Young Whan Kim

Keimyung University, Sŏul, Seoul, South Korea

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Publications (164)365.93 Total impact

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    ABSTRACT: Multiple comorbidities related to chronic obstructive pulmonary disease (COPD) have been reported and make it a difficult disease to treat.•We analyzed the relationship between comorbidities and COPD.•Only hypertension and a history of pulmonary tuberculosis were independently associated with COPD after adjustment for confounders.•The results of our study suggest that majority of COPD patients might have similar risk factors with its comorbidities.
    Respiratory Medicine. 11/2014;
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    ABSTRACT: Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease of unknown causes. Three proteins (mammalian target of rapamycin, mTOR; zinc finger E-box-binding homeobox 1, ZEB1; Rho-associated, coiled-coil containing protein kinase 1, ROCK1) may be related to pulmonary fibrosis. However, they have not been assessed in human pulmonary fibrosis. We assessed the clinical significance of mTOR, ZEB1, and ROCK1 expression in human pulmonary fibrosis of usual interstitial pneumonia (UIP) pattern.
    BMC Pulmonary Medicine 10/2014; 14(1):168. · 2.76 Impact Factor
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    ABSTRACT: Objective While several prognostic models have been presented in NSCLC patients with brain metastasis, none of these models have included molecular markers as an index. The aim of our study was to evaluate the prognostic value of EGFR mutations and to integrate these EGFR mutations into the prognostic index in NSCLC patients with brain metastasis. Materials and Methods We analyzed retrospectively 292 lung adenocarcinoma patients with brain metastasis. Clinico-pathological features and overall survival (OS) were compared between patients with EGFR mutations and patients with EGFR wild type. EGFR mutation status was integrated with lung specific Graded Prognostic Assessment (GPA) score. Results Among 292 patients, EGFR mutation status was tested in 183 patients. One hundred and five patients (57.4%) had EGFR activating mutations, 14 (7.7%) had EGFR non-activating mutations and 64 (35.0%) had EGFR wild type. OS was significantly longer in patients with EGFR activating mutations than in those with EGFR wild type patients (20.4 vs. 10.1 months, p = 0.002). However, patients with EGFR non-activating mutations did not show superior OS compared with EGFR wild type patients (14.6 vs. 10.1 months, p = 0.83). Multivariate analysis revealed that the presence of EGFR activating mutation is an independent positive prognostic factor for OS (adjusted hazard ratio 0.56, p = 0.002). Conclusions EGFR activating mutations have a prognostic role in lung adenocarcinoma patients with brain metastasis that is independent of other known prognostic factors. The frequency of EGFR mutation was higher than expected. The presence of EGFR activating mutations should be included as an index in the prognostic models for lung adenocarcinoma patients with brain metastasis.
    Lung Cancer. 10/2014;
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    ABSTRACT: To assess whether measuring the solid portion of adenocarcinomas appearing as part-solid ground-glass nodules (GGNs) can predict a patient's prognosis accurately and how the prognosis corresponds to that of solid nodules.
    European radiology. 10/2014;
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    ABSTRACT: Background:Previous studies have investigated the relationship between occupational and environmental agents and idiopathic pulmonary fibrosis (IPF). However, there have been few studies regarding the prognosis of IPF patients, according to patient occupation. Objective:We investigated whether occupational dust exposure was associated with clinically decreased lung function and poor prognosis. Design:The Korean Interstitial Lung Disease Research Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of IPF patients. A total of 1,311 IPF patients were stratified into five groups, according to their occupation: (1) unemployed or homemakers (n = 628); (2) farmers, fishers, or ranchers (n = 230); (3) sales or service personnel (n = 131); (4) clerical or professional personnel (n = 151); (5) specific dust-exposed workers (n = 171). Results:The mean age of subjects, at diagnosis, was 67.5 ± 9.7 years. Current smokers were 336 patients, 435 were ex-smokers, and 456 were never smokers. Dust-exposed workers showed early onset of IPF (61.3 ± 8.6 years, p < 0.001) and a longer duration of symptoms at diagnosis (17.0 ± 28.2 months, p = 0.004). Aging (p = 0.001; hazard ratio [HR], 1.034; 95% confidence interval [CI], 1.014-1.054), forced vital capacity (% of predicted) at diagnosis (p = 0.004; HR, 0.984; 95% CI, 0.974-0.995), and dust-exposure occupation (p = 0.033; HR, 1.813; 95% CI, 1.049-3.133) were associated with mortality. Conclusion:These findings indicate that occupational dust may be an aggravating factor associated with a poor prognosis in IPF.
    Chest 10/2014; · 7.13 Impact Factor
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    ABSTRACT: Inhaled corticosteroid (ICS) is recommended in the management of patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS), but its effectiveness has not been clearly proved.
    Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology 09/2014; · 3.45 Impact Factor
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    ABSTRACT: Background:No study has determined whether the risk of mortality predicted by the gender, age, and physiological variables (GAP) model matches the observed mortality from idiopathic pulmonary fibrosis (IPF) in non-Western populations. We evaluated the clinical course of IPF and validated the GAP model in Korean IPF patients. Methods:We included 268 patients who had been diagnosed with IPF at Seoul National University Hospital between 2005 and 2009. For each patient, demographics and clinical data such as lung physiological parameters at the diagnosis of IPF were evaluated. And, we validated the GAP model using discrimination and calibration to predict the risk of death in Korean IPF patients. Results:The study population comprised 181 men and 87 women, with a mean age of 65.9 years. The mean baseline percent predicted functional vital capacity (FVC) was 77 and percent predicted carbon monoxide diffusing capacity (DLCO) was 65.9. 157 (58.6%) deaths occurred during the follow-up, and the median time to death was 4.64 years. The observed cumulative mortality rates at 1, 2, and 3 years were 10.4%, 20.9%, and 31.0%, respectively. The GAP model produced estimates of 1-year mortality risk consistent with the observed data (c-statistic: GAP calculator 0.74 and GAP index and staging system 0.72, P < 0.29). However, calibration of the GAP model at 3 years was not satisfactory. Conclusion:The GAP model showed similar discrimination power compared with the original cohort. But it did not predict the 3-year risk of death accurately. Further multinational validation study will be needed.
    Chest 09/2014; · 7.13 Impact Factor
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    ABSTRACT: To evaluate the feasibility of percutaneous access via the recanalized paraumbilical vein for varix embolization.
    Korean journal of radiology: official journal of the Korean Radiological Society 09/2014; 15(5):630-6. · 1.32 Impact Factor
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    ABSTRACT: IntroductionThe solitary pulmonary nodule (SPN) is a common clinical problem usually detected incidentally during screening tests for lung cancer. Video-assisted thoracoscopic surgery (VATS) is performed for diagnosing SPNs when there are technical difficulties with transthoracic needle aspiration biopsy or bronchoscopic biopsy, inconclusive biopsy results, or when there is a high suspicion of malignancy.Objectives This study aimed to identify factors that can reduce unnecessary VATS for the diagnosis of SPNs.Methods We retrospectively analyzed patients with SPNs (n = 107) who had undergone diagnostic VATS at Seoul National University Hospital from January 2007 to December 2008. Clinical and radiological parameters were evaluated to compare benign and malignant SPNs.ResultsBenign SPNs were diagnosed in 31 patients (29.0%). The most common reason for patients to undergo a diagnostic VATS was a previous history of previous malignancy. The most common histological findings in patients with benign SPNs were nonspecific inflammatory lesions (29.0%) and tuberculosis (TB) (16.1%). The presence of respiratory symptoms was significantly associated with benign diseases (p = 0.004, odds ratio [OR] 0.189, 95% confidence interval [CI] 0.060-0.590), and part-solid nodules were significantly related to malignancy (p = 0.026, OR 6.34, 95% CI 1.248-32.169).Conclusion Approximately 30% of SPNs resected by VATS were benign. Although we did not identify a definite factor for predicting benign disease or malignancy, the presence of respiratory symptoms was related to benign disease and the presence of part-solid nodules was associated with malignancy.
    The Clinical Respiratory Journal 08/2014; · 1.66 Impact Factor
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    ABSTRACT: Objectives The incidence of Pneumocystis jirovecii pneumonia (PCP) in patients without HIV infection (non-HIV PCP) has been increasing along with the increased use of chemotherapeutic agents and immunosuppressants, but the prognostic factors of non-HIV PCP remain unclear. This study aimed to identify the prognostic factors of non-HIV PCP Methods Immunocompromised patients without HIV infection who were diagnosed and treated for PCP were included. The PCP diagnosis was based on positive direct fluorescent antibody (DFA) or polymerase chain reaction (PCR) results and compatible clinical symptoms and radiological findings. Results In total, 372 non-HIV patients with positive PCP DFA or PCR findings were screened and 173 were included. Univariate analysis indicated that age, smoking, chronic lung disease or hematologic malignancy, chemotherapeutic agents, high alveolar-arterial oxygen gradient (D[A-a]O2), C-reactive protein, albumin, blood urea nitrogen (BUN), CMV antigenemia, combined bacteremia, high percentage of neutrophils and rate of co-infection in BAL fluid, and mechanical ventilator care were related to the prognosis of non-HIV PCP. Multivariate analysis revealed that high D(A-a)O2, combined bacteremia, increased BUN and preexisting lung disease were indicators of a poor prognosis. Conclusions High D(A-a)O2, combined bacteremia, increased BUN and preexisting lung disease were independent factors of poor prognosis in non-HIV PCP patients.
    The Journal of infection 07/2014; · 4.13 Impact Factor
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    ABSTRACT: C-reactive protein (CRP) is considered a useful predictor of mortality from community- acquired pneumonia (CAP). Serum CRP concentration reflects its production in the liver, and impaired liver function may affect CRP level. The purpose of this study was to evaluate whether the initial CRP level is a prognostic factor for mortality from CAP in patients with liver cirrhosis (LC). CAP patients with LC admitted to two tertiary referral hospitals from January 2005 to June 2009 were included in this study. The associations between the initial clinical findings including CRP level and mortality were analyzed. Sixty-one men and 15 women were included. Seventeen patients (22.4%) died while in the hospital. Univariate analysis showed that an initial CRP level above the median value of 6.93 mg/dL was related to a lower risk of mortality (P=0.048). Multivariate Cox regression analysis showed that the significance of the relationship between the initial CRP level and mortality risk in CAP patients with LC was sustained after adjusting for the CURB-65 score, presence of malignancy, MELD score, and underlying lung condition. Higher initial serum CRP level is associated with lower mortality risk in CAP patients with LC.
    Hepato-gastroenterology 07/2014; 61(133):1331-8. · 0.77 Impact Factor
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    ABSTRACT: Polyunsaturated fatty acids (PUFAs) have important pharmacological effects on mammalian cells. Here, we show that carboxyl group-containing PUFAs inhibit lysophosphatidic acid (LPA)-induced focal adhesion formation, thereby inhibiting migration and adhesion. Carboxyl group-containing PUFAs inhibit LPA-induced calcium mobilization, whereas ethyl ester-group containing PUFAs have no effect. In addition, carboxyl group-containing PUFAs functionally inhibit LPA-dependent RhoA activation. Given these results, we suggest that PUFAs may inhibit LPA-induced calcium/RhoA signaling pathways leading to focal adhesion formation. Carboxyl group-containing PUFAs may have a functional role in this regulatory mechanism.
    FEBS letters. 06/2014;
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    ABSTRACT: The impact of chronic obstructive pulmonary disease (COPD) on the mortality of patients with lung cancer has not been studied extensively. The objective of this study is to compare the mortality and clinical characteristics of patients with non-small-cell lung cancer (NSCLC) according to the presence of COPD. The medical records of 221 smokers diagnosed with NSCLC were reviewed. Eligible patients were dichotomized into the COPD group (n = 111) and the non-COPD group (n = 110). The overall survival and clinical characteristics were compared, and predictors of worse survival were analyzed using Cox proportional hazards regression. COPD was present in 50.2% of all patients with NSCLC, and most of the patients (92.8%) with COPD were unaware of the disease before the diagnosis of lung cancer. Patients in the COPD group were older and had a lower body mass index, higher pack-years smoking history, higher frequency of dyspnea, and higher incidence of previous malignancy. The overall survival of enrolled patients and propensity score-matched subjects was comparable between the two groups (log-rank test, p = 0.2 and 0.396, respectively). Old age, low body mass index, advanced disease stage (stages III and IV), non-squamous histology, Eastern Cooperative Oncology Group performance status of greater than or equal to 2, weight loss, and coexistence of interstitial lung disease were independent risk factors for shorter survival. COPD frequently and subliminally coexists with NSCLC. Although differences in clinical characteristic did exist, there was no impact of COPD on the mortality of patients with NSCLC with a positive smoking history in this study.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 05/2014; · 4.55 Impact Factor
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    ABSTRACT: Thrombocytosis and coagulation systems activation are commonly associated with disease progression and are suggested poor prognostic factors in patients with malignancies. This study aimed to investigate the prevalence and prognostic significance of thrombocytosis and elevated fibrinogen levels in patients with advanced non-small cell lung cancer (NSCLC). Initial platelet counts and fibrinogen levels were reviewed in 854 patients with histologically proven NSCLC. Thrombocytosis was defined as platelet counts > 450 × 10(9)/L. A serum fibrinogen level > 4.5 g/L was considered high. At the time of diagnosis, initial platelet counts and serum fibrinogen levels were evaluated before treatment. Clinicopathologic data including histological type, tumor, node, metastasis (TNM) stage, performance status, treatment method, and survival time were evaluated. Initial thrombocytosis was found in 6.9% of patients, and elevated fibrinogen levels were found in 55.1% of patients. Patients with thrombocytosis had a significantly poorer prognosis than patients with normal platelet counts (P < 0.001). In multivariate survival analysis, thrombocytosis was an independent prognostic factor (P < 0.001). An elevated serum fibrinogen level was associated with poor prognosis (P < 0.001). In conclusion, initial thrombocytosis and a high fibrinogen level are independent factors for predicting poor prognosis in patients with advanced NSCLC.
    Journal of Korean medical science 04/2014; 29(4):507-11. · 0.84 Impact Factor
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    ABSTRACT: The presence of radiographic lesions suggesting old healed tuberculosis (TB) is one of the strongest risk factors for the subsequent development of active TB. We elucidated the metabolic activity of radiographic lesions suggesting old healed TB using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT). This cross-sectional study included 63 participants with radiographic lesions suggesting old healed TB and with available (18)F-FDG PET/CT scans. The maximum standardized uptake value (SUVmax) measured in the lesions, the clinical characteristics, results of the tuberculin skin test (TST) and interferon-γ release assay (IGRA) were analyzed. The SUVmax in old healed TB was 1.5 or higher among nine (14.3%) participants. Age (adjusted odds ratio [aOR], 1.23; 95% CI, 1.03-1.46), history of previous TB (aOR, 60.43; 95% CI, 1.71-2131.65), and extent of the lesions (aOR, 1.34; 95% CI, 1.02-1.75) were associated with higher SUVmax. The positive rates for the TST and IGRA were not different between groups with and without increased FDG uptake. Increased FDG uptake on (18)F-FDG PET/CT was observed in a subset of patients with radiographic lesions suggesting old healed TB. Given that the factors associated with increased FDG uptake are known risk factors for TB development, the possibility exists that participants with old healed TB lesions with higher SUV on (18)F-FDG PET/CT scans might be at higher risk for active TB.
    Journal of Korean medical science 03/2014; 29(3):386-91. · 0.84 Impact Factor
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    ABSTRACT: Background: Patients with interstitial lung disease (ILD) have a high incidence of postoperative pulmonary complications (PPCs) after lung resection, but there is little data about these complications in ILD after other types of surgery. Objectives: The aim of this study was to examine the characteristics and predictors of PPCs after major surgery in patients with ILD. Methods: We included 336 patients with ILD who underwent major surgery between January 2005 and December 2010 at two tertiary hospitals in Korea. All types of surgery that had been performed under general anesthesia were included. Demographic characteristics, preoperative lung function, and operative conditions including anesthesia time and estimated blood loss were compared between patients with and without PPCs. Results: PPCs occurred in 37 patients (11%). Thirteen patients developed pneumonia, the most common PPC, and 11 had acute exacerbation of ILD. In multivariable analysis, BMI <23 (OR = 2.488, 95% CI: 1.084-5.710, p = 0.031), emergency surgery (OR = 23.992, 95% CI: 2.629-218.949, p = 0.005), lung surgery (OR = 5.090, 95% CI: 1.391-18.628, p = 0.014), and longer anesthesia time (OR = 1.595, 95% CI: 1.143-2.227, p = 0.006) were statistically significant risk factors. Conclusions: The incidence of PPCs detected over all surgeries was not as high as that reported for lung surgery alone in ILD patients. Lower BMI, emergency surgery, lung surgery, and longer anesthesia time were risk factors. Operative conditions as well as lung function should be considered in preoperative planning and management for ILD patients undergoing major surgery. © 2014 S. Karger AG, Basel.
    Respiration 02/2014; · 2.92 Impact Factor
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    ABSTRACT: Blood lactate levels and central venous oxygen saturation (ScvO2) are known to be useful indicators of global tissue hypoxia. However, it is unclear whether ScvO2 correlates with lactate levels when measured simultaneously and whether changes in ScvO2 or lactate levels in serial measurements have prognostic value. We investigated the correlation between ScvO2 and lactate levels measured simultaneously and their association with clinical outcomes. We performed a prospective observational study of patients with severe systemic inflammatory response syndrome (SIRS) and severe sepsis who were admitted to the medical intensive care unit. ScvO2 and lactate levels were measured simultaneously at the time of study enrollment, every 6 h for 24 h, and then every 24 h until the goal was reached. Twenty-five patients were enrolled in the study; 13 have died and 12 have survived. There was no correlation between lactate levels and ScvO2. Neither lactate levels nor ScvO2 at the time of admission differed between nonsurvivors and survivors. Normalization of lactate levels within 48 h was significantly associated with survival. In patients with severe SIRS and severe sepsis, simultaneously measured ScvO2 and lactate levels showed no correlation, and normalization of lactate levels within 48 h was a predictive factor for survival.
    Beiträge zur Klinik der Tuberkulose 02/2014; · 2.06 Impact Factor
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    ABSTRACT: Although combined pulmonary fibrosis and emphysema (CPFE) might be relevant to lung cancer, no comparison studies have been done. We evaluated the risk of lung cancer among CPFE patients compared to IPF and emphysema patients. We retrospectively reviewed the medical records of patients who were diagnosed as CPFE, IPF and emphysema using chest CT scans at Seoul National University Hospital from Jan 2000 to Dec 2011. Patients with CPFE were enrolled and matched (1:1:2) with IPF and emphysema patients based on the radiological criteria. The main outcome was time to diagnosis of lung cancer and evaluated with Cox-proportional hazard regression. Forty-eight CPFE, 48 IPF, and 96 emphysema patients were included in this study. Twenty-five cases of lung cancer occurred. The CPFE group had a higher risk of lung cancer (adjusted HR 4.62, 95% CI 1.58-13.55) than that of the emphysema group. Also, IPF group had a higher risk of lung cancer (adjusted HR 4.15, 95% CI 1.03-16.78) than that of emphysema group. However, there was no statistically significant difference in lung cancer risk between the CPFE and IPF group. Additionally, the CPFE group had a higher risk of lung cancer or death (adjusted HR 4.62, 95% CI 2.25-9.47) than that of the emphysema group. In conclusion, patients with CPFE and IPF had a higher risk of lung cancer than those with emphysema, although lung cancer risk was similar between CPFE and IPF.
    Respiratory medicine 01/2014; · 2.33 Impact Factor
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    ABSTRACT: There have been few studies of pulmonary actinomycosis, which is an uncommon anaerobic infection. Consequently, the optimal therapeutic regimen, appropriate duration of treatment, long-term prognosis, and factors predicting prognosis are not well established. We retrospectively reviewed the medical records of histopathologically confirmed cases of pulmonary actinomycosis seen between November 2003 and December 2012. The study included 68 patients with a mean age of 58.4 +/- 11.6 years. Of the 68, initial surgery was performed in 15 patients (22.1%), while the remaining 53 (77.9%) received antibiotic therapy initially. In the initial antibiotic group, 45/53 (84.9%) were cured without relapse (median antibiotic duration 5.3 months). 5/53 (9.4%) patients were refractory medically (median antibiotic duration 9.7 months), and 3/53 (5.7%) experienced a recurrence (median time to relapse 35.3 months). In the initial surgery group, 14/15 (93.3%) were cured and treatment failure occurred in one (6.7%). In the multivariate analysis, the absence of an antibiotic response at 1 month was the only independent factor associated with a poor treatment outcome, with an adjusted odds ratio of 49.2 (95% CI, 3.34-724.30). There was no significant difference in treatment outcome based on the size of the parenchymal lesion, comorbidities, whether intravenous antibiotics were used, antibiotic therapy duration, or whether the initial treatment was surgical. Antibiotic treatment with or without surgery was effective for treatment of pulmonary actinomycosis. Nevertheless, treatment failure or recurrence occurred in a considerable proportion of patients, especially those resistant to the initial antibiotic treatment.
    BMC Infectious Diseases 01/2014; 14(1):10. · 3.03 Impact Factor
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    ABSTRACT: The culture-negative conversion rate of sputum after 2 months of treatment in patients with pulmonary tuberculosis (TB) is used as a reliable surrogate marker for relapse after completion of treatment. We hypothesized that culture conversion of sputum at 2 months of anti-TB treatment and the time to culture conversion are different among pulmonary TB patients who are diagnosed using different methods.
    PLoS ONE 01/2014; 9(8):e103768. · 3.53 Impact Factor

Publication Stats

982 Citations
365.93 Total Impact Points

Institutions

  • 2011–2014
    • Keimyung University
      • College of Medicine
      Sŏul, Seoul, South Korea
    • Yeungnam University
      Daikyū, Daegu, South Korea
    • Soonchunhyang University
      • College of Medicine
      Onyang, South Chungcheong, South Korea
  • 1998–2014
    • Seoul National University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2004–2013
    • Seoul National University Bundang Hospital
      Sŏul, Seoul, South Korea
  • 1998–2013
    • Seoul National University
      • • Department of Internal Medicine
      • • College of Medicine
      Sŏul, Seoul, South Korea
  • 2012
    • Pusan National University
      • Department of Pharmacology
      Pusan, Busan, South Korea
  • 2009–2012
    • Inje University Paik Hospital
      • Department of Internal Medicine
      Goyang, Gyeonggi, South Korea
  • 2010
    • Seongnam Central Hospital
      Sŏngnam, Gyeonggi Province, South Korea
    • Yonsei University
      • Department of Internal Medicine
      Seoul, Seoul, South Korea
    • Kangwon National University Hospital
      Shunsen, Gangwon, South Korea
  • 2006
    • National Cancer Center Korea
      Kōyō, Gyeonggi Province, South Korea
  • 1990
    • Korea Advanced Institute of Science and Technology
      • Department of Computer Science
      Seoul, Seoul, South Korea