Jang Hwan Kim

Wonju Severance Christian Hospital, Genshū, Gangwon, South Korea

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Publications (45)85.53 Total impact

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    ABSTRACT: Dry mouth is among the most common side effects of antimuscarinic therapy. This study evaluated the drug-related change in dry mouth after the solifenacin treatment and the impact of dry mouth on the drug efficacy against overactive bladder syndrome (OAB). OAB patients (n = 331) were enrolled in a prospective, multicenter, 8-week observational study of solifenacin treatment. Participants were >20 years of age and presented with OAB symptoms for ≥3 months, a total overactive bladder symptom score (OABSS) of ≥3, and an urgency score of ≥2. Primary endpoints were changes in dry mouth according to baseline dry mouth status using Xerostomia Inventory (XI) and the effect of dry mouth to the drug efficacy according to improvements in the OABSS. Three hundred and thirty-three patients were initially screened for the study, with 331 actually enrolled. One hundred and ninety-four patients completed the study. Mean total XI scores increased by 2.8 points in the entire patient population, with larger increases for patients stratified into the non-dry mouth group (NDG) versus the dry mouth group (DG) (4.0 vs. 1.9, p = 0.015) at study baseline. Mean total OABSSs decreased by 3.2 points, with no significant differences between the NDG and the DG (-3.4 vs. -3.0 points, p = 0.578). The dry mouth aggravated in 71 patients (29.2 %) (NDG 30.1 % and DG 27.1 %), but only 10/331 individuals (3.0 %) stopped medication due to xerostomia. Dry mouth progressed in approximately 30 % of the OAB patients, regardless of its presence before solifenacin treatment. However, OAB symptoms were well relieved by solifenacin, and the adverse influence of dry mouth on drug persistence was low.
    International Urology and Nephrology 12/2014; · 1.29 Impact Factor
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    ABSTRACT: The aims of this study were to investigate the efficacy of combining the systematized behavioral modification program (SBMP) with desmopressin therapy and to compare this with desmopressin monotherapy in the treatment of nocturnal polyuria (NPU). Patients were randomized at 8 centers to receive desmopressin monotherapy (group A) or combination therapy, comprising desmopressin and the SBMP (group B). Nocturia was defined as an average of 2 or more nightly voids. The primary endpoint was a change in the mean number of nocturnal voids from baseline during the 3-month treatment period. The secondary endpoints were changes in the bladder diary parameters and questionnaires scores, and improvements in self-perception for nocturia. A total of 200 patients were screened and 76 were excluded from the study, because they failed the screening process. A total of 124 patients were randomized to receive treatment, with group A comprising 68 patients and group B comprising 56 patients. The patients' characteristics were similar between the groups. Nocturnal voids showed a greater decline in group B (-1.5) compared with group A (-1.2), a difference that was not statistically significant. Significant differences were observed between groups A and B with respect to the NPU index (0.37 vs. 0.29, P=0.028), the change in the maximal bladder capacity (-41.3 mL vs. 13.3 mL, P<0.001), and the rate of patients lost to follow up (10.3% [7/68] vs. 0% [0/56], P=0.016). Self-perception for nocturia significantly improved in both groups. Combination treatment did not have any additional benefits in relation to reducing nocturnal voids in patients with NPU; however, combination therapy is helpful because it increases the maximal bladder capacity and decreases the NPI. Furthermore, combination therapy increased the persistence of desmopressin in patients with NPU.
    International neurourology journal 12/2014; 18(4):213-20.
  • International Urogynecology Journal 10/2014; · 2.17 Impact Factor
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    ABSTRACT: Few clinical studies have evaluated the integrity of repaired tendons and identified the timing of retears through the use of serial imaging.
    The American Journal of Sports Medicine 09/2014; · 4.70 Impact Factor
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    ABSTRACT: Urinary nerve-growth-factor (NGF) level reflected the severity of urgency in patients with lower urinary tract symptoms (LUTS) and pain in patients with Bladder pain syndrome/interstitial cystitis (BPS/IC). The aim of this study was to investigate the levels of biomarkers, nerve growth factor (NGF), and prostaglandin E2 (PGE2) among disease groups sharing similar urinary symptoms and to elucidate which symptoms are related to individual biomarker levels.
    International Urogynecology Journal 05/2014; · 2.16 Impact Factor
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    ABSTRACT: Objective To show the noninferiority of silodosin 8-mg once-daily (QD) to 4-mg twice-daily (BID) in efficacy and safety in patients with lower urinary tract symptoms or benign prostatic hyperplasia in the Korean population. Methods A prospective, multicenter, double-blind, randomized, comparative study was conducted. A total of 532 male patients aged ≥50 years with lower urinary tract symptoms or benign prostatic hyperplasia were included. All patients received silodosin QD or BID for 12 weeks. The primary end point was the change from baseline in total International Prostate Symptom Score (IPSS) at 12 weeks. Adverse drug reactions, vital signs, and laboratory tests were recorded. Results A total of 424 patients were randomized to the silodosin QD or BID groups. These groups were not significantly different in baseline characteristics. The mean total IPSS change in QD group was not inferior to that in BID group (−6.70 and −6.94, respectively; 95% confidence interval, −0.88 to 1.36). The QD and BID groups did not significantly differ in the following: percentages of patients with ≥25% (63.41% and 67.82%, respectively; P = .349) or ≥4-point improvement in total IPSS (65.85% and 69.31%, respectively; P = .457), maximum urinary flow rate improvement ≥30% (47.32% and 40.59%, respectively; P = .172), changes in IPSS voiding subscore (−4.42 ± 4.93 and −4.65 ± 4.77; P = .641), IPSS storage subscore (−2.05 ± 3.07 and −2.52 ± 2.97; P = .117), quality of life (−1.19 ± 1.49 and −1.40 ± 1.42; P = .136), maximum urinary flow rate (3.55 ± 5.93 and 3.74 ± 6.79 mL/s; P = .768), International Continence Society male questionnaire score, Patient Goal Achievement Score, or Treatment Satisfaction Question. The 2 groups had similar frequencies of adverse drug reactions. Conclusion QD administration of silodosin was not inferior to BID in efficacy. The 2 groups had similar adverse drug reaction profiles.
    Urology 04/2014; · 2.13 Impact Factor
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    ABSTRACT: Objective To investigate the associations between prostate elasticity and lower urinary tract symptoms (LUTS). Methods From August 2009 to December 2009, 48 patients with no history of neoadjuvant therapy or previous prostate surgery who underwent robot-assisted radical prostatectomy were included in this study. A novel palpation system was used to measure the tissue elasticity of the prostate specimens. The elasticity of the prostate was defined as the mean elastic modulus (kilopascals [kPa]) of 21 sites from the posterior surface of prostate. All patients completed an International Prostate Symptoms Score questionnaire before surgery, and LUTS was defined as an International Prostate Symptoms Score total of ≥8. Significant voiding symptoms were identified by a score of ≥5 on the basis of patient responses to 4 questions (Q1, Q3, Q5, and Q6), and storage symptoms were identified by a score ≥4 on the basis of patient responses to 3 questions (Q2, Q4, and Q7). Results The median elastic modulus of the prostate was 20.8 kPa (interquartile range 15.6-22.9), and the LUTS incidences and voiding symptoms were significantly higher in patients with an elastic modulus >20 kPa. The multivariate logistic regression results indicated that a higher elastic modulus (as a continuous variable) was independently associated with voiding symptoms (odds ratio 1.18, P = .038) after controlling for age and prostate volume. However, the elastic modulus was not independently associated with LUTS or storage symptoms. Conclusion Patients with greater prostate stiffness are more likely to develop LUTS. Specifically, prostate elasticity was independently associated with voiding symptoms.
    Urology 03/2014; 83(3):544–549. · 2.13 Impact Factor
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    ABSTRACT: Purpose: These are the clinical experiences of Korean incidental prostate cancer patients detected by transurethral resection of the prostate according to initial treatment: active surveillance (AS), radical prostatectomy (RP) and hormone therapy (HT). Materials and Methods: We retrospectively reviewed the records of 156 incidental prostate cancer patients between 2001 and 2012. The clinicopathologic outcomes were reviewed and follow-up results were obtained. Results: Among 156 patients, 97 (62.2%) had T1a and 59 (37.8%) had T1b. Forty-six (29.5%) received AS, 67 (42.9%) underwent RP, 34 (21.8%) received HT, 4 (2.6%) received radiotherapy, and 5 (3.2%) chose watchful waiting. Of 46 patients on AS, prostate-specific antigen (PSA) progression occurred in 12 (26.1%) patients. Among them, 3 patients refused treatment despite PSA progression. Five patients, who underwent RP as an intervention, all had organ-confined Gleason score ≤6 disease. In 67 patients who underwent RP, 50 (74.6%) patients had insignificant prostate cancer and 8 (11.9%) patients showed unfavorable features. During follow-up, biochemical recurrence occurred in 2 patients. Among 34 patients who received HT, 3 (8.8%) patients had PSA progression. Among 156 patients, 6 patients died due to other causes during follow-up. There were no patients who died due to prostate cancer. Conclusion: The clinical outcomes of incidental prostate cancer were satisfactory regardless of the initial treatment. However, according to recent researches and guidelines, immediate definite therapy should be avoided without a careful assessment. We also believe that improved clinical staging is needed for these patients.
    Yonsei medical journal 01/2014; 55(1):78-83. · 0.77 Impact Factor
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    ABSTRACT: Objectives To evaluate the efficacy and safety of sacral neuromodulation for treating patients with refractory overactive bladder based on urodynamic data. Methods Patients older than 18 years of age, with overactive bladder symptoms refractory to conventional therapies were eligible. Patients with more than a 50% reduction in frequency, urgency, or urge incontinence symptoms during a 2-week test stimulation period retained the sacral neuromodulation. Voiding diaries, overactive bladder questionnaires, and urodynamic studies were performed before and 1 year after sacral neuromodulation. ResultsForty patients received sacral neuromodulation and 31 patients of those were followed more than 1 year. The mean age of the 31 patients was 54.2 ± 15.4 (range, 30–76) years, and the mean duration of symptoms was 4.4 ± 5.7 (range, 1–31) years. After 12 months of sacral neuromodulation, significant decreases in the episodes of daily urgency (from 20.2 to 5.7, P < 0.001), urgency incontinence (from 7.3 to 0.2; P = 0.011), day time micturition (from 21.8 to 9.9; P < 0.001), night time micturition (from 3.2 to 1.2; P = 0.006) and in severity of urgency episodes (from 3.8 to 2.7; P = 0.015) were observed compared to baseline. Significant increases occurred in bladder volume at the first unstable contraction (from 182.4 ± 92.7 to 216.8 ± 115.6 mL), bladder volume at first desire to void (from 150.5 ± 90.8 to 167.8 ± 81.5 mL), maximal cystometric capacity (from 260.7 ± 120.4 to 291.7 ± 124.3 mL) and bladder volume at urgency sensation (from 182.4 ± 92.7 to 208.2 ± 106.6 mL) (all P < 0.05). Conclusions Sacral neuromodulation is an effective and safe treatment for refractory overactive bladder.
    Lower urinary tract symptoms 10/2013; · 0.54 Impact Factor
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    ABSTRACT: We compared the effectiveness of the retropubic tension-free vaginal tape (TVT) and the transobturator inside-out tape (TVT-O) in treating symptoms of overactive bladder (OAB) in women with stress urinary incontinence (SUI). Women with urodynamic SUI and OAB (mean urgency episodes ≥1 and frequency ≥8/24 hours on a 3-day voiding diary) were assigned to the TVT or TVT-O group. Preoperative measures were based on a urodynamic study, 3-day voiding diary, the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTSSF), and the urgency perception scale (UPS). At 12 postoperative months, the 3-day voiding diary, symptoms questionnaire, patient satisfaction, and standing stress test were assessed. The primary endpoint was change in the number of urgency episodes/24 hours from baseline to 12 months. In this group of 132 women, 42 received TVT and 90 received TVT-O. The mean urgency episodes/24 hours decreased from 6.3±5.5 to 1.6±3.2 in the TVT group and from 5.1±4.4 to 1.8±3.0 in the TVT-O group. The mean percent change was significantly greater after TVT than after TVT-O (73% vs. 60%, P=0.049). All subscales of BFLUTSSF and UPS were significantly improved using either method, with significantly greater improvement seen in the quality of life (QoL) domain after TVT (P=0.002). There were no significant differences in the cure and satisfaction rates between the two groups. Intervention with the TVT or the TVT-O significantly improved symptoms of OAB in women with SUI and OAB. Urgency and QoL significantly improved after TVT compared with that after TVT-O.
    International neurourology journal 09/2013; 17(3):145-51.
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    ABSTRACT: To investigate the prevalence of lower urinary tract symptoms (LUTS) in a cohort of methamphetamine abusers (MAs) and to assess the therapeutic efficacies of ą-blockers and anticholinergics. From May 2011 to March 2013, 78 male MAs diagnosed with methamphetamine addiction were identified at the National Forensic Hospital, Korea. International Prostate Symptom Scores (IPSS) with consultation was used to investigate the prevalence of LUTS, defined as total IPSS =8 and quality of life (QoL) index =2. These values for MAs were compared to those of 71 age-matched controls. For MAs with LUTS, ą-blockers and anticholinergics were administered according to predominant voiding and storage symptoms based on voiding-to-storage subscore ratios. For MAs with no response, defined as =4 reduction in total IPSS, the alternative drug or combination was administered. Efficacies were assessed based on a 4-week interval. The median periods of methamphetamine abuse and abstinence were 18.1 years and 5.7 months, respectively. MAs showed higher prevalence of LUTS compared to controls (77% vs. 15%; p<0.001), with higher IPSS and QoL indexes (13.3 vs. 5.6 and 2.9 vs. 0.9, respectively; p<0.001). Anticholinergics showed the greatest effect on IPSS reduction, with overall response rates for ą-blockers, anticholinergics, and combinations of 13%, 61%, and 14%, respectively. Seven (12%) MAs did not respond to any therapy. LUTS was highly prevalent among MAs. Our results imply that pathologic dopaminergic mechanisms play a role in methamphetamine-associated LUTS. Moreover, first-line anticholinergics and prompt combination with ą-blockers conferred the most therapeutic benefit for non-responders.
    The Journal of urology 08/2013; · 3.75 Impact Factor
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    ABSTRACT: Anatomic tunnel positioning is important in anterior cruciate ligament (ACL) reconstructive surgery. Recent studies have suggested the limitations of a traditional transtibial technique to place the ACL graft within the anatomic tunnel position of the ACL on the femur. The purpose of this study is to determine if the 2-incision tibial tunnel-independent technique can place femoral tunnel to native ACL center when compared with the transtibial technique, as the placement with the tibial tunnel-independent technique is unconstrained by tibial tunnel. In sixty-nine patients, single-bundle ACL reconstruction with preservation of remnant bundle using hamstring tendon autograft was performed. Femoral tunnel locations were measured with quadrant methods on the medial to lateral view of the lateral femoral condyle. Tibial tunnel locations were measured in the anatomical coordinates axis on the top view of the proximal tibia. These measurements were compared with reference data on anatomical tunnel position. With the quadrant method, the femoral tunnel centers of the transtibial technique and tibial tunnel-independent technique were located. The mean (± standard deviation) was 36.49% ± 7.65% and 24.71% ± 4.90%, respectively, from the over-the-top, along the notch roof (parallel to the Blumensaat line); and at 7.71% ± 7.25% and 27.08% ± 7.05%, from the notch roof (perpendicular to the Blumensaat line). The tibial tunnel centers of the transtibial technique and tibial tunnel-independent technique were located at 39.83% ± 8.20% and 36.32% ± 8.10%, respectively, of the anterior to posterior tibial plateau depth; and at 49.13% ± 4.02% and 47.75% ± 4.04%, of the medial to lateral tibial plateau width. There was no statistical difference between the two techniques in tibial tunnel position. The tibial tunnel-independent technique used in this study placed femoral tunnel closer to the anatomical ACL anteromedial bundle center. In contrast, the transtibial technique placed the femoral tunnel more shallow and higher from the anatomical position, resulting in more vertical grafts. After single-bundle ACL reconstruction, three-dimensional computed tomography showed that the tibial tunnel-independent technique allows for the placement of the graft closer to the anatomical femoral tunnel position when compared with the traditional transtibial technique.
    Clinics in orthopedic surgery 03/2013; 5(1):26-35.
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    Jang Hwan Kim
    International neurourology journal 03/2013; 17(1):41.
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    ABSTRACT: PURPOSE: Alpha-blockers improve lower urinary tract symptoms (LUTS) associated with benign prostatic obstruction (BPO). Nocturia-a storage symptom-is a common complaint in men, however, it does not fully respond to alpha-blocker therapy, likely due to its multifactorial pathophysiology. We evaluated the efficacy and safety of desmopressin as add-on therapy for refractory nocturia in men previously treated with an alpha-blocker for LUTS. MATERIALS AND METHODS: Eligible patients were men 50 years of age or older with LUTS and persistent nocturia despite alpha-blocker treatment for a minimum of 4 weeks. The optimum dose of oral desmopressin was determined during a 4-week dose-titration period, and this dose was maintained for 24 weeks. Flow volume charts, total IPSS, IPSS subscores, uroflowmetry and post-void residual urine volume were assessed. RESULTS AND CONCLUSIONS: A total of 216 patients were enrolled in the study. Of these patients, there were 158(76%) patients with nocturnal polyuria, 15(7.2%) with decreased nocturnal bladder capacity, and 35(16.8%) with nocturia due to both causes. The number of nocturnal voids significantly decreased from a baseline mean of 7.0 to 5.7 episodes for 3 days at the 24 week visit. The average IPSS total and IPSS subscore significantly decreased by 4 weeks and were maintained at 24 weeks. In patients aged less than 65 years, IPSS voiding subscores were significantly improved at 24 weeks compared to those 65 years or over. Desmopressin add-on therapy for refractory nocturia in men previously treated with an alpha-blocker for LUTS improved voiding symptoms as well as nocturia, storage symptoms.
    The Journal of urology 01/2013; · 3.75 Impact Factor
  • Jang Hwan Kim
    International neurourology journal 01/2013; 17(2):96.
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    ABSTRACT: Purpose: To evaluate the outcome of transmesocolic (TMC) laparoscopic pyeloplasty compared with conventional laterocolic procedure for surgeons with limited experience. Materials and Methods: We started laparoscopic pyeloplasty for ureteropelvic junction obstruction in 2009. Since then, 21 patients of left side disease have undergone this surgery in our institution. To access the left ureteropelvic junction, we used the conventional laterocolic approach in 9 patients, while the transmesocolic approach was used in the remaining 12 patients, and perioperative results and follow-up data were then compared. Results: The mean operative time using the transmesocolic approach was significantly shorter than the conventional laterocolic approach (242 vs. 308 min, p=0.022). Furthermore, there was no complication or open conversion. Postoperative pain was significantly decreased in the TMC group (2.8 vs. 4.0 points, measured using the visual analogue scale on the first postoperative day, p=0.009). Postoperative complications were encountered in two patients. All patients were symptom-free after 1 year of follow-up, and radiologic success rates for each group were 92 and 89%, respectively. Conclusion: Direct exposure of the ureteropelvic junction via the mesocolon saves time during the colon mobilization procedure. The approach is safe and feasible even for surgeons with limited experience, and has success rates similar to those of the conventional laterocolic approach.
    Yonsei medical journal 01/2013; 54(1):197-203. · 0.77 Impact Factor
  • Jang Hwan Kim
    International neurourology journal 01/2013; 17(3):152.
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    ABSTRACT: To evaluate the protection of the urogenital function after robot-assisted total mesorectal excision (R-TME) for rectal cancer compared to those of laparoscopic TME (L-TME). 69 patients who underwent L-TME (n = 39) or R-TME (n = 30) were prospectively enrolled. Their urogenital function was evaluated by uroflowmetry, a standard questionnaire of the international prostate symptom score (IPSS) and the international index of erectile function (IIEF) before surgery and 1, 3, 6, and 12 months after surgery. The pre- and postoperative IPSS and IIEF scores were compared to detect functional deterioration by paired t test for each group. How postoperative IPSS and IIEF scores and uroflowmetry data deviated from the preoperative values (Δ) were statistically compared between the two groups. The IPSS score significantly increased 1 month after surgery; the recovery from decreased urinary function took 6 months for patients in the L-TME group (8.2 ± 6.3; P = 0.908) but 3 months in the R-TME group (8.36 ± 5.5; P = 0.075). The ΔIPSS scores were significantly different between the two groups at 3 months (P = 0.036). In male patients (L-TME 20, R-TME 18), the total IIEF score in R-TME and L-TME significantly decreased 1 month after surgery, L-TME gradually recovered over 12 months (46.00 ± 16.9; P = 0.269), but R-TME recovered within 6 months (44.61 ± 13.76; P = 0.067). The ΔIIEF score value was not significantly different at any time between the two groups, but in an itemized analysis of the change in erectile function and sexual desire, there were significant differences at 3 months between the two groups. R-TME for rectal cancer is associated with earlier recovery of normal voiding and sexual function compared to patients who underwent L-TME, although this result needs to be verified by larger prospective comparative studies.
    Annals of Surgical Oncology 03/2012; 19(8):2485-93. · 3.94 Impact Factor
  • Jang Hwan Kim
    International neurourology journal 01/2012; 16(3):157.
  • The Journal of Urology 04/2011; 185(4). · 3.75 Impact Factor

Publication Stats

258 Citations
85.53 Total Impact Points

Institutions

  • 2014
    • Wonju Severance Christian Hospital
      Genshū, Gangwon, South Korea
  • 2010–2014
    • CHA University
      Sŏul, Seoul, South Korea
  • 2005–2014
    • Yonsei University Hospital
      • • Department of Internal Medicine
      • • Surgery
      Sŏul, Seoul, South Korea
  • 2013
    • Kangbuk Samsung Hospital
      Sŏul, Seoul, South Korea
  • 2002–2009
    • Yonsei University
      • • Department of Urology
      • • College of Medicine
      Seoul, Seoul, South Korea
  • 2003–2007
    • University of Pittsburgh
      • Department of Urology
      Pittsburgh, PA, United States