Publications by authors named "Yoo Seok Kim"

23 Publications

  • Page 1 of 1

Breast Cancer Statistics in Korea, 2018.

J Breast Cancer 2021 Apr;24(2):123-137

Department of Surgery, Research Institute of Clinical Medicine, Jeonbuk National University Hospital, Jeonbuk National University and Biomedical Research Institute, Jeonju, Korea.

Breast cancer is the most common malignancy in Korean women, and its incidence continues to increase. The Korean Breast Cancer Society (KBCS) established a nationwide breast cancer database through its online enrollment program in 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea, and to assess the pattern of changes in breast cancer management in 2018. We analyzed the KBCS and Korea Central Cancer Registry (KCCR) databases in 2018. In 2018, 28,157 patients were newly diagnosed with breast cancer, of whom 4,510 had noninvasive breast cancer and 23,647 had invasive breast cancer. The age-standardized rate of breast cancer in 2018 was 79.0 per 100,000 women (65.6 invasive, 13.4 noninvasive). The median age of female patients diagnosed with breast cancer in 2018 was 52 years, and the incidence of breast cancer was the highest in the 40-49-years age group (9,432 patients, 33.6%). The proportion of patients with stage 0 and stage I breast cancer continued to increase, accounting for 63.8% of cases, and breast-conserving surgery was performed more often than mastectomy (66.2% vs. 33.0%). The most common subtypes of breast cancer were hormone receptor [HR]-positive and human epidermal growth factor receptor-2 (HER2)-negative types (65.9% of cases), while the HR-negative and HER2-positive types accounted for 9.2% of cases. According to the KCCR data, from 2014 to 2018, the 5-year relative survival rate of patients with breast cancer was 93.3%, which was 14.0% higher than that from 1993 to 1995 (79.3%). The clinical characteristics of breast cancer in Korea have been changing, and national databases can improve our understanding of the disease characteristics of Korean women. Therefore, updating the KBCS registry is important for the effective management of breast cancer in Korea.
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http://dx.doi.org/10.4048/jbc.2021.24.e22DOI Listing
April 2021

Dexmedetomidine decreased the post-thyroidectomy bleeding by reducing cough and emergence agitation - a randomized, double-blind, controlled study.

BMC Anesthesiol 2021 Apr 12;21(1):113. Epub 2021 Apr 12.

Department of Anesthesiology and Pain Medicine, Chosun University Hospital, 365 Pilmun-dearo, Donggu, 61453, Gwangju, Korea.

Background: Bleeding after thyroidectomy occurs due to violent coughing during emergence. Dexmedetomidine is helpful for the smooth emergence and suppression of cough. The purpose of the present study was to compare the effects of dexmedetomidine on postoperative bleeding after thyroidectomy.

Methods: Randomized, double-blind, controlled trials were conducted in female patients (ASA I-II, aged 20 to 60 years). The patients were randomly allocated into two groups. Approximately 15 min before the end of the surgery, dexmedetomidine was administered (0.6 µg/kg/h) without a loading dose in group D (n = 69), and normal saline was administered in group S (n = 70) at the same infusion rate. Hemodynamic data, coughing reflex, extubation time, Ramsay sedation scale (RSS), and recovery time were assessed during the administration of the study drugs and recovery from anesthesia. The amount of postoperative hemorrhage was measured for 3 days.

Results: Data from a total of 139 patients were analyzed. The incidence of severe cough was significantly lower in group D than in group S (4.3 % vs. 11.5 %, P = 0.022). The emergence agitation in the postanesthetic care unit was significantly lower in group D than in group S (P = 0.01). Postoperative bleeding was significantly lower in group D than in group S until the second postoperative day (P = 0.015).

Conclusions: Dexmedetomidine can be helpful in decreasing bleeding after thyroidectomy by reducing coughing and emergence agitation.

Trial Registration: This study was registered at http://clinicaltrials.gov (registration number NCT02412150, 09/04/2015).
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http://dx.doi.org/10.1186/s12871-021-01325-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040200PMC
April 2021

Development of an algorithm for intraoperative autofluorescence assessment of parathyroid glands in primary hyperparathyroidism using artificial intelligence.

Surgery 2021 Mar 3. Epub 2021 Mar 3.

Department of Endocrine Surgery, Cleveland Clinic, OH; Department of General Surgery, Cleveland Clinic, OH. Electronic address:

Background: Previous work showed that normal and abnormal parathyroid glands exhibit different patterns of autofluorescence, with the former appearing brighter and more homogenous. However, an objective algorithm based on quantified measurements was not provided. The aim of this study is to develop objective algorithms for intraoperative autofluorescence assessment of parathyroid glands in primary hyperparathyroidism using artificial intelligence.

Methods: The utility of near-infrared fluorescence imaging in parathyroidectomy procedures was evaluated in a study approved by the institutional review board. Autofluorescence patterns of parathyroid glands were measured intraoperatively. Comparisons were performed between normal and abnormal glands, as well as between different pathologies. Using machine learning, decision trees were created.

Results: Normal parathyroid glands were brighter (higher normalized autofluorescence pixel intensity) and more homogenous (lower heterogeneity index) compared to abnormal glands. Optimal cutoffs to differentiate normal from abnormal parathyroid glands were >2.0 for normalized autofluorescence intensity (sensitivity 73%, specificity 70%, area under the curve 0.756) and <0.12 for parathyroid heterogeneity index (sensitivity 75%, specificity 81%, area under the curve 0.839). Decision trees created by machine learning using normalized autofluorescence intensity, heterogeneity index, and gland volume were 95% accurate in predicting normal versus abnormal glands and 84% accurate in predicting subclasses of parathyroid pathologies.

Conclusion: To our knowledge, this is the first study to date reporting objective algorithms using quantified autofluorescence data to intraoperatively assess parathyroid glands in primary hyperparathyroidism. These results suggest that objective data can be obtained from autofluorescence signals to help differentiate abnormal parathyroid glands from normal glands.
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http://dx.doi.org/10.1016/j.surg.2021.01.033DOI Listing
March 2021

A Critical Analysis of Computed Tomography Washout in Lipid-Poor Adrenal Incidentalomas.

Ann Surg Oncol 2021 May 18;28(5):2756-2762. Epub 2020 Nov 18.

Department of Endocrine Surgery, Cleveland Clinic, 9500 Euclid Ave/F20, Cleveland, OH, 44195, USA.

Background: Contrast-enhanced computed tomography (CT) with washout has emerged as an option to distinguish lipid-poor adenomas from non-adenomas.

Objective: The aim of this study was to assess the utility of CT washout in characterizing indeterminate lipid-poor adrenal incidentalomas.

Methods: From an Institutional Review Board-approved database, patients with adrenal incidentalomas who had adrenal protocol CT scans with a 15-min washout between 2003 and 2019 were identified. Non-contrast CT attenuation and washout patterns of different tumor types were compared.

Results: Overall, 156 patients with 175 adrenal lesions were included. Average tumor size was 3.0 cm, non-contrast CT density was 24.7 Hounsfield units (HU), and absolute washout was 52.6%. In 102 lesions (58.3%), CT washout was ≥ 60%; 94 (92.2%) of these were benign adrenocortical adenomas, 7 (6.9%) were pheochromocytomas, and 1 (0.9%) was an adrenal hematoma. Furthermore, in 73 tumors (41.7%), CT washout was < 60%; diagnosis was benign adrenocortical adenoma in 45 (61.6%) lesions, pheochromocytoma in 8 (11%) lesions, metastasis in 9 (12.3%) lesions, adrenocortical cancer in 6 (8.2%) lesions, and 'others' in 5 (6.9%) lesions. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of  > 60% absolute CT washout for detecting an adrenal adenoma was 67.6%, 77.8%, 92.2%, 38.4%, and 69.7%, respectively.

Conclusion: CT washout should be incorporated into the management algorithm of indeterminate adrenal incidentalomas with a high non-contrast CT attenuation to 'rule-in' benign tumors. For small tumors with mild elevation of plasma metanephrines, it should be kept in mind that adenomas and pheochromocytomas may have similar imaging and washout characteristics.
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http://dx.doi.org/10.1245/s10434-020-09329-1DOI Listing
May 2021

The impact of near infrared fluorescence imaging on parathyroid function after total thyroidectomy.

J Surg Oncol 2020 Oct 29;122(5):973-979. Epub 2020 Jun 29.

Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.

Background: Compared with conventional thyroidectomy, hypocalcemia rate was reported to be lower after total thyroidectomy (TT) utilizing near infrared fluorescence imaging (NIFI). The aim of this study is to evaluate the impact of NIFI on postoperative parathyroid function after TT.

Methods: This was a retrospective institutional review board-approved study comparing 100 patients who underwent TT with NIFI guidance and 200 patients without, by the same surgeon. Clinical parameters were compared using χ and t test.

Results: Average number of parathyroid glands identified intraoperatively was similar between two groups. However, rate of incidental parathyroidectomy was higher in conventional (14%) versus NIFI group (6%) (P = .039), despite similar (4% vs 6%, respectively) autotransplantation rates (P = .562). Incidences of transient (6.5% vs 5.0%) and permanent (0.5% vs 0%) hypocalcemia were not statistically different between conventional and NIFI groups (P = NS).

Conclusion: The use of NIFI during thyroidectomy may decrease the rate of incidental parathyroidectomy by increasing the ability of the surgeon to recognize parathyroid glands with fluorescent contrast distinction. Nevertheless, in contrary to recent reports in literature, postoperative hypocalcemia rate was not altered compared with conventional technique, suggesting that preservation of parathyroid vasculature, rather than an augmented ability to detect the glands, may dominantly affect postoperative function.
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http://dx.doi.org/10.1002/jso.26098DOI Listing
October 2020

Breast Cancer Statistics in Korea in 2017: Data from a Breast Cancer Registry.

J Breast Cancer 2020 Apr 7;23(2):115-128. Epub 2020 Apr 7.

Department of Surgery, Research Institute of Clinical Medicine, Jeonbuk National University Hospital, Jeonbuk National University and Biomedical Research Institute, Jeonju, Korea.

This article describes the breast cancer statistics in Korea, including the incidence, type of surgical procedure, stage, and molecular subtype, using the Korean Breast Cancer Society (KBCS) and Korea Central Cancer Registry data. There were a total of 26,534 new breast cancer diagnoses in 2017 in Korea, of which 4,139 were carcinoma cases and 22,395 were invasive cancer cases. The age standardized rate of breast cancer was 75.3 per 100,000 women in 2017 (63.0 of invasive carcinoma and 12.3 of carcinoma ), and it has been steadily increasing across all age groups. Breast cancer occurred most commonly in the 40-49 age group. Compared to 2016, breast conserving surgery (BCS) has increased, and 67.4% of patients were treated with BCS in 2017. The proportions of stage 0 and stage I have continued to increase, accounting for 60.7%. The most common subtype of breast cancer was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (HER2) negative type comprising 65.9% of the cases, whereas HR negative and HER2 positive type was the rarest comprising 10.2% of the cases. The 5-year relative survival rate of breast cancer patients had increased by 14.0% from 79.2% in 1993-1995 to 93.2% in 2013-2017. It is essential to actively enter breast cancer data into the KBCS registry to improve our understanding.
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http://dx.doi.org/10.4048/jbc.2020.23.e24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192743PMC
April 2020

Association of depression and anxiety disorder with the risk of mortality in breast cancer: A National Health Insurance Service study in Korea.

Breast Cancer Res Treat 2020 Jan 31;179(2):491-498. Epub 2019 Oct 31.

Department of Surgery, Chosun University College of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju, 61453, Republic of Korea.

Purpose: To examine whether depression, anxiety disorder, and their co-occurrence would increase the risk of mortality in patients with breast cancer, and whether antidepressant treatment would reduce the same.

Methods: Data were retrieved from the database of the Korean National Health Insurance Service. Of 145,251 patients diagnosed with breast cancer between 2007 and 2014, 20,870 patients diagnosed with depression or anxiety disorder one year before breast cancer diagnosis were excluded. Thus, data of 124,381 patients were included in this study.

Results: Depression and anxiety disorder were associated with an increased risk of mortality [Hazard Ratio (HR) 1.26, 95% CI 1.18-1.36; HR 1.14, 95% CI 1.08-1.22, respectively] and their co-occurrence further increased the risk (HR = 1.38, 95% CI 1.24-1.54). Antidepressant treatment was related to a reduced risk of mortality. Compared to patients without any psychiatric comorbidity with no antidepressant treatment, the mortality risk increased in patients with either psychiatric comorbidity or both, but the risk seemed to attenuate with antidepressant treatments.

Conclusion: The current findings suggest that psychiatric comorbidities are markers of increased mortality risk in patients with breast cancer, and antidepressant treatment may attenuate the risk. This underscores the need for screening and treating depression and anxiety disorders to improve survival in patients with breast cancer.
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http://dx.doi.org/10.1007/s10549-019-05479-3DOI Listing
January 2020

Erratum: Basic Findings Regarding Breast Cancer in Korea in 2015: Data from a Breast Cancer Registry.

J Breast Cancer 2019 03 19;22(1):153. Epub 2019 Feb 19.

Department of Surgery, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University and Biomedical Research Institute, Jeonju, Korea.

[This corrects the article on p. 1 in vol. 21, PMID: 29628978.].
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http://dx.doi.org/10.4048/jbc.2019.22.e12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438832PMC
March 2019

The effect of heart failure and left ventricular assist device treatment on right ventricular mechanics: a computational study.

Biomed Eng Online 2018 May 22;17(1):62. Epub 2018 May 22.

Department of IT Convergence Engineering, Kumoh National Institute of Technology, 61 Daehak-ro, Gumi, Gyeongbuk, 39177, Republic of Korea.

Background And Aims: Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model.

Methods: In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value.

Results: Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment.

Conclusion: LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.
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http://dx.doi.org/10.1186/s12938-018-0498-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963151PMC
May 2018

Basic Findings Regarding Breast Cancer in Korea in 2015: Data from a Breast Cancer Registry.

J Breast Cancer 2018 Mar 23;21(1):1-10. Epub 2018 Mar 23.

Department of Surgery, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University and Biomedical Research Institute, Jeonju, Korea.

The Korean Breast Cancer Society (KBCS) has established a nationwide breast cancer database using an online registration program in 1996. The present study aimed to analyze the basic findings and trends of breast cancer in Korea in 2015 using the data provided by the Korea Central Cancer Registry and the KBCS. In 2015, a total of 22,550 patients were newly diagnosed with breast cancer, of which 3,331 were carcinoma cases and 19,219 were invasive cancer cases. The incidence rate of breast cancer in Korea has steadily increased since the nationwide database was established, and the crude rate and age-standardized rate including that of carcinoma , were 88.1 and 66.0 cases per 100,000 women, respectively. In terms of age, the incidence of breast cancer was the highest in the 40-49-year-old age group (7,889 patients, 35.0%). With regard to surgical procedure, breast-conserving surgery was frequently performed (62.3%). However, the rate of mastectomy has been gradually increasing since 2012, that is, from 32.3% in 2014 to 36.1% in 2015. The rate of early breast cancer has continued to increase, and that of stages III and IV breast cancer was only 9.1% at the time of diagnosis. However, the 5-year survival rate of patients with carcinoma from 2011 to 2015 was 92.3%, which was 14.4% higher than that from 1993 to 1995 (77.9%). Analysis of data from the nationwide registry of breast cancer will not only help to understand the characteristics of breast cancer in individuals in Korea, but will also significantly contribute to the treatment and research of breast cancer. Therefore, a high quality database for breast cancer in Korea must be established by further initiating registration project and establishing an objective legal basis.
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http://dx.doi.org/10.4048/jbc.2018.21.1.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880959PMC
March 2018

Computational analysis of the effect of mitral and aortic regurgitation on the function of ventricular assist devices using 3D cardiac electromechanical model.

Med Biol Eng Comput 2018 May 28;56(5):889-898. Epub 2017 Oct 28.

Department of IT Convergence Engineering, Kumoh National Institute of Technology, 61 Daehak-ro, Gumi, Gyeongbuk, 39253, Republic of South Korea.

Valvular insufficiency affects cardiac responses and the pumping efficacy of left ventricular assist devices (LVADs) when patients undergo LVAD therapy. Knowledge of the effect of valvular regurgitation on the function of LVADs is important when treating heart failure patients. The goal of this study was to examine the effect of valvular regurgitation on the ventricular mechanics of a heart under LVAD treatment and the pumping efficacy of an LVAD using a computational model of the cardiovascular system. For this purpose, a 3D electromechanical model of failing ventricles in a human heart was coupled with a lumped-parameter model of valvular regurgitation and an LVAD-implanted vascular system. We used the computational model to predict cardiac responses with respect to the severity of valvular regurgitation in the presence of LVAD treatment. An LVAD could reduce left ventricle (LV) pressure (up to 34%) and end-diastolic ventricular volume (up to 80%) and maintain cardiac output at the estimated flow rate from the LVAD under the condition of mitral regurgitation (MR); however, the opposite would occur under the condition of aortic regurgitation (AR). Considering these physiological responses, we conclude that AR, and not MR, diminishes the pumping function of LVADs.
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http://dx.doi.org/10.1007/s11517-017-1727-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906511PMC
May 2018

Identification of ganglioside GM2 activator playing a role in cancer cell migration through proteomic analysis of breast cancer secretomes.

Cancer Sci 2016 Jun 27;107(6):828-35. Epub 2016 Apr 27.

Center for Theragnosis, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea.

Cancer cell secretomes are considered a potential source for the discovery of cancer markers. In this study, the secretomes of four breast cancer (BC) cell lines (Hs578T, MCF-7, MDA-MB-231, and SK-BR-3) were profiled with liquid chromatography-tandem mass spectrometry analysis. A total of 1410 proteins were identified with less than 1% false discovery rate, of which approximately 55% (796 proteins) were predicted to be secreted from cells. To find BC-specific proteins among the secreted proteins, data of immunohistochemical staining compiled in the Human Protein Atlas were investigated by comparing the data of BC tissues with those of normal tissues. By applying various criteria, including higher expression level in BC tissues, higher predicted potential of secretion, and sufficient number of tandem mass spectra, 12 biomarker candidate proteins including ganglioside GM2 activator (GM2A) were selected for confirmation. Western blot analysis and ELISA for plasma samples of healthy controls and BC patients revealed elevation of GM2A in BC patients, especially those who were estrogen receptor-negative. Additionally, siRNA-mediated knockdown of GM2A in BC cells decreased migration in vitro, whereas the overexpression of GM2A led to an increase in cell migration. Although GM2A as a diagnostic and prognostic marker in BC should be carefully verified further, this study has established the potential role of GM2A in BC progression.
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http://dx.doi.org/10.1111/cas.12935DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968593PMC
June 2016

Mathematical analysis of the effects of valvular regurgitation on the pumping efficacy of continuous and pulsatile left ventricular assist devices.

Integr Med Res 2016 Mar 8;5(1):22-29. Epub 2016 Jan 8.

Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Gumi, Korea.

Background: A left ventricular assist device (LVAD) is normally contraindicated in significant aortic regurgitation (AR) and requires intraoperative valve repair or exclusion. Nevertheless, AR can coexist with an LVAD, so a valid question when asked might still be of clinical significance. The purpose of this study is to analyze the effects of valve regurgitation on the pumping efficacy of continuous and pulsatile LVADs with a computational method.

Methods: A cardiovascular model was developed based on the Windkessel model, which reflects the hemodynamic flow resistance and the blood wall elasticity. Using the Windkessel model, important cardiovascular components, such as the right atrium, right ventricle, pulmonary artery, pulmonary vein, left atrium (LA), left ventricle (LV), aorta, and branching blood vessels, were expressed.

Results: In the case of AR, continuous and pulsatile LVADs improved cardiac output and reduced mechanical load slightly. In the case of mitral regurgitation, the LVADs improved cardiac output (cardiac outputs were about 5 L/min regardless of the severity of regurgitation) and reduced afterload significantly.

Conclusion: AR reduced both continuous and pulsatile LVAD function significantly while mitral regurgitation did not affect their pumping efficacy.
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http://dx.doi.org/10.1016/j.imr.2016.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381421PMC
March 2016

Semen parameters from 2002 to 2013 in Korea young population: A preliminary report.

Korean J Urol 2015 Dec 10;56(12):831-6. Epub 2015 Dec 10.

Department of Urology, National Police Hospital, Seoul, Korea.

Purpose: To analyze the differences of semen parameters in Korean young population for three periods from 2002 to 2013.

Materials And Methods: A total of 516 semen samples were collected from Korean men presenting for infertility, varicoceles or other infectious problems for three periods from 2002 to 2012: January 2002-December 2003, January 2007-December 2008, and January 2012-December 2013. A standard World Health Organization procedure for semen analysis was performed for assessment of semen concentration, volume, motility, morphology, and pH.

Results: A total of 160, 162, 194 men constituted the study populations in 2002 to 2003, in 2007 to 2008, and in 2012 to 2013, respectively. The overall sperm parameter results suggested a statistically significant difference between 2002 to 2003 and 2012 to 2013 except pH. However, considering the data from 2007 to 2008, there were no trends in changes in overall semen parameters. Negative correlations were observed in all semen parameters with increasing age in all patients, except for pH. In addition, semen volume, motility, and morphology had higher negative correlation coefficients with age, from 2002 to 2013, serially.

Conclusions: There were no significant changes in the semen parameters of Korean men from 2002 to 2013. In addition, semen volume, motility, and morphology showed higher negative correlation coefficients with age from 2002 to 2013, serially.
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http://dx.doi.org/10.4111/kju.2015.56.12.831DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681761PMC
December 2015

A Randomized, Phase I Pharmacokinetic Study Comparing SB2 and Infliximab Reference Product (Remicade(®)) in Healthy Subjects.

BioDrugs 2015 Dec;29(6):381-8

PAREXEL International Early Phase Clinical Unit, Berlin, Germany.

Objective: SB2, a biosimilar to infliximab reference product (INF), has an identical amino acid sequence and similar physicochemical functional properties to its reference product. The primary objective of this study is to demonstrate pharmacokinetic (PK) bioequivalence between SB2 and EU-sourced INF (EU-INF), between SB2 and US-sourced INF (US-INF), and between EU-INF and US-INF.

Methods: This study was a randomized, single-blind, three-arm, parallel group study in 159 healthy subjects. All subjects received a single 5 mg/kg intravenous infusion of study drug and then were observed for 10 weeks to study PK, safety and immunogenicity. The primary PK parameters were area under the concentration-time curve (AUC) from time zero to infinity (AUCinf), AUC from time zero to the last quantifiable concentration (AUClast) and maximum concentration (C max). Bioequivalence for the primary PK parameters was to be concluded using an analysis of variance (ANOVA) if the 90 % confidence intervals (CIs) for the ratio of geometric least squares means (LSMeans) of the treatments compared were completely contained within the pre-defined equivalence margin, 0.8-1.25.

Results: All of the 90 % CIs for the geometric LSMean ratios of primary PK parameters for each comparison were within the pre-defined equivalence margin. The proportion of subjects who experienced treatment-emergent adverse events was comparable between treatments. The incidences of anti-drug antibodies between the three treatments were comparable.

Conclusion: This study demonstrated biosimilarity of SB2 to its marketed reference products of infliximab in terms of PK equivalence in healthy subjects. SB2 was generally well tolerated and showed comparable safety and immunogenicity profiles to the reference products (ClinicalTrials.gov Identifier: NCT01922336).
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http://dx.doi.org/10.1007/s40259-015-0150-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684585PMC
December 2015

Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with breast cancer.

Psychooncology 2016 Mar 4;25(3):308-15. Epub 2015 Aug 4.

Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Objective: The aims of this study were to determine the prevalence of severe, definite depression symptoms, as measured using the Center for Epidemiological Studies Depression Scale (CES-D), and the association between high CES-D scores (i.e., ≥25) and sociodemographic and perioperative factors during perioperative period.

Methods: Among 1690 consecutive breast cancer patients who were admitted for definitive breast surgery during the study period, 1499 patients were included in this study. Patients with a past medical history of psychiatric medication or support, a plan for elective surgery due to locoregional recurrence, or any metastatic disease were excluded. The CES-D score was checked 1 day before definitive surgeries. The sociodemographic data and perioperative data were analyzed.

Results: The mean CES-D score was 18.5, with 24.1% (362/1499) and 56.7% (850/1499) having high CES-D scores of ≥25 and ≥16, respectively. Multivariate analysis revealed that the number of family members with any malignancy (≥2 vs. 0), sedative medication (yes vs. no), and postoperative numeric rating scale scores (persistent, severe pain vs. stably mild pain) were significantly associated factors for severe, definite depression symptoms [CES-D score of ≥25: adjusted odds ratio (OR) = 1.56, 95% confidence interval (CI) = 1.10-2.21, p = 0.013; adjusted OR = 1.65, 95% CI = 1.00-2.71, p = 0.048; and adjusted OR = 2.14, 95% CI = 1.15-3.95, p = 0.016, respectively].

Conclusion: Depression may increase the intensity of postoperative acute pain. Self-reporting of persistent postoperative pain intensity is potentially useful in detecting hidden depression symptoms in breast cancer patients during the perioperative period.
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http://dx.doi.org/10.1002/pon.3919DOI Listing
March 2016

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health.

Korean J Urol 2015 May 21;56(5):386-92. Epub 2015 Apr 21.

Department of Family Medicine, National Police Hospital, Seoul, Korea.

Purpose: There is no reported evidence for an anthropometric index that might link obesity to men's sexual health. We evaluated the ability of an anthropometric index and the symptom scores of five widely used questionnaires to detect men's health problems. We determined the predictive abilities of two obesity indexes and other clinical parameters for screening for lower urinary tract symptoms and sexual dysfunction in middle-aged men.

Materials And Methods: A total of 1,910 middle-aged men were included in the study. Participants underwent a detailed clinical evaluation that included recording the symptom scores of five widely used questionnaires. The participants' body mass index and waist-to-hip ratio were determined. Serum prostate-specific antigen, urinalysis, testosterone, estimated glomerular filtration rate, evaluation of metabolic syndrome, and transrectal ultrasonography were assessed.

Results: By use of logistic regression analysis, age and total prostate volume were independent predictors of lower urinary tract symptoms. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis symptoms. Age and metabolic syndrome were independent predictive factors for erectile dysfunction. Waist-to-hip ratio had a statistically significant value for predicting erectile dysfunction.

Conclusions: Our data showed that total prostate volume is a significant predictor of lower urinary tract symptoms, and central obesity has predictive ability for erectile dysfunction. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis-like symptoms. The management of correctable factors such as waist-to-hip ratio and metabolic syndrome may be considered preventive modalities against the development of men's health problems.
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http://dx.doi.org/10.4111/kju.2015.56.5.386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426511PMC
May 2015

Efficacy of scrotal Doppler ultrasonography with the Valsalva maneuver, standing position, and resting-Valsalva ratio for varicocele diagnosis.

Korean J Urol 2015 Feb 30;56(2):144-9. Epub 2015 Jan 30.

Department of Urology, National Police Hospital, Seoul, Korea.

Purpose: To determine effectiveness of Valsalva maneuver and standing position on scrotal color Doppler ultrasound (CDU) for the varicocele diagnosis.

Materials And Methods: We reviewed the physical examination and CDU finding in 87 patients who visited National Police Hospital from January 2011 to April 2014. Diameters of pampiniform plexus were measured bilaterally during resting and Valsalva maneuver in the supine position and standing position. We calculated the ratio of mean of maximal vein diameter (mMVD) during resting and Valsalva maneuver (resting-Valsalva ratio) and compared in the both position.

Results: In the resting and supine position, mMVD of varicocele testis units were 1.8 mm, 2.1 mm, 2.6 mm (grades I, II, III, respectively), and that of normal testis units (NTU) 1.2 mm. During Valsalva maneuver in the supine position, mMVD were 3.0 mm, 3.4 mm, 4.2 mm (grades I, II, III) vs 1.8 mm (NTU) (p=0.007, p<0.001, p<0.001, respectively). Average of resting-Valsalva ratio in the supine position were 0.69, 0.74, 0.74 (grades I, II, III) and 0.67 (NTU). Whereas in the resting and standing position, mMVD were 2.8 mm, 3.3 mm, 3.8 mm (grades I, II, III) and 1.8 mm (NTU) (p=0.002, p<0.001, p<0.001). During Valsalva maneuver in the standing position, mMVD were 5.0 mm, 5.8 mm, 6.6 mm (grades I, II, III) and 2.5 mm (NTU) (p=0.002, p<0.001, p<0.001). And average resting-Valsalva ratio were 0.76, 0.90, 0.71 (grades I, II, III) and 0.26 (NTU), which showed significant differences from all grades (p<0.001, p<0.001, p<0.001).

Conclusions: It is suggested that the standing position and Valsalva maneuver during CDU could improve diagnostic ability for varicocele. Resting-Valsalva ratio in the standing position could be a new diagnostic index for varicocele diagnosis using CDU.
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http://dx.doi.org/10.4111/kju.2015.56.2.144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325119PMC
February 2015

SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy.

Clin Med Insights Case Rep 2014 24;7:87-9. Epub 2014 Aug 24.

Department of Surgery, Chosun University College of Medicine, Gwangju, Korea.

Superior mesenteric artery (SMA) syndrome is a mechanical duodenal obstruction by the SMA. The traditional approach to SMA syndrome was open bypass surgery. Nowadays, a conventional approach has been replaced by laparoscopic surgery. But single incision laparoscopic approach for SMA syndrome is rare. Herein, we report the first case of SMA syndrome patient who was treated by single incision laparoscopic duodenojejunostomy.
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http://dx.doi.org/10.4137/CCRep.S17553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149391PMC
September 2014

Early gastric cancer with neurofibroma mimicking a metastatic node: a case report.

J Gastric Cancer 2013 Sep 30;13(3):185-7. Epub 2013 Sep 30.

Department of Surgery, Chosun University College of Medicine, Gwangju, Korea.

Neurofibromas are benign tumors that originate from the peripheral nerves, including neurites and fibroblasts. Generally, a solitary neurofibroma is located in the skin and rarely in other places. A 72-year-old female suffered from epigastric discomfort for 2 months. Endoscopic findings showed an early gastric cancer type IIc at the antrum. Abdominal computed tomography revealed early gastric cancer with a 1.6 cm-sized metastatic node posterior to the duodenum. Laparoscopic assisted distal gastrectomy and retro-pancreatic dissection were performed uneventfully. Histological examination revealed gastric adenocarcinoma, invading the mucosa without nodal metastasis, and a neurofibroma. Herein, we present a case of a gastric cancer patient with a solitary retroperitoneal neurofibroma which mimicked a distant metastatic node.
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http://dx.doi.org/10.5230/jgc.2013.13.3.185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804678PMC
September 2013

Fabrication of carbon nanotube-emitters on Ag-Cu alloy film by thermal welding.

J Nanosci Nanotechnol 2011 Jul;11(7):6341-4

BK21 Physics Research Division, Sungkyunkwan University, Suwon 440-746, Republic of Korea.

A field emission electron source was fabricated on a Si substrate using Ag-Cu alloy (ACa) and carbon nanotubes (CNTs). The ACa was adopted as a binder material due to its excellent electrical conductivity, oxidation stability, and suitable melting point (783 degrees C). The surface morphology of the ACa-film was improved by introducing an Nb layer as an adhesion layer between the ACa-film and the Si substrate. The ACa-film thickness was varied from 100 to 500 nm. The spray method was employed to deposit a CNT film on the ACa/Nb/Si substrate for large area fabrication. After annealing the substrate at 700 degrees C for 10 min, the CNT film was tightly welded on the ACa-films, and the CNT-emitters fabricated on the 400-nm-thick ACa-film exhibited high current density and stability with a low turn-on voltage. It is worth noting that ACa could be applied to the glass substrate because the CNT-emitters fabricated at 500 degrees C exhibited good field emission characteristics.
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http://dx.doi.org/10.1166/jnn.2011.4433DOI Listing
July 2011

Computational analysis of hemodynamics using a two-dimensional model in moyamoya disease.

J Neurosurg Pediatr 2010 Mar;5(3):297-301

Department of Neurosurgery, Kangwon National University, Chuncheon, South Korea.

Object: Bilateral intimal thickening of the distal internal carotid arteries (ICAs) and the development of many collateral vessels in the base of the brain characterize moyamoya disease (MMD). Although the etiology of and the reason why MMD is limited to the major intracranial vessels remain unclear, flow dynamics, such as shear stress, may be related to its smooth-muscle cell migration. Therefore, this study was performed to determine the local hemodynamic factor, which concerns the predominance of specific anatomical sites, such as the distal ICA in the early stage and the proximal posterior cerebral artery (PCA) in the advanced stage of MMD.

Methods: The authors simulated the hemodynamics in the circle of Willis using computational models of 2D geometries of the distal ICA and PCA. A finite-element commercial package, automatic dynamics incremental nonlinear analysis (ADINA), was used to simulate blood flow in these arteries.

Results: Numerical results demonstrated that shear stress was relatively low at the ICA region. The distribution of shear stress was related to the predisposing area of MMD.

Conclusions: Diminished shear stress may promote stenosis of the distal ICA, which is a major pathological region in MMD.
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http://dx.doi.org/10.3171/2009.10.PEDS09452DOI Listing
March 2010

Synthesis of bandgap-controlled semiconducting single-walled carbon nanotubes.

ACS Nano 2010 Feb;4(2):1012-8

Sungkyunkwan University, Suwon 440-746, Republic of Korea.

Bandgap-controlled semiconducting single-walled carbon nanotubes (s-SWNTs) were synthesized using a uniquely designed catalytic layer (Al(2)O(3)/Fe/Al(2)O(3)) and conventional thermal chemical vapor deposition. Homogeneously sized Fe catalytic nanoparticles were prepared on the Al(2)O(3) layer and their sizes were controlled by simply modulating the annealing time via heat-driven diffusion and subsequent evaporation of Fe at 800 degrees C. Transmission electron microscopy and Raman spectroscopy revealed that the synthesized SWNTs diameter was manipulated from 1.4 to 0.8 nm with an extremely narrow diameter distribution below 0.1 nm as the annealing time is increased. As a result, the bandgap of semiconducting SWNTs was successfully controlled, ranging from 0.53 to 0.83 eV, with a sufficiently narrow energy distribution, which can be applied to field-effect transistors based on SWNTs.
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http://dx.doi.org/10.1021/nn901135bDOI Listing
February 2010