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Juwhan Choi,이승룡 대한면역학회 2020 Immune Network Vol.20 No.1
Immune checkpoint inhibitors (ICIs) have been changing the paradigm of cancer treatment. However, immune-related adverse effects (irAEs) have also increased with the exponential increase in the use of ICIs. ICIs can break up the immunologic homeostasis and reduce T-cell tolerance. Therefore, inhibition of immune checkpoint can lead to the activation of autoreactive T-cells, resulting in various irAEs similar to autoimmune diseases. Gastrointestinal toxicity, endocrine toxicity, and dermatologic toxicity are common side effects. Neurotoxicity, cardiotoxicity, and pulmonary toxicity are relatively rare but can be fatal. ICI-related gastrointestinal toxicity, dermatologic toxicity, and hypophysitis are more common with anti- CTLA-4 agents. ICI-related pulmonary toxicity, thyroid dysfunction, and myasthenia gravis are more common with PD-1/PD-L1 inhibitors. Treatment with systemic steroids is the principal strategy against irAEs. The use of immune-modulatory agents should be considered in case of no response to the steroid therapy. Treatment under the supervision of multidisciplinary specialists is also essential, because the symptoms and treatments of irAEs could involve many organs. Thus, this review focuses on the mechanism, clinical presentation, incidence, and treatment of various irAEs.
( Juwhan Choi ),( Jee Youn Oh ),( Young Seok Lee ),( Kyung Hoon Min ),( Jae Jeong Shim ),( Sue In Choi ),( Dong Won Park ),( Chan Kwon Park ),( Eun Joo Kang ),( Hwan Seok Yong ),( Bong Kyung Shin ),( 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.1
Background/Aims: Adjuvant chemotherapy is the standard of care for resected stage II-IIIA non-small cell lung cancer (NCSLC). The efficacy of adjuvant chemotherapy in stage IB (< 4 cm) NSCLC with high-risk factors is controversial. Methods: This retrospective multicenter study included 285 stage IB NSCLC patients with high-risk factors according to the 8th edition tumor, node, metastasis (TNM) classification from four academic hospitals. High-risk factors included visceral pleural invasion, vascular invasion, lymphatic invasion, lung neuroendocrine tumors, and micropapillary histology patterns. Results: Of the 285 patients, 127 (44.6%) were included in the adjuvant chemotherapy group and 158 (55.4%) were included in the non-adjuvant chemotherapy group. The median follow-up was 41.5 months. Patients in the adjuvant chemotherapy group had a significantly reduced recurrence rate and risk of mortality than those in the non-adjuvant chemotherapy group (hazards ratio, 0.408; 95% confidence interval, 0.221 to 0.754; p = 0.004 and hazards ratio, 0.176; 95% confidence interval, 0.057 to 0.546; p = 0.003, respectively). Adjuvant chemotherapy should be particularly considered for the high-risk factors such as visceral pleural involvement or vascular invasion. Based on the subgroup analysis, adjuvant chemotherapy should be considered when visceral pleural involvement is present, even if the tumor size is < 3 cm. Conclusions: Adjuvant chemotherapy may be useful for patients with stage IB NSCLC with high-risk factors and is more relevant for patients with visceral pleural involvement or vascular invasion.
Usefulness of adjuvant chemotherapy in Stage IB NSCLC with high risk factor
( Juwhan Choi ),( Jee Youn Oh ),( Young Seok Lee ),( Kyung Hoon Min ),( Jae Jeong Shim ),( Sue In Choi ),( Dong Won Park ),( Chan Kwon Park ),( Eun Joo Kang ),( Hwan Seok Yong ),( Bong Kyung Shin ),( 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-
Purpose: The efficacy of adjuvant chemotherapy in stage IB non-small-cell lung cancer (NSCLC) with high-risk factors remains unclear and is the focus of our study. Methods: This was a retrospective multi-center study of four academic hospitals. We analyzed 285 stage IB NSCLC patients with high-risk factors according to the 8th edition TNM classification. High-risk factors were visceral pleural invasion, vascular invasion, lymphatic invasion, lung neuroendocrine tumors, and micropapillary histology pattern. We used a Kaplan-Meier survival curve and Cox proportional hazards model to analyze recurrence- free survival and overall survival. Results: Of the 285 cases, 127 (44.6%) were in the adjuvant chemotherapy group and 158 (55.4%) were in the non-adjuvant chemotherapy group (control group). Mean follow-up was 40.2 ± 18.1 months, and median follow-up was 41.5 months. Adjuvant chemotherapy significantly reduced the recurrence risk compared to the control group (Hazards ratio, 0.362; 95% Confidence interval, 0.195-0.672; P = 0.001) and the risk of death compared to the control group (Hazards ratio, 0.155; 95% Confidence interval, 0.050-0.478; P = 0.001). A higher risk of recurrence was found with a larger tumor size and a greater number of risk factors (P = 0.012, P < 0.001, respectively). The risk of death increased when vascular invasion, smoking, or multiple risk factors were present (P = 0.043, P < 0.001, P = 0.048, respectively). Conclusion: Adjuvant chemotherapy may be useful for patients with stage IB NSCLC with high-risk factors and more relevant for patients with larger tumors and multiple risk factors.
Juwhan Lee,Sung-Tae Kim,Yong Woo Shim,Jin Wook Back,Jung Hae Ko,이원희,Sung Hwa Paeng,Se Young Pyo,Young Jin Heo,Hae Woong Jeong,정영균 대한뇌혈관외과학회 2020 Journal of Cerebrovascular and Endovascular Neuros Vol.22 No.3
Objective: Microsurgical treatment could be a good alternative for the treatment of recurrent cerebral aneurysm after coil embolization. The purpose of this study was to present our experience of microsurgical treatment for recurrent cerebral aneurysm previously treated using coil embolization. Methods: From June 2012 to May 2019, 34 patients consecutively received microsurgical treatment for a recurrent cerebral aneurysm previously treated using coil embolization after it ruptured. Results: Of the 34 patients with aneurysm, 33 had the aneurysm located in the anterior circulation. The most common location was the anterior communicating artery (13 cases). Immediate radiologic outcome at coil embolization was completed (n=6), residual neck (n=26), and residual sac (n=2). The reason for microsurgical treatment included rebleeding (n=12), persistent residual sac (n=1), and recurrence on follow-up study (n=21). Rebleeding occurred within 10 days after coil embolization in 10 cases, and the other 2 were due to regrowth. In the 20 recurred and saccular aneurysms, coil compaction was present in 11 aneurysms and regrowth in 9 aneurysms. Simple neck clipping (n=29) and clipping with coil mass extraction (n=3) was possible in the saccular aneurysms. The blood blister like aneurysm (n=2) were treated using bypass and endovascular internal carotid artery trapping. In the follow-up study group after microsurgical treatment there were no severe complications due to the treatment. Age, cause of retreatment, and modified Rankin Scale before microsurgery were associated with good outcome (p<0.001). Conclusions: Microsurgical treatment may be a viable and effective option for treating recurrent aneurysms previously treated by endovascular techniques.
( Juwhan Choi ),( Sung Yong Lee ),( Zepa Yang ),( Jinhwan Lee ),( Jun Hee Lee ),( Hyun Koo Kim ),( Hwan Seok Yong ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Purpose The usefulness of pulmonary rehabilitation in patients with reduced lung function before lung surgery remains unclear, and there is no adequate method for evaluating the effect of rehabilitation. We aimed to evaluate the usefulness of rehabilitation in patients with non-small cell lung cancer (NSCLC) undergoing lung cancer surgery. Materials and Materials and Methods We retrospectively analyzed the medical records of patients with NSCLC who underwent lung surgery at Korea University Guro Hospital between 2018 and 2020. Patients were divided into two groups depending on whether they underwent pulmonary rehabilitation. Pulmonary function test (PFT) data and muscle index determined using chest computed tomography (CT) images were analyzed. Because the baseline characteristics were different between the two groups, propensity score matching was performed. Results Of 325 patients, 75 (23.1%) and 250 (76.9%) were included in the rehabilitation and non-rehabilitation (control) groups, respectively. The rehabilitation group had a worse general condition at baseline. After propensity score matching, 45 patients remained in each group. Pulmonary function (forced expiratory volume in 1 s, %) (P = 0.001) and the muscle index (P = 0.001) were better preserved in the rehabilitation group. Muscle loss of 3.4% and 0.6% was observed in the control and rehabilitation groups, respectively (P = 0.003). In addition, the incidence of embolic events was low in the rehabilitation group (P = 0.044). Conclusion Pulmonary rehabilitation is useful in patients with NSCLC undergoing lung surgery. Pulmonary rehabilitation preserves lung function, muscle and reduces embolic events after surgery. Pulmonary rehabilitation is recommended for patients with NSCLC undergoing surgery.
Kim, Juwhan,CoIIins, Kevin R.,Lim, Yun Mook Techno-Press 2007 Structural Engineering and Mechanics, An Int'l Jou Vol.25 No.6
A formula to approximate the fundamental period of a fixed-free mass-spring system with varying mass and varying stiffness is formulated. The formula is derived mainly by taking the dominant parts from the general form of the characteristic polynomial, and adjusting the initial approximation by a coefficient derived from the exact solution of a uniform case. The formula is tested for a large number of randomly generated structures, and the results show that the approximated fundamental periods are within the error range of 4% with 90% of confidence. Also, the error is shown to be normally distributed with zero mean, and the width of the distribution (as measured by the standard deviation) tends to decrease as the total number of discretized elements in the system increases. Other possible extensions of the formula are discussed, including an extension to a continuous cantilever structure with distributed mass and stiffness. The suggested formula provides an efficient way to estimate the fundamental period of building structures and other systems that can be modeled as mass-spring systems.
송주환(Juwhan Song) 한국정보기술학회 2018 한국정보기술학회논문지 Vol.16 No.5
In this paper, we propose a content-based image retrieval system using hue and value of the HSV color model and edge orientation. The proposed algorithm converts an RGB color image into an HSV color image, and then finds the edge orientation using the hue and the value. The values, which are obtained by quantizing the hue, value, and edge orientation, respectively, are defined as feature vectors of the image. The feature vectors of each image are stored in the database and then compared with the feature vector of the input image. The retrieval performance was tested using 1000 images of Corel 1000 database. Experimental results show that the proposed method retrieves images more effectively than the standard color histogram method, the color difference histogram method, and the color corelogram method. The average precision for the top 20 was 0.06, 0.01, and 0.10 higher than the comparison methods.