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Background The benefit of regular follow-up after curative resection for gastric cancer is controversial as there is no evidence that it will improve survival. This study assessed whether regular follow-up leads to improved survival in patients after surgery for gastric cancer. Methods A secondary analysis was undertaken of patients who participated in an RCT of laparoscopic versus open distal gastrectomy for advanced gastric cancer between November 2011 and April 2015. Depending on whether patients were compliant with the initial trial follow-up protocol or not, they were analysed as having had either regular or irregular follow-up. Clinicopathological characteristics, recurrence patterns, detection, treatments, and survival were compared between the groups. Results The regular and irregular follow-up groups comprised 712 and 263 patients respectively. Disease recurrence within 36 months was more common in the regular group than in the irregular group (17.0 versus 11.4 per cent; P = 0.041). Recurrence patterns did not differ between the groups. The 3-year recurrence-free survival rate was worse in the regular than in the irregular group (81.2 versus 86.5 per cent; P = 0.031). However, the 5-year overall survival rate was comparable (84.5 versus 87.5 per cent respectively; P = 0.160). Multivariable analysis revealed that type of follow-up was not an independent factor affecting 5-year overall survival. Conclusion Regular follow-up after radical gastrectomy was not associated with improved overall survival.

Background: Genotype 4 Eurasian avian-like lineage swine H1N1 viruses, which are reassortants containing the pandemic 2009 H1N1 virus lineage, triple reassortant lineage internal genes, and EA lineage external genes, have been reported in China since 2013. These have been predominant in pig populations since 2016 and have exhibited pandemic potential. Objectives: Examination of the circulation of G4 and its-related EA H1N1 viruses in Korea. Methods: We developed a one-step multiplex RT-qPCR that targeted M, HA1, and PB2 genes to detect G4 and its-related EA H1N1 viruses. We performed the analytical sensitivity and specificity of the multiplex RT-qPCR. The developed multiplex RT-qPCR was applied to swine respiratory samples between 2020 and 2022 in Korea. Results: Among the swine samples, a G4 EA H1N1 virus-related positive sample (6IP) was detected. Phylogenetic analysis based on all eight partial gene segments showed that 6IP contains nucleic acids of IAV segmented genes, which are closely related to G4 EA H1N1 viruses in HA, NA, PB2, NS, and NP genes. Conclusions: The developed multiplex RT-qPCR proved the sensitivity and specificity for the efficient surveillance of G4 and its-related EA H1N1 virus in clinical samples. Considering the phylogenetic analysis, additional screening for G4 EA H1N1 or its related viruses should be performed in future epidemiological studies.

The Korean Air Chemistry Modeling System (K_ACheMS) has been developed to enhance the predictability of PM2.5 in South Korea. In the current version (v2.0) of K_ACheMS, two meteorological models are used to produce meteorological fields. The first model is version 4.1.5 of the Weather Research and Forecasting (WRF) model. The WRF v4.1.5 model is initialized using four cycles (00Z, 06Z, 12Z, and 18Z) of real-time Global Forecasting System (GFS) data from the National Oceanic and Atmospheric Administration (NOAA). The other model is the Regional Data Assimilation and Prediction System (RDAPS), which is the regional operational model of the Korean Meteorological Administration (KMA) based on the Unified Model (UM) developed by the Met Office of the United Kingdom.For air quality model simulations, the Community Multi-scale Air Quality version GIST (CMAQ-GIST) model has been developed based on the CMAQ v5.2.1 model. The CMAQ-GIST model mainly uses a modified version of the Statewide Air Pollution Research Center 07 (SAPRC07TC) chemical mechanism with several important updates, including the following: (i) daytime HONO photo-chemistries; (ii) heterogeneous HO2 reactions; (iii) gas- and aqueous-phase halogen chemistries; and (iv) new yield data for SOA formation acquired from multiple smog chamber experiments conducted under typical conditions of northeast Asia. In order to update chemical initial conditions for the CMAQ-GIST model simulations, a three-dimensional variational (3D-VAR) method is applied to the operational mode of K_ACheMS.Here, we introduce the development of the K_ACheMS v2.0 and present the current performances of the operational mode of K_ACheMS v2.0 by comparing the ground-based observations in South Korea.

The dissolution of a horizontal salt body is theoretically and numerically investigated by considering the coupled dynamics of the dissolution reaction and the diffusive and convective mass transfer at the salt surface. To take into account the nature of the recessing salt surface and the dissolution-driven convection, a dynamic moving boundary condition coupled with a dissolution reaction are employed By employing a newly derived moving interface condition and parameters, a theoretical analysis predicts the onset of gravitational instability, suggesting scaling relationships between parameters to describe the onset of instability (in transport-dominant (Damkholer number $Da \to \infty $ and Rayleigh number $Ra > {10^5}$ ), onset time ${\tau _d}\sim R{a^{ - 2/3}}$ and ${\tau _d}\sim (RaDa)^{1/4}$ for reaction-dominant regimes $(Da \to 0)$ ). The scaling relationships on dissolution (the average height change, $\Delta {h_{avg}}\sim \sqrt \tau $ for the diffusion-dominant regime and $\Delta {h_{avg}}\sim R{a^{0.79/3}}{\tau ^{0.86}}$ for the convection-dominant regime) are also suggested to explain the pattern formation. Under a convective mass transfer condition, the concentration gradient of the solute developed during the recession of the salt surface results in an adverse density gradient, which causes gravitational instability motion and finally determines the formation of a dissolution pattern. In addition, two-dimensional and three-dimensional numerical simulations visualize dissolution-driven convective flow fields, the recession of the liquid-solid interface and pattern formation on the dissolving interface. Theoretical and numerical analyses of the dissolution process suggest that the control of gravitational instability is important to prevent or enhance dissolution pattern formation. This systematic parameter study provides a deep understanding of the effect of gravitational instability on convection-driven dissolution in a horizontal geometry.

African swine fever (ASF) is a deadly disease in swine caused by African swine fever virus (ASFV). The global spread of ASFV has resulted in significant economic losses worldwide. Improved early detection has been the most important first line of defense for preventing ASF outbreaks and for activating control measures. Despite the availability of rapid amplification methods, nucleic acid extraction from specimens still needs to be performed in a laboratory. To facilitate this step, we exploited the strong affinity of biotin-streptavidin binding by functionalizing streptavidin-coated magnetic beads with biotinylated oligonucleotide capture probes to efficiently capture genotype II ASFV DNA directly from crude clinical samples. The captured DNA is suitable for detection using real-time quantitative PCR (qPCR) and recombinase polymerase amplification (RPA). In this study, ASFV DNA was efficiently captured from swine feces, serum, and tissue samples. Both DNA-capture-assisted qPCR and RPA-based detection methods have a limit of detection (LOD) of 10

Previously, we identified eight novel minisatellites in the MUC2, of which allelic variants in MUC2-MS6 were examined to influence susceptibility to gastric cancer. However, studies on the susceptibility to gastrointestinal cancer of other minisatellites in the MUC2 region still remain unprogressive. In this study, we investigated whether polymorphic variations in the MUC2-MS8 region are related to susceptibility to gastrointestinal cancer. We assessed the association between MUC2-MS8 and gastrointestinal cancers by a case–control study with 1229 controls, 486 gastric cancer cases, 220 colon cancer cases and 278 rectal cancer cases. To investigate whether intronic minisatellites affect gene expression, various minisatellites were inserted into the luciferase-reporter vector and their expression levels were examined. We also examined the length of MUC2-MS8 alleles in blood and cancer tissue matching samples of 107 gastric cancer patients, 125 colon cancer patients, and 85 rectal cancer patients, and investigated whether the repeat sequence affects genome instability. A statistically significant association was identified between rare MUC2-MS8 alleles and the occurrence of rectal cancer: odds ratio (OR), 6.66; 95% confidence interval (CI), 1.11–39.96; and P = 0.0165. In the younger group (age

In recent years, several novel circular single-stranded DNA viruses have been detected in various mammals, birds, insects, and environmental samples using metagenomic and high-throughput sequencing approaches. In this study, we tested for the presence of circoviruses in 243 bat fecal samples collected between 2018 and 2019 from 48 sampling sites across Korea. To detect circoviruses, nested PCR was performed with degenerate primers targeting a conserved replication-associated protein (rep) gene of circovirus/cyclovirus. Among 243 samples tested, a total of 37 fecal samples from 14 sampling sites were PCR-positive for circoviruses at a frequency rate of 15.23%. We obtained 36 partial rep gene sequences of circoviruses and one complete genome sequence of bat-associated circovirus 12, encompassing a genome size of 2097 nt containing two inversely arranged open reading frames and a conserved nonamer sequence in the apex of a stem-loop structure. In addition, we found four bat species that were harboring circoviruses in Korea based on species identification PCR of circovirus-positive bat fecal samples. Detailed sequence analysis indicated that the bat-associated circovirus sequences identified in this study were related to those of known bat and avian groups of circoviruses. Herein, we report evidence for the presence of bat-associated circoviruses in Korean bats.

The discrepancy between preoperative and final pathological staging has been a long-standing challenge for the application of clinical trials or appropriate treatment options. This study aimed to demonstrate the accuracy of preoperative staging of locally advanced gastric cancer using data from a large-scale randomized clinical trial.Of the 1050 patients enrolled in the clinical trial, 26 were excluded due to withdrawal of consent (Regarding T staging by computed tomography, accuracy rates were 74.48, 61.62, 58.56, and 85.16% for T1, T2, T3 and T4a, respectively. Multivariate analysis for underestimation of T staging revealed that younger age, ulcerative gross type, circular location, larger tumor size, and undifferentiated histology were independent risk factors. Regarding nodal status estimation, 54.9% of patients with clinical N0 disease were pathologic N0, and 36.4% of patients were revealed to have pathologic N0 among clinical node-positive patients. The percentage of metastasis involvement at the D1, D1+, and D2 lymph node stations significantly increased with the advanced clinical N stage. Among all patients, 29 (2.8%), including 26 with peritoneal seeding, exhibited distant metastases.Estimating the exact pathologic staging remains challenging. A thorough evaluation is mandatory before treatment selection or trial enrollment. Moreover, we need to set a sufficient case number when we design the clinical trial considering the stage migration.

The long-term safety of laparoscopic distal gastrectomy for locally advanced gastric cancer (AGC) remains uncertain given the lack of 5-year follow-up results.To compare the 5-year follow-up results in patients with clinically AGC enrolled in the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS)-02 randomized clinical trial who underwent laparoscopic or open distal gastrectomy.The KLASS-02, a multicenter randomized clinical trial, showed that laparoscopic surgery was noninferior to open surgery for patients with locally AGC. The present study assessed the 5-year follow-up results, including 5-year overall survival (OS) and relapse-free survival (RFS) rates and long-term complications, in patients enrolled in KLASS-02. From November 21, 2011, to April 29, 2015, patients aged 20 to 80 years diagnosed preoperatively with locally AGC were enrolled. Final follow-up was on June 15, 2021. Data were analyzed June 24 to September 9, 2021.Patients were treated with R0 resection either by laparoscopic gastrectomy or open gastrectomy as the full analysis set of the KLASS-02 trial.Five-year OS and RFS rates, recurrence patterns, and long-term surgical complications were evaluated.This study enrolled a total of 1050 patients. A total of 974 patients were treated with R0 resection; 492 (50.5%) in the laparoscopic gastrectomy group (mean [SD] age, 59.8 [11.0] years; 351 men [71.3%]) and 482 (49.5%) in the open gastrectomy group (mean [SD] age, 59.4 [11.5] years; 335 men [69.5%]). In patients who underwent laparoscopic and open distal gastrectomy, the 5-year OS (88.9% vs 88.7%) and RFS (79.5% vs 81.1%) rates did not differ significantly. The most common types of recurrence were peritoneal carcinomatosis (73 of 173 [42.1%]), hematogenous metastases (36 of 173 [20.8%]), and locoregional recurrence (23 of 173 [13.2%]), with no between-group differences in types of recurrence at each cancer stage. The correlation between 3-year RFS and 5-year OS at the individual level was highest in patients with stage III gastric cancer (ρ = 0.720). The late complication rate was significantly lower in the laparoscopic than in the open surgery group (32 of 492 [6.5%] vs 53 of 482 [11.0%]). The most common type of complication in both groups was intestinal obstruction (13 of 492 [2.6%] vs 24 of 482 [5.0%]).The 5-year outcomes of the KLASS-02 trial support the 3-year results, which is the noninferiority of laparoscopic surgery compared with open gastrectomy for locally AGC. The laparoscopic approach can be recommended in patients with locally AGC to achieve the benefit of low incidence of late complications.ClinicalTrials.gov Identifier: NCT01456598.

The onset time of buoyancy-driven instability in a saline solution where evaporation proceeds through the solution-air interface is analyzed theoretically and numerically. Based on linear stability theory, new stability equations are derived and numerically solved. Also, nonlinear numerical simulations are conducted using FEM solver, COMSOL Multiphysics.® It is clearly shown that as the evaporation proceeds, the height of solution continuously decreases with time. Moreover, as the evaporation proceeds, concentrated saline solution near the evaporating surface induces gravitational instability. The critical time determined from the linear stability analysis explains the numerical simulation results reasonably. The present theoretical and numerical studies present that evaporation-driven instability is governed by the dimensionless evaporation rate, α, and the initial salt concentration, Ra. The present numerical simulations explain the previous experimental plume dynamics in the evaporation-driven instability systems quite well.

Purpose Quality of life (QOL) has become important in the trend of emphasizing patient satisfaction. This study aimed to evaluate the QOL in patients who underwent laparoscopic or robotic gastrectomy for gastric cancer. Methods A prospective trial was performed involving patients who underwent laparoscopic or robotic gastrectomy for primary gastric cancer at 11 hospitals in Korea. Within this comparative trial, QOL, postoperative pain, and long-term complications were exanimated. The quality-of-life questionnaire (QLQ)-C30 and QLQ-STO22 developed by the European Organization for Research and Treatment of Cancer were used for the QOL survey. We compared the data after dividing it into several types of characteristics as follows; device (robotic or laparoscopic), operation type, pathological stage, and sex. Biased components were extracted by logistic regression analysis. Propensity score matching was applied to the data set with the biased components. Results In total, 434 patients (211 for laparoscopic surgery and 223 for robotic surgery) were enrolled, out of which 321 patients who responded to both preoperative and postoperative surveys were selected for analysis. Robotic gastrectomy was not different from laparoscopic gastrectomy with respect to postoperative QOL. Distal gastrectomy showed better scores than total gastrectomy in terms of role functioning, social functioning, fatigue, nausea/vomiting, pain, dyspnea, constipation, financial difficulties, dysphagia, eating restrictions, anxiety, taste, and body image. Male patients showed better scores on the 19 scales compared to female patients. Conclusion Robotic and laparoscopic approaches for gastric cancer surgery did not differ from each other with respect to QOL. Distal gastrectomy resulted in better QOL than total gastrectomy.

OBJECTIVE To qualify surgeons to participate in a randomized trial comparing laparoscopic and open distal D2 gastrectomy for advanced gastric cancer. SUMMARY OF BACKGROUND DATA No studies have sought to qualify surgeons for a randomized trial comparing laparoscopic and open D2 gastrectomy for advanced gastric cancer. METHODS We conducted a multicenter prospective observational study evaluating unedited videos of laparoscopic and open D2 gastrectomy performed by 27 surgeons. Surgeons performed 3 of each laparoscopic and open distal gastrectomies with D2 lymphadenectomy for gastric cancer. Five peers reviewed each unedited video using a video assessment form. Based on experts' review of videos, a separate review committee decided surgeons as "Qualified" or "Not-qualified." RESULTS Twelve surgeons (44.4%) were qualified on initial evaluation whereas the other 15 surgeons were not. Another 9 surgeons were finally qualified after re-evaluation. The median score for Qualified was significantly higher than Not-qualified (P < 0.001).Significant differences between Qualified and Not-qualified were noted both in operation type and in all evaluation area of surgical skill, perigastric, and extra-perigastric lymphadenectomy, although the inter-rater variability of the assessment score was low (kappa = 0.285). However, Not-qualified surgeons' scores improved upon re-evaluation of resubmitted videos.When compared laparoscopy with open surgery, median scores were similar between the 2 groups (P = 0.680). However, open gastrectomy scores for surgical skills were significantly higher than for laparoscopic surgery (P = 0.016). CONCLUSIONS Our surgeon quality control study for gastrectomy represents a milestone in surgical standardization for surgical clinical trials. Our methods could also serve as a system for educating surgeons and assessing surgical proficiency.

Laparoscopic distal gastrectomy for early gastric cancer has been widely accepted, but laparoscopic total gastrectomy has still not gained popularity because of technical difficulty and unsolved safety issue. We conducted a single-arm multicenter phase II clinical trial to evaluate the safety and the feasibility of laparoscopic total gastrectomy for clinical stage I proximal gastric cancer in terms of postoperative morbidity and mortality in Korea. The secondary endpoint of this trial was comparison of surgical outcomes among the groups that received different methods of esophagojejunostomy (EJ). The 160 patients of the full analysis set group were divided into three groups according to the method of EJ, the extracorporeal circular stapling group (EC; n = 45), the intracorporeal circular stapling group (IC; n = 64), and the intracorporeal linear stapling group (IL; n = 51). The clinicopathologic characteristics and the surgical outcomes were compared among these three groups. There were no significant differences in the early complication rates among the three groups (26.7% vs. 18.8% vs. 17.6%, EC vs. IC vs. IL; p = 0.516). The length of mini-laparotomy incision was significantly longer in the EC group than in the IC or IL group. The anastomosis time was significantly shorter in the EC group than in the IL group. The time to first flatus was significantly shorter in the IL group than in the EC group. The long-term complication rate was not significantly different among the three groups (4.4% vs. 12.7% vs. 7.8%; EC vs. IC vs. IL; p = 0.359), however, the long-term incidence of EJ stenosis in IC group (10.9%) was significantly higher than in EC (0%) and IL (2.0%) groups (p = 0.020). The extracorporeal circular stapling and the intracorporeal linear stapling were safe and feasible in laparoscopic total gastrectomy, however, intracorporeal circular stapling increased EJ stenosis.

Introduction Testing the fluorescence emission of the vascular circulation status of the indocyanine green (ICG) fluorescence contrast agent to validate the system performance is crucial. Hence, the development of an ICG phantom is imperative, and this study proposes a method for manufacturing an ICG phantom. Method The ICG with an initial concentration was subjected to 0.2 cc sampling through syringe(x), and an ICG (0.2 cc) is diluted with silicon (Si) latex lubber (10 mL) during the manufactured the phantom. The brightest fluorescence expression state is 30 μM, and if it exceeded 50 μM, fluorescence fading occurred and changed to a dark color. Results The liquid (ICG) of the concentration range is 0.003 mM to 0.24 mM, and the maximum fluorescence expression range is 0.005 to 0.006 mM when the phantom is irradiated using a 780-nm (800 mW) LED. In addition, the fluorescence emission is reduced to 0.24 mM, and the fluorescence expression concentration is 10 μM, 30 μM, and 50 μM, respectively. The decreasing of the fluorescence emission is beginning to 50 μM. Conclusions In this study, the proposed phantom with ICG fluorescence emission using latex lubber is proposed. In this works, the proposed phantom is improved the performance for ICG fluorescence emission. In the manufactured phantom, the phantom is used for gelatin, and the advance of phantom has easy manufacturing and long-life fluorescence emission (semipermanent) due to incorrodible material (latex lubber). To experimental results of a phantom, the ICG fluorescent contrast medium (0.055 mM) is same to 30 μM. Then, the 0.055 mM and 30 μM have high resolution and fluorescence emission status. Thus, the results are in good agreement.

We compared the prevalence of adenoma and cancerous colon polyps in patients undergoing endoscopic removal or gastric surgery for gastric adenoma or gastric cancer and in healthy individuals.The medical records of 707 patients with gastric neoplasm and 798 age- and sex-matched healthy subjects were retrospectively analyzed between January 2010 and July 2018. The clinicopathological characteristics, prevalence of colorectal neoplasm diagnosed by colonoscopy, and risk factors for colorectal polyps were also investigated.When comparing the two groups, the prevalence of overall colorectal polyps and its distribution was not different between the two groups (54.0% vs.49.5%, P = .079), whereas, the number of colon polyps (1.20 ± 1.71 vs 0.99 ± 1.54, P = .015) and the maximal size (3.53 ± 6.14 vs 2.08 ± 2.88, P .001) were significantly larger in the gastric neoplasm group. The prevalence of advanced colon adenoma was significantly higher in the gastric neoplasm group (10.7% vs 3.8%, P .001). Risk factors such as elevated glucose levels and the presence of gastric neoplasm were related to the prevalence of all colon polyps. The presence of gastric neoplasm is an important risk factor for advanced colon polyps.Patients with gastric neoplasms had a significantly higher prevalence of advanced colon adenoma. Advanced colon adenoma is associated with the chain from benign adenomas through malignant altered adenomas to advanced colon cancer. Thus, patients with gastric neoplasm are regarded as a high-risk group for colorectal cancer and are recommended for screening colonoscopy at the time of diagnosis.

Previously, we identified eight novel minisatellites in the MUC2, of which allelic variants in MUC2-MS6 were examined to influence susceptibility to gastric cancer. However, studies on the susceptibility to gastrointestinal cancer of other minisatellites in the MUC2 region still remain unprogressive.In this study, we investigated whether polymorphic variations in the MUC2-MS8 region are related to susceptibility to gastrointestinal cancer.We assessed the association between MUC2-MS8 and gastrointestinal cancers by a case-control study with 1229 controls, 486 gastric cancer cases, 220 colon cancer cases and 278 rectal cancer cases. To investigate whether intronic minisatellites affect gene expression, various minisatellites were inserted into the luciferase-reporter vector and their expression levels were examined. We also examined the length of MUC2-MS8 alleles in blood and cancer tissue matching samples of 107 gastric cancer patients, 125 colon cancer patients, and 85 rectal cancer patients, and investigated whether the repeat sequence affects genome instability.A statistically significant association was identified between rare MUC2-MS8 alleles and the occurrence of rectal cancer: odds ratio (OR), 6.66; 95% confidence interval (CI), 1.11-39.96; and P = 0.0165. In the younger group (age, 55), rare alleles were significant associated with an increased risk of rectal cancer (odds ratio, 24.93 and P = 0.0001). Suppression of expression was found in the reporter vector inserted with minisatellites, and loss of heterozygosity (LOH) of the MUC2-MS8 region was confirmed in cancer tissues of gastrointestinal cancer patients (0.8-5.9%).Our results suggest that the rare alleles of MUC2-MS8 could be used to identify the risk of rectal cancer and that this repeat region is related to genomic instability.