• Journal of Medicine and Life Science
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• 제20권2호
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• pp.94-98
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• 2023

This report presents the case of 75-year-old men with spindle cell neoplasm. The patient underwent percutaneous nephrolithotomy and transurethral resection of the prostate (TURP) for renal stones and benign prostatic hyperplasia. One month postoperatively, the patient was able to void without any difficulty. Five months later, the patient experienced difficulty voiding and presented to the emergency room with severe pelvic pain. Computed tomography (CT) showed regrowth of the prostate mass into the posterior bladder and penile root. The prostate-specific antigen level remained constant at 1.14 ng/mL during the pre-and postoperative periods. Five months before the TURP operation, the patient's CT scan showed a soft and mildly enlarged prostate with no protrusion into the bladder. Biopsy of the prostate, however, showed a protruding mass, indicative of a spindle cell neoplasm. The patient was subsequently treated with the chemotherapeutic drug adriamycin. Unfortunately, treatment was unsuccessful, and the patient died 18 months later.

• Korean Journal of Radiology
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• 제22권6호
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• pp.922-930
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• 2021

Objective: It is uncertain why a b-value range of 1500-2000 s/mm² is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods: This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000-3000 s/mm² using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm². We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses. For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRI-suggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI. The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results: The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761-1805 s/mm² and 1640-1771 s/mm² (median, 1790 s/mm² vs. 1705 s/mm²; p = 0.003) for reader 1, and 1835-1895 s/mm² and 1705-1841 s/mm² (median, 1872 s/mm² vs. 1763 s/mm²; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735-1873 s/mm² and 1573-1867 s/mm² for reader 1, and 1775-1945 s/mm² and 1591-1955 s/mm² for reader 2, respectively. Bland-Altman plots consistently demonstrated a mean difference of less than 100 s/mm² between qualitatively and quantitatively selected optimal b-values. Conclusion: b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500-2000 s/mm².

• The Korean Journal of Pain
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• 제10권1호
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• pp.134-137
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• 1997

We report a case of cauda equine syndrome following caudal anesthesia possibly caused by metastatic spine tumor. Male, 80-year-old, who had prostatic carcinoma with $L_3$ and $L_4$ spine metastasis was scheduled for bilateral orchiectomy. Twenty two-gauge needle was introduced at sacral hiatus and 15 ml of 2% lidocaine administered. The next morning, patient complained of perineal numbness and urination difficulty. During the next several day patient had episodes of fecal incontinence and motor weakness on both lower extremities. This case reminded us that neuroaxial blocks such as spinal, epidural and caudal anesthesia, should be used with extreme care in patients having neoplasm with high incidence of spine metastasis.

• Tuberculosis and Respiratory Diseases
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• 제69권4호
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• pp.284-287
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• 2010

We report the case of a 68-year-old man with a stromal tumor of uncertain malignant potential (STUMP), which had metastasized to the lung. The patient complained of an enlarged mass in the anterior chest. Chest computed tomography (CT) showed a sternal abscess with multiple nodules in both lungs. A thoracoscopic lung biopsy of the nodules and incision/drainage of the sternal mass were performed simultaneously. CT of the pelvis revealed an enlarged prostate with irregular cystic lesions in the pelvis. Prostate biopsy was done and demonstrated hypercellular stroma with minimal cytological atypia, a distinct pattern of STUMP. The sternal abscess proved to be tuberculosis and the lung lesion was consistent with STUMP, which had spread from the prostate. However, to our knowledge, the tuberculous abscess might not be assoicated with STUMP in the lung. The patient refused surgical prostatectomy and was discharged with anti-tuberculosis medication. On one-year follow up, the patient had no evidence of disease progression.

• Archives of Pharmacal Research
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• 제27권4호
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• pp.429-435
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• 2004

Ginseng has an anti-cancer effect in several cancer models. This study was to characterize active constituents of ginseng and their effects on proliferation of prostate cancer cell lines, LNCaP and PC3. Cell proliferation was measured by $[^3H]$thymidine incorporation, the intracellular calcium concentration by a dual-wavelength spectrophotometer system, effects on mite-gen-activated protein (MAP) kinases by Western blotting, and cell attachment and morphologic changes were observed under a microscope. Among 11 ginsenosides tested, ginsenosides $Rg_3\;and\;Rh_2$ inhibited the proliferation of prostate cancer cells. $EC_{50}s\;of\;Rg_3\;and\;Rh_2$ on PC3 cells were $8.4{\mu}M\;and\;5.5{\mu}M$, respectively, and $14.1{\mu}M\;and\;4.4{\mu}M$ on LNCaP cells, respectively. Both ginsenosides induced cell detachment and modulated three modules of MAP kinases activities differently in LNCaP and PC3 cells. These results suggest that ginsenosides $Rg_3\;and\;Rh_2$-induced cell detachment and inhibition of the proliferation of prostate cancer cells may be associated with modulation of three modules of MAP kinases.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6913-6917
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• 2013

Background: Although the PSA test has been used in Korea for over 20 years, the incidence of prostate cancer has risen, and the associated mortality has increased about 13-fold over the 20-year period. Also, several investigators have suggested that Asians in America are more likely to present with more advanced prostate cancer than Caucasians. We compared the characteristics of native Koreans and Americans (Caucasians and African-Americans) undergoing radical prostatectomies in Korea and the US. Materials and Methods: Study subjects comprised patients at Korean and US hospitals from 2004 to 2012 who had undergone radical prostatectomies. We compared the characteristics of the subjects, including age, preoperative prostate-specific antigen (PSA) levels, body mass index (BMI), Gleason score, and pathological T stage. Results: In total, 1,159 males (502 Koreans, 657 Americans) were included. The Korean and American patients had mean ages of $67.1{\pm}6.6$ and $59.2{\pm}6.7$ years, respectively. The mean preoperative PSAs were $15.4{\pm}17.9$ and $6.2{\pm}4.6ng/mL$ (p=0.0001) and the mean BMIs were $23.6{\pm}2.6$ and $28.7{\pm}4.4kg/m^2$ (p=0.0001), respectively. Pathological localized prostate cancer represented 71.7% of cases for Koreans and 77.6% for Americans (p=0.07). According to age, Koreans had higher T stages than Americans in their 50s (p=0.021) and higher Gleason scores than Americans in all age groups. According to PSA, Koreans had higher Gleason scores than Americans for PSA >10 ng/mL (p<0.05). According to prostate size and Gleason scores, Koreans had higher PSA values than Americans (p<0.01). Conclusions: These results show that Korean patients have elevated risk of malignant prostate cancers, as indicated by the significantly higher Gleason scores and PSAs, suggesting a need for novel prostate cancer treatment strategies in Korea.

• Investigative Magnetic Resonance Imaging
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• 제21권3호
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• pp.139-147
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• 2017

Purpose: To evaluate differences in staging accuracy of prostate cancer according to the extent of hemorrhage on multiparametric MRI performed after biopsy. Materials and Methods: We enrolled 71 consecutive patients with biopsy-proven prostate cancer. Patients underwent MRI followed by a prostatectomy at our institution in 2014. Two radiologists reviewed the MRI to determine the tumor stage. Correlation between biopsy-MRI interval and extent of hemorrhage was evaluated. Regression analyses were used to determine factors associated with accuracy of tumor staging. Results: The mean interval between biopsy and MRI was $17.4{\pm}10.2days$ (range, 0-73 days). The interval between prostate biopsy and MRI and the extent of hemorrhage were not significantly correlated (P = 0.880). There was no significant difference in the accuracy rate of staging between the small and large hemorrhage groups. Conclusion: Biopsy-induced hemorrhage in the prostate gland is not sufficiently absorbed over time. The extent of hemorrhage and the short interval between biopsy and MRI may not impair tumor detection or staging on multiparametric MRI.

• Annals of Occupational and Environmental Medicine
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• 제35권
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• pp.52.1-52.13
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• 2023

Background: In 2019, the International Agency for Research on Cancer re-evaluated the carcinogenicity of night-shift work and reported that there is limited evidence that night-shift work is carcinogenic for the development of prostate cancer. Therefore, in 2020 and 2021, the Korean Epidemiologic Investigation Evaluation Committee concluded that 2 cases of prostate cancer were occupational diseases related to the night-shift work. Here, we report the 2 cases of prostate cancer in night-shift workers which were first concluded as occupational diseases by the Korean Epidemiologic Investigation Evaluation Committee. Case presentation: Patient A: A 61-year-old man worked as a city bus driver for approximately 17 years, from 2002 to 2019, and was exposed to night-shift work during this period. In March 2017, the patient was diagnosed with high-grade prostate cancer through core-needle biopsy after experiencing stinging pain lasting for 2 months. Patient B: A 56-year-old man worked as an electrician and an automated equipment operator in a cement manufacturing plant for 35 years from 1976 to 2013 and was exposed to night-shift work during this period. In 2013, the patient was diagnosed with high-grade prostate cancer through core needle biopsy at a university hospital because of dysuria that lasted for 6 months. Conclusions: The 2 workers were diagnosed with high-grade prostate cancer after working night shifts for 17 and 35 years respectively. Additionally, previous studies have reported that high-grade prostate cancer has a stronger relationship with night-shift work than low or medium-grade prostate cancer. Therefore, the Korean Epidemiologic Investigation Evaluation Committee concluded that night-shift work in these 2 patients contributed to the development of their prostate cancer.

• Radiation Oncology Journal
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• 제32권3호
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• pp.187-197
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• 2014

Purpose: We aimed to analyze the treatment outcome and long-term toxicity of 70 Gy hypofractionated intensity-modulated radiotherapy (IMRT) for localized prostate cancer using a customized rectal balloon. Materials and Methods: We reviewed medical records of 86 prostate cancer patients who received curative radiotherapy between January 2004 and December 2011 at our institution. Patients were designated as low (12.8%), intermediate (20.9%), or high risk (66.3%). Thirty patients received a total dose of 70 Gy in 28 fractions over 5 weeks via IMRT (the Hypo-IMRT group); 56 received 70.2 Gy in 39 fractions over 7 weeks via 3-dimensional conformal radiotherapy (the CF-3DRT group, which served as a reference for comparison). A customized rectal balloon was placed in Hypo-IMRT group throughout the entire radiotherapy course. Androgen deprivation therapy was administered to 47 patients (Hypo-IMRT group, 17; CF-3DRT group, 30). Late genitourinary (GU) and gastrointestinal (GI) toxicity were evaluated according to the Radiation Therapy Oncology Group criteria. Results: The median follow-up period was 74.4 months (range, 18.8 to 125.9 months). The 5-year actuarial biochemical relapse-free survival rates for low-, intermediate-, and high-risk patients were 100%, 100%, and 88.5%, respectively, for the Hypo-IMRT group and 80%, 77.8%, and 63.6%, respectively, for the CF-3DRT group (p < 0.046). No patient presented with acute or late GU toxicity ${\geq}$grade 3. Late grade 3 GI toxicity occurred in 2 patients (3.6%) in the CF-3DRT group and 1 patient (3.3%) in the Hypo-IMRT group. Conclusion: Hypo-IMRT with a customized rectal balloon resulted in excellent biochemical control rates with minimal toxicity in localized prostate cancer patients.