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.

PURPOSE: This study investigated the incidence trends and associated factors of type 1 (T1DM) and type 2 diabetes mellitus (T2DM) in children and adolescents under 15 years of age in Busan and Gyeongnam, Korea from 2001 to 2010. METHODS: Medical records of newly diagnosed diabetes patients (n=328; 160 males, 168 females) were collected in questionnaire form from 5 tertiary and 42 general hospitals in Busan and Gyeongnam. RESULTS: The average crude incidence rate of T1DM and T2DM was 2.01/100,000 (95% confidence interval [CI], 1.76-2.28) and 0.75/100,000 (95% CI, 0.60-0.92), respectively. The incidence rate ratio (IRR) of T1DM was 1.31 (95% CI, 1.01-1.69), and that of T2DM was 1.97 (95% CI, 1.25-3.11) in the latter half-decade (2006 to 2010) compared to the early half-decade (2001 to 2005). There were gradually increasing incidence trends in both T1DM and T2DM over the 10-year period (P for trend: T1DM, 0.0009; T2DM, <0.0001). Age-specific IRR was highest in the 10- to 14-year-old group, regardless of diabetes type. In particular, a rapid increase in incidence of T2DM occurred in the 10- to 14-year-old group. IRR for females was 1.07 (95% CI, 0.83-1.38) for T1DM and 1.56 (95% CI, 1.01-2.41) for T2DM. IRR for Busan (urban) was 1.41 (95% CI, 1.09-1.83) for T1DM and 1.49 (95% CI, 0.96-2.30) for T2DM. CONCLUSION: T1DM and T2DM incidence both increased over time in youth under age 15 living in Busan and Gyeongnam; in particular, the incidence of T2DM in adolescents increased more rapidly.
Adolescent* ; Busan* ; Child* ; Cohort Studies* ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Female ; Hospitals, General ; Humans ; Incidence* ; Korea ; Male ; Medical Records ; Retrospective Studies*

Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial lung diseases, but vertebral osteomyelitis caused by MAC is rare. We experienced a case of vertebral osteomyelitis with epidural abscess in a rheumatoid arthritis patient who received immunosuppressive agents. Initial assessment was tuberculous vertebral osteomyelitis, and then treated with antituberculous drugs. Fifty-six days later, Mycobacterium intracellulare was identified from abscess culture and drugs were altered to clarithromycin, rifabutin, and ethambutol. After 3 months of M. intracellulare treatment, the radiological findings showed increases of epidural abscess. According to the suseptibility, the patient received intravenous amikacin for four weeks, and then, oral ciprofloxacin in addition to clarithromycin, rifabutin, and ethambutol. The patient is being treated with the medication for 13 months and currently showing slow improvements.
Abscess ; Amikacin ; Arthritis, Rheumatoid ; Ciprofloxacin ; Clarithromycin ; Epidural Abscess ; Ethambutol ; Humans ; Immunosuppressive Agents ; Lung Diseases ; Mycobacterium ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Osteomyelitis ; Rifabutin

BACKGROUND: To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. MATERIALS AND METHODS: Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. RESULTS: Thirty-seven (88%) of 42 invited participants attended exercise. All members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. CONCLUSION: Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.
Anonyms and Pseudonyms ; Asia, Southeastern ; Compliance ; Influenza, Human ; Pandemics ; Surveys and Questionnaires

BACKGROUND: To evaluate the usefulness and compliance of a hospital-based tabletop exercise in setting of pandemic influenza in hospitals. MATERIALS AND METHODS: Tabletop exercise was held in Pusan National University Hospital and forty two hospital employees were invited to participate in the exercise. The scenario for hospital-based tabletop exercise was designed. It consisted of three modules, which simulated the influx and outbreak of H5N1 influenza that was epidemic in Southeast Asia. Pre-, post-exercise surveys were completed by anonymous questions. RESULTS: Thirty-seven (88%) of 42 invited participants attended exercise. All members of the administration group and the ancillary services group participated. But, only 77% members of the clinical services group participated. In pre-exercise survey, priorities of eight goals regarding skills and knowledge during exercise were inquired., The highest priorities pointed out by the respondents were "Increase the knowledge of pandemic influenza" (22%), "Development of strategies for optimal communication among employees within specific department" (19%) and "Development of strategies for improved coordination between facilities within the health system" (19%). Twenty-one (57%) of participants completed the post-exercise surveys. At post-exercise surveys, 81% of the participants stated that the tabletop exercise was extremely or very useful, 86% of the participants also stated that it increased their knowledge of pandemic influenza. CONCLUSION: Tabletop exercise is an effective modality for increasing pandemic influenza preparedness in hospitals, and this method is useful for guiding preparedness activities within the hospital environment. Further studies to determine the appropriate method of discussion, questionnaire, duration of exercise and injection are needed.
Anonyms and Pseudonyms ; Asia, Southeastern ; Compliance ; Influenza, Human ; Pandemics ; Surveys and Questionnaires

BACKGROUND: The prevalence of HIV drug resistance mutations in drug-naive patients has been shown to differ with geographic origin. The purpose of this study is to assess the prevalence of transmitted antiretroviral drug resistance mutations in drug-naive patients in Korea. METHODS: Genotypic resistance was determined by the use of the Viroseq Genotyping System in 42 antiretroviral treatment naive HIV-infected patients between March 2005 and July 2006. Transmitted drug resistance was estimated according to the IAS-USA 2005 definition, taking into account only major mutations in the protease and all mutations in the reverse transcriptase, including revertant mutations at codon 215. RESULTS: The median age of the patients was 42 years and 37 (88%) were male. The median CD4+T cell count was 136/mm3 and the mean plasma RNA level was 4.98 log copies/mL. Among 42 patients studied, 37 (88%) were newly diagnosed patients. None of the patients were recent seroconverters; 38 patients (90%) were infected with subtype B and 4 patients were infected (10%) with the non-B subtype strains (2 patients with CRF01-AE 1 as CRF02-AG; 1 patient with subtype A). Of the 42 subjects tested, we found 2 (4.8%) mutations in NRTI (V118I), but did not find a mutation in NNRTI as well as in the PI region. CONCLUSIONS: The prevalence of transmitted antiretroviral drug resistance in drug-naive patients is still low in Korean patients.
Cell Count ; Codon ; Drug Resistance* ; HIV ; HIV-1* ; Humans ; Korea ; Male ; Plasma ; Prevalence ; RNA ; RNA-Directed DNA Polymerase

The number of HIV infected women continues to rise sharply these days and 58% of these women were childbearing age. The increase in the number of AIDS cases among childbearing women has led to an increase in the maternal - infant transmission of human acquired immunodeficiency virus. The aim of our study is to assess the available evidence for preventing mother-to-infant transmission of HIV infection by experience from University Teaching Hospital. Four pregnant women with HIV infection delivered in Pusan National University Hospital from 1999 to 2005 years. Three women visitied at 3rd trimester, only one woman delivered by planned perinatal care. They received antiretroviral therapy during pregnancy, labor, after delivery, and infant received antiretroviral therapy by consideration of their situation. They were compliant with treatment and had a sustained virologic response below the detectable level. Just 2% of infants were trasmitted by human acquired immunodeficiency virus, if HIV infected women had an appropriate prophylaxis. Therefore HIV infected women must be identified early for prevention of maternal-infant transmission, they must receive effective antiretrovirus therapy.
Busan ; Female ; HIV Infections ; HIV* ; Hospitals, Teaching* ; Humans ; Infant ; Perinatal Care ; Pregnancy ; Pregnant Women

The number of HIV infected women continues to rise sharply these days and 58% of these women were childbearing age. The increase in the number of AIDS cases among childbearing women has led to an increase in the maternal - infant transmission of human acquired immunodeficiency virus. The aim of our study is to assess the available evidence for preventing mother-to-infant transmission of HIV infection by experience from University Teaching Hospital. Four pregnant women with HIV infection delivered in Pusan National University Hospital from 1999 to 2005 years. Three women visitied at 3rd trimester, only one woman delivered by planned perinatal care. They received antiretroviral therapy during pregnancy, labor, after delivery, and infant received antiretroviral therapy by consideration of their situation. They were compliant with treatment and had a sustained virologic response below the detectable level. Just 2% of infants were trasmitted by human acquired immunodeficiency virus, if HIV infected women had an appropriate prophylaxis. Therefore HIV infected women must be identified early for prevention of maternal-infant transmission, they must receive effective antiretrovirus therapy.
Busan ; Female ; HIV Infections ; HIV* ; Hospitals, Teaching* ; Humans ; Infant ; Perinatal Care ; Pregnancy ; Pregnant Women

BACKGROUND: The transfer of vancomycin resistance from vancomycin-resistant enterococci (VRE) to Staphylococcus aureus has been predicted. The purpose of this study is to determine the prevalence and antibiotics resistance of S. aureus among patients colonized with VRE. METHODS: Between January 2001 and December 2001, a prospective study was performed at Pusan National University Hospital on 27 patients. Surveillance swabs from nasal cavity, axilla, perineum, and rectum were obtained at weekly intervals. Methicillin susceptability of S. aureus was determined by oxacillin disk diffusion test and minimum inhibitory concentration (MIC) for vancomycin by microdilution broth test. RESULTS: Total of 292 swab cultures were performed and 67 S. aureus isolates were collected. 64 isolates (95.5%) were resistant to methicillin. The prevalence of nasal MRSA carrier in 19 patients colonized with VRE was higher than that in 8 patients not colonized with VRE (58% vs. 37.5%). In 64 MRSA isolates, MIC (microgram/mL) for vancomycin ranged from 0.5 to 2. No isolates with MIC >2 microgram/mL were observed. MIC of 1 microgram/mL was shown (observed) in 54 isolates, 2 microgram/mL in 6 isolates, and 0.5 microgram/mL in 4 isolates. CONCLUSION: The prevalence of S. aureus with colonization of VRE is higher than that without colonization of VRE. Most of S. aureus isolates were resistant to methicillin. VRSA isolates were not observed.
Anti-Bacterial Agents ; Axilla ; Busan ; Colon ; Diffusion ; Enterococcus* ; Humans ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Nasal Cavity ; Oxacillin ; Perineum ; Prevalence ; Prospective Studies ; Rectum ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin Resistance ; Vancomycin*