Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

Background/Aims: Healthcare-associated (HCA) infection is a recently suggested new category of community-onset infections. The implications of HCA infections in terms of diagnosis, treatment, and outcomes of spontaneous bacterial peritonitis (SBP) are not well understood. We sought to delineate the differences between community-acquired (CA) SBP and HCA SBP with specific interest in the antimicrobial resistance of causative microorganisms and outcomes. Methods: We conducted a retrospective cohort study of all SBP episodes with positive ascitic culture and/or blood culture from June 2000 to August 2011. Community-onset SBP episodes were included when they occurred within 48 hours after admission and were classified as CA SBP and HCA SBP based on the predefined criteria. Results: A total of 188 episodes of community-onset SBP were analyzed (65.4% HCA SBP and 34.6% CA SBP). HCA SBP had a higher resistance rate to third-generation cephalosporin (6.8% vs. 1.6%, p = 0.168). The overall 30-day mortality was similar between both groups (37.4% vs. 41.5%, p = 0.638). The independent risk factors for 30-day all-cause mortality in community-onset SBP included high Child-Pugh score, acute kidney injury, and resistance to third-generation cephalosporins; HCA infection was not associated. Conclusions Hepatic functional status, renal dysfunction, and third-generation cephalosporin resistant pathogens more adversely affected the outcome of cirrhotic patients with community-onset SBP rather than HCA infection. The higher rate of third-generation cephalosporin resistance was notable in HCA SBP, which will require a novel approach to empirical antibiotic treatment selection in this population.

Fungal contamination of built-in furniture is a frequent problem in Korea when new apartment is built. However, domestic information on the contaminating fungi is very limited. This study was conducted to isolate, identify and characterize the fungi of the problem in one of the apartment houses where the fungi were claimed in the built-in furniture before the house owner moves in. Fungi present in the furniture installed in a main room, dress room, and kitchen side were visually and microscopically confirmed and purely isolated on PDA. The isolated fungi were identified by analyzing the morphological characteristics and nucleotide sequence of the ITS, calmodulin gene, and TEF-1α gene. Aspergillus creber, A. niger, A. pseudoglacus, A. ruber, Cladosporium perangustum and Penicillium commune were identified. Four out of the six fungal species were positive for at least one enzyme in six kinds of extracellular enzyme assays. When these four species (A. creber, A. niger, C. perangustum and P. commune) were inoculated onto four kinds of wood chips of furniture materials, they were able to colonize all of the wood chips. Their settlement was better at 95% humidity condition than at 30% humidity condition. Among the four species, C. perangustum caused the darkest discoloration and secreted the most number of extracellular enzymes. The four species were re-isolated from the colonized wood chips and confirmed as the problematic fungi in the built-in furniture.

Uterine fibroids (leiomyomas or myomas), benign monoclonal tumors, are the most common benign tumors in women. Heavy or prolonged menstrual bleeding, abnormal uterine bleeding, resultant anemia, pelvic pain, infertility, and/or recurrent pregnancy loss are generally associated with uterine fibroids. Although curative treatment of this tumor relies on surgical therapies, medical treatments are considered the first-line treatment to preserve fertility and avoid or delay surgery. The aim of this review is to provide available and emerging medical treatment options for symptomatic uterine fibroids. Literature review and consensus of expert opinion. Many uterine fibroids are asymptomatic and require no intervention, although it is advisable to follow-up patients to document stability in size and growth. Fibroid-associated symptoms include heavy menstrual bleeding and pain or pelvic discomfort. The association between infertility and fibroids increases with age. Treatment options for symptomatic uterine fibroids — include medical, surgical, and radiologically guided interventions. Various medical therapies are now available for women with uterine fibroids, although each therapy has its own advantages and disadvantages. Currently, gonadotrophin-releasing hormone (GnRH) agonists and selective progesterone receptor modulators (SPRMs) are the most effective medical therapies, with the most evidence to support their reduction of fibroid volume and symptomatic improvement in menstrual bleeding. The choice of treatment depends on the patient's personal treatment goals, as well as efficacy and need for repeated interventions.
Anemia ; Consensus ; Expert Testimony ; Female ; Fertility ; Follow-Up Studies ; Hemorrhage ; Humans ; Infertility ; Leiomyoma* ; Pelvic Pain ; Pregnancy ; Receptors, LHRH ; Receptors, Progesterone ; Uterine Hemorrhage

During the growing season of 2015, leaf specimens with yellow rust spots were collected from Salix koreensis Andersson, known as Korean willow, in riverine areas in Cheonan, Korea. The fungus on S. koreensis was identified as the rust species, Melampsora yezoensis, based on the morphology of urediniospores observed by light and scanning electron microscopy, and the molecular properties of the internal transcribed spacer rDNA region. Pathogenicity tests confirmed that the urediniospores are the causal agent of the rust symptoms on the leaves and young stems of S. koreensis. Here, we report a new rust disease of S. koreensis caused by the rust fungus, M. yezoensis, a previously unrecorded rust pathogen in Korea.
Chungcheongnam-do ; DNA, Ribosomal ; Fungi ; Korea* ; Microscopy, Electron, Scanning ; Salix* ; Seasons ; Virulence

Acanthopanax divaricatus, a member of the Araliaceae family, has been used as an invigorant in traditional Korean medicine. During disease monitoring, a stem with small, irregular, brown lesions was sampled at a farm in Cheonan in 2011. The symptoms seen were sunken cankers and reddish-brown needles on the infected twig. The isolated fungal colonies were whitish, having crenated edges and aerial mycelium on the surface, and with black gregarious fruiting bodies. The reverse plate was creamy white. Conidia were 17~22 x 3.5~4.2 microm, fusiform, 4-septate, and straight to slightly curved. The nucleotide sequence of the partial translation elongation factor 1 alpha gene of the fungal isolate, shares 99% sequence identity with that of known Pestalotiopsis ellipsospora. Based on the results of the morphological and molecular analyses, the fungal isolate was identified as P. ellipsospora. In Korea, this is the first report of canker on A. divaricatus.
Eleutherococcus* ; Araliaceae ; Base Sequence ; Chungcheongnam-do ; Fruit ; Humans ; Korea ; Mycelium ; Needles ; Peptide Elongation Factor 1 ; Spores, Fungal

A 37-year-old female patient admitted due to dyspnea on exertion and peripheral edema. For one and a half years, the patient had been taking various drugs and supplements to reduce weight, including amphetamine-like drugs. The patient had no major cardiovascular risk factors except three pack-years of smoking. A chest computed tomography showed a 1.7 cm diameter, capsulated space-occupying lesion in the left ventricle (LV) and 2-dimensional echocardiography showed LV systolic dysfunction (Left ventricular ejection fraction [LVEF], 30%) with a mobile cystic mass (1.1x1.8 cm) that was attached to the LV apex, which was increased in size and number the next day, even with low dose low-molecular-weight heparin. With an increased dose of anticoagulation medication and heart failure management with diuretics and angiotensin receptor II blocker, LV dysfunction was recovered and the LV thrombus disappeared.
Adult ; Amphetamine ; Angiotensins ; Cardiomyopathies* ; Diuretics ; Dyspnea ; Echocardiography ; Edema ; Female ; Heart Failure ; Heart Ventricles ; Heparin, Low-Molecular-Weight ; Humans ; Risk Factors ; Smoke ; Smoking ; Stroke Volume ; Thorax ; Thrombosis* ; Weight Loss*

Fungi are the known sources of irritation associated with atopic diseases (e.g., asthma, allergic rhinoconjunctivitis, and atopic eczema). To quantitatively estimate their presence in the indoor environment of atopic dermatitis-inflicted child patient's houses (ADCPHs), the high-efficiency particulate air (HEPA) filters installed inside the air cleaners of three different ADCPHs were investigated for the presence of mold. The air cleaner HEPA filters obtained from the three different ADCPHs were coded as HEPA-A, -B, and -C, respectively, and tested for the presence of mold. The colony forming units (CFUs) corresponding to the HEPA-A, -B, and -C filters were estimated to be 6.51 x 10(2) +/- 1.50 x 10(2) CFU/cm2, 8.72 x 10(2) +/- 1.69 x 10(2) CFU/cm2, and 9.71 x 10(2) +/- 1.35 x 10(2) CFU/cm2, respectively. Aspergillus, Penicillium, Alternaria, Cladosporium, Trichoderma, and other fungal groups were detected in the 2,494 isolates. The distribution of these fungal groups differed among the three filters. Cladosporium was the major fungal group in filters HEPA-A and -C, whereas Penicillium was the major fungal group in the filter HEPA-B. Nine fungal species, including some of the known allergenic species, were identified in these isolates. Cladosporium cladosporioides was the most common mold among all the three filters. This is the first report on the presence of fungi in the air cleaner HEPA filters from ADCPHs in Korea.
Air Filters* ; Alternaria ; Aspergillus ; Asthma ; Child* ; Cladosporium ; Dermatitis, Atopic* ; Fungi* ; Humans ; Korea ; Penicillium ; Stem Cells ; Trichoderma

Paraneoplastic encephalitis associated with an ovarian teratoma has been related to the development of antibodies to specific heteromers of the N-methyl-D-aspartate receptor (NMDAR). The disorder, known as anti-NMDAR encephalitis, is characterized by psychiatric symptoms, seizures, mood and behavioral changes as well as involuntary movement. Since the NMDAR is the target of many anesthetic drugs, the presence of anti-NMDAR antibodies might influence the requirements of anesthetics or their effects. We report the presentation and anesthetic experience of a young patient with anti-NMDAR encephalitis undergoing surgical excision of two ovarian teratomas, and we also review the relevant literature.
Anesthesia, General ; Anesthetics ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Antibodies ; Dyskinesias ; Encephalitis ; Humans ; N-Methylaspartate ; Paraneoplastic Syndromes ; Seizures ; Teratoma