clinicaltrials.gov Identifier: NCT01725789.

PurposeThe aim of this study was to evaluate recent trends in gastric cancer incidence according to the age, sex, and tumor location in the Korean population. Materials and MethodsUsing data from the Korea Central Cancer Registry between 1999 and 2014, gastric cancer incidence, annual percent changes, and male-to-female incidence rate ratios (IRRs) according to tumorlocationwere determined. The distribution of disease extent according to the tumor location and its changes between 2006 and 2014 were also analyzed.ResultsIncidence of gastric cancer was stable until 2011 and decreased between 2011 and 2014. The age-standardized incidence rate of gastric cancer was 43.6 (per 100,000) in 1999 and 35.8 in 2014. The proportion of cardia/fundus cancer remained stable (5.9% to 7.1%), and that of body cancer increased (35.3% to 43.2%). The male-to-female IRR decreased in most age groups, except for those in their 60s. In the distribution of disease extent, the proportion of localized disease increased, and regional and distant disease decreased in all tumor locations (53.9% to 66.0%, 31.4% to 22.5%, and 14.8% to 11.5%, respectively; p < 0.001). For histological type, the proportion of carcinoid tumor and non-epithelial tumor increased (0.3% to 1.0%, and 0.8% to 1.4%, respectively). ConclusionIn the 15 years from 1999 through 2014, age-standardized incidence of gastric cancer started to decrease from 2012, and the proportion of cardia/fundus cancer remained unchanged. The trend of increasing localized cancer was observed in all tumor locations.

Antibiotic resistance has become a global crisis in recent years, while wastewater treatment plants (WWTPs) have been identified as a significant source of both antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs). However, commonly used disinfectants have been shown to be ineffective for the elimination of ARGs. With the goal of upgrading the conventional UV disinfection unit with stronger capability to combat ARB and ARGs, we developed a UV-assisted electrochemical oxidation (UV-EO) process that employs blue TiO2 nanotube arrays (BNTAs) as photoanodes. Inactivation of tetracycline- and sulfamethoxazole-resistant E. coli along with degradation of the corresponding plasmid coded genes (tetA and sul1) is measured by plate counting on selective agar and qPCR, respectively. In comparison with UV254 irradiation alone, enhanced ARB inactivation and ARG degradation is achieved by UV-EO. Chloride significantly promotes the inactivation efficiency due to the electrochemical production of free chlorine and the subsequent UV/chlorine photoreactions. The fluence-based first-order kinetic rate coefficients of UV-EO in Cl– are larger than those of UV254 irradiation alone by a factor of 2.1–2.3 and 1.3–1.8 for the long and short target genes, respectively. The mechanism of plasmid DNA damage by different radical species is further explored using gel electrophoresis and computational kinetic modeling. The process can effectively eliminate ARB and ARGs in latrine wastewater, though the kinetics were retarded.

Background Anastomotic leakage (AL) after gastrectomy in gastric cancer patients is associated with high mortality rates. Various endoscopic procedures are available to manage this postoperative complication. The aim of study was to evaluate the outcome of two endoscopic modalities, clippings and stents, for the treatment of AL. Patients and methods There were 4916 gastric cancer patients who underwent gastrectomy between December 2007 and January 2016 at the National Cancer Center, Korea. A total of 115 patients (2.3%) developed AL. Of these, 85 patients (1.7%) received endoscopic therapy for AL and were included in this retrospective study. The endpoints were the complete leakage closure rates and risk factors associated with failure of endoscopic therapy. Results Of the 85 patients, 62 received endoscopic clippings (with or without detachable snares), and 23 received a stent insertion. Overall, the complete leakage closure rate was 80%, and no significant difference was found between the clipping and stent groups (79.0% vs. 82.6%, respectively; P = 0.89). The complete leakage closure rate was significantly lower in the duodenal and jejunal stump sites (60%) than esophageal sites (86.1%) and gastric sites (94.1%; P = 0.026). The multivariate analysis showed that stump leakage sites (adjusted odds ratio [aOR], 4.51; P = 0.031) and the presence of intra-abdominal abscess (aOR, 4.92; P = -0.025) were associated with unsuccessful leakage closures. Conclusions Endoscopic therapy using clippings or stents is an effective method for the postoperative management of AL in gastric cancer patients. This therapy can be considered a primary treatment option due to its demonstrated efficacy, safety, and minimally invasive nature.

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Blood transfusions were once believed to the most potent and cost-effective method of improving patients' survival outcomes, but accumulating evidence over the past thirty years strongly suggests allogeneic transfusions as independent prognosticators of complications, prolonged hospital stay, and higher costs. A growing body of health care providers in Korea and throughout the world recognize a causal relationship between these adverse outcomes with liberal transfusion policies and call for a universal paradigm shift regarding the management of blood. Currently, the most promising contender is Patient Blood Management (PBM), which has been found to improve patient outcomes by conserving or optimizing the patient's own blood and physiologic reserves and advocating for restrictive transfusion policies. PBM incorporates evidence-based transfusion replacements to address anemia, bleeding, and blood disorders. These various methods-such as intravenous iron, erythropoiesis stimulating agents, coagulating factors, and topical hemostatic agents-are gaining recognition because of their ability to preclude the need for allogenic transfusions while effectively managing the patient's blood. (Korean J Blood Transfus 2017;28:103-112)

vintage bridged-race postcensal population estimates. https://www.cdc.gov /nchs/nvss/bridged_race.htm. Accessed December 15, 2015. 5.Papania MJ, Orenstein WA. Defining and assessing measles elimination goals.