Jae Dong Chung

Bio: Jae Dong Chung is an academic researcher from Chung-Ang University. The author has contributed to research in topics: Magnetic resonance imaging & Prostate. The author has an hindex of 2, co-authored 2 publications receiving 10 citations.

Influence of Overweight on 24-hour Urine Chemistry Studies and Recurrent Urolithiasis in Children

Abstract: Results: A total of 125 patients were included. The age of the patients in the NBW group was older than that of patients in the LBW group, but 24-hour urine chemistry studies did not differ significantly between the three groups. Mean urine citrate levels were lower (0.273±0.218 mg/mg/d vs. 0.429±0.299 mg/mg/d, p＜0.05) and the incidence of hypocitraturia was higher (81.5% vs. 45.7%, p＜0.05)) in the recurrent stone former group. In the univariate analysis, hypocitraturia and acidic urinary pH were risk factors, but in the multivariate analysis, only hypocitraturia was a risk factor for stone recurrence (hazard ratio, 3.647; 95% confidence interval, 1.047 to 12.703). In the Kaplan-Meier curve, the hypocitraturia group showed higher recurrence than did the normocitraturia group (p＜0.05). Conclusions: Unlike in adults, in children, overweight adjusted for gender and age was not associated with 24-hour urine chemistry studies and was not a risk factor for recurrent UL. Hypocitraturia was the only risk factor for UL in children.

Histopathological differences between prostate cancer foci that are detected and missed using multiparametric magnetic resonance imaging in Korean patients

Abstract: Objectives We investigated whether multiparametric magnetic resonance imaging is appropriate to localize prostate cancer foci in Koreans. Methods A total of 141 prostate cancer foci in 115 prostate specimens from patients who had undergone radical prostatectomy with preoperative 3 Tesla multiparametric magnetic resonance imaging including T2-weighted imaging, diffusion weighted imaging and magnetic resonance spectroscopy. Differences in the histopathological findings between detected and undetected prostate cancer foci on multiparametric magnetic resonance imaging were investigated. Results The mean tumor size was 1.9 cm, and 31.9%, 48.9%, and 19.9% of the patients had Gleason scores of 6, 7, or ≥8, respectively. The detection rates of prostate cancer foci were 54.6%, 57.4%, 55.3%, and 45.4% on multiparametric magnetic resonance imaging, T2-weighted imaging, diffusion weighted imaging, and magnetic resonance spectroscopy, respectively. On multivariate analysis, tumor size ≥1.5 cm (odds ratio 3.1; 95% confidence interval 1.31–7.49), Gleason score >7 (4 + 3; odds ratio 2.9; 95% confidence interval 1.05–8.05), and a malignant epithelium/stroma ratio of ≥60% (odds ratio 2.9; 95% confidence interval 1.14–7.20) were significant independent predictors of prostate cancer foci detection on multiparametric magnetic resonance imaging and diffusion weighted imaging. In a multivariate linear model analysis, the apparent diffusion coefficient value was inversely associated with maximum tumor diameter (β = −0.242, P < 0.05), Gleason score (β = −0.234, P < 0.05) and high malignant epithelium/stroma ratio (β = −0.229, P < 0.05). Conclusions Distinct histological differences between prostate cancer foci that were detected and missed by multiparametric magnetic resonance imaging can be identified. Despite limitations, multiparametric magnetic resonance imaging seems useful for determining prostate cancer in Korean patients, particularly with Gleason score >7 and tumor diameter >1.5 cm.

The Emerging Role of MRI in Prostate Cancer Active Surveillance and Ongoing Challenges

Abstract: OBJECTIVE. Active surveillance (AS) has emerged as a management strategy for preventing overtreatment of indolent prostate cancer. Selection of patients for AS has traditionally proved challenging and resulted in 20–30% misclassification rates. MRI has potential to help overcome this limitation, broaden selection criteria to increase recruitment, and minimize the invasive nature of AS follow-up. CONCLUSION. The main issues surrounding MRI and AS are the heterogeneity of inclusion criteria, the definition of significant disease, and agreement about what constitutes radiologic progression. Prospective cohorts with MRI at enrollment and long-term follow-up are required to further address these issues.

Dyslipidaemia in overweight children and adolescents is associated with an increased risk of kidney stones.

Abstract: Aim There is conflicting evidence about the role of obesity in paediatric nephrolithiasis. This Polish study explored the influence of nutritional status and lipid disturbances on urinary lithogenic factors and the risk of kidney stone formation in children and adolescents from three to 18 years of age. Methods We carried out serum lipid profile evaluations and 24-h urine chemistry analyses on 493 overweight/obese paediatric participants (mean age 13 years) without nephrolithiasis and 492 healthy normal weight sex and age-matched controls. Results A third (33%) of the study group had blood lipid disturbances, with more acidic urine, lower urinary citrate excretion and a higher fraction of ionised calcium and higher Bonn Risk Index than the controls. The participants' body mass index standard deviation score (BMI Z-score) was positively correlated with urinary oxalate and uric acid and negatively correlated with citrate excretion. Total cholesterol, low-density lipoprotein cholesterol and triglycerides correlated negatively with citraturia, while high-density lipoprotein cholesterol correlated positively. Conclusion The main factor that predisposed overweight and obese children to kidney stones was hypocitraturia. Urinary citrate excretion was related to both BMI Z-scores and all lipid fraction abnormalities. However, hypercholesterolaemia and particularly low-density lipoprotein hypercholesterolaemia seemed to play a major role.

Patient- and tumor-level risk factors for MRI-invisible prostate cancer

Abstract: Multiparametric MRI is highly sensitive for detection of clinically significant prostate cancer, but has a 10–20% false negative rate. It is unknown if there are clinical factors that predict MRI invisibility. We sought to identify predictors of MRI-invisible (MRI(−)) disease. Men undergoing MRI/US-fusion targeted + systematic biopsy by two surgeons at our institution from 2015 to 2018 were reviewed. Patient demographics, clinical data, MRI metrics, and biopsy pathology results were obtained by chart review. An MRI(−) tumor was defined as a positive systematic biopsy in a zone without an MRI lesion. Factors associated with presence of MRI(−) tumors were identified using stepwise multivariable logistic regression. Of 194 men included in the analysis, 79 (41%) and 25 (13%) men had GG1+ and GG2+ MRI(−) tumors, respectively. On multivariable analysis, only Black race was associated with presence of GG1+ MRI(−) tumors (OR 2.2, 95% CI 1.02–4.96). Black race (OR 3.5, 95% CI 1.24–9.87) and higher PSA density (OR 2.0, 95% CI 1.34–3.20) were associated with presence of GG2+ MRI(−) tumors. In non-Black and Black men, detection of MRI(−) tumors on systematic biopsy upgraded patients from no disease to GG2+ disease 1% and 11% of the time, respectively, and from GG1 to GG2+ disease 42% and 60% of the time, respectively. Black race and PSA density were associated with presence of MRI(−) prostate cancer. Further study on racial differences is warranted based on these results. Surgeons should consider pre-biopsy risk factors before deciding to omit systematic prostate biopsy regardless of mpMRI results.