11370 Anderson St Suite 2100
Loma Linda CA 92354
Medical School: University Of Michigan Medical School - 1994
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: Yes
Participates In EHR: No
License #: A75393
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Awards & Recognitions
Dr. John Kim is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:31575||Description:Diagnostic laryngoscopy||Average Price:$326.11||Average Price Allowed
|HCPCS Code:99203||Description:Office/outpatient visit new||Average Price:$289.25||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$177.00||Average Price Allowed
HCPCS Code Definitions
- Laryngoscopy, flexible fiberoptic; diagnostic
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
Medical Malpractice Cases
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Kim has made to other doctors
Readmission After Hysterectomy is Highly Correlated to Reoperation, Morbidity, and Mortality . - Obstetrics and gynecology
Although the rates of readmission after hysterectomy have been reported, risk factors and morbidity associated with readmission are not well-defined.We identified women undergoing hysterectomy for benign indications between 2011 and 2012 in the American College of Surgeons National Surgical Quality Improvement Program database. Outcomes of interest included rates of 30-day unscheduled readmission, risk factors for readmission, and morbidity and mortality rates associated with readmission. Multivariable logistic regression analyses were performed to identify independent risk factors for readmission.Of the 21,228 hysterectomies identified, 658 patients (3.1%) required unscheduled readmission within 30 days. Perioperative complications were more likely in patients requiring readmission (49.2% compared with 6.1%, P<.001), most commonly surgical site infection (28.4%) and sepsis (12.8%). Reoperation (26.3% compared with 0.6%, P<.001) and mortality (0.01% compared with 0.3%, P<.001) were markedly increased in patients requiring readmission. After multivariable analysis, independent risk factors for readmission included longer operative time, younger age, smoking, diabetes, dyspnea, bleeding disorders, higher ASA (American Society of Anesthesiologists) level, previous surgery within 30 days of hysterectomy, and longer length of stay. Anesthesia type, resident physician involvement, hysterectomy type, and work relative value units did not independently affect readmission.Readmission after hysterectomy was associated with a 40-fold increase in reoperation and 30-fold increase in mortality. Surgeons should counsel patients toward smoking cessation, strive to minimize operative time, and consider delaying nonemergent hysterectomy for benign indications in patients with uncontrolled comorbidities or recent surgery. Future research should aim to further delineate modifiable risk factors for readmission.
Operative Time Longer Than 240 Minutes is Predictive of 30-Day Complications After Vaginal Hysterectomy . - Obstetrics and gynecology
The relationship between operative time and morbidity is incompletely understood in gynecology. We aimed to evaluate the effect of operative time on 30-day complication rates after vaginal hysterectomy.Patients undergoing vaginal hysterectomy for benign indications from 2005 to 2012 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Clinical characteristics and complications were compared for patients with operative time shorter and longer than 240 minutes. Multivariable analysis was performed to determine the independent effect of operative time on complications.A total of 10,311 vaginal hysterectomies were identified. Complications increased significantly as surgical duration increased, with an inflection point at 240 minutes. Characteristics associated with operative time longer than 240 minutes included older age, nonsmoking status, hypertension, chronic obstructive pulmonary disease, higher ASA (American Society of Anesthesiologists) level, higher relative value units average, inpatient status, general anesthesia, and resident physician involvement. Operative time longer than 240 minutes was associated with increased rates of overall complications (15.7% compared with 6.7%, P<.001), medical complications (13.5% compared with 5.6%, P<.001), urinary tract infection (UTI; 8.9% compared with 3.5%, P<.001), blood transfusion (4.3% compared with 1.5%, P<.001), and reoperation (2.9% compared with 1.2%, P=.02), although mortality rates were similar (0% compared with 0.4%, P=.74). After multivariable analysis, longer operative time independently predicted overall complications, medical complications, UTI, and reoperation.We demonstrated that operative time longer than 4 hours during vaginal hysterectomy is predictive of 30-day overall complications, medical complications, UTI, and reoperation. Future research should aim to identify modifiable contributors to prolonged operative time.
Salivary duct carcinoma: Treatment, outcomes and patterns of failure. - Head & neck
Salivary duct carcinoma (SDC) is rare, with distinct morphology and behaviour. We reviewed our institutional experience with SDC, aiming to characterise clinical behaviour and treatment outcomes.All SDC treated curatively between 1999-2010 were reviewed. Overall survival (OS), locoregional control (LRC), distant control (DC) and patterns of failure were analysed. Multivariate analysis identified predictors of overall survival.Fifty-four SDC (parotid gland: 49; submandibular gland: 5) patients were included in the analysis. 53 patients underwent primary surgery, and 48 (89%) received post-operative radiotherapy (median dose 60Gy). Median follow-up 5.7 years. The 5-year OS, LRC, and DC were 43%, 70%, and 48% respectively. Nine local (6 involving facial nerve), 10 regional, and 28 distant failures were identified. Multiple pathologic involved lymph nodes (pN2b/N2c) predicted reduced OS (HR=3.6, p=0.02).Distant recurrence is common. Presence of pN2b/N2c disease is associated with reduced OS. Local recurrence frequently involved facial nerve. This article is protected by copyright. All rights reserved.Â© 2015 Wiley Periodicals, Inc.
Seroprevalence of human T-cell lymphotropic viruses types 1 and 2 antibodies in hepatitis C virus-positive patients: manitoba, Canada, 2012-2014. - Open forum infectious diseases
Human T-cell lymphotropic viruses types 1 and 2 are probably among the most neglected blood-borne pathogens that have experienced significant changes in their epidemiology since discovery, which could be attributed to globalization and intravenous drug use practices as well as enhanced screening recommendations; however, systematic prevalence studies, especially in high-risk populations in North America, are not updated.
Extra-pulmonary small cell carcinoma in the head and neck setting: The role of prophylactic cranial irradiation. - Oral oncology
Head-and-neck small cell carcinoma (HN-SmCC) is a rare entity and there is limited data to support management decisions. The role of prophylactic cranial irradiation (PCI) remains controversial. A retrospective review of 21 consecutive HN-SmCCs was performed. No case received PCI. The 2-year overall survival, local, regional and distant control rates were 65%, 94%, 88%, and 76% respectively. Despite no patient receiving PCI, brain metastases were uncommon (n=2) and routine use of PCI is not justified in this population.Copyright Â© 2015 Elsevier Ltd. All rights reserved.
Alternative CD44 splicing identifies epithelial prostate cancer cells from the mesenchymal counterparts. - Medical oncology (Northwood, London, England)
An epithelial to mesenchymal transition (EMT) has been shown to be a necessary precursor to prostate cancer metastasis. Additionally, the differential expression and splicing of mRNAs has been identified as a key means to distinguish epithelial from mesenchymal cells by qPCR, western blotting and immunohistochemistry. However, few markers exist to differentiate between these cells by flow cytometry. We previously developed two cell lines, PC3-Epi (epithelial) and PC3-EMT (mesenchymal). RNAseq was used to determine the differential expression of membrane proteins on PC3-Epi/EMT. We used western blotting, qPCR and flow cytometry to validate the RNAseq results. CD44 was one of six membrane proteins found to be differentially spliced between epithelial and mesenchymal PC3 cells. Although total CD44 was positive in all PC3-Epi/EMT cells, PC3-Epi cells had a higher level of CD44v6 (CD44 variant exon 6). CD44v6 was able to differentiate epithelial from mesenchymal prostate cancer cells using either flow cytometry, western blotting or qPCR.
Reducing margins of wide local excision in head and neck melanoma for function and cosmesis: 5-year local recurrence-free survival. - Journal of surgical oncology
The proximity of head and neck (H&N) melanomas to critical anatomical structures requires that surgeons achieve a balance between adequate margins of excision and the functional and cosmetic needs of patients. This study sought to determine the risk associated with reducing margins of wide local excision (WLE) in H&N melanoma and to identify risk factors of recurrence.Seventy-nine cases of primary, invasive H&N melanoma were treated by WLE and followed prospectively for local recurrence. Forty-two WLEs were performed according to current practice guidelines (1cm for lesions<1.0â€‰mm thick, 1-2â€‰cm for lesions 1.01-2.0â€‰mm thick, and 2â€‰cm for lesions >2.0â€‰mm thick). Reduced margins (0.5â€‰cm for lesions â‰¤1.0â€‰mm thick, 0.5-1.0â€‰cm for lesions 1.01-2.0â€‰mm thick, and 1.0â€‰cm for lesion >2.0â€‰mm thick) were utilized in 37 cases to preserve critical anatomical structures such as the eyelid, nose, mouth and auricle.Overall local recurrence rate was 8.9% over a mean follow-up period of 71.3 months and a minimum of 60 months. Reducing margins of WLE did not increase local recurrence rates as demonstrated by local recurrence-free survival (90.4% vs. 91.9%, Pâ€‰=â€‰0.806).Margins of WLE may be safely reduced in melanomas in close proximity to structures of the H&N without affecting local recurrence rates. J. Surg. Oncol. 2015 111:795-799. Â© 2014 Wiley Periodicals, Inc.Â© 2015 Wiley Periodicals, Inc.
Pharmacokinetics, pharmacodynamics and food effect of LB30870, a novel direct thrombin inhibitor, after single oral doses in healthy men. - Xenobiotica; the fate of foreign compounds in biological systems
Abstract 1.â€‚The safety, tolerability, pharmacokinetics, pharmacodynamics, and food effect of LB30870, a new selective thrombin inhibitor, were studied in 16 healthy men. 2.â€‚A double-blind, placebo-controlled single ascending dose study was done at oral doses of 5, 15, 30, 60, 120, and 240â€‰mg under fasting conditions. An open, randomized, balanced cross-over food effect study was done at 60â€‰mg dose. Plasma and urinary concentrations were measured up to 48â€‰h post-dose. Coagulation and thrombin activity markers were measured at selected time points. 3.â€‚Cmax of LB30870 was at 1.3-3.0â€‰h post-dose with a mean apparent terminal half-life (t1/2) of 2.8-4.1â€‰h. AUC after doses above 15â€‰mg appeared greater than dose-proportional. In fed state, AUC showed 80% reduction relative to fasting condition. 4.â€‚At doses 60 and 120â€‰mg, peak activated partial thromboplastin time (aPTT) increased by 1.5- and 2-fold, respectively, from baseline. The aPTT and international normalized ratio (INR) were concentration-dependent, with less within-individual variability than ecarin clotting time (ECT), prothrombin time (PT), or thrombin time (TT). 5.â€‚Single oral doses of LB30870 up to 240â€‰mg were well tolerated. The food effect must be overcome if LB30870 is to be used as an oral anti-coagulant.
Refining American Joint Committee on Cancer/Union for International Cancer Control TNM stage and prognostic groups for human papillomavirus-related oropharyngeal carcinomas. - Journal of clinical oncology : official journal of the American Society of Clinical Oncology
To refine stage and prognostic group for human papillomavirus (HPV) -related nonmetastatic (M0) oropharyngeal cancer (OPC).All patients with nonmetastatic (M0) p16-confirmed OPC treated with radiotherapy with or without chemotherapy from 2000 to 2010 were included. Overall survival (OS) was compared among TNM stages for patients with HPV-related and HPV-unrelated OPC separately. For HPV-related OPC, recursive partitioning analysis (RPA) derived new RPA stages objectively. Cox regression was used to calculate adjusted hazard ratios (AHRs) to derive AHR stages. The performance of survival prediction of RPA stage and AHR stage was assessed against the current seventh edition TNM stages. Prognostic groups were derived by RPA, combining RPA stage and nonanatomic factors.The cohort comprised 573 patients with HPV-related OPC and 237 patients with HPV-unrelated OPC, with a median follow-up of 5.1 years. Lower 5-year OS with higher TNM stage was evident for patients with HPV-unrelated OPC (stage I, II, III, and IV 5-year OS: 70%, 58%, 50%, and 30%, respectively; P = .004) but not for patients with HPV-related OPC (stage I, II, III, and IV 5-year OS: 88%, 78%, 71%, and 74%, respectively; P = .56). RPA divided HPV-related OPC into RPA-I (T1-3N0-2b), RPA-II (T1-3N2c), and RPA-III (T4 or N3; 5-year OS: 82%, 76%, and 54%, respectively; P < .001). AHR also yielded a valid classification, but RPA stage demonstrated better survival prediction. A further RPA (including RPA stage, age, and smoking pack-years [PYs]) derived the following four valid prognostic groups for survival: group I (T1-3N0-N2c_â‰¤ 20 PY), group II (T1-3N0-N2c_> 20 PY), group III (T4 or N3_age â‰¤ 70), and group IVA (T4 or N3_age > 70; 5-year OS: 89%, 64%, 57%, and 40%, respectively; P < .001).An RPA-based TNM stage grouping (stage I/II/III: T1-3N0-N2b/T1-3N2c/T4 or N3, with M1 as stage IV) is proposed for HPV-related OPC as a result of significantly improved survival prediction compared with the seventh edition TNM, and prognostication is further improved by an RPA-based prognostic grouping within the American Joint Committee on Cancer/Union for International Cancer Control TNM framework for HPV-related OPC.Â© 2015 by American Society of Clinical Oncology.
Thermographic analysis of the radiant heat of chicken and duck eggs in relation to the embryo's oxygen consumption. - Journal of thermal biology
In eggs, the metabolic activities of the developing embryo produce heat (H) that is dissipated in various forms, including radiation. Given that much of the total heat radiated by an egg (Htot) is heat acquired passively, we asked whether it was possible to detect the fraction produced metabolically (Hmetab) and the extent of its correlation with the embryo's metabolic rate. In chicken and duck eggs at various incubation ages, under standardized experimental conditions of heat conduction and convection, Hmetab was measured by thermography as the difference in Htot between fertile and sterile eggs. Then, Hmetab was correlated to the embryo's oxygen consumption ( [Formula: see text] ), measured by an open-circuit methodology. Heat loss by water evaporation was found to be less than 3% of the total. During the first half of incubation Hmetab was too small to be significantly separated from Htot. In the second half of incubation Hmetab was significant, represented 30-50% of the total energy consumed and correlated linearly with [Formula: see text] for a good fraction of incubation. We conclude that under standardized conditions of heat conduction and convection, in the second half of incubation thermography offers a simple tool not only to verify the progression of the embryo's incubation but also to estimate its metabolic rate.Copyright Â© 2015 Elsevier Ltd. All rights reserved.
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