing bias in clinical research. Numerous questionnaires for measuring symptoms and quality of life in urologic diseases have been developed worldwide; however, they cannot be directly used in clinical studies without validation processes. This review aimed to explain the common procedures for translation, linguistic, and psychometric validation of developed questionnaires from other languages. Furthermore, we comprehensively reviewed currently available questionnaires for evaluating lower urinary tract symptoms in the Korean population.

노후 고층아파트의 도시사회경제에 미칠 영향에 대한 이론적 고찰

서준교 한국거버넌스학회 2008 한국거버넌스학회보 Vol.15 No.1

본 연구는 도시의 노후 고층아파트 노후화가 도시의 사회경제에 미치는 영향에 대하여 이론적으로 고찰해보고자 한다. 아파트는 도시의 부족한 택지를 효율적으로 활용하여 대량의 주택을 공급할 수 있는 긍정적인 특성을 갖고 있다. 이러한 아파트의 특성을 최대한 활용하여, 한국은 장기간 아파트 중심의 주택보급정책을 실행하였으며, 주택보급률에 긍정적인 결과를 가져오는 계기를 마련하였다. 하지만, 아파트의 효율성 극대화는 전체 주택유형에서 아파트가 차지하는 점유율을 과도하게 높였을 뿐만 아니라 빠르게 고층화시켰다. 아파트의 효율성은 누구도 인정하지만, 향후 고층화된 대량의 아파트가 동시다발적으로 노후화 과정을 거칠 경우 재건축에 있어 여러 문제를 양산할 수 있으며, 특히 재건축에 대한 경제성 문제의 대두로 재건축이 불확실하게 되면 노후 고층아파트가 밀집한 지역의 생활환경 낙후로 인한 사회경제적 쇠퇴를 초래할 수 있다. 영국 맨체스터의 Hulme 지역의 사례를 토대로 장래 한국 대도시의 고층아파트 낙후가 지역 사회경제에 미칠 잠재적 영향에 대하여 분석하고, 이러한 문제에 대한 대안을 모색하도록 한다. The aim of this study is to find out the effect of urban housing deterioration on urban socio-economic decline. For this purpose, the study primarily focuses upon existing studies on the relationship between urban housing deterioration and urban socio-economic decline. In the main part of the study, it examines the possibility of reconstructing deteriorated high-rise apartment estates in metropolitan cities in Korea through a case study of Hulme in Manchester, which has successfully achieved neighbourhood regeneration. The result of the study is that there are some differences in the condition of reconstructing deteriorated high-rise apartment estates between Hulme in Manchester and metropolitan cities in Korea. The most problematic aspect of reconstructing the estates is economical efficiency that metropolitan cities in Korea seem not to be able to secure. As the differences, unlike the successful regeneration of Hulme, it seems to be almost impossible to reconstruct deteriorated apartment estates in metropolitan cities in Korea, which might lead to further decline in socio-economies of the areas.

문화도시전략을 통한 도시재생의 순환체계 확립에 관한 연구 : Glasgow의 문화도시전략을 중심으로

서준교 한국거버넌스학회 2006 한국거버넌스학회보 Vol.13 No.1

In recent years, the perception of culture and arts has changed from the common people's enjoyment to an important variable for economic development. Particularly, culture and arts have been used to turn economically, socially, and environmentally declined cities into new image possessed cities such as a cultural city. In many old industrial cities of western European countries, the use of culture and arts has become an increasingly significant component of economic and physical regeneration strategies. Especially, many cities in Britain have adopted culture and arts as a way of escaping from urban decline. A typical example of British city using culture and arts as a means of regenerating urban decline is a Scotland city, Glasgow. The city faced with massive economic and social decline in the 1960s and 70s. However, Glasgow has used culture and arts to change the overall image of the city to a cultural city which led to sustained urban development. The city of Glasgow is one of the best examples for the application of culture and arts as a means of urban development strategies through the circulation system of urban regeneration. This study attempts to illustrate the process of Glasgow's overall regeneration effort. 인간의 삶에 있어 문화·예술의 중요성은 오래전부터 인식되어 왔지만, 문화·예술의 활용은 과거의 향유 위주에서 벗어나 도시경제발전에 중요한 변수로 대두되고 있다. 문화·예술은 경제적·사회적·환경적 쇠퇴화에 처한 도시들에게 과거의 부정적인 이미지를 척결하고 새롭고 긍정적인 이미지를 주입시키는 도시개발전략, 즉 문화도시전략으로 거듭나고 있다. 이러한 문화도시전략은 서구 유럽의 여러 공업도시들에서 경제적·사회적 재생을 위한 중요한 구성요소로 여겨지면서 새로운 시각으로 문화·예술의 중요성을 바라보게 하고 있다. 특히, 영연방 (United Kingdom) Scotland 최대의 도시인 Glasgow는 문화도시전략을 통해 성공적인 도시재생을 달성한 대표적인 도시로 문화·예술이 도시발전에 원동력이 될 수 있음을 증명하는 중요한 사례가 되고 있다. Glasgow는 1960년대와 70년대에 경제적, 사회적 쇠퇴화로 엄청난 시련을 겪었지만, 1980년대 중반부터 지역 문화·예술의 활성화를 기반으로 하는 문화도시전략을 통해 지역의 경제적·사회적·환경적 변화를 가져오는 문화도시의 순환체계를 촉진시킴으로써 지속적인 도시발전을 가져오게 하였다. Glasgow의 사례는 우리에게 문화·예술의 활용한 도시발전전략에 있어 중요한 시사점이 될 수 있으리라 여겨진다.

Efficacy and safety of low power holmium laser enucleation of the prostate: A prospective short- and medium-term single-blind randomized trial

서준교,추민수,오승준 대한비뇨의학회 2023 Investigative and Clinical Urology Vol.64 No.5

Purpose: We evaluated the efficacy and safety of mid-term follow-up in low-power (LP) Holmium laser enucleation of the prostate (HoLEP) compared with high-power (HP) surgery for benign prostatic hyperplasia (BPH). Materials and Methods: This prospective, single-blind, randomized controlled study was conducted between September 2020 and April 2021. Ninety male patients >50 years who underwent HoLEP for BPH were randomly assigned to HP (80 W/2 J/40 Hz) and LP (24 W/2 J/12 Hz) groups. The primary endpoint was the total International Prostate Symptom Score (IPSS) six months after surgery. The secondary endpoints were perioperative results and postoperative outcomes at two weeks, three and six months after the surgery, including Clavien–Dindo complication classification. Results: At six months after HoLEP, 41 and 42 patients were followed up in the HP and LP groups, respectively. There was no difference in the preoperative characteristics between the two groups. The prostate volumes were 67.1±23.7 mL for the HP group and 64.3±25.7 mL for the LP group (p=0.592), respectively. Although the total operative time was significantly longer by 13.1 minutes in the LP group (47.8±20.3 min vs. 60.9±23.3 min, p=0.006), the total delivered energy was significantly lower, which was only about 68% of the HP group (58.2±23.9 kJ vs. 39.9±13.2 kJ, p<0.001). Surgical outcomes significantly improved postoperatively in both groups compared to baseline, except for storage symptoms. Improvement in IPSS storage subscore was observed from the immediate postoperative 2 weeks in the LP group (8.1±3.1 to 6.9±3.8, p<0.001), whereas there was no significant recovery in the HP group (8.0±3.2 to 7.7±3.4, p=0.842). In the 6-month follow, there was no significant difference between the two groups in the IPSS total score (5.9±5.6 vs. 7.3±5.3, p=0.260) as well as IPSS storage subscore. In addition, there was no significant difference in postoperative complications, including bleeding or urinary incontinence, between the two groups. Conclusions: The HoLEP procedure performed using an LP laser device resulted in lower total delivered energy, faster recovery, and significantly improved surgical outcomes up to mid-term follow-up. There was no difference in efficiency or safety between the HP device system.

압축적 개발을 통한 도시재생에 대한 논쟁적 접근: 도시생활환경과 사회적 공평을 중심으로

서준교 한국거버넌스학회 2016 한국거버넌스학회보 Vol.23 No.1

The problems associated with urban sprawl have long been recognized. Particularly, as its major characteristics of unlimited outward extension of new development, it has evoked a variety of environmental and socioeconomic problems that have led to a threat to urban sustainability. In response to the problems of urban sprawl, compact urban development has been proposed. The main essence of compact urban development consists of high-dense development including the preservation of undeveloped green-field, the mixture of land uses, the provision of efficient urban transport systems, the proximity of various urban functions to increase social and economic interactions, and etc, which promote environmentally friendly urban development and socioeconomically efficient urban form that encourage urban sustainability. The idea of the compact urban development has increasingly been utilized the core strategies for urban regeneration in many cities of the world in recent years. However, it is doubted that the main characteristics of the compact urban development, such as high-density and the mixture of land uses, would promote sustainable urban development. Particularly, the urban regeneration through the compact development tends to concentrate on the redevelopment of the central city areas, which could produce negative effects on urban living environment and social equity. In spite of economic efficiency, the compactness of development on the central city leads to the bustle of city life as the intensity of various urban functions in the limited space, which negatively affects the overall urban living condition. Moreover, the concentration of development potentials on the central city raises real estate and housing price in there that makes difficulties with access to the revitalized central city for lower-income households. As a result, the central city becomes a place for those affluent upper and middle classes who are able to bear the expanse that leads to the gentrification of the central city. Furthermore, as the concentration of redevelopment on the central city, the socioeconomic aspects of inner-city areas have further been depressed due to a lack of financial investment from both public and private bodies. This leads to the polarization between the central city and the inner-city in terms of development potentials, which divides the city into two cities. Overall, it seems that the urban regeneration through the compact development may not be seen as a way of achieving sustainable urban development. The purpose of this study is to examine the validity of the compact urban development, particularly the urban regeneration through the compact development, in terms of its impact on urban living environment and social equity. 도시의 외연적 확산은 도시규모를 외연적으로 팽창시키는 개발의 특징으로 인해 다양한 환경적 그리고사회경제적 문제를 불려와 도시의 지속가능성을 위협하는 요인으로 지목받고 있다. 최근 도시의 외연적확산으로 비롯된 문제에 대응하기 위한 개발방식으로 압축적 도시개발이 제시되고 있다. 압축적 도시개발의 핵심은 고밀의 혼합토지이용으로 자연녹지로의 개발억제를 통한 보존과 함께 대중교통 중심의 효율적인 도시교통시스템으로 다양한 도시기능 간 접근성 향상에 따른 사회 및 경제적 상호작용을 증진시키는 도시형태로의 개발을 통해 도시의 지속가능성을 촉진시키는 것이다. 이러한 압축적 도시개발은 세계의 여러도시에서 도시재생을 위한 중심전략으로 널리 활용되고 있다. 하지만, 압축적 도시개발의 핵심적 특징인고밀의 혼합토지개발로 도시의 지속가능성을 성취할 수 있는가에 대한 의문을 갖게 한다. 특히, 압축적 개발을 통한 도시재생은 도시중심부에 집중된 재개발을 중심으로 함에 따라 도시생활환경이나 사회적 공평에 부정적인 영향을 줄 수 있을 것으로 보고 있다. 즉, 도시중심부의 압축적 개발은 한정된 공간에 도시기능의 집중으로 도시의 혼잡성을 확대시킴으로써 도시의 전반적인 생활환경에 부정적인 영향을 줄 수밖에없다는 것이다. 여기에, 재개발의 도시중심부 집중은 부동산과 주택가격을 상승시켜 경제적으로 열악한저소득계층의 진입을 어렵게 만드는 원인이 되고 있다. 결과적으로, 도시중심부는 이러한 비용을 부담할수 있는 중상위 계층의 거주지로 탈바꿈하는 고급주택화로 이어지고 있다. 게다가, 도시중심부를 한정한도시재생은 부도심 지역의 사회경제적 낙후를 더욱 심화시킴으로써 도시의 공간적 분리와 양극화에 따른이원적 도시를 낳고 있다. 전체적으로, 압축적 개발의 도시재생은 도시의 지속가능성을 확보하는 지속가능한 개발로서의 한계를 갖고 있음을 지적한다. 본 연구는 압축적 도시개발의 유효성, 특히 압축적 개발의도시재생에 따른 도시생활환경과 사회적 공평에 미칠 영향을 집중적으로 분석하는 것을 목적으로 한다.

Long-term oncologic outcomes after radical prostatectomy in clinically localized prostate cancer: 10-year follow-up in Korea

서준교,정재현,정창욱,이상은,이은식,구자현,김현회,곽철 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.3

Purpose: The clinical behavior of prostate cancer differs by race and ethnicity; however, data on the Korean population are scarce. We assessed the long-term oncologic outcomes of clinically localized prostate cancer after radical prostatectomy in Korean men. Materials and Methods: We analyzed 786 clinically localized prostate cancer patients who underwent radical prostatectomy, from June 1993 to June 2008. Kaplan–Meier survival curve analysis and log-rank test were used to assess the oncologic outcomes. Results: The mean age of the patients was 64.9±6.6 years. Pelvic lymph node dissection was performed in 373 patients. Pathologic T and N stage cancer with local advancement and invasion were detected by radical prostatectomy in 307 and 22 patients, respectively. In total, 38 patients who underwent adjuvant therapy were excluded from the analysis of progression after biochemical recurrence (BCR), which occurred in 261 men. In total, 219 patients underwent salvage treatment. Local recurrence and distant metastasis occurred in 109 and 42 patients, respectively; 36 patients experienced metastasis with local recurrence. Castration-resistant prostate cancer developed in 22 patients, and overall and disease-specific mortality was noted in 148 and 23 patients, respectively. The median duration from operation to BCR, BCR to metastasis, and metastasis to disease-specific death was 25, 40, and 22 months, respectively. Conclusions: We demonstrated the long-term prognosis of localized prostate cancer after radical prostatectomy among Koreans. Our results differ from those reported in the Western literature, with a lower prevalence of distant metastasis and shorter time to metastasis after BCR.

Targeted next-generation sequencing for locally advanced prostate cancer in the Korean population

서준교,정창욱,최성민,구자현,김현회,김광수,곽철 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.2

Purpose: This study aimed to evaluate the feasibility of pan-cancer panel analysis for locally advanced prostate cancer in the Korean population. Materials and Methods: We analyzed 20 patients with locally advanced prostate cancer who underwent radical prostatectomy. A pan-cancer panel (1.9 Mbp) developed by Seoul National University Hospital (SNUH), composed of 183 target genes, 23 fusion genes, and 45 drug target regions was used for this analysis. We compared the SNUH pan-cancer panel results with The Cancer Genome Atlas (TCGA) database to search for different mutations in the Korean population. Clinical data were analyzed with univariate and multivariate analysis, and p-values <0.05 were considered statistically significant. Kaplan–Meier curve and log-rank tests were performed to evaluate survival. Results: The average age of the patients and initial prostate-specific antigen values were 69.3±7.8 years and 66.3±16.9 ng/dL, respectively. Average sequencing depth was 574.5±304.1×. Ninety-nine genetic mutations and 5 fusions were detected. SPOP (25%), KMT2D (20%), and BRAF (15%) were frequently detected. ERG fusions were recurrently detected in 20% of the patients, with SLMAP and SETD4 as novel fusion partners. BRAF mutation was frequently detected in this study, but not in the TCGA database. Multivariate analysis showed BRAF mutation as an independent prognostic factor for biochemical recurrence (hazard ratio, 9.84; p=0.03). Conclusions: The pan-cancer panel comprising genes related to prostate cancer is a useful tool for evaluating genetic alterations in locally advanced prostate cancers. Our results suggest that the BRAF mutation is associated with biochemical recurrence in the Korean population.

Prevalence and management status of urologic disease in geriatric hospitals in South Korea: A population-based analysis

서준교,김계환,이상헌,김형석,이영주,이상림,정창욱 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.4

Purpose: This study aimed to investigate the prevalence and management status of urologic disease in geriatric hospitals in Korea. Materials and Methods: We conducted population-based analyzed using cohort established by the National Health Insurance Service of Korea, which contains the medical insurance data of 1 million people from 2002 to 2013. The prevalence, prescription rate, and complication incidence of urologic disease in geriatric hospitals were compared with similar-sized general hospitals. We analyzed the changes that followed the adoption of the fixed sum medical fee per day for geriatric hospitals, which began in January 2008. Subgroup analysis was conducted in an elderly group and a propensity score matching (PSM) group. Results: During this time, the number of geriatric hospitals exponentially increased over general hospitals (675.5%/y vs. 30.9%/y). The prevalence, prescription rate, and complication incidence of urologic disease was higher in geriatric hospitals than in general hospitals (2.1, 1.8, and 1.4 times higher). In the elderly group, the prevalence of urologic disorders was higher in geriatric hospitals than in general hospitals, but the prescription rate was lower (26.5% vs. 19.9% and 6.8% vs. 10.0%). This tendency also founded in the PSM analysis. After the medical fee system changed, diagnosis and prescription rates decreased in geriatric hospitals but increased in general hospitals. Conclusions: Urologic diseases are more prevalent yet management has some problem in geriatric hospitals. Lack of institutional urologists and changes in the medical payment system should be associated with this problem. Additional study and political support are needed to overcome this issue.

Next-generation Proteomics-Based Discovery, Verification, and Validation of Urine Biomarkers for Bladder Cancer Diagnosis

서준교,한도현,구자현,김현회,곽철,정창욱 대한암학회 2022 Cancer Research and Treatment Vol.54 No.3

PurposeWe aimed to identify, verify, and validate a multiplex urinary biomarker-based prediction model for diagnosis and surveillance of urothelial carcinoma of bladder, using high-throughput proteomics methods. Materials and MethodsLabel-free quantification of data-dependent and data-independent acquisition of 12 and 24 individuals was performed in each of the discovery and verification phases using mass spectrometry, simultaneously using urinary exosome and proteins. Based on five scoring system based on proteomics data and statistical methods, we selected eight proteins. Enzyme-linked immunosorbent assay on urine from 120 patients with bladder mass lesions used for validation. Using multivariable logistic regression, we selected final candidate models for predicting bladder cancer. ResultsComparing the discovery and verification cohorts, 38% (50/132 exosomal differentially expressed proteins [DEPs]) and 44% (109/248 urinary DEPs) are consistent at statistically significance, respectively. The 20 out of 50 exosome proteins and 27 out of 109 urinary proteins were upregulated in cancer patients. From eight selected proteins, we developed two diagnostic models for bladder cancer. The area under the receiver operating characteristic curve (AUROC) of two models were 0.845 and 0.842, which outperformed AUROC of urine cytology. ConclusionThe results showed that the two diagnostic models developed here were more accurate than urine cytology. We successfully developed and validated a multiplex urinary protein-based prediction, which will have wide applications for the rapid diagnosis of urothelial carcinoma of the bladder. External validation for this biomarker panel in large population is required.

Corrigendum: Correction of the Acknowledgment.Prevalence and management status of urologic disease in geriatric hospitals in South Korea: A population-based analysis

서준교,김계환,이상헌,김형석,이영주,이상림,정창욱 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.3