Dae-Yun Kim

Publications (2)6.86 Total impact

• Article: Fetal pyelectasis as predictor of decreased differential renal function.

  Dae-Yun Kim, Jennie J Mickelson, Brian T Helfand, Max Maizels, William E Kaplan, Elizabeth B Yerkes
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  ABSTRACT: A decreased percent of differential function is a common indication for infant pyeloplasty but there is no recognized fetal ultrasound parameter to predict this deficit. We determined whether there is a correlation between fetal pyelectasis and the newborn percent differential function that may enhance prenatal counseling and guide postnatal evaluation. Our database was queried for fetal and newborn measures with fetal pyelectasis on ultrasound and the percent of differential function on renal scintigraphy. Fetal pyelectasis data were stratified by estimated gestational age and the percent of differential function. The affected cohort was defined as having 35% or less differential function and the unaffected cohort was defined as having greater than 35%. The Wilcoxon 2-sample test was used for statistical analysis with logistic regression to generate estimated probability models of a decreased percent of differential function vs mm fetal pyelectasis. A total of 831 cases had fetal and newborn ultrasound data available with a total of 229 renal scans identified. Of the 229 cases 36 (16%) had 35% or less differential function on scintigraphy. At estimated gestational age 33 weeks or less the affected cohort had 8 mm greater pyelectasis than the unaffected cohort (OR 1.2, p <0.0001). At estimated gestational age greater than 33 weeks the affected cohort had 4 mm greater pyelectasis than the unaffected cohort (OR 1.07, p <0.07). Subgroup analysis before 33 weeks of estimated gestational age showed similar significance (OR >1, p <or=0.001). Approximately 16% of all fetuses with pyelectasis have 35% or less differential function as newborns, including 36% identified by pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks. Fetal pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks and greater than 16 mm at greater than 33 weeks is associated with 35% or less differential function in the newborn.
  The Journal of urology 08/2009; 182(4 Suppl):1849-53. · 4.02 Impact Factor
• Article: Outcomes of radical prostatectomy for patients with clinical stage T1a and T1b disease.

  Brian T Helfand, Anne K Mongiu, Donghui Kan, Dae-Yun Kim, Stacy Loeb, Kimberly A Roehl, Joshua J Meeks, Norm D Smith, William J Catalona
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  ABSTRACT: To compare the outcomes between patients with stage T1a/b with those of patients with T1c cancer of the prostate treated with radical retropubic prostatectomy (RRP), as the appropriate management of clinical stage T1a/b prostate cancer is subject to debate; although many patients are managed expectantly, some have adverse pathological features suggesting that more active treatment might be beneficial. From 1983 to 2003, 3478 men had RRP by one surgeon. From this group, we retrospectively identified 29 men with clinical stage T1a and 83 with clinical stage T1b disease. Using statistical analysis we compared the treatment outcomes of these patients with those of 1774 men with clinical stage T1c disease. Men with T1a/b disease had a significantly lower preoperative prostate-specific antigen (PSA) level, a greater proportion with organ-confined disease, and a lower mean/median prostatectomy Gleason score than those with T1c disease. Also, men with T1a/b disease were less likely to be potent before surgery, although the frequency of recovery of potency was similar among all groups. On multivariate analysis with age, year of surgery, PSA level and Gleason score, there was no statistical difference in the rates of biochemical recurrence and the 10-year overall survival rates. However, patients with T1b disease had a significantly lower cancer-specific survival. T1a and T1b prostate cancer can be associated with aggressive pathological features and have a similar rate of progression as clinical stage T1c disease. That notwithstanding, most patients in the study were cured with RRP and had favourable long-term functional outcomes.
  BJU International 03/2009; 104(3):304-9. · 2.84 Impact Factor