Hwang Gyun Jeon

Sungkyunkwan University, Sŏul, Seoul, South Korea

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Publications (54)110.09 Total impact

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    ABSTRACT: To evaluate the oncologic outcomes and postoperative complications of high-intensity focused ultrasound (HIFU) as a salvage therapy after external-beam radiotherapy (EBRT) failure in patients with prostate cancer. Between February 2002 and August 2010, we retrospectively reviewed the medical records of all patients who underwent salvage HIFU for transrectal ultrasound-guided, biopsy-proven locally recurred prostate cancer after EBRT failure (by ASTRO definition: prostate-specific antigen [PSA] failure after three consecutive PSA increases after a nadir, with the date of failure as the point halfway between the nadir date and the first increase or any increase great enough to provoke initiation of therapy). All patients underwent prostate magnetic resonance imaging and bone scintigraphy and had no evidence of distant metastasis. Biochemical recurrence (BCR) was defined according to the Stuttgart definition (PSA nadir plus 1.2 ng/mL). A total of 13 patients with a median age of 68 years (range, 60-76 years) were included. The median pre-EBRT PSA was 21.12 ng/mL, the pre-HIFU PSA was 4.63 ng/mL, and the period of salvage HIFU after EBRT was 32.7 months. The median follow-up after salvage HIFU was 44.5 months. The overall BCR-free rate was 53.8%. In the univariate analysis, predictive factors for BCR after salvage HIFU were higher pre-EBRT PSA (p=0.037), pre-HIFU PSA (p=0.015), and short time to nadir (p=0.036). In the multivariate analysis, there were no significant predictive factors for BCR. The complication rate requiring intervention was 38.5%. Salvage HIFU for prostate cancer provides effective oncologic outcomes for local recurrence after EBRT failure. However, salvage HIFU had a relatively high rate of complications.
    Korean journal of urology 02/2014; 55(2):91-6.
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    ABSTRACT: To assess the location of recurrent tumors and suggest the optimal target volume in adjuvant or salvage radiotherapy (RT) after a radical prostatectomy (RP). From January 2000 to December 2012, 113 patients had been diagnosed with suspected recurrent prostate cancer by MRI scan and received salvage RT in the Samsung Medical Center. This study assessed the location of the suspected tumor recurrences and used the inferior border of the pubic symphysis as a point of reference. There were 118 suspect tumor recurrences. The most common site of recurrence was the anastomotic site (78.8%), followed by the bladder neck (15.3%) and retrovesical area (5.9%). In the cranial direction, 106 (87.3%) lesions were located within 30mm of the reference point. In the caudal direction, 12 lesions (10.2%) were located below the reference point. In the transverse plane, 112 lesions (94.9%) were located within 10mm of the midline. A MRI scan acquired before salvage RT is useful for the localization of recurrent tumors and the delineation of the target volume. We suggest the optimal target volume in adjuvant or salvage RT after RP, which includes 97% of suspected tumor recurrences.
    Radiotherapy and Oncology 01/2014; · 4.52 Impact Factor
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    ABSTRACT: To evaluate the accuracy of preoperative multiparametric 3.0-T magnetic resonance imaging(MRI) for local staging of prostate cancer(PCa) and its influence on the decision to preserve neurovascular bundles(NVB) at robotic-assisted laparoscopic radical prostatectomy(RALRP). Between 2008 and 2011, 353 patients, who had confirmed PCa and underwent preoperative MRI and RALRP, were included. The extent of NVB sparing was initially determined on the basis of the clinical information and nerve sparing surgical plan was reevaluated after review of the MRI report. The value of preoperative MRI in the prediction of extracapsular extension(ECE) and in the decision of surgical plan according to D'Amico risk classification were analyzed. The MRI performed correct, over- and under- staging in 261(73.9%), 43(12.2%), and 49(13.9%) patients, respectively. After review of the MRI reports, the initial surgical plan was not changed in 260 patients(260/353, 74%) and changed in 93 patients(93/353, 26%). RALRP was changed to a more preservable NVB sparing procedure in 53 patients(53/93, 57%) and changed to a more aggressive NVB resecting procedure in 40 patients(40/93, 43%). For the patients with a change to more conservative surgery, the appropriateness was 91%. The sensitivity of MRI in predicting ECE showed a tendency to increase from low to high risk groups(33%,46%,80%, respectively; p<0.001). In intermediate and high risk groups, there was a surgical plan change in 40 patients(40/129, 31%) and 27 patients(27/67, 40%), respectively. The preoperative MRI significantly improves the decision-making to preserve or resect the NVB at RALRP which lacks haptic feedback.
    The Journal of urology 01/2014; · 4.02 Impact Factor
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    ABSTRACT: Background and purpose To assess the location of recurrent tumors and suggest the optimal target volume in adjuvant or salvage radiotherapy (RT) after a radical prostatectomy (RP). Material and methods From January 2000 to December 2012, 113 patients had been diagnosed with suspected recurrent prostate cancer by MRI scan and received salvage RT in the Samsung Medical Center. This study assessed the location of the suspected tumor recurrences and used the inferior border of the pubic symphysis as a point of reference. Results There were 118 suspect tumor recurrences. The most common site of recurrence was the anastomotic site (78.8%), followed by the bladder neck (15.3%) and retrovesical area (5.9%). In the cranial direction, 106 (87.3%) lesions were located within 30 mm of the reference point. In the caudal direction, 12 lesions (10.2%) were located below the reference point. In the transverse plane, 112 lesions (94.9%) were located within 10 mm of the midline. Conclusions A MRI scan acquired before salvage RT is useful for the localization of recurrent tumors and the delineation of the target volume. We suggest the optimal target volume in adjuvant or salvage RT after RP, which includes 97% of suspected tumor recurrences.
    Radiotherapy and Oncology. 01/2014;
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    ABSTRACT: To investigate the ability of six contemporary active surveillance protocols to appropriately select active surveillance candidates among Korean men who underwent radical prostatectomy. Between January 2001 and December 2011, 1968 patients underwent radical prostatectomy for prostate cancer at Samsung Medical Center, Seoul, Korea. Patients met the criteria for active surveillance according to six currently used criteria, including those from the Johns Hopkins Hospital, the University of Toronto, the University of California at San Francisco, the Prospective Prostate Cancer Research International Active Surveillance, the University of Miami and the Memorial Sloan-Kettering Cancer Center. The rates of Gleason score upgrading, upstaging and misclassification at final pathology were assessed. Among 1006 assessable patients, the percentage of men eligible for active surveillance varied from 13.5% to 38.5%, depending on the criteria used. The rates of upgrading ranged from 41.6% to 50.6%. Extracapsular extension was reported in 4.1% to 8.5% of patients, whereas seminal vesicle invasion was reported in 0.5% to 1.6% of patients. The upstaging rates according to the six active surveillance criteria varied from 4.5% to 9.3%, and the rates of misclassification varied from 44.5% to 54.8%. Currently available active surveillance criteria might not be suitable in Korean patients with prostate cancer, as they have a high likelihood of underestimating cancer.
    International Journal of Urology 10/2013; · 1.73 Impact Factor
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    ABSTRACT: To investigate the impact of tumour size on postoperative glomerular filtration rate (GFR) in patients undergoing radical nephrectomy (RN) for renal cell carcinoma (RCC). We retrospectively identified 1371 patients who underwent RN between 1995 and 2010. Serum creatinine levels were measured preoperatively, within 7days of RN, at 3months, 1 and 3years. We divided patients into three groups based on tumour size: A: ⩽4cm, B: 4-7cm, C: >7cm. The changes in GFR were compared and multivariate logistic regression was used to analyse the predictive value of tumour size for new-onset chronic kidney disease (CKD, GFR<60mL/min/1.73m(2)). The preoperative GFR was significantly different among the three groups (A: 83.0, B: 82.0, C: 79.4ml/min/1.73m(2), P=0.040). The decrease in GFR from preoperative to within 7days was greater in group A than in groups B and C (28.2 versus 24.2 versus 18.5ml/min/1.73m(2), P<0.001). The GFR at 1year postoperative was lower in group A than in group C (58.4 versus 61.5ml/min/1.73m(2), P=0.009), in contrast to preoperative GFR. The incidence of GFR decrease >30% was higher in Group A than in Groups B and C at 1year (52.4% versus 41.5% versus 33.7%, P<0.001). On multivariate analysis Groups A and B had a 2.37-fold (95% confidence interval (CI) 1.56-3.60, P<0.001) and 2.24-fold (95% CI 1.49-3.38, P<0.001) higher risk of new-onset CKD compared with Group C. Small tumour size is associated with CKD after RN. Partial nephrectomy should be considered in patients with tumour size 7cm or less.
    European journal of cancer (Oxford, England: 1990) 09/2013; · 4.12 Impact Factor
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    ABSTRACT: To evaluate predictors of more aggressive disease and the role of multiparametric 3.0-T magnetic resonance imaging (MRI) in selecting prostate cancer patients for active surveillance. We retrospectively assessed 298 prostate cancer patients who met the Prostate Cancer Research International: Active Surveillance (PRIAS) criteria, defined as T1c/T2, PSA level of ≤10 ng/mL, PSA density of <0.2 ng/mL(2) , Gleason score <7, and one or two positive biopsy cores. All patients underwent preoperative MRI, including T2-weighted, diffusion-weighted, and dynamic contrast-enhanced imaging, as well as radical prostatectomy between June 2005 and December 2011. Imaging results were correlated with pathological findings to evaluate the ability of MRI to select patients for active surveillance. In 35(11.7%) patients, no discrete cancer was visible on MRI while in the remaining 263(88.3%) patients, a discrete cancer was visible. Pathologic examination of radical prostatectomy specimens resulted in upstaging (>T2) in 21(7%) patients, upgrading (Gleason score>6) in 136(45.6%), and a diagnosis of unfavorable disease in 142(47.7%) patients. The 263 patients(88.3%) with visible cancer on imaging were more likely to have their cancer status upgraded(49.8% vs. 14.3%) and be diagnosed with unfavorable disease(52.1% vs. 14.3%) than the 35 patients(11.7%) with no cancer visible upon imaging, and these differences were statistically significant(p<0.001 for all). A visible cancer lesion on MRI, PSA density, and patient age were found to be predictors of unfavorable disease in multivariate analysis. MRI can predict adverse pathologic features and be used to assess the eligibility of prostate cancer patients for active surveillance.
    BJU International 08/2013; · 3.05 Impact Factor
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    ABSTRACT: The aim of this study was to improve understanding of the characteristics of micropapillary urothelial carcinoma (MPUC) in the renal pelvis and ureter, and to compare oncological outcomes between MPUC and non-MPUC. From September 1994 to October 2010, 418 patients underwent nephroureterectomy with bladder excision due to presumed urothelial carcinoma. Pathological review of all specimens was done by one uropathologist. Perioperative data from these patients were reviewed retrospectively. Patients were divided into MPUC and non-MPUC groups. Oncological outcomes were compared between the two groups via progression-free survival (PFS) and cancer-specific survival (CSS) rates. A total of 386 patients were included in the study. Of these, seven patients (1.81%) had MPUC. The median follow-up duration was 39.0 months (IQR range 21.1-70.6). All MPUC patients were men and had lymphovascular invasion, and six patients (85.7%) had grade III and T3 disease. On univariable analysis, MPUC showed significantly worse prognosis with regard to disease progression (p<0.001). In the subgroup analysis confined to T3 or T4 disease, MPUC showed worse prognosis than non-MPUC in terms of PFS and CSS, respectively (p<0.05). In the multivariable model, MPUC still remained a statistically significant independent predictor for PFS (HR (95% CI)=3.85 (1.59-9.32), p=0.003). MPUC was associated with poorer CSS than non-MPUC (p<0.001). We have observed that upper tract MPUC is associated with poor oncological outcomes in terms of PFS and CSS. MPUC was an independent prognostic factor for PFS in multivariable analysis.
    Journal of clinical pathology 08/2013; · 2.43 Impact Factor
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    ABSTRACT: We assessed the predictive factors for renal insufficiency in patients followed for more than 5 years after radical nephrectomy. Age, gender, history of diabetes, history of hypertension, body mass index, preoperative estimated glomerular filtration rate (eGFR), serum uric acid, urine albumin, normal renal parenchymal volume, tumor size, and ratio of normal parenchymal volume of the removed kidney to that of the remaining kidney were evaluated retrospectively in 89 patients who underwent radical nephrectomy from January 2001 to December 2005. Patients were included whose renal parenchymal volume was measurable by use of perioperative imaging (computed tomography or magnetic resonance imaging), whose preoperative eGFR was greater than 60 mL/min/1.73 m(2), and who were followed for more than 5 years. To measure renal parenchymal volume from imaging, we integrated the extent of the normal renal parenchyma from axial slides of images. In univariate and multivariate binary regression analysis, the parenchymal volume of the remnant kidney (p=0.001), a history of diabetes (p=0.035), and preoperative eGFR (p=0.011) were independent factors for renal insufficiency. By use of a receiver operating characteristic curve, a volume of 170 mL was determined to be an appropriate cutoff value, with sensitivity of 58.7% and specificity of 74.4% for the parenchymal volume of the remnant kidney for predicting eGFR less than 60 mL/min/1.73 m(2) (area under the curve, 0.678). The parenchymal volume of the remnant kidney was also an independent factor for the downgrading of the chronic kidney disease category in the multivariate linear regression analysis (p=0.021). Preoperative eGFR, a history of diabetes, and the radiologic volume of the remaining kidney parenchyma could be useful factors for predicting postoperative renal function. Patients with parenchymal volumes of less than 170 mL have a higher risk of postoperative renal insufficiency, which should be considered carefully when choosing a treatment modality.
    Korean journal of urology 05/2013; 54(5):303-310.
  • Hwang Gyun Jeon
    Canadian Urological Association journal = Journal de l'Association des urologues du Canada 05/2013; 7(5-6):193-4. · 1.66 Impact Factor
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    ABSTRACT: The purpose of this article was to announce the establishment of the multicenter Korean Prostate Cancer Database (K-CaP) and to provide urologists with details about K-CaP's methodology. The initial participating K-CaP institutions include five medical centers in Korea. First, we registered prostate cancer patients who underwent radical prostatectomy as the basic background data. K-CaP is poised to combine these initial observational longitudinal studies with those of other eligible institutions as the database grows. All current prostate cancer patients in Korea are able to be registered into the Web-based database system and thereby have a role in several observational studies. The structure of the database for K-CaP was developed by matching it with the respective data from different studies. The operability of the K-CaP database system was verified by using the existing databases from three participating institutions. The analysis of clinicopathologic characteristics of patients with the use of the Web-based database was successfully conducted. We confirmed the accurate operation of the Web-based database system without any difficulties. We are announcing the establishment of K-CaP the first database of comprehensive observational longitudinal studies about prostate cancer in Korea. The database will be successfully maintained by sufficiently and continuously updating all patient data covering several treatments. Complete statistical results for registered prostate cancer patients are forthcoming for the basic background data to establish the database. Even though much trial and error are expected during the development process, we expect that K-CaP will eventually become one of the most powerful longitudinal observation databases.
    Korean journal of urology 04/2013; 54(4):229-33.
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    ABSTRACT: Human adult stem cells are a readily available multipotent cell source that can be used in regenerative medicine. Despite many advantages, including low tumorigenicity, their rapid senescence and limited plasticity have curtailed their use in cell-based therapies. In this study, we isolated CD34/CD73 double-positive (CD34+/CD73+) testicular stromal cells (HTSCs) and found that the expression of CD34 was closely related to the cells' stemness and proliferation. The CD34+/CD73+ cells grew in vitro for an extended period of time, yielding a multitude of cells (5.6 x 1016 cells) without forming tumors in vivo. They also differentiated into all 3 germ layer lineages both in vitro and in vivo, produced cartilage more efficiently compared to bone marrow stem cells and, importantly, restored erectile function in a cavernous nerve crush injury rat model. Thus, these HTSCs may represent a promising new autologous cell source for clinical use.
    Stem cells and development 03/2013; · 4.15 Impact Factor
  • Urology 01/2013; 81(1):213–214. · 2.42 Impact Factor
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    ABSTRACT: Background and Aims: Immunomodulatory properties of mesenchymal stem cells (MSCs) have been applied to reduce the incidence of graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). Among the various sources of MSCs that have immunomodulatory effects in vitro, only placenta-derived MSCs (PD-MSCs) have not been evaluated in an in vivo model of GVHD. In this study, we investigated the immunomodulatory properties of PD-MSCs in vitro and evaluated their clinical potential for controlling GVHD in an animal model. Methods: A GVHD animal model was established by transplanting C57BL/6 donor bone marrow cells and spleen cells into lethally irradiated BALB/c recipient mice. To control GVHD, human PD-MSCs were transplanted into recipient mice (5 × 10(5) or 1 × 10(6) cells). Results: PD-MSCs suppressed mitogen-stimulated T cell proliferation in vitro in a dose-dependent manner. Moreover, PD-MSCs inhibited cytokine secretion (interleukin-12, tumor necrosis factor-α and interferon-γ) of activated T cells. In vivo, the survival rate in the PD-MSC group (transplanted with 1 × 10(6) cells) was higher than that in the control group and histological scores were low in the PD-MSC group. Conclusion: We present the first evidence that human PD-MSCs can efficiently control GVHD in an HSCT in vivo model.
    Acta Haematologica 12/2012; 129(4):197-206. · 0.89 Impact Factor
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    ABSTRACT: PURPOSE:: We investigated the relationship between preoperative uric acid levels and GFR preoperatively and postoperatively in patients with RCC. MATERIALS AND METHODS:: We included 1,534 patients who underwent radical or partial nephrectomy for RCC between 1994 and 2008. Uric acid was measured preoperatively and estimated GFR was calculated using the modification of diet in renal disease equation preoperatively and postoperatively within 7 days and at 3 months, 1 year, and 3 years. We looked for correlations of uric acid with GFR, patient demographics, and comorbidities. We also evaluated the predictive value of uric acid for preoperative GFR and new-onset chronic kidney disease (GFR<60mL/min/1.73m(2)) after nephrectomy using multivariate regression analysis. RESULTS:: The mean uric acid (SD, range) concentration was 5.2 (1.5, 1.3-11.3)mg/dL. The mean preoperative uric acid level was correlated with preoperative GFR (r=-0.313, p<0.001) and associated with prevalent chronic kidney disease. Decreased preoperative GFR correlated significantly with earlier year of surgery (p<0.001), old age (p<0.001), male gender (p<0.001), hypertension (p<0.001), high uric acid level (p<0.001), and larger tumor size (p<0.001) in multivariate regression analysis. Hypertension (p<0.001), male gender (p<0.001), and a high body mass index (p<0.001) were correlated with high levels of uric acid. Older age (p<0.001), diabetes mellitus (p=0.002), a low preoperative GFR (p<0.001), and a high preoperative uric acid level (p=0.002) were significant predictors of new-onset chronic kidney disease at 3 years after nephrectomy. CONCLUSIONS:: The elevated preoperative uric acid level was an independent predictor of low preoperative GFR and new-onset chronic kidney disease in RCC patients who underwent nephrectomy.
    The Journal of urology 11/2012; · 4.02 Impact Factor
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    ABSTRACT: To evaluate stone diameter and ureteral dilation using computerized tomography as a predictor of ureteral stone expulsion after medical expulsive therapy. We retrospectively reviewed the records of 328 patients with symptomatic ureteral stones <10 mm on axial computerized tomography images, who were treated with alpha blockers for 2 weeks. Computerized tomography scans were also performed 2 weeks after medical expulsive therapy to confirm ureteral stone expulsion. Patients were divided into upper ureteral stones and lower ureteral stones above and below the iliac vessels, respectively. Transverse stone diameter and longitudinal stone diameter were defined as the largest stone diameter determined on the axial and coronal computerized tomography images, respectively. Ureteral diameter was determined on one computerized tomography slice proximal to each ureteral stone on axial computerized tomography images, and the ratio of ureter-to-stone diameter was defined as ureteral diameter divided by transverse stone diameter. Among 328 patients, the stone expulsion rate was 44.1% in 145 upper ureteral stones and 69.4% in 183 lower ureteral stones. Transverse stone diameter, longitudinal stone diameter, ureteral diameter, and the ratio of ureter-to-stone diameter were significantly lower in patients with ureteral stone expulsion in upper ureteral stones and lower ureteral stones (P < .001 for all parameters). Logistic regression analysis revealed that only longitudinal stone diameter was a significant predictor of stone expulsion in patients with upper ureteral stones (odds ratio 0.580, P = .040) and lower ureteral stones (odds ratio 0.415, P = .012). Longitudinal stone diameter was a significant predictor of stone expulsion in patients with upper ureteral stones and lower ureteral stones after medical expulsive therapy. Measurement of stone diameters in coronal reconstruction may help to better choose a patient who is suitable for medical expulsive therapy.
    Urology 08/2012; 80(4):784-9. · 2.42 Impact Factor
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    ABSTRACT: Minimally invasive management of small renal tumors has become more common. We compared the results of partial nephrectomy by video-assisted minilaparotomy surgery (VAMS), open, and laparoscopic techniques. We retrospectively compared clinicopathological, oncological, and functional outcomes in 271 patients who underwent partial nephrectomy for renal tumors at one institution from 1993 to 2007; including 138 by VAMS, 102 by open, and 31 by laparoscopic technique. Mean follow-up was 47.7 ± 29.1 months. No statistically significant differences in the three groups were found in tumor size, tumor location, estimated blood loss, complication rate, preoperative glomerular filtration rate (GFR), and GFR at last follow-up. Ischemic time was shorter in the open (26.9 min) and VAMS (29.3 min) groups than in the laparoscopic group (31.0 min, p=0.021). Time to normal diet and hospital stay were shorter in the VAMS (1.8 days and 5.4 days) and laparoscopic (1.8 days and 4.7 days) groups than in the open group (2.4 days and 7.3 days, p=0.036 and p<0.001, respectively). Of 180 patients with cancer, positive surgical margins occurred in 2 of 82 patients (2.4%) in the VAMS group, none of 75 patients in the open group, and 3 of 23 patients (13.0%) in the laparoscopic group (p=0.084). In the VAMS, open, and laparoscopic groups, 5-year disease- free survival was 94.8%, 95.8%, and 90.3% (p=0.485), and 5-year cancer-specific survival was 96.3%, 98.6%, and 100%, respectively (p=0.452). Partial nephrectomy using VAMS technique provides surgical, oncologic, and functional outcomes similar to open and laparoscopic techniques.
    Yonsei medical journal 01/2012; 53(1):151-7. · 0.77 Impact Factor
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    ABSTRACT: We measured kidney volume using software and investigated the relationship between kidney volume and renal function. Age, gender, height, body weight, body mass index, body surface area and serum creatinine were recorded for 539 normal individuals. A tissue segmentation tool program was used to measure kidney volume from computerized tomography images. The glomerular filtration rate was calculated using the Cockcroft-Gault equation and an abbreviated modification of diet in renal disease equation. We looked for correlations of renal parenchymal volume with age and anthropometric measurements. We also tested for a correlation between kidney volume and renal function using the glomerular filtration rate according to the Cockcroft-Gault and modification of diet in renal disease equations. Mean kidney volume in all participants was 261.3 ± 58.1 ml. Mean volume in men was approximately 14 ml greater than in women (266.1 vs 251.8 ml, p = 0.004). Kidney volume correlated significantly with height (r = 0.344, p <0.001), body weight (r = 0.343, p <0.001), body mass index (r = 0.177, p <0.001), body surface area (r = 0.371, p <0.001) and age (r = -0.418, p <0.001). Kidney volume also correlated with the glomerular filtration rate according to the Cockcroft-Gault and modification of diet in renal disease equations (p <0.001, r = 0.615 and p <0.001, r = 0.432, respectively). Kidney volume and the glomerular filtration rate decreased in parallel with increasing age. Kidney volume correlates well with renal function and anthropometric measurements. Knowledge of these relationships will be valuable in clinical urology and nephrology.
    The Journal of urology 11/2011; 187(1):344-9. · 4.02 Impact Factor
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    ABSTRACT: There has been some controversy about the gender differences in survival in patients with RCC. Korean women with RCC had a lower proportion of clear cell histology and a higher proportion of chromophobe histology. This histological difference might have driven the better survival rates in Korean women. To assess whether there are gender-specific differences in the clinicopathological features and prognosis in a large cohort of Korean patients with renal cell carcinoma (RCC) compared with Western patients. Medical records of 1616 patients clinically diagnosed with RCC who underwent partial or radical nephrectomy were analysed between January 1988 and July 2009. In all, 1508 patients diagnosed with RCC based on pathology reports were included for evaluation. The mean follow-up period was 73.1 months. The gender-specific differences in the clinicopathological features and survival rates were evaluated using the Kaplan-Meier method and Cox proportional hazards models. Of the 1508 patients, 439 (29.1%) were women. Korean men had a higher proportion of clear cell histology (84.3% vs 72.0%, P < 0.001) and a lower percentage of chromophobe histology (5.2% vs 12.5%, P < 0.001) than Korean women. There were no gender-specific differences in pathological T stage, positive lymph nodes or distant metastases, or Fuhrman's nuclear grade (P > 0.05). For both cancer-specific and overall survival, Kaplan-Meier curves showed that women had a better survival rate than men (P = 0.039 and P = 0.015, respectively). Korean women with RCC had significantly better survival rates than Korean men. Additionally, Korean women with RCC had a lower proportion of clear cell histology and a higher proportion of chromophobe histology. This histological difference might have driven the better survival rates in Korean women.
    BJU International 11/2011; 110(2 Pt 2):E28-33. · 3.05 Impact Factor
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    ABSTRACT: Previously we reported that the histone deacetylase inhibitor trichostatin A (Sigma®) synergistically potentiates the antitumor effects of cisplatin in human bladder cancer cells. In the current study we explored the synergistic interaction between trichostatin A and gemcitabine (Novartis Korea, Seoul, Korea), the other mainstay chemotherapeutic regimen for advanced bladder cancer. The bladder cancer cell lines HTB5, HTB9, T24, J82, UMUC14 and SW1710 (ATCC®) were exposed to gemcitabine and/or trichostatin A. Synergism between the 2 drugs was determined by the combination index based on the Cell Counting Kit-8 assay (Dojindo Molecular Technologies, Rockville, Maryland) and by a clonogenic assay. Flow cytometry was used to evaluate cell cycle distribution and apoptosis. The expression of cell cycle (p21(WAF1/CIP1), cyclin A, B1 and D1, p-CDC2C, CDC2C, p-CDC25C, CDC25C and pRb), apoptosis (caspase-3, 8 and 9, PARP, Bcl-2, Bad and Bax), NF-κB (NF-κB, p-IκBα, IκBα, p-IKKα, IKKα, cIAP1, cIAP2 and XIAP) and survival (p-Akt, Akt, p-mTOR, mTOR and PTEN) related proteins was analyzed by Western blot. Isobolic analysis of the Cell Counting Kit-8 assay revealed strong synergism between gemcitabine and trichostatin A, which caused a 4.6 to 25.4-fold gemcitabine dose reduction and a 1.9 to 41.4-fold trichostatin A dose reduction while killing an estimated 90% of bladder cancer cells. The underlying mechanisms could be synergistic cell cycle arrest, induction of caspase mediated apoptosis, and down-regulation of the antiapoptotic NF-κB and Akt signaling pathways. Results show that trichostatin A may synergistically enhance gemcitabine mediated cell cycle arrest and apoptosis, suggesting the potential of using histone deacetylase inhibitors as combination agents to enhance the antitumor effect of gemcitabine for advanced bladder cancer.
    The Journal of urology 09/2011; 186(5):2084-93. · 4.02 Impact Factor

Publication Stats

302 Citations
55 Downloads
110.09 Total Impact Points

Institutions

  • 2012–2014
    • Sungkyunkwan University
      • Department of Urology
      Sŏul, Seoul, South Korea
  • 2010–2012
    • CHA University
      Sŏul, Seoul, South Korea
    • Yonsei University
      • Department of Urology
      Seoul, Seoul, South Korea
    • Seoul National University
      • Department of Urology
      Seoul, Seoul, South Korea
  • 2011
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2009–2011
    • Seoul National University Hospital
      • Department of Urology
      Seoul, Seoul, South Korea