Dong Wook Shin

Seoul National University Hospital, Sŏul, Seoul, South Korea

Are you Dong Wook Shin?

Claim your profile

Publications (164)519.56 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the efficacy of tamsulosin, solifenacin, and combination therapy of both agents for the treatment of ureteral stent-related symptoms (SRSs). An open-label, randomized controlled trial was conducted with 112 patients who underwent unilateral ureteral stent insertion following ureteroscopic stone surgery. Patients were randomized with a 2 × 2 factorial design to one of four groups, i.e., A (control), B (tamsulosin 0.2 mg once daily), C (solifenacin 5 mg once daily), and D (both active treatments). Patients were evaluated at week 2 by the ureteral stent symptom questionnaire (USSQ). The primary efficacy outcome was the urinary symptom score of the USSQ, and the secondary efficacy outcomes were the scores in the other five USSQ domains, the Euro-QOL score, and oral analgesic requirements during the 2 weeks. Efficacy outcomes were primarily analyzed for the per-protocol set population. The four groups were generally well balanced in terms of baseline characteristics. Eighty-one patients (72.3 %) completed the study protocol. Comparison of the six USSQ domain scores at week 2 showed no differences between the four groups. Similarly, comparison of the domain scores stratified by tamsulosin or solifenacin medication showed no differences for either medication. The other secondary outcomes were also similar in the group comparisons. Neither tamsulosin nor solifenacin medications provide beneficial effects for relieving various SRSs. In addition, the combination therapy did not have beneficial effects. Further studies are warranted to determine the benefit of medical therapy for the treatment of SRSs and to determine the optimal management strategy for SRSs.
    World Journal of Urology 03/2015; DOI:10.1007/s00345-015-1544-1 · 3.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to examine the following questions: (1) To what extent do patients and caregivers perceive their family members to be avoidant of communication regarding patient's cancer, and to what extent do these perceptions interrelate, and (2) How do such perceptions influence their own and each other's communication behaviors, communication outcome, mental health, and quality of life. A national survey was performed with 990 patient-caregiver dyads (participation rate:76.2%). To examine the dyadic interaction, we developed linked patient and family member questionnaires, including the Family Avoidance of Communication about Cancer scale. The mean scores (standard deviations) of patient- and caregiver-perceived FACC were low at 10.9 (15.5) and 15.5 (17.5), respectively (P < 0.001), and concordance was low, a well (Spearman's rho =0.23). Patient-perceived FACC was associated with lower levels of disclosure and behaviors of holding back communication, as well as lower levels of mental health outcome and quality of life. The same was true for caregivers (all Ps < 0.05). Patient-perceived FACC was associated with caregiver holding back, caregiver's depression level, and caregiver quality of life (all Ps < 0.05). Both patient- and caregiver-perceived FACC were independently associated with communication difficulty within the family. s Future research would benefit from the measurement of FACC from both patients and caregivers, and promote family intervention to enhance openness to communication, which would be helpful for improving mental health and quality of life for both patients and caregivers.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to evaluate the cancer care cost during the last year of life of patients in Korea. We studied the breakdown of spending on the components of cancer care. Cancer decedents in 2009 were identified from the Korean Central Cancer Registry and linked with the Korean National Health Insurance Claims database. The final number of patients included in the study was 70,558. In 2009, the average cancer care cost during the last year of life was US $15,720. Patients under age 20 spent US $53,890 while those 70 or over spent US $11,801. Those with leukemia incurred the highest costs (US $43,219) while bladder cancer patients spent the least (US $13,155). General costs, drugs other than analgesics, and test fees were relatively high (29.7%, 23.8%, and 20.7% of total medical costs, respectively). Analgesic drugs, rehabilitation, and psychotherapy were still relatively low (4.3%, 0.7%, and 0.1%, respectively). Among the results of multiple regression analysis, few were notable. Age was found to be negatively related to cancer care costs while income level was positively associated. Those classified under distant Surveillance, Epidemiology, and End. stages of cancer and higher comorbidity level also incurred higher cancer care costs. Average cancer care costs varied significantly by patient characteristics. However, the study results suggest an underutilization of support services likely due to lack of alternative accommodations for terminal cancer patients. Further examination of utilization patterns of healthcare resources will help provide tailored evidence for policymakers in efforts to reduce the burdens of cancer care.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Screening for second primary cancer (SPC) is one of the key components to survivorship care. We aim to evaluate the oncologists' experience with SPCs and assess the current practice, perceived barriers, and recommendations related to SPC screening. A nationwide survey was conducted with a representative sample of 496 Korean oncologists. A questionnaire based on the findings from our previous qualitative study was administered. More than three-fourths of oncologists (76.3%), who participated in the study, had experience with SPC patients. Over half of them (51.9%) stated that it was an embarrassing experience. While the current management practice for SPC varies, most oncologists (80.2%) agreed on the necessity in proactively providing information on SPC screening. A short consultation time (52.3%), lack of guidelines and evidence on SPC screening (47.7%), and patients' lack of knowledge about SPCs (45.1%) or SPC screening (41.4%) were most frequently reported as barriers to providing appropriate care for managing SPC. Oncologists recommended the development of specific screening programs or guidelines in accordance to the type of primary cancer (65.9%), the development of an internal system for SPC screening within the hospital (59.7%) or systematic connection with the national cancer screening program (44.3%), and education of oncologists (41.4%) as well as patients (48.9%) regarding SPC screening. Many oncologists reported the occurrence of SPC as an embarrassing experience. Given the variations in current practice and the lack of consensus, further studies are warranted to develop the optimal clinical strategy to provide SPC screening for cancer survivors.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The complexity of end-of-life (EOL) communication in cancer care is often increased by family caregivers, who frequently affect the information and decision-making process. We assessed cancer patient preferences (PP), family caregiver preferences (FCP), and family caregiver predictions of patient preferences (FCPPP) regarding the disclosure of terminal status, family involvement in the disclosure process, and EOL choices, and we evaluated the concordances among them.
    Psycho-Oncology 02/2015; 24(2). DOI:10.1002/pon.3631 · 4.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In response to the challenges and difficulties imposed by rare cancers, multi-stakeholder initiatives dedicated to improving rare cancer care was launched, and several recommendations were made by professional societies. However, these primarily reflect the view of the advocates and supporters, and may not represent the views of the "average" clinician or researcher. In this study, we sought to investigate perceived difficulties with regard to rare cancer care and potential solutions endorsed by oncologists. A representative sample of 420 oncologists recruited in 13 cancer centers participated in a nationwide survey. Oncologists faced various difficulties in treatment of patients with rare cancers, including the lack of clinical practice guidelines (65.7%) and personal experience (65.2%), lack of approved treatment options (39.8%), and reimbursement issues (44.5%). They were generally supportive of recent recommendations by multi-stakeholder initiatives as well as professional societies for development of clear clinical practice guidelines (66.0%), flexible reimbursement guidelines (52.9%), and a national rare cancer registry (47.4%). However, there was only moderate endorsement for referrals to high-volume centers (35.5%) and encouragement of off-label treatments (21.0%). Insights into the general attitudes of oncologists gained through our nationwide survey of representative samples would be helpful in development of clinical practices and public health policies in rare cancer treatment and research.
    Cancer Research and Treatment 01/2015; DOI:10.4143/crt.2014.086 · 2.98 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate perceived risk, diagnostic testing, and acceptance of a diagnosis of irritable bowel syndrome (IBS) among the Korean laypersons. We designed a conceptual framework to evaluate the health-seeking behavior of subjects based on a knowledge, attitude, and practice model. We developed a vignette-based questionnaire about IBS based on a literature review and focused group interviews. The vignette described a 40-year-old woman who meets the Rome III criteria for IBS without red-flag signs. It was followed by questions about demographic characteristics, health behaviors, IBS symptoms, risk perception, perceived need for diagnostic tests, and acceptance of a positive diagnosis of IBS. We planned a nationwide survey targeting laypersons without IBS and between the ages of 20 and 69 years. Survey participants were selected by quota sampling stratified by gender, age, and nationwide location. A multivariate logistic model was constructed based on literature reviews, univariate analysis, and a stepwise selection method to investigate correlations between the perceived risk, need for diagnostic tests, and acceptance of a positive diagnosis. Of 2354 eligible households, 1000 subjects completed the survey and 983 subjects were analyzed, excluding those who met symptom criteria for IBS. After reading the IBS vignette, the majority of subjects (86.8%) responded that the patient was at increased risk of severe disease. The most frequent concern was colon cancer (59.8%), followed by surgical condition (51.5%). Most subjects responded the patient needs diagnostic tests (97.2%). Colonoscopy was the most commonly required test (79.5%). Less than half of the respondents requested a stool examination (45.0%), blood test (40.7%), abdominal ultrasound (36.0%), or computed tomography (20.2%). The subjects who felt increased risk were more likely to see a need for colonoscopy [adjusted odds ratio (aOR) = 2.10, 95%CI: 1.38-3.18]. When asked about the positive diagnosis, the most frequent response was that "the patient would not be reassured" (65.7%). The increased risk perception group was less likely to be reassured by a positive diagnosis of IBS, compared to the other respondents (aOR = 0.52, 95%CI: 0.34-0.78). For IBS diagnosis, increased risk perception is a possible barrier to the appropriate use of diagnostic tests and to the patient's acceptance of a positive diagnosis.
  • JAMA Internal Medicine 12/2014; DOI:10.1001/jamainternmed.2014.6569 · 13.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Screening for hepatocellular carcinoma (HCC) is clinically important as its early detection has remarkable survival benefits. We investigated the possible role of FIB-4, a recently developed noninvasive marker for liver fibrosis based on routine laboratory tests, as a clinical indicator for predicting future HCC among hepatitis B surface antigen (HBsAg) carriers. Our retrospective cohort study involved 986 Korean HBsAg carriers aged 40 or older who visited Seoul National University Hospital for health check-up. National medical service claims data was used to determine HCC incidence. Median follow-up time was 5.4 years (interquartile range 4.4 years). Adjusted for age, sex, body mass index, smoking, alcohol, and anti-viral medication for hepatitis B, compared to subjects with FIB-4 <1.25, subjects with 1.7≤ FIB-4 <2.4 showed aHR 4.57 (95% CI 1.50-13.92) and subjects with FIB-4 ≥2.4 showed aHR 21.34 (95% CI 7.73-58.92) for HCC incidence. FIB-4 was shown to have incremental predictive value to ultrasonographic liver cirrhosis for HCC incidence (C-index 0.701 vs. 0.831; P=0.001). FIB-4 was also better predictive of HCC incidence compared to that of ultrasonographic liver cirrhosis (C-index 0.775 vs. 0.701; P=0.040). Conclusion: High FIB-4 is a highly predictive risk factor for HCC incidence among Korean HBsAg carriers. FIB-4 is a promising, easily applicable, and cost-effective clinical tool in identifying a subpopulation of HBsAg carriers who are at heightened risk. Our study needs to be replicated in larger future studies on various ethnic groups; nonetheless, our study suggests FIB-4 may play a valuable role in HCC screening among HBsAg carriers. This article is protected by copyright. All rights reserved.
    Hepatology 12/2014; DOI:10.1002/hep.27654 · 11.19 Impact Factor
  • Dong Wook Shin, Jong Hyock Park
    Cancer 12/2014; 120(23). DOI:10.1002/cncr.28939 · 4.90 Impact Factor
  • Source
    Korean journal of anesthesiology 12/2014; 67(Suppl):S79-80. DOI:10.4097/kjae.2014.67.S.S79
  • Ji Eun Lee, Dong Wook Shin, Be Long Cho
    12/2014; 10(2):58-62. DOI:10.14216/kjco.14012
  • [Show abstract] [Hide abstract]
    ABSTRACT: The fabrication of interlayer dielectrics (ILDs) in flexible organic light-emitting diodes (OLEDs) not only requires flexible materials with a low dielectric constant, but also ones that possess the electrical, thermal, chemical, and mechanical properties required for optimal device performance. Porous polymer-silica hybrid materials were prepared to satisfy these requirements. Hollow SiO2 spheres were synthesized using Atomic Layer Deposition (ALD) and a thermal calcination process. The hybrid film which consists of hollow SiO2 spheres and polyimide shows a low dielectric constant of 2.35 and excellent thermal stability up to 530oC. After the bending test for 50,000 cycles, the porous hybrid film exhibits no degradation in its dielectric constant or leakage current. These results indicate that the hybrid film made of hollow SiO2 spheres and polyimide (PI) is useful as a flexible insulator with a low dielectric constant and high thermal stability for flexible OLEDs.
    Physical Chemistry Chemical Physics 11/2014; 17(4). DOI:10.1039/C4CP04266B · 4.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether a cardiovascular disease (CVD) health screening program is associated with CVD-related health conditions, incidence of cardiovascular events, mortality, healthcare utilization, and costs. Cohort study of a 3% random sample of all Korea National Health Insurance members 40years of age or older and free of CVD or CVD-related health conditions was conducted. A total 443,337 study participants were followed-up from January 1, 2005 through December 31, 2010. In primary analysis, the hazard ratios for CVD mortality, all-cause mortality, incident composite CVD events, myocardial infarction, cerebral infarction, and cerebral hemorrhage comparing participants who attended a screening exam during 2003-2004 compared to those who did not were 0.58 (95% CI: 0.53-0.63), 0.62 (95% CI: 0.60-0.64), 0.82 (95% CI: 0.78-0.85), 0.84 (95% CI: 0.75-0.93), 0.84 (95% CI: 0.79-0.89), and 0.73 (95% CI: 0.67-0.80), respectively. Screening attenders had higher rates of newly diagnosed hypertension, diabetes mellitus, and dyslipidemia, lower inpatient days of stay and cost, and lower outpatient cost compared to non-attenders. Participation in CVD health screening was associated with lower rates of CVD, all-cause mortality, and CVD events, higher detection of CVD-related health conditions, and lower healthcare utilization and costs. Copyright © 2014. Published by Elsevier Inc.
    Preventive Medicine 11/2014; 70C:19-25. DOI:10.1016/j.ypmed.2014.11.007 · 2.93 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Continuity of care is considered a core element of high-quality primary care, but its impact on mortality and health care costs is unclear. We aimed to determine the impact of continuity of care on mortality, costs, and health outcomes in patients with newly diagnosed cardiovascular risk factors.
    The Annals of Family Medicine 11/2014; 12(6):534-41. DOI:10.1370/afm.1685 · 4.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Previous studies on the association of alcohol consumption with lower urinary tract symptoms (LUTS) have been inconsistent, and none took into account the dynamic nature of LUTS, fluctuating over time. The purpose of the study was to determine the longitudinal association of alcohol consumption with LUTS.Methods We used generalized estimating equations to analyze the longitudinal association of alcohol consumption with LUTS in a longitudinal study of 9,712 healthy men 30 years or older who visited our institution multiple times for routine comprehensive health evaluations, with an average follow-up period of 27.9 months.ResultsLight–moderate alcohol consumption (0.1 to 29 g/d) was associated with decreased likelihood of moderate–severe LUTS, whereas heavy alcohol consumption (≥30 g/d) was associated with increased likelihood of moderate–severe LUTS in a dose-dependent manner. Compared to those with 0 g/d alcohol intake, subjects who drank 0.1 to 9.9, 10 to 19.9, 20 to 29.9, 30 to 39.9, or ≥40 g/d of alcohol were in general significantly associated with moderate–severe LUTS with adjusted odds ratio (95% confidence interval) as follows respectively: 0.94 (0.87 to 1.02), 1.00 (0.91 to 1.09), 0.85 (0.77 to 0.93), 1.08 (0.98 to 1.19), and 1.31 (1.19 to 1.44). However, the protective association of light–moderate alcohol consumption with LUTS was greatly attenuated when serum high-density lipoprotein (HDL) was added to the analysis, specifically for voiding symptoms.Conclusions We show strong evidence there is longitudinal association of alcohol consumption with LUTS. The protective effect of light–moderate alcohol consumption on LUTS is in part modulated by HDL as a confounder, similar to its effect on coronary heart disease.
    Alcoholism Clinical and Experimental Research 11/2014; 38(11). DOI:10.1111/acer.12564 · 3.31 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Female physicians have a more patient-centered communication style than their male counterparts; however, few studies have investigated how the biomedical or psychosocial nature of a patient diagnosis might moderate this relationship. Seventy six 3rd year residents (50 male and 26 females) seeking board certification from the Korean Academy of Family Medicine participated in the 2013 Clinical Practice Examination by conducting two simulated patient (SP) interviews, one presenting a largely psychosocial case and the other largely biomedical. The interview recordings were coded with the Roter Interaction Analysis System (RIAS). Female physicians and their SPs engaged in more dialog than male physicians in both cases. Female physicians were more patient-centered than males for the psychosocial case (t=-3.24, P<0.05), however, their scores did not differ for the biomedical case. In multivariate analysis, a significant interaction between physician gender and case (z=-3.90, P<0.001) similarly demonstrated greater female patient-centeredness only for the predominantly psychosocial case. Case characteristics moderated the association between physician gender and patient-centeredness. Case characteristics need to be considered in future research on the association of physician gender and the patient-centered communication, as well as in the tailoring of physician communication training. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Patient Education and Counseling 10/2014; 98(1):55-60. DOI:10.1016/j.pec.2014.10.008 · 2.60 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Many tissues of the human body encounter hyperosmotic stress. The effect of extracellular osmotic changes on melanin production has not yet been elucidated. In this study, we determined that hyperosmotic stress induced by organic osmolytes results in reduced melanin production in human melanoma MNT-1 cells. Under hyperosmotic stress, few pigmented mature melanosomes were detected, but there was an increase in swollen vacuoles. These vacuoles were stained with an anti-M6PR antibody that recognizes late endosomal components and with anti-TA99 and anti-HMB45 antibodies, implying that melanosome formation was affected by hyperosmotic stress. Electron microscopic analysis revealed that the M6PR-positive swollen vacuoles were multi-layered and contained melanized granules, and they produced melanin when L-DOPA was applied, indicating that these vacuoles were still capable of producing melanin, but the inner conditions were not compatible with melanin production. The vacuolation phenomenon induced by hyperosmotic conditions disappeared with treatment with the PI3K activator 740 Y-P, indicating that the PI3K pathway is affected by hyperosmotic conditions and is responsible for the proper formation and maturation of melanosomes. The microarray analysis showed alterations of the vesicle organization and transport under hyperosmotic stress. Our findings suggest that melanogenesis could be regulated by physiological conditions, such as osmotic pressure.
    PLoS ONE 08/2014; 9(8):e105965. DOI:10.1371/journal.pone.0105965 · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Testosterone is an endocrine hormone with functions in the reproductive organs, anabolic events and skin homeostasis. We report here that GPRC6A serves as a sensor and mediator of the rapid action of testosterone in epidermal keratinocytes. The silencing of GPRC6A inhibited testosterone-induced intracellular calcium ([Ca2+]i) mobilization and H2O2 generation. These results indicated that a testosterone-GPRC6A complex is required for the activation of Gq protein, IP3 generation, and [Ca2+]i mobilization, leading to Duox1 activation. H2O2 generation by testosterone stimulated the apoptosis of keratinocytes through the activation of caspase-3. The application of testosterone into 3-D skin equivalents increased the apoptosis of keratinocytes between the granular and stratified corneum layers. These results support an understanding of the molecular mechanism of testosterone-dependent apoptosis in which testosterone stimulates H2O2 generation through the activation of Duox1.
    Journal of Biological Chemistry 08/2014; 289(42). DOI:10.1074/jbc.M114.583450 · 4.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Communication between cancer patients and caregivers is often suboptimal. The Cancer Communication Assessment Tool for Patient and Families (CCAT-PF) is a unique tool developed to measure congruence in patient–family caregiver communication employing a dyadic approach. We aimed to examine the cross-cultural applicability of the CCAT in the Korean healthcare setting.Methods Linguistic validation of the CCAT-PF was performed through a standard forward–backward translation process. Psychometric validation was performed with 990 patient–caregiver dyads recruited from 10 cancer centers.ResultsMean scores of CCAT-P and CCAT-F were similar at 44.8 for both scales. Mean CCAT-PF score was 23.7 (8.66). Concordance of each items between patients and caregivers was low (weighted kappa values <0.20 for all items and Spearman's rho <0.18 for scale scores). Scale scores did not differ significantly across a variety of cancer types and stages. The CCAT-P or CCAT-F score was weakly associated with mental health and quality of life outcomes. The CCAT-PF was correlated weakly with both patient-perceived and caregiver-perceived family avoidance of cancer care scales.Conclusion The CCAT-PF Korean version showed similar psychometric properties to the original English version in the assessment of communication congruence between cancer patient and family caregivers. Copyright © 2014 John Wiley & Sons, Ltd.
    Psycho-Oncology 07/2014; DOI:10.1002/pon.3629 · 4.04 Impact Factor

Publication Stats

1k Citations
519.56 Total Impact Points


  • 2010–2015
    • Seoul National University Hospital
      • Department of Family Medicine
      Sŏul, Seoul, South Korea
  • 2014
    • Seoul National University
      Sŏul, Seoul, South Korea
  • 2012–2014
    • CHA University
      Sŏul, Seoul, South Korea
    • Kwangwoon University
      • Department of Electrical Engineering
      Sŏul, Seoul, South Korea
  • 2011–2014
    • Frontiers in Bioscience Research Institute
      Irvine, California, United States
  • 2009–2014
    • Sungkyunkwan University
      • • Department of Biological Science
      • • SKKU Advanced Institute of Nanotechnology (SAINT)
      Sŏul, Seoul, South Korea
  • 2007–2014
    • Amorepacific Corporation
      Sŏul, Seoul, South Korea
  • 2006–2014
    • Hanyang University
      • Division of Materials Science and Engineering (MSE)
      Sŏul, Seoul, South Korea
  • 2013
    • Korean Institute of Ceramic Engineering and Technology
      Sŏul, Seoul, South Korea
  • 2011–2013
    • University of Texas at Austin
      • Department of Materials Science and Engineering
      Austin, Texas, United States
  • 2009–2011
    • National Cancer Center Korea
      • Gastric Cancer Branch
      Kōyō, Gyeonggi-do, South Korea
  • 2006–2009
    • Korea Institute of Science and Technology
      • Electronic Materials Research Center
      Sŏul, Seoul, South Korea
  • 2005–2009
    • Yonsei University
      • Department of Materials Science and Engineering
      Sŏul, Seoul, South Korea
  • 2004
    • Hanwha Chemical Corporation
      Sŏul, Seoul, South Korea
    • Gwangju Institute of Science and Technology
      • Department of Life Sciences
      Gwangju, Gwangju, South Korea
  • 2002
    • Robert Wood Johnson University Hospital
      Нью-Брансуик, New Jersey, United States