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Articles by D. Y Kim
Total Records ( 7 ) for D. Y Kim
  C. H Lee , J. H Mo , I. J Choi , H. J Lee , B. S Seo , D. Y Kim , P. Y Yun , I. Y Yoon , H Won Lee and J. W. Kim

Objectives  To evaluate retrospectively the efficacy of the mandibular advancement device (MAD) in Korean patients with obstructive sleep apnea (OSA) in terms of severity and to evaluate prognostic factors deciding the success of MAD application.

Design  Retrospective analysis.

Setting  Academic tertiary referral center.

Patients  Of 142 patients who underwent MAD application for OSA management, 50 (46 men and 4 women; mean [SD] age, 50.2 [9.8] years) were included from March 2005 through August 2007.

Intervention  Full-overnight polysomnography was performed before and at least 3 months after intraoral MAD application in 50 patients. Questionnaires for sleep quality, Epworth sleepiness scale, and cephalometry were also studied.

Main Outcome Measures  Treatment results were evaluated and prognostic factors deciding success of MAD application were assessed.

Results  The mean (SD) apnea-hypopnea index (AHI) decreased significantly (P < .001) from 36.6 (18.9) to 12.3 (11.4). The success rate, defined by an AHI of lower than 20 and a 50% decrease in AHI, were 74% (37 of 50 patients). Even patients who were not categorized into the success group had a decreased AHI. The success rates of patients with mild, moderate, and severe OSA were 43% (3 of 7), 82% (22 of 27), and 75% (12 of 16), respectively, and a higher success rate in patients with severe OSA showed that MAD could be applied even in patients with severe OSA. The duration of apnea and hypopnea, percentage of patients with snoring, and the Pittsburgh Sleep Quality Index were improved significantly after treatment. Epworth sleepiness scale scores and lowest oxygen saturation did not change significantly. An analysis of prognostic factors did not reveal any significant difference between the success and nonsuccess groups.

Conclusions  The application of MAD significantly improved nocturnal respiratory function and sleep quality in patients with OSA, even in patients with severe OSA. In patients with OSA, MAD can be used as a good alternative treatment modality regardless of severity because it is noninvasive, easy to manufacture, and has good treatment results.

  C. H Lee , J. W Kim , H. J Lee , P. Y Yun , D. Y Kim , B. S Seo , I. Y Yoon and J. H. Mo

Objective  To quantitatively evaluate the effects of the mandibular advancement device (MAD) on changes in the upper respiratory tract during sleep using sleep videofluoroscopy (SVF) in patients with obstructive sleep apnea (OSA).

Design  Retrospective analysis.

Setting  Academic tertiary referral center.

Patients  Seventy-six patients (68 men and 8 women) who were treated with the MAD for OSA were included from September 1, 2005, through August 31, 2008.

Intervention  All patients underwent nocturnal polysomnography and SVF before and at least 3 months after receipt of the custom-made MAD. Sleep videofluoroscopy was performed before and after sleep induction and was analyzed during 3 states of awakeness, normoxygenation sleep, and desaturation sleep.

Main Outcome Measures  Changes in the length of the soft palate, retropalatal space, retrolingual space, and angle of mouth opening were evaluated during sleep events with or without the MAD.

Results  Without the MAD, the length of the soft palate and the angle of mouth opening increased during sleep events, especially in desaturation sleep, compared with the awake state. The retropalatal space and retrolingual space became much narrower during sleep compared with the awake state. The MAD had marked effects on the length of the soft palate, retropalatal space, retrolingual space, and angle of mouth opening. The retropalatal space and retrolingual space were widened, and the length of the soft palate was decreased. The MAD kept the mouth closed.

Conclusions  Sleep videofluoroscopy showed dynamic upper airway changes in patients with OSA, and the MAD exerted multiple effects on the size and configuration of the airway. Sleep videofluoroscopy demonstrated the mechanism of action of the MAD in patients with OSA. The MAD increased the retropalatal and retrolingual spaces and decreased the length of the soft palate and the angle of mouth opening, resulting in improvement of OSA.

  H. J Jeon , J. H Choi , I. H Jung , J. G Park , M. R Lee , M. N Lee , B Kim , J. Y Yoo , S. J Jeong , D. Y Kim , J. E Park , H. Y Park , K Kwack , B. K Choi , B. S Kwon and G. T. Oh

Background— The tumor necrosis factor receptor superfamily, which includes CD40, LIGHT, and OX40, plays important roles in atherosclerosis. CD137 (4-1BB), a member of the tumor necrosis factor receptor superfamily, has been reported to be expressed in human atherosclerotic lesions. However, limited information is available on the precise role of CD137 in atherosclerosis and the effects of blocking CD137/CD137 ligand signaling on lesion formation.

Methods and Results— We generated CD137-deficient apolipoprotein E–knockout mice (ApoE–/– CD137–/–) and LDL-receptor–knockout mice (Ldlr–/–CD137–/–) to investigate the role of CD137 in atherogenesis. The deficiency of CD137 induced a reduction in atherosclerotic plaque lesions in both atherosclerosis mouse models, which was attributed to the downregulation of cytokines such as interferon-, monocyte chemoattractant protein-1, and tumor necrosis factor-. CD137 signaling promoted the production of inflammatory molecules, including monocyte chemoattractant protein-1, interleukin-6, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1, in endothelial cells. Stimulation of CD137 ligand signaling activated monocytes/macrophages and augmented the production of proinflammatory cytokines in atherosclerotic vessels.

Conclusions— CD137/CD137 ligand signaling plays multiple roles in the progression of atherosclerosis, and thus, blockade of this pathway is a promising therapeutic target for the disease.

  K. C Chun , D. Y Kim , J. H Kim , Y. M Kim , Y. T Kim and J. H. Nam

To date, only seven women with Stage Ib1 to IIb cervical cancer during pregnancy treated with neoadjuvant chemotherapy followed by radical surgery have been reported. We describe three cases of pregnant women with Stage Ib1 to IIa cervical cancer who were treated with paclitaxel plus platinum neoadjuvant chemotherapy followed by radical surgery. The first patient had a Stage Ib1 small cell neuroendocrine carcinoma of the cervix, the second had a Stage IIa, 8 cm squamous cell carcinoma of the cervix and the third had a Stage Ib2 squamous cell carcinoma and positive lymph nodes. The three patients and their newborns were followed up. All patients had a partial or complete response to neoadjuvant chemotherapy. Two of these patients developed recurrences and one died due to progressive disease at 49 months. All neonates were healthy and had no abnormalities. In conclusion, neoadjuvant chemotherapy with paclitaxel and platinum followed by radical surgery may be an option for pregnant women with invasive cervical cancer.

  S. G Yeo , D. Y Kim , T. H Kim , S. Y Kim , H. J Chang , J. W Park , H. S Choi and J. H. Oh

To investigate the long-term outcomes of selected patients with cT3 distal rectal cancer treated with local excision following pre-operative chemoradiotherapy.


Between January 2003 and February 2008, 11 patients with cT3 distal rectal cancer received a local excision following pre-operative chemoradiotherapy. The median age of the patients was 61 years (range, 42–71). The median tumor size was 3 cm (range, 2–5), and the median distance of the caudal tumor edge from the anal verge was 3 cm (range, 1–4). Clinical lymph node status was positive in five patients. Pre-operative chemoradiotherapy consisted of a 50.4 Gy in 28 fractions with concurrent chemotherapy. A transanal full-thickness local excision was performed after a median of 54 days (range, 31–90) from chemoradiotherapy completion. Ten patients received post-operative chemotherapy.


Pathologically complete responses occurred in eight patients, ypT1 in two and ypT2 in one. The pathologic tumor size for three ypT1–2 tumors was 0.9, 1.1 and 2.2 cm. The follow-up period was a median of 59 months (range, 24–85). One patient (ypT0) developed recurrence at the excision site 14 months after surgery, but was successfully salvaged with an abdominoperineal resection and adjuvant chemotherapy. Another patient (ypT2) developed bone metastasis after 8 months and died of the disease. The 5-year local recurrence-free, disease-free and overall survival rates were 90.9%, 81.8% and 88.9%, respectively. No Grade 3 or worse gastrointestinal toxicity was detected.


Full-thickness local excision following chemoradiotherapy may be an acceptable option for cT3 distal rectal cancer that responds well to chemoradiotherapy.

  T Nagatake , S Fukuyama , D. Y Kim , K Goda , O Igarashi , S Sato , T Nochi , H Sagara , Y Yokota , A. M Jetten , T Kaisho , S Akira , H Mimuro , C Sasakawa , Y Fukui , K Fujihashi , T Akiyama , J. i Inoue , J. M Penninger , J Kunisawa and H. Kiyono

The eye is protected by the ocular immunosurveillance system. We show that tear duct–associated lymphoid tissue (TALT) is located in the mouse lacrimal sac and shares immunological characteristics with mucosa-associated lymphoid tissues (MALTs), including the presence of M cells and immunocompetent cells for antigen uptake and subsequent generation of mucosal immune responses against ocularly encountered antigens and bacteria such as Pseudomonas aeruginosa. Initiation of TALT genesis began postnatally; it occurred even in germ-free conditions and was independent of signaling through organogenesis regulators, including inhibitor of DNA binding/differentiation 2, retinoic acid–related orphan receptor t, lymphotoxin (LT) 1β2–LTβR, and lymphoid chemokines (CCL19, CCL21, and CXCL13). Thus, TALT shares immunological features with MALT but has a distinct tissue genesis mechanism and plays a key role in ocular immunity.

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