Young Seok Kim

Korea Institute of Construction Technology, Kōyō, Gyeonggi-do, South Korea

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Publications (243)489.25 Total impact

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    ABSTRACT: Background & AimsThe outcomes of hepatitis C virus (HCV)-related liver cirrhosis was limitedly studied in a hepatitis B virus-endemic area. This multicenter, prospective cohort study was conducted to elucidate the incidence of hepatocellular carcinoma (HCC) and mortality in the Korean patients with HCV-related cirrhosis.Methods From Jan. 2007 through Jun. 2012, 196 patients with HCV-related cirrhosis were prospectively enrolled and regularly followed at six university hospitals to determine HCC occurrence and mortality. A multivariable analysis using Cox proportional hazards regression was performed to clarify the related factors to the outcomes.ResultsDuring a mean follow-up period of 39.2 months, 31 (15.8%) patients developed HCC, and 33 (16.8%) patients died or underwent liver transplantation. The estimated HCC incidence was 5.8 per 100 person-years, and the independent factors for HCC were absence of anti-HBs (hazard ratio [HR], 5.018; 95% confidence interval [CI], 1.710-14.726; p=0.003) and serum albumin < 3.8 g/dl (HR, 3.051; 95% CI, 1.318-7.067; p=0.009). The overall mortality rate was 5.1 per 100 person-years, and the related independent factors were the presence of ascites (HR, 2.448; 95% CI, 1.142-5.210; p=0.022), serum albumin < 3.8 g/dl (HR, 3.067; 95% CI, 1.254-8.139, p=0.014), and non-achievement of sustained virologic response (SVR) (HR, 0.066; 95% CI, 0.001-0.484, p=0.002).Conclusion The incidence of HCC in HCV-related cirrhosis seems to be high in Korea, and advanced liver disease and no achievement of SVR were associated with mortality. The absence of anti-HBs in hepatocarcinogenesis related to HCV warrants further study.
    Journal of Gastroenterology and Hepatology 03/2015; DOI:10.1111/jgh.12950 · 3.63 Impact Factor
  • Jangguen Lee, Young Seok Kim, Deokho Chae, Wanjei Cho
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    ABSTRACT: The seasonally frozen ground has been focused on as research topics such as the frost heaving under the asphalt road rather than the permafrost ground due to the latitudinal location of Korea. However, the recent construction of the second Korean Antarctic research station, the Jangbogo station and the participation on the development of the natural gas pipeline in Russia arouse the research interests on the behavior of the permafrost ground. At the design process of the geotechnical structures on the permafrost ground, the evaluation of the mechanical characteristics of frozen soil is very important. In the laboratory tests, it is crucial to understand the effects of testing conditions such as loading rate and temperature on the mechanical behavior of frozen soils. Therefore, unconfined compression tests are performed to evaluate the loading rate effects on the mechanical characteristics of frozen granular soils. Based on the experimental results, the loading rate affects both the strength and deformation characteristics of the frozen soils. The ASTM standards on the loading rate of the frozen sands are fast enough for the strength evaluations but not for the stiffness evaluations. Furthermore, the loading rate effects are evaluated on the bearing capacity and deformation of pile installed on the permafrost via numerical analyses with experimental results.
    KSCE Journal of Civil Engineering 02/2015; DOI:10.1007/s12205-015-1417-6 · 0.51 Impact Factor
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    ABSTRACT: This multicenter, randomized, open-labeled, clinical trial evaluated the efficacy and safety of cisplatin/5-fluorouracil (5-FU) hepatic arterial infusion chemotherapy (CF-HAIC) versus adriamycin adding to CF-HAIC (ACF-HAIC) in advanced HCC patients. Fifty-six patients with advanced HCC were randomized to two treatment groups: (1) CF-HAIC group [n = 29, 5-FU, 500 mg/m(2) on days 1-3, and cisplatin, 60 mg/m(2) on day 2] and (2) ACF-HAIC group [n = 27, adriamycin, 50 mg/m(2) on day 1, 5-FU, 500 mg/m(2) on days 1-3, and cisplatin, 60 mg/m(2) on day 2] every 4 weeks via an implantable port system. Primary efficacy endpoint was overall survival (OS). Treatment response and time to progression were secondary endpoints. Treatment response rates did not differ significantly between the two treatment groups. Time to progression (5.4 vs. 5.8 months, P = 0.863) and OS (11.1 vs. 8.8 months, P = 0.448) were not significantly different. When the factors affecting patient OS were analyzed, disease control rate [P < 0.001, HR 6.437 (95 % CI 2.580-16.064)] was independently associated with OS. Age (≥60 years) and serum AFP level (≥200 ng/dL) also were significant factors for OS [P = 0.007, HR 4.945 (95 % CI 1.543-15.850), P = 0.048, HR 2.677 (95 % CI 1.010-7.095), respectively]. Grade 4 treatment-related toxicity and mortality was not observed in both groups. Although both HAIC regimens are safe and effective in patients with advanced HCC, HAIC adding adriamycin did not show delayed tumor progression and survival benefit compared to CF-HAIC in advanced HCC.
    Cancer Chemotherapy and Pharmacology 02/2015; 75(4). DOI:10.1007/s00280-015-2692-0 · 2.57 Impact Factor
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    ABSTRACT: Background/aimsTransient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC).Methods From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centers were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)–to–platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used.ResultsThe median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients versus 51 years, 6.8 kPa and 0.55, respectively in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P<0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P=0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P>0.05) in CHC patients. In CHB patients, optimal cutoff LS values were 7.8 kPa for ≥ F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, versus 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients.ConclusionsTE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 02/2015; DOI:10.1111/liv.12808 · 4.41 Impact Factor
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    ABSTRACT: EUS-guided fine needle aspiration (EUS-FNA) is one of the alternative methods for tissue sampling of liver solid mass. However, the diagnostic efficacy using cytology alone was limited. In this study, we evaluate the diagnostic accuracy of EUS-guided fine needle biopsy (EUS-FNB) as a percutaneous biopsy rescue for liver solid mass. The EUS-FNB using core biopsy needle for liver solid mass was performed prospectively for patients who were failure to acquire a tissue or achieve a diagnosis using percutaneous liver biopsy. The primary outcome was the diagnostic accuracy of EUS-FNB for malignancy and specific tumor type. The secondary outcomes were the median numbers of passes required to establish a diagnosis, the proportions of patients in whom immunohistochemical (IHC) stain was possible and obtained adequate specimen, and safety of EUS-FNB. Twenty-one patients (12 women; mean age, 63 years [range, 37-81]) underwent EUS-FNB for solid liver masses. The median number of needle passes was 2.0 (range, 1-5). On-site cytology and cytology with Papanicolaou stain showed malignancy in 16 patients (76.2%) and 17 patients (81.0%), respectively. In histology with hematoxylin and eosin (H&E) stain, 19 patients (90.5%) were diagnosed malignancy and optimal to IHC stain. The overall diagnostic accuracy for malignancy and specific tumor type were 90.5% and 85.7%, respectively. No complications were seen. EUS-FNB with core biopsy needle for solid liver mass may be helpful in the management of patients who are unable to diagnose using percutaneous liver biopsy. This article is protected by copyright. All rights reserved.
    Journal of Gastroenterology and Hepatology 02/2015; DOI:10.1111/jgh.12922 · 3.63 Impact Factor
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    ABSTRACT: The effect of viral suppression on long-term disease outcome after decompensation in patients with hepatitis B virus (HBV)-related cirrhosis has not been established. The aim of this study was to determine the long-term effect of antiviral therapy in patients with HBV-related decompensated cirrhosis. This was a multicenter, prospective, inception cohort study of 707 patients who presented with first-onset decompensated complications, including 284 untreated patients and 423 antiviral-treated patients (58 previously treated, 253 with early treatment, and 112 with delayed treatment). The primary endpoint was 5-year liver transplantation (LT)-free survival. Secondary endpoints included virologic/serologic response and improvement in liver function. Despite baseline high HBV activity and worse liver function, antiviral-treated patients had significantly better transplant-free survival than untreated patients (5-year survival rates of 59.7% vs. 46.0%, respectively), with more apparent benefits from antivirals in Child-Turcotte-Pugh class B/C and high-viremia groups. The 5-year cumulative rate of virologic response and HBeAg seroconversion in antiviral-treated patients was 14.2% and 49.1%, respectively. A significant improvement in liver function was observed in treated versus untreated patients, with 33.9% of treated patients delisted for LT. Patients with early treatment had better clinical outcomes than those with delayed treatment. Survival was dependent on antiviral response, being significantly better in responders than in non-responders or untreated cases. The initial benefit of antiviral therapy was negated over time in non-responders. Antiviral treatment and maintained virologic response remained independently predictive of survival. The study results were corroborated by propensity score-matching analysis. Conclusion: Antiviral therapy significantly modifies the natural history of decompensated cirrhosis, improving liver function and increasing survival. The results underscore the importance of promptly administering potent antiviral drugs to patients under consideration for LT. This article is protected by copyright. All rights reserved.
    Hepatology 01/2015; DOI:10.1002/hep.27723 · 11.19 Impact Factor
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    ABSTRACT: Tenofovir disoproxil fumarate (TDF) plays a pivotal role in the management of drug-resistant chronic hepatitis B. However, it remains unclear whether TDF-nucleoside analogue combination therapy provides better outcomes than TDF monotherapy. This study aimed to compare the efficacy of TDF monotherapy with that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B. This retrospective cohort study included 76 patients receiving TDF-based rescue therapy for more than 12 months. Suboptimal response was defined as serum HBV-DNA level of >60 IU/mL during prior rescue therapy. Multi-drug resistance was defined as the presence of two or more drug resistance-related mutations confirmed by mutation detection assay. The relationship between baseline characteristics and virologic response (HBV DNA <20 IU/mL) at 12 months were evaluated using logistic regression analysis. Fifty-five patients (72.4%) were suboptimal responders to prior rescue therapy, and 26 (34.2%) had multi-drug resistance. Forty-two patients (55.3%) received combination therapy with nucleoside analogues. Virologic response at 12 months was not significantly different between the TDF monotherapy group and TDF-nucleoside analogue combination therapy group (p=0.098). The serum HBV DNA level was reduced to -4.49±1.67 log10 IU/mL in the TDF monotherapy group and to -3.97±1.69 log10 IU/mL in the TDF-nucleoside analogue combination therapy group at 12 months (p=0.18). In multivariate analysis, female sex (p=0.032), low baseline HBV-DNA level (p=0.013), and TDF monotherapy (p=0.046) were predictive factors for virologic response at 12 months. TDF monotherapy showed similar efficacy to that of TDF-nucleoside analogue combination therapy in patients with drug-resistant chronic hepatitis B. (Korean J Gastroenterol 2015;65:35-42).
    The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 01/2015; 65(1):35-42. DOI:10.4166/kjg.2015.65.1.35
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    ABSTRACT: The limited studies with F-fluorodeoxyglucose (F-FDG)-PET reported results and interpretations that differed between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (IHCC). We investigated the correlation between preoperative PET results and postoperative prognosis, including early (time-to-recurrence<6 months) tumor recurrence, and histopathological tumor differentiation in patients who had undergone surgery for primary malignant intrahepatic tumors, including HCC and IHCC. We retrospectively reviewed 357 patients who had undergone curative surgery for malignant hepatic tumors, including primary HCC or IHCC, other than Klatskin tumors at a tertiary academic hospital between January 2005 and June 2012. All patients had undergone an F-FDG PET/computed tomography scan preoperatively and the maximum standardized uptake value of the tumor (maxSUVtumor) and the tumor-to-nontumor SUV ratio (TNR) were calculated from F-FDG uptake. Histopathological differentiation grading was confirmed postoperatively. Among the patients, 115 cases with primary malignant intrahepatic tumors fulfilled the inclusion criteria. On univariate analysis, preoperative maxSUVtumor and TNR showed a correlation with the overall and early tumor recurrence of HCC, but only maxSUVtumor was associated with overall and early recurrence of IHCC (P<0.05). When considering postoperative histopathological differentiation, a correlation between maxSUVtumor and TNR with HCC and between maxSUVtumor and IHCC was found (P<0.05). However, on multivariate analysis, only early recurrence was associated with TNR in HCC and with maxSUVtumor in IHCC. A preoperative F-FDG PET scan can be considered a useful reference for postoperative tumor recurrence and histopathological differentiation in cases of primary malignant intrahepatic tumors. F-FDG PET scan results should be interpreted separately for malignant liver tumors.
    Nuclear Medicine Communications 01/2015; 36(4). DOI:10.1097/MNM.0000000000000254 · 1.37 Impact Factor
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    ABSTRACT: The prevalence of hepatitis C virus (HCV) infection in Korea exhibits significant geographic variation, with it being higher in Busan and Jeonam than in other areas. The reason for this intranational geographic difference was investigated in this study by conducting a comparative analysis of the risk factors related to HCV infection among three geographic areas: the capital (Seoul), Busan, and the province of Jeolla. In total, 990 patients with chronic HCV infection were prospectively enrolled at 5 university hospitals located in Seoul (n=374), Busan (n=264), and Jeolla (n=352). A standardized questionnaire survey on the risk factors for HCV infection was administered to these three groups of patients, and a comparative analysis of the findings was performed. The analysis revealed significant regional differences in exposure to the risk factors of HCV infection. By comparison with patients in Seoul as a control group in the multivariate analysis, patients in Busan had significantly more experience of invasive medical procedures, acupuncture, cosmetic procedures, and multiple sex partners. In contrast, patients in Jeolla were significantly older, and they had a higher prevalence of hepatocellular carcinoma, a lower prevalence of multiple sex partners, and had experienced fewer invasive procedures. There was a significant geographic difference in the exposure to potential risk factors of HCV infection between patients from the three studied regions. This may explain the regional variation of the prevalence of HCV infection in Korea, and should be taken into account when planning strategies for the prevention and management of HCV infection.
    12/2014; 20(4):361-7. DOI:10.3350/cmh.2014.20.4.361
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    ABSTRACT: To investigate the association between the baseline profiles and dynamics of hepatitis B virus (HBV) DNA polymerase gene mutations and the long-term virological response of lamivudine (LAM)-adefovir (ADV) combination therapy in patients with LAM-resistant chronic hepatitis B.
    Gut and liver 10/2014; DOI:10.5009/gnl14018 · 1.49 Impact Factor
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    ABSTRACT: Background & Aims Both corticosteroid and pentoxifylline reduce short-term mortality in severe alcoholic hepatitis. However, few studies have directly compared the efficacy of pentoxifylline and corticosteroid in patients with this condition. Methods In this multicentre, open-labelled, randomised non-inferiority trial, we assigned 121 patients with severe alcoholic hepatitis (Maddrey’s discriminant function ⩾32) to receive either pentoxifylline (400 mg, 3 times daily, in 62 subjects) or prednisolone (40 mg daily, in 59 subjects). The primary end point was non-inferiority in survival at the 1 month time point for the pentoxifylline treatment compared with prednisolone. Results The 1-month survival rate of patients receiving pentoxifylline was 75.8% (15 deaths) compared with 88.1% (7 deaths) in those, taking prednisolone, for a treatment difference of 12.3% (95% confidence interval, −4.2% to 28.7%; p = 0.08). The 95% confidence interval for the observed difference exceeded the predefined margin of non-inferiority (Δ15%) and included zero. The 6-month survival rate was not significantly different between the pentoxifylline and prednisolone groups (64.5% vs. 72.9%; p = 0.23). At 7 days, the response to therapy assessed by the Lille model was significantly lower in the prednisolone group (n = 58) than in the pentoxifylline group (n = 59): 0.35 vs. 0.50 (p = 0.012). Hepatitis complications, including hepatorenal syndrome and side effects, such as infection and gastrointestinal bleeding, were similar in the two groups. Conclusions The findings demonstrate that the efficacy of the pentoxifylline is not statistically equivalent to the efficacy of prednisolone, supporting the use of prednisolone as a preferred treatment option in patients with severe alcoholic hepatitis.
    Journal of Hepatology 10/2014; 61(4):792–798. DOI:10.1016/j.jhep.2014.05.014 · 10.40 Impact Factor
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    ABSTRACT: Purpose To evaluate the effects of total body irradiation (TBI), as a conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT), in pediatric acute leukemia patients. Materials and Methods From January 2001 to December 2011, 28 patients, aged less than 18 years, were treated with TBI-based conditioning for allo-SCT in our institution. Of the 28 patients, 21 patients were diagnosed with acute lymphoblastic leukemia (ALL, 75%) and 7 were diagnosed with acute myeloid leukemia (AML, 25%). TBI was completed 4 days or 1 day before stem cell infusion. Patients underwent radiation therapy with bilateral parallel opposing fields and 6-MV X-rays. The Kaplan-Meier method was used to calculate survival outcomes. Results The 2-year event-free survival and overall survival rates were 66% and 56%, respectively (71.4% and 60.0% in AML patients vs. 64.3% and 52.4% in ALL patients, respectively). Treatment related mortality rate were 25%. Acute and chronic graft-versus-host disease was a major complication; other complications included endocrine dysfunction and pulmonary complications. Common complications from TBI were nausea (89%) and cataracts (7.1%). Conclusion The efficacy and toxicity data in this study of TBI-based conditioning to pediatric acute leukemia patients were comparable with previous studies. However, clinicians need to focus on the acute and chronic complications related to allo-SCT.
    09/2014; 32(3):198-207. DOI:10.3857/roj.2014.32.3.198
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    ABSTRACT: BackgroundCurrently, breast conservation therapy is commonly performed for the treatment of early breast cancer. Depending on the volume excised, patients may require volume replacement, even in cases of partial mastectomy. The use of the latissimus dorsi muscle is the standard method, but this procedure leaves an unfavorable scar on the donor site. We used an endoscope for latissimus dorsi harvesting to minimize the incision, thus reducing postoperative scars.MethodsTen patients who underwent partial mastectomy and immediate partial breast reconstruction with endoscopic latissimus dorsi muscle flap harvest were reviewed retrospectively. The total operation time, hospital stay, and complications were reviewed. Postoperative scarring, overall shape of the reconstructed breast, and donor site deformity were assessed using a 10-point scale.ResultsIn the mean follow-up of 11 weeks, no tumor recurrence was reported. The mean operation time was 294.5 (±38.2) minutes. The postoperative hospital stay was 11.4 days. Donor site seroma was reported in four cases and managed by office aspiration and compressive dressing. Postoperative scarring, donor site deformity, and the overall shape of the neobreast were acceptable, scoring above 7.ConclusionsReplacement of 20% to 40% of breast volume in the upper and the lower outer quadrants with a latissimus dorsi muscle flap by using endoscopic harvesting is a good alternative reconstruction technique after partial mastectomy. Short incision benefits from a very acceptable postoperative scar, less pain, and early upper extremity movement.
    09/2014; 41(5):513-519. DOI:10.5999/aps.2014.41.5.513
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    ABSTRACT: Background: To compare dosimetric parameters of volumetric modulated arc therapy (VMAT) and non-coplanar intensity modulated radiotherapy (IMRT) for nasal cavity and paranasal sinus cancer with regard to the coverage of planning target volume (PTV) and the sparing of organs at risk (OAR). Methods: Ten patients with nasal cavity or paranasal sinus cancer were re-planned by VMAT (two-arc) plan and non-coplanar IMRT (7-, 11-, and 15-beam) plans. Planning objectives were to deliver 60 Gy in 30 fractions to 95% of PTV, with maximum doses (D-max) of <50 Gy to the optic nerves, optic chiasm, and brainstem, <40 Gy to the eyes and <10 Gy to the lenses. The target mean dose (D-mean) to the parotid glands was <25 Gy, and no constraints were applied to the lacrimal glands. Planning was optimized to minimized doses to OAR without compromising coverage of the PTV. VMAT and three non-coplanar IMRT (7-, 11-, and 15-beam) plans were compared using the heterogeneity and conformity indices (HI and CI) of the PTV, D-max and D-mean of the OAR, treatment delivery time, and monitor units (MUs). Results: The HI and CI of VMAT plan were superior to those of the 7-, 11-, and 15-beam non-coplanar IMRT. VMAT and non-coplanar IMRT (7-, 11-, and 15-beam) showed equivalent sparing effects for the optic nerves, optic chiasm, brainstem, and parotid glands. For the eyes and lenses, VMAT achieved equivalent or better sparing effects when compared with the non-coplanar IMRT plans. VMAT showed lower MUs and reduced treatment delivery time when compared with non-coplanar IMRT. Conclusions: In 10 patients with nasal cavity or paranasal sinus cancer, a VMAT plan provided better homogeneity and conformity for PTV than non-coplanar IMRT plans, with a shorter treatment delivery time, while achieving equal or better OAR-sparing effects and using fewer MUs.
    International Journal of Radiation OncologyBiologyPhysics 08/2014; 9(1):193. DOI:10.1186/1748-717X-9-193 · 4.18 Impact Factor
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    ABSTRACT: Global warming may induce an increase of active layer thickness in the Arctic region. The freezing and thawing of the active layer can damage infrastructures such as roads, railways, and embedded pipe lines in cold regions. A few methods, however, have been proposed to characterize the active layer. The objective of this study is to evaluate the characteristics of the active layer by laboratory and field tests, especially using the instrumented dynamic cone penetrometer (IDCP). Geographical and geological characteristics of Ny-Alesund, Svalbard are introduced, and the geotechnical properties, microstructure observations, and thermal properties of the Ny-Alesund soils are investigated. In addition, subsurface temperatures monitored for a year are discussed. The IDCP, which is able to measure the energies transferred into the rod head and the cone tip, is applied to the evaluation of the strength variation and the thickness of the active layer in Ny-Alesund. During dynamic penetration tests, the IDCP can produce profiles of the corrected cone tip resistance as well as the dynamic cone penetration index (DCPI). The results show that the active layer thickness estimated from the DCPI and corrected cone tip resistance profiles is approximately 1,700 mm. Furthermore, the bottom of the active layer significantly corresponds to that estimated by the maximum ground temperature profile with a soil thermal diffusivity of 5.5 · 10- 7 m2 · s- 1. This study represents the characteristics of Ny-Alesund soils investigated with a variety of laboratory tests, and suggests that the IDCP may be effectively used for active layer characterization.
    Cold Regions Science and Technology 08/2014; 104. DOI:10.1016/j.coldregions.2014.04.003 · 1.44 Impact Factor
  • Jinhong Jung, Geumju Park, Young Seok Kim
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    ABSTRACT: To evaluate the efficacy and toxicity of definitive extended-field intensity-modulated radiotherapy (EF-IMRT) with chemotherapy in cervical cancer with para-aortic lymph node (PAN) metastasis.
    Anticancer research 08/2014; 34(8):4361-6. · 1.87 Impact Factor
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    ABSTRACT: Chronic hepatocellular damage is closely associated with hepatic fibrosis and fatal complication in most liver diseases. The aim of this study is to compare the efficacy and safety of biphenyl dimethyl dicarboxylate (DDB) and ursodeoxycholic acid (UDCA) in patients with abnormal ALT.
    The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 07/2014; 64(1):31-9. DOI:10.4166/kjg.2014.64.1.31
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    ABSTRACT: Background The aim of this study was to compare the efficacy of hepatic arterial infusion chemotherapy (HAIC) and sorafenib in advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). Methods A total of 110 patients were observed between February 2008 and May 2013 in seven Korean centers. Fifty patients were treated with HAIC, and 60 patients were treated with sorafenib. Results The disease control rate in the HAIC was significantly higher than that in the sorafenib group (p p = 0.214). The median overall survival (OS) was significantly longer in the HAIC group than in the sorafenib group (7.1 vs. 5.5 months, p = 0.011). The median time to-progression (TTP) was also significantly longer in the HAIC group than in the sorafenib group (3.3 vs. 2.1 months, p = 0.034). In the multivariate analysis, tumor diameter (≥ 10 cm) and the absence of combined loco-regional treatment were significant prognostic factors influencing OS (p = 0.002 and p = 0.010, respectively) and TTP (p = 0.017 and p = 0.006, respectively). The treatment modality tended to be a significant prognostic factor for survival (p = 0.052), but not for tumor progression (p = 0.121). Conclusions HAIC is comparable with sorafenib in terms of OS and TTP in advanced HCC patients with PVTT. HAIC shows more favorable treatment responses compared with sorafenib. Therefore, HAIC might be an alternative treatment modality to sorafenib in advanced HCC patients with PVTT.
    Journal of Gastroenterology 07/2014; 50(4). DOI:10.1007/s00535-014-0978-3 · 4.02 Impact Factor
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    ABSTRACT: Choledocholithiasis is one of the causes of jaundice and may require urgent treatment. Endoscopic retrograde cholangiopancreatography (ERCP) has been the primary management strategy for choledocholithiasis. However, small stones can be overlooked during ERCP. The aim of this study was to evaluate the accuracy of intraductal ultrasonography (IDUS) for detecting choledocholithiasis in icteric patients with highly suspected common bile duct (CBD) stones without definite stone diagnosis on ERCP. Ninety-five icteric (bilirubin a parts per thousand yen3 mg/dL) patients who underwent ERCP for highly suspected choledocholithiasis without definite filling defects on cholangiography were prospectively enrolled in the present study. We evaluated the bile duct using IDUS for the presence of stones or sludge. Reference standard for choledocholithiasis was endoscopic extraction of stone or sludge. Bile duct stones were detected with IDUS in 31 of 95 patients (32.6 %). IDUS findings were confirmed by endoscopic stone extraction in all patients. The mean diameter of CBD stones detected by IDUS was 2.9 mm (range 1-7 mm). IDUS revealed biliary sludge in 24 patients (25.2 %) which was confirmed by sludge extraction in 21 patients (87.5 %). In dilated CBD, detection rate of bile duct stone/sludge based on IDUS was significantly higher than in non-dilated CBD (p = 0.004). IDUS is useful for the detection of occult CBD stone on ERCP in icteric patients with highly suspected CBD stones.
    Digestive Diseases and Sciences 07/2014; 59(8). DOI:10.1007/s10620-014-3127-1 · 2.55 Impact Factor
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    ABSTRACT: Hepatitis C virus (HCV) infection causes chronic liver diseases leading to hepatocellular carcinoma (HCC) and liver failure. We have previously shown that HCV sensitizes hepatocytes to mitochondrial apoptosis via the TRAIL death receptors DR4 and DR5. Although TRAIL and its receptors are selective targets for cancer therapy, their potential against HCC with chronic HCV infection has not been explored yet. Here we show that HCV induces DR4/DR5-dependent activation of caspase-8 leading to elevation of apoptotic signaling in infected cells and also present TRAIL effect in HCV-induced apoptotic signaling. HCV induced proteolytic cleavage of caspase-9 by stimulating DR4 and DR5, resulting in subsequent cleavage of caspase-3. Further, HCV-induced proteolytic cleavage in caspase-8, caspase-9, and caspase-3 was enhanced in the presence of recombinant TRAIL. HCV-induced cleavage in caspase-9 and increase in caspase-3/7 activity was completely suppressed by silencing of either DR4 or DR5. Perturbing DR4/DR5-caspase-8 signaling complex by silencing DR4 and DR5 or by chemical inhibitor specific to caspase-8 led to decrease of HCV-induced cleavage of poly(ADP-ribose) polymerase (PARP), a substrate for caspase-3 during apoptosis, indicating the functional role of caspase-8 in HCV-induced apoptotic signaling network. Furthermore, TRAIL enhanced PARP cleavage in apoptotic response induced by HCV infection, indicating the effect of TRAIL for the induction of selective apoptosis of HCC cells infected with HCV. Given the importance of apoptosis in HCC development, our data suggest that HCV-induced DR4 and DR5 may be considered as an attractive target for TRAIL therapy against HCC with chronic HCV infection.
    PLoS ONE 06/2014; 9(6):e98171. DOI:10.1371/journal.pone.0098171 · 3.53 Impact Factor

Publication Stats

1k Citations
489.25 Total Impact Points

Institutions

  • 2012–2015
    • Korea Institute of Construction Technology
      Kōyō, Gyeonggi-do, South Korea
    • Seoul National University
      • Department of Materials Science and Engineering
      Sŏul, Seoul, South Korea
  • 2007–2015
    • Soonchunhyang University
      • College of Medicine
      Onyang, Chungcheongnam-do, South Korea
  • 2011–2014
    • Ulsan University Hospital
      Urusan, Ulsan, South Korea
  • 2008–2014
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
    • Yonsei University
      • Department of Plastic & Reconstructive Surgery
      Sŏul, Seoul, South Korea
    • Yuhan College
      South Korea
  • 2003–2014
    • University of Ulsan
      • • College of Medicine
      • • Department of Radiation Oncology
      Urusan, Ulsan, South Korea
  • 2013
    • Hallym University
      Sŏul, Seoul, South Korea
    • Korea Electronics Technology Institute
      • Display Components and Materials Research Center
      Sŏngnam, Gyeonggi Province, South Korea
    • Sungkyunkwan University
      Sŏul, Seoul, South Korea
    • Chungnam National University Hospital
      Sŏul, Seoul, South Korea
  • 2009–2013
    • Asan Medical Center
      • • Department of Pathology
      • • Department of Urology
      Sŏul, Seoul, South Korea
    • Chung-Ang University Hospital
      Sŏul, Seoul, South Korea
    • Chung-Ang University
      Sŏul, Seoul, South Korea
  • 2004–2013
    • Soon Chun Hyang University Hospital
      • Department of Gastroenterology
      Sŏul, Seoul, South Korea
  • 2009–2010
    • University of Massachusetts Amherst
      • Department of Chemical Engineering
      Amherst Center, Massachusetts, United States
  • 2008–2010
    • Korea Institute of Industrial Technology
      Anzan, Gyeonggi Province, South Korea
  • 2006–2010
    • University of Florida
      • Department of Chemical Engineering
      Gainesville, FL, United States
    • Gachon University
      • Gil Medical Center
      Seongnam, Gyeonggi, South Korea
  • 2006–2007
    • Inha University
      • Department of Chemistry
      Seoul, Seoul, South Korea
  • 2003–2005
    • Korea University
      • Department of Chemical and Biological Engineering
      Sŏul, Seoul, South Korea