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: To compare the clinical outcomes of cataract surgery using the ARTIS ® PL E (Cristalens Industrie, Lannion, France) intraocular lens (IOL) and conventional Tecnis ® ZCB00 (Johnson & Johnson Vision, Santa Ana, CA, USA) IOL. Methods: This retrospective study examined patients who underwent in-the-bag implantation of either an ARTIS ® PL E (33 eyes, group A) or Tecnis ® ZCB00 (45 eyes, group B) IOL after phacoemulsification performed by a single surgeon. Best-corrected visual acuity (BCVA), spherical equivalent, and higher-order aberrations (HOA) were measured 1 and 3 months after cataract surgery. Results: Preoperative BCVA did not differ significantly in groups A and B. Postoperative BCVA at 1 and 3 months improved significantly (p < 0.001) in both groups compared to preoperative baseline BCVA. At 1 and 3 months postoperatively, total HOA, spherical aberration, and coma were significantly lower compared to the preoperative baseline HOA (p < 0.05) in both groups. However, there were no significant differences in the trefoil values 1 and 3 months postoperatively compared to the preoperative baseline in both groups. The absolute refractive error 3 months postoperatively was 0.27 ± 0.20 (group A) and 0.28 ± 0.20 (group B), both within ± 0.50 diopters of the targeted goal diopter; there were no significant differences in the accuracy or predictability of the IOL power calculation in both groups (p = 0.390, p = 0.959). The absolute refractive error 1 and 3 months postoperatively did not differ significantly; there were no significant differences in the stability of both IOLs (p = 0.482, p = 0.372). Conclusions Conventional cataract surgery using the ARTIS ® PL E IOL significantly increased the BCVA, while obtaining comparable clinical results to the verified Tecnis ® ZCB00 IOL in postoperative visual acuity and HOA.

PURPOSE: To compare the pupil sizes measured using the automatic pupillometer and pupil card. METHODS: We measured pupil sizes using a pupil card (Rosenbaum Card, J.G. Rosenbaum, Cleveland, OH, USA) and automated pupillometer (VIP(TM)-200, Neuroptics Inc., San Clemente, CA, USA) under different luminous intensities in 60 eyes of 60 patients who visited the ophthalmology clinic during August 2013. RESULTS: Under the photopic condition, pupil sizes measured using automated pupillometer were larger than those measured using the pupil card with statistical significance. The 2 techniques were not different under mesopic and scotopic conditions. Under all light conditions, automated pupillometer showed higher inter-rater reliability. Under the scotopic condition, pupil sizes measured using the pupil card were smaller than pupil sizes measured using the pupillometer according to increased pupil size. CONCLUSIONS: When compared with pupil card, automated pupillometer provided accurate and reliable measurement with small inter-rater variation and was easy and simple to use. However, based on comparable measurements of both techniques under mesopic and scotopic conditions, the pupil card can be used as preoperative evaluation when considering the cost of purchase and maintenance.
Humans ; Ophthalmology ; Pupil*

PURPOSE: We investigated the incidence of retinal lesions before and after surgery and the percentage of preoperative prophylactic laser treatment in patients who underwent corneal refractive surgery or phakic intraocular lens implantation (pIOLi). METHODS: The medical records of patients who underwent refractive surgery from January 2005 to June 2013 were reviewed retrospectively. We investigated the incidence and type of retinal lesions identified during the preoperative examination. Additionally, the percentage of preoperative prophylactic laser treatment and the incidence of postoperative newly developed retinal lesions were analyzed. RESULTS: A total of 894 eyes of 466 subjects (laser in situ keratomileusis [LASIK] 225 eyes, 117 subjects; laser-assisted subepithelial keratectomy [LASEK] or photorefractive keratectomy [PRK] 450 eyes, 231 subjects; pIOLi 219 eyes, 121 subjects) were enrolled in the present study. Retinal lesions were found in 268 eyes (29.98%) and of those, 144 eyes (16.11%) received prophylactic laser treatment. Postoperative newly developed retinal lesions were detected in 8 cases (LASEK or PRK, 5 cases; pIOLi, 3 cases) during the follow-up period. There was a significant correlation between preoperative spherical equivalent and the presence of retinal lesions. CONCLUSIONS: The patient population of refractive surgery is largely myopic and thus particularly vulnerable to retinal lesions. Additionally, a considerable number of patients required preoperative prophylactic laser treatment. Therefore, both surgeons and patients should be aware of the risks of developing postoperative retinal lesions.
Follow-Up Studies ; Humans ; Incidence* ; Keratectomy, Subepithelial, Laser-Assisted ; Medical Records ; Myopia ; Phakic Intraocular Lenses ; Photorefractive Keratectomy ; Refractive Surgical Procedures* ; Retinaldehyde* ; Retrospective Studies

PURPOSE: To compare the additive effects of two types of non-steroidal anti-inflammatory drugs (NSAIDs), bromfenac 0.1% or ketorolac 0.45%, relative to topical steroid alone in cataract surgery. MATERIALS AND METHODS: A total 91 subjects scheduled to undergo cataract operation were randomized into three groups: Group 1, pre/postoperative bromfenac 0.1%; Group 2, pre/postoperative preservative-free ketorolac 0.45%; and Group 3, postoperative steroid only, as a control. Outcome measures included intraoperative change in pupil size, postoperative anterior chamber inflammation control, change in macular thickness and volume, and ocular surface status after operation. RESULTS: Both NSAID groups had smaller intraoperative pupil diameter changes compared to the control group (p<0.05). There was significantly less ocular inflammation 1 week and 1 month postoperatively in both NSAID groups than the control group. The changes in central foveal subfield thickness measured before the operation and at postoperative 1 month were 4.30+/-4.25, 4.87+/-6.03, and 12.47+/-12.24 microm in groups 1 to 3, respectively. In the control group, macular thickness and volume increased more in patients with diabetes mellitus (DM), compared to those without DM. In contrast, in both NSAID groups, NSAIDs significantly reduced macular changes in subgroups of patients with or without DM. Although three ocular surface parameters were worse in group 1 than in group 2, these differences were not significant. CONCLUSION: Adding preoperative and postoperative bromfenac 0.1% or ketorolac 0.45% to topical steroid can reduce intraoperative miosis, postoperative inflammation, and macular changes more effectively than postoperative steroid alone.
Aged ; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/pharmacology ; Benzophenones/*administration & dosage/pharmacology ; Bromobenzenes/*administration & dosage/pharmacology ; *Cataract ; *Cataract Extraction ; Female ; Humans ; Inflammation/prevention & control ; Ketorolac/*administration & dosage/pharmacology ; Lens Implantation, Intraocular ; Macular Edema/*prevention & control ; Male ; Middle Aged ; Miosis/*prevention & control ; Phacoemulsification ; Postoperative Complications/drug therapy ; Postoperative Period ; Premedication ; Treatment Outcome

PURPOSE: To compare axial length (AL) and keratometry (K) using optical low-coherence reflectometry (OLCR, Lenstar LS900(R), Haag-Streit, Bern, Switzerland) with current ocular biometry devices and evaluate the accuracy of intraocular lens (IOL) power calculation. METHODS: In this prospective, comparative observational study of eyes with cataracts, AL and K were measured using an OLCR device (Lenstar LS900(R), Haag-Streit), partial coherence interferometry (PCI, IOL Master(R), Carl Zeiss, Jena, Germany), A-scan (Eyecubed) and automated keratometry (KR-7100, Topcon, Tokyo, Japan). IOL power calculation was performed using the Sanders-Retzlaff-Kraff (SRK/T) formula. The IOL prediction error (PE) was calculated by subtracting the predicted IOL power from the postoperative (PO) IOL power (PO 4 weeks, PO 12 weeks). RESULTS: A total of 50 eyes of 39 patients with cataracts (mean age 67.12 +/- 8.51 years) were evaluated in this study. AL and K were not significantly different between the OLCR device and other devices (analysis of variance [ANOVA], p = 0.946, 0.062, respectively). The mean PE in IOL power calculation was -0.22 +/- 0.50D with the OLCR device, 0.08 +/- 0.45D with the PCI device and -0.01 +/- 0.48D with A-scan and automated keratometry (ANOVA, p = 0.006). The highest percentage of eyes with PE smaller than +/- 0.5D was IOL Master(R) followed by Eyecubed and then Lenstar LS900(R). The mean absolute PE was not statistically significant among the 3 devices (ANOVA, p = 0.684). CONCLUSIONS: Ocular biometry measurements were comparable between the OLCR device and the PCI ultrasound device. However, the IOL power prediction showed significant differences among the 3 devices. Therefore, the differences in application of these devices should be considered.
Biometry* ; Cataract ; Glycyrrhetinic Acid ; Humans ; Interferometry ; Lenses, Intraocular* ; Observational Study ; Prospective Studies ; Ultrasonography

PURPOSE: We compared the clinical results after implantation of the newly-developed aspheric intraocular lens iSert 250 NC60 (Hoya Corporation Ltd., Tokyo, Japan) with 2 other types of widely used intraocular lenses, AcrySof IQ SN60WF (Alcon Laboratories, INC., Fort Worth, TX, USA) and TECNIS 1-piece ZCB00 (AMO Inc., Santa Ana, CA, USA). METHODS: Seventy cataract eyes were implanted with 1 of 3 aspheric intraocular lenses (Hoya iSert 250 NC60, TECNIS 1-piece ZCB00 or AcrySof IQ SN60WF) by the same surgeon. Uncorrected vision, best corrected vision, spherical equivalent, higher order aberrations, and modulation transfer function were measured 1 and 3 months after the cataract surgery. RESULTS: Uncorrected vision and best corrected vision were not significantly different among the 3 groups; however, eyes implanted with iSert250 NC60 showed more hyperopic-shifted postoperative spherical equivalents than expected compared to the other 2 groups. Total ocular aberrations and internal optics aberrations were similar among the 3 groups while the root mean square of the corneal aberrations showed differences. Eyes implanted with iSert 250 NC60 showed superior results in modulation transfer function compared with the other 2 groups in a majority of spatial frequencies 3 months postoperatively. CONCLUSIONS: The newly developed aspheric intraocular lens iSert 250 NC60 showed clinically equal results compared with 2 other verified intraocular lenses AcrySof IQ SN60WF and TECNIS 1-piece ZCB00 in vision, higher-order aberrations, and modulation transfer functions.
Cataract ; Lens Implantation, Intraocular* ; Lenses, Intraocular

PURPOSE: High sensitive C-reactive protein (hs CRP) is well known as a strong risk factor of cardiovascular disease (CVD). The aim of this study is to evaluate the impact of elevated hs CRP on coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACh) provocation test. MATERIALS AND METHODS: A total of 1729 consecutive patients without significant CVD who underwent coronary angiography and intracoronary ACh test between November 2004 and August 2010 were analyzed. The patients were divided into five groups according to quintiles of hs CRP levels. RESULTS: At baseline, the prevalence of elderly, hypertension, diabetes mellitus, current smoking, and lipid levels were higher in patients with higher hs CRP. During ACh test, the incidences of significant CAS, ischemic electrocardiography (EKG) change, multivessel, and diffuse CAS were higher in patients with higher hs CRP. Multivariate analysis showed that the old age (OR=1.01, CI; 1.0-1.02, p=0.0226), myocardial bridge (OR=3.34, CI; 2.16-5.17, p<0.001), and highest quintile hs CRP (OR=1.54, CI; 1.12-2.18, p=0.008) were independent predictors of ACh induced CAS. However, there was no difference in clinical outcomes up to 12 months. CONCLUSION: In conclusion, higher hs CRP was associated with higher incidence of CAS, worse angiographic characteristics and ischemic EKG change, but was not associated with clinical outcomes.
Acetylcholine/*metabolism ; Adult ; C-Reactive Protein/*metabolism ; Coronary Vasospasm/*metabolism ; Diabetes Mellitus/metabolism ; Female ; Humans ; Hypertension/metabolism ; Male ; Middle Aged ; Retrospective Studies

PURPOSE: To investigate long-term satisfaction and quality of life after myopic laser refractive surgery. METHODS: This study included 231 myopic patients who underwent laser refractive surgery (LASIK, LASEK or PRK) at least five years prior, between 2002 and 2005, at 5 hospitals. Using a telephone survey, patients were asked to subjectively answer 26 questions regarding satisfaction, quality of life changes, and visual symptoms. RESULTS: The mean patient satisfaction score was 8.12 (scale of 1 to 10). Improvement in quality of life was reported by 91% of the subjects. Intention to have surgery again was reported by 87.9% of the subjects and intention to recommend refractive surgery to a friend or family was reported by 80.5% of the subjects. The most common discomfort symptoms after myopic laser refractive surgery were dry eye symptoms (57.1%), followed by night vision disturbances (54.3%). CONCLUSIONS: Long-term satisfaction and quality of life were shown to be positive in patients treated with myopic refractive surgery.
Eye ; Friends ; Humans ; Intention ; Keratectomy, Subepithelial, Laser-Assisted ; Night Vision ; Patient Satisfaction ; Quality of Life ; Refractive Surgical Procedures ; Telephone