Appropriate Number of Adjuvant Chemotherapy Cycles for Patients with Stage 2 or 3 Gastric Cancer After Curative Gastrectomy: A Multicenter Cohort Study.

BACKGROUND: Few studies have presented evidence pertaining to the adequate minimum number of adjuvant chemotherapy (AC) cycles required to achieve an oncologic benefit for gastric cancer. METHODS: From January 2012 to December 2013, data from patients who underwent curative radical gastrectomy and consequently received AC for pathologic stage 2 or 3 gastric cancer at 27 institutions in South Korea were analyzed. RESULTS: The study enrolled 925 patients, 661 patients (71.5%) who completed 8 cycles of AC and 264 patients (28.5%) who did not. Compared with the mean disease-free survival (DFS) of the patients who completed 8 AC cycles (69.3 months), the mean DFS of patients who completed 6 AC cycles (72.4 months; p = 0.531) and those who completed 7 AC cycles (63.7 months; p = 0.184) did not differ significantly. However, the mean DFS of the patients who completed 5 AC cycles (48.2 months; p = 0.016) and those who completed 1-4 AC cycles (62.9 months; p = 0.036) was significantly lower than the DFS of those who completed 8 AC cycles. In the multivariate Cox proportional hazards analysis, the mean DFS was significantly affected by advanced stage, large tumor size, positive vascular invasion, and number of completed AC cycles (1-5 cycles: hazard ratio 1.45; 95% confidence interval 1.01-2.08; p = 0.041). CONCLUSION: The current multicenter observational cohort study showed that the mean DFS for 6 or 7 AC cycles was similar to that for 8 AC cycles as an adjuvant treatment for gastric cancer.

Comparison of surgical outcomes among different methods of esophagojejunostomy in laparoscopic total gastrectomy for clinical stage I proximal gastric cancer: results of a single-arm multicenter phase II clinical trial in Korea, KLASS 03.

BACKGROUND: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: The extracorporeal circular stapling and the intracorporeal linear stapling were safe and feasible in laparoscopic total gastrectomy, however, intracorporeal circular stapling increased EJ stenosis.

A feasibility study of laparoscopic total gastrectomy for clinical stage I gastric cancer: a prospective multi-center phase II clinical trial, KLASS 03.

BACKGROUND: With improved short-term surgical outcomes, laparoscopic distal gastrectomy has rapidly gained popularity. However, the safety and feasibility of laparoscopic total gastrectomy (LTG) has not yet been proven due to the difficulty of the technique. This single-arm prospective multi-center study was conducted to evaluate the use of LTG for clinical stage I gastric cancer. METHODS: Between October 2012 and January 2014, 170 patients with pathologically proven, clinical stage I gastric adenocarcinoma located at the proximal stomach were enrolled. Twenty-two experienced surgeons from 19 institutions participated in this clinical trial. The primary end point was the incidence of postoperative morbidity and mortality at postoperative 30 days. The severity of postoperative complications was categorized according to Clavien-Dindo classification, and the incidence of postoperative morbidity and mortality was compared with that in a historical control. RESULTS: Of the enrolled patients, 160 met criteria for inclusion in the full analysis set. Postoperative morbidity and mortality rates reached 20.6% (33/160) and 0.6% (1/160), respectively. Fifteen patients (9.4%) had grade III or higher complications, and three reoperations (1.9%) were performed. The incidence of morbidity after LTG in this trial did not significantly differ from that reported in a previous study for open total gastrectomy (18%). CONCLUSIONS: LTG performed by experienced surgeons showed acceptable postoperative morbidity and mortality for patients with clinical stage I gastric cancer.

An Efficient Amphiphilic-Type Triphenylamine-Based Organic Hole Transport Material for High-Performance and Ambient-Stable Dopant-Free Perovskite and Organic Solar Cells.

A new set of simply structured triphenylamine-based small molecules are synthesized and evaluated as dopant-free hole transporting materials (HTMs) for high-performance perovskite solar cells (PSCs) and bulk heterojunction inverted organic solar cells (BHJ IOSCs). Surprisingly, the new amphiphilic-type HTM-1 (with internal hydrophilic groups and peripheral hydrophobic alkyl tails) showed better compatibility and performance than the actual target molecule, that is, HTM-2 in PSCs and BHJ IOSCs. Importantly, the HTM-1-based dopant-free PSCs and BHJ IOSCs exhibited high power conversion efficiencies (PCEs) of 11.45 % and 8.34 %, respectively. These performances are superior and comparable to those of standard HTMs Spiro-OMeTAD (2,2',7,7'-tetrakis(N,N-di-p-methoxyphenylamine)-9,9'-spirobifluorene) and PEDOT:PSS (poly(3,4-ethylenedioxythiophene)/polystyrene sulfonate) in PSCs and BHJ IOSCs, respectively. The enhanced device performance of the HTM-1-based PSCs is ascribed to its strong affinity towards the perovskite, properly aligned energy levels with respect to the perovskite valence band, and excellent hole transporting behavior. In addition, the well-organized energy levels of the HTMs showed excellent compatibility in BHJ IOSCs. The new amphiphilic-type HTM-based photovoltaic devices also showed long-term air stability over 700 h. These promising results offer new and unexpected prospects for engineering the interface between the photoactive material and HTMs in PSCs and BHJ IOSCs.

Electrochemical reactive oxygen species detection by cytochrome c immobilized with vertically aligned and electrochemically reduced graphene oxide on a glassy carbon electrode.

A new amperometric biosensor for hydrogen peroxide (H2O2) and superoxide anion (SO) has been developed. The biosensor developed uses cytochrome c (Cyt c) modified glassy carbon electrodes coupled with electrochemically reduced graphene oxide (ErGO). To immobilize Cyt c, the "one step" electrochemical deposition of vertically aligned and ErGO (VAErGO) has been performed by using a pulse reverse technique, thus resulting in a very simple and efficient system. The well-established vertical alignment of ErGO was confirmed by atomic force microscopy and the electrochemical characteristics of the biosensor were investigated by cyclic voltammetric, electrochemical impedance spectroscopy and amperometric techniques. The surface coverage (Γ) of immobilized Cyt c was effectively increased by the vertical alignment of ErGO and found to be 1.03 × 10-10 mol cm-2. The direct electron transfer property of Cyt c was also improved by VAErGO and the heterogeneous electron transfer rate constant (ket) was estimated to be 6.40 s-1. To detect H2O2 and SO, amperometric measurements were carried out at different operating potentials (0.0 V vs. Ag/AgCl for H2O2 and +0.2 V for SO). The sensitivity and detection limit for H2O2 were found to be 46.3 µA mM-1 cm-2 and 2.3 µM, and for SO were found to be 32.1 µM nA-1 cm-2 and 6.84 nM s-1, respectively. Additionally, the designed biosensor exhibited strong anti-interference ability and satisfactory reproducibility.

An easy route to red emitting homoleptic IrIII complex for highly efficient solution-processed phosphorescent organic light-emitting diodes.

A thiophene-phenylquinoline-based homoleptic Ir(III) complex, [Ir(Th-PQ)(3)], has been synthesised by a simple route and utilised as a dopant in solution-processed phosphorescent organic light-emitting diodes (PhOLEDs). It shows the current efficiency of approximately 26 cd A(-1) and the external quantum efficiency of about 21 %, which are the highest values reported to date for PhOLEDs prepared by solution-process.

Synthesis and properties of an ionic conducting material: in-situ preparation of poly(2-ethynyl-N-iodopyridinium iodide) and its electro-optical and electrochemical properties.

Poly(2-ethynyl-N-iodopyridinium iodide) [PEIPI] was easily prepared via in-situ uncatalyzed polymerization of 2-ethynylpyridine by using iodine. The activated acetylenic bond of 2-ethynyl-N-iodopyridinium iodide formed at the initial reaction time was assumed to be susceptible to linear polymerization, followed by an identical propagation step that contains the produced macroanion and quaternized monomeric species. The polymer structure was characterized by various instrumental methods to have the conjugated polymer backbone system bearing the designed substituents. The electro-optical and electrochemical properties of polymer were studied. The UV-visible spectrum of PEIPI showed a characteristic absorption peak in the visible region up to 800 nm. The PL emission spectrum of PEIPI shows two peaks at 515 and 550 nm. The cyclic voltammetry of PEIPI exhibited irreversible electrochemical behavior between the oxidation and reduction peaks.

Synthesis and characterization of an ionic conjugated polymer: poly[2-ethynyl-N-(2-furoyl)pyridinium chloride].

A new ionic polyacetylene derivative with furoyl substituents was prepared by the uncatalyzed polymerization of 2-ethynylpyridine by using 2-furoyl chloride in high yield. The polymer structure was characterized by such instrumental methods as NMR, IR, and UV-visible spectroscopies to have a polyacetylene backbone system with the N-(2-furoyl)pyridinium chloride. The electro-optical and electrochemical properties of poly[2-ethynyl-N-(2-furoyl)pyridinium chloride [PEFPC] were studied. The photoluminescence spectrum showed that the PL peak is at 578 nm corresponding to the photon energy of 2.15 eV. The cyclovoltammograms of PEFPC exhibited the irreversible electrochemical behaviors between the oxidation and reduction peaks. The oxidation current density of polymer versus the scan rates is approximately linear relationship in the range of 30 mV/sec-150 mV/sec. It was found that the kinetics of redox process is controlled by the reactant diffusion process from the oxidation current density of PEFPC versus the scan rates.

Uncatalyzed synthesis and characterization of a water-soluble polyacetylene: poly[2-ethynyl-N-(propylsulfonate)pyridinium betaine].

A new ionic conjugated polymer was prepared by the activated polymerization of 2-ethynylpyridine with the ring-opening of 1,3-propanesultone without any additional initiator or catalyst. This polymer was characterized by various instrumental methods to have conjugated polymer backbone system with pendant N-propylsulfonate functional groups. The photoluminescence spectrum of polymer showed that the PL peak is located at 552 nm corresponding to the photon energy of 2.25 eV. The cyclovoltammograms of polymer exhibited the irreversible electrochemical behaviors between the oxidation and reduction peaks. The oxidation current density of polymer versus the scan rates is approximately linear relationship in the range of 30-120 mV/sec. It was found that the kinetics of the redox process is almost controlled by the reactant diffusion process from the oxidation current density of polymer versus the scan rates.

Synthesis and properties of new low band gap semiconducting polymers.

Low band gap organic semiconducting polymers were prepared as p-type donors for organic photovoltaic devices. A novel dibrominated monomer composed of phenothiazine, thiophene, and benzothiadiazole (DPDTBT) was synthesized as a low band gap core block. DPDTBT was copolymerized with three different boronic esters of dithiophene, fluorene, and phenothiazine by the Suzuki coupling polycondensation reaction. The band gap energies of the synthesized polymers ranged between 2.05 and 2.11 eV, depending on the polymer structure. Bulk heterojunction solar cells fabricated using the polymers and [6,6]-phenyl C71-butyric acid methyl ester (PC70BM) as an acceptor were characterized. The best power conversion efficiency obtained from the fabricated devices under simulated AM 1.5 G solar irradiation of 100 mW/cm2 was 0.46%.

Synthesis and characterization of phenylpyridine-based iridium(III) complex for solution-processed phosphorescent organic light-emitting diode.

A novel main ligand 2-(2,4-dimethoxyphenyl)-5-trifluoromethylpyridine (MeO2CF3ppy) and its complex bis[2-(2,4-dimethoxy-phenyl)-5-trifluoromethyl pyridinato-N,C2]iridium acetylacetonate (MeO2CF3ppy)2Ir(acac) was synthesized. 2,4-Dimethoxy and 5-trifluoromethyl group were incorporated into main ligand to tune luminescence color. The phosphorescence organic light-emitting diodes (PhOLEDs) based on this complex with the configuration of ITO/PEDOT:PSS (40 nm)/PVK:CBP:Ir(III) complex (50 nm)/BCP (20 nm)/LiF (0.7 nm)/Al (100 nm) were fabricated. The solution-processed PhOLEDs based on (MeO2CF3ppy)2Ir(acac) exhibited a maximum quantum efficiency of 4.18% and luminance efficiency 9.04 cd/A with CIE coordinate of (0.32, 0.64).

Nonhalogenated Solvent-Processed Efficient Ternary All-Polymer Solar Cells Enabled by the Introduction of a Naphthyloxy Group into the Side Chain of Polymer Donors.

Conjugated polymer donors are crucial for enhancing the power conversion efficiencies (PCEs) in all-polymer solar cells (All-PSCs) in nonhalogenated solvents. In this work, three wide-band-gap polymer donors (Sil-D1, Ph-Sil-D1, and Nap-Sil-D1) based on dithienobenzothiadiazole (DTBT) and benzodithiophene (BDT) donor moieties optimized by side chain engineering were designed and synthesized. Alkyl (Sil-D1), phenyloxy (Ph-Sil-D1), and naphthyloxy (Nap-Sil-D1) alkyl siloxane side chain units were incorporated into these polymer donors, respectively. Notably, the Nap-Sil-D1 polymer donor had a greater conjugation length, π-electron delocalization, and improved dipole moment. The deepest highest occupied molecular orbital level of Nap-Sil-D1, with a high absorption coefficient, showed better aggregation properties. In addition, reduced bimolecular recombination and trap-state density generated a high charge transfer to cause a significant enhancement of open-circuit voltage, current density, and fill factor values of 0.94 V, 25.5 mA/cm2, and 70.4%, respectively, for the Nap-Sil-D1-blended All-PSC ternary device (PM6:Nap-Sil-D1:PY-IT), with the highest PCE of 16.8% in the o-xylene solvent, compared to other polymers (Sil-D1 and Ph-Sil-D1) with PCEs of 15.5 and 16.2%. As a result, this optimized device architecture was found to be the most promising as a nonhalogenated solvent processed in additive-free ternary All-PSCs with good stability.

Accomplishing High-Performance Organic Solar Sub-Modules (≈55 cm2) with >16% Efficiency by Controlling the Aggregation of an Engineered Non-Fullerene Acceptor.

The fabrication of environmentally benign, solvent-processed, efficient, organic photovoltaic sub-modules remains challenging due to the rapid aggregation of the current high performance non-fullerene acceptors (NFAs). In this regard, design of new NFAs capable of achieving optimal aggregation in large-area organic photovoltaic modules has not been realized. Here, an NFA named BTA-HD-Rh is synthesized with longer (hexyl-decyl) side chains that exhibit good solubility and optimal aggregation. Interestingly, integrating a minute amount of new NFA (BTA-HD-Rh) into the PM6:L8-BO system enables the improved solubility in halogen-free solvents (o-xylene:carbon disulfide (O-XY:CS2)) with controlled aggregation is found. Then solar sub-modules are fabricated at ambient condition (temperature at 25 ± 3 °C and humidity: 30-45%). Ultimately, the champion 55 cm2 sub-modules achieve exciting efficiency of >16% in O-XY:CS2 solvents, which is the highest PCE reported for sub-modules. Notably, the highest efficiency of BTA-HD-Rh doped PM6:L8-BO is very well correlated with high miscibility with low Flory-Huggins parameter (0.372), well-defined nanoscale morphology, and high charge transport. This study demonstrates that a careful choice of side chain engineering for an NFA offers fascinating features that control the overall aggregation of active layer, which results in superior sub-module performance with environmental-friendly solvents.

π-Conjugated Polymer with Pendant Side Chains as a Dopant-Free Hole Transport Material for High-Performance Perovskite Solar Cells.

Dopant-free polymeric hole transport materials (HTMs) have attracted considerable attention in perovskite solar cells (PSCs) due to their high carrier mobilities and excellent hydrophobicity. They are considered promising candidates for HTMs to replace commercial Spiro-OMeTAD to achieve long-term stability and high efficiency in PSCs. In this study, we developed BDT-TA-BTASi, a conjugated donor-π-acceptor polymeric HTM. The donor benzo[1,2-b:4,5-b']dithiophene (BDT) and acceptor benzotriazole (BTA) incorporated pendant siloxane, and alkyl side chains led to high hole mobility and solubility. In addition, BDT-TA-BTASi can effectively passivate the perovskite layer and markedly decrease the trap density. Based on these advantages, dopant-free BDT-TA-BTASi-based PSCs achieved an efficiency of over 21.5%. Furthermore, dopant-free BDT-TA-BTASi-based devices not only exhibited good stability in N2 (retaining 92% of the initial efficiency after 1000 h) but also showed good stability at high-temperature (60 °C) and -humidity conditions (80 ± 10%) (retaining 92 and 82% of the initial efficiency after 400 h). These results demonstrate that BDT-TA-BTASi is a promising HTM, and the study provides guidance on dopant-free polymeric HTMs to achieve high-performance PSCs.

Finely Tuned Molecular Packing Realized by a New Rhodanine-Based Acceptor Enabling Excellent Additive-Free Small- and Large-Area Organic Photovoltaic Devices Approaching 19 and 12.20% Efficiencies.

A new nonfullerene acceptor (NFA), BTA-ERh, was synthesized and integrated into a PM6:Y7:PC71BM ternary system to regulate the blend film morphology for enhanced device performance. Due to BTA-ERh's good miscibility with host active blend films, an optimized film morphology was obtained with appropriate phase separation and fine-tuning of film crystallinity, which ultimately resulted in efficient exciton dissociation, charge transport, lower recombination loss, and decreased trap-state density. The resulting additive-free quaternary devices achieved a remarkable efficiency of 18.90%, with a high voltage, fill factor, and current density of 0.87 V, 76.32%, and 28.60 mA cm-2, respectively. By adding less of a new small molecule with high crystallinity, the favorable nanomorphology shape of blend films containing NFAs might be adjusted. Consequently, this strategy can enhance photovoltaic device performance for cutting-edge NFA-based organic solar cells (OSCs). In contrast, the additive-free OSCs exhibited good operational stability. More importantly, large-area modules with the quaternary device showed a remarkable efficiency of 12.20%, with an area as high as 55 cm2 (substrate size, 100 cm2) in an air atmosphere via D-bar coating. These results highlight the enormous research potential for a multicomponent strategy for future additive-free OSC applications.

Multifunctional Narrow Band Gap Terpolymer-Enabled High-Performance Dopant-Free Perovskite and Additive-Free Organic Solar Cells with Long-Term Stability.

The optoelectronic devices endowing multifunctionality while utilizing a single low-cost material have always been challenging. For this purpose, we adopted a random ternary copolymerization strategy for designing two terpolymers, namely TP-0.8-EG and TP-0.8-TEG comprising a benzothiadiazole (BT)-benzo[1,2-b:4,5-b']dithiophene-diketopyrrolo[3,4-c]pyrrole (A1-π-D-π-A2) backbone. The figure of merits of the narrow band gap TP-0.8-EG terpolymer include deepened frontier energy levels, high hole mobility, better film formability, enriched multifunctionality, and passivation capability. Accordingly, the suitable electronic properties of TP-0.8-EG revealed that it can function as a dopant-free hole-transporting material in perovskite solar cells (PSCs) as well as the third component in organic solar cells (OSCs). Remarkably, TP-0.8-EG outperforms by exhibiting a higher power conversion efficiency (PCE) of 20.9% over TP-0.8-TEG (PCE of 18.3%) and BT-UF (PCE of 14.6%) in dopant-free PSCs. Interestingly, TP-0.8-EG fabricated along with PM6:Y7 displayed a high PCE of 16.52% in ternary OSCs. Also, TP-0.8-EG established good device storage stabilities (85 and 83% of their initial PCEs for 1200 and 500 h) in dopant-free PSC as well as OSC devices. Notably, the devices with TP-0.8-EG showed excellent thermal and moisture stabilities. To the best of our knowledge, A1-π-D-π-A2 terpolymer performing both in PSCs and OSCs with decent efficiencies and good device stabilities is a rare scenario.

Role of reduction gastrectomy in patients with gastric cancer with a single non-curable factor: Supplementary analysis of REGATTA trial.

Background: REGATTA trial failed to demonstrate the survival benefit of reduction gastrectomy in patients with advanced gastric cancer with a single non-curable factor. However, a significant interaction was found between the treatment effect and tumor location in the subset analysis. Additionally, the treatment effect appeared to be different between Japan and Korea. This supplementary analysis aimed to elucidate the effect of reduction surgery based on tumor location and country. Methods: Multivariable Cox regression analyses in each subgroup were performed to estimate the hazard ratio (HRadj), including the following variables as explanatory variables: country, age, sex, incurable factor, cT, cN, primary tumor, performance status, histological type, and macroscopic type. Results: Patients (95 in Japan and 80 in Korea) were randomized to chemotherapy alone (86 patients) or gastrectomy plus chemotherapy (89 patients). The subgroup analysis according to the country revealed a worse overall survival in gastrectomy plus chemotherapy arm in Japan (hazard ratio: 1.32, 95% confidence interval: 0.85-2.05), but not in Korea (hazard ratio: 0.85.95% confidence interval: 0.52-1.40). Overall survival was better in distal gastrectomy plus chemotherapy compared with chemotherapy alone (hazard ratio = 0.69, 95% confidence interval: 0.42-1.13), and worse in total gastrectomy plus chemotherapy compared with chemotherapy alone (hazard ratio = 1.34, 95% CI: 0.93-1.94), which was more remarkable in Korea than in Japan. Conclusions: Primary chemotherapy is a standard of care for advanced gastric cancer; however, the survival benefits from reduction by distal gastrectomy remained controversial.

Prognosis of curatively resected pT4b gastric cancer with respect to invaded organ type.

PURPOSE: Curative resection, including gastrectomy, extensive lymph node dissection, and combined resection of invaded organs, is the mainstay of treatment for T4b gastric cancers. We sought to investigate the clinicopathologic features, surgical outcomes, and prognostic factors of curatively resected pathologic T4b gastric cancer with a focus on organs invaded. METHODS: Data of 243 pT4b gastric cancer patients who underwent curative resection at Korea Cancer Center Hospital from 1991 to 2005 were retrospectively subjected to univariate and multivariate analyses. RESULTS: Overall 5-year survival rate and median survival time were 36.8% and 26 months, respectively. Five-year survival rates were 23.3% in the pancreatic invasion group (n = 67) and 42.1% in the nonpancreatic invasion group (n = 176) (P = 0.002). Regarding operative methods used for pancreatectomy in pancreatic invasion group, 5-year survival rates were 0% in the pancreaticoduodenectomy group (n = 9) and 27.4% in the other pancreatectomies group (n = 58) (P = 0.013). Multivariate analysis revealed that advanced lymph node stages (hazard ratio [HR] 1.637 for N0 vs. N1, HR 2.177 for N0 vs. N2, HR 3.241 for N0 vs. N3a, and HR 4.000 for N0 vs. N3b), encircling type of tumor (HR 1.804), and pancreatic invasion (HR 1.463) were independently unfavorable prognostic factors. CONCLUSIONS: In pT4b gastric cancer, pancreatic invasion was found to portend the least favorable prognosis, especially in cases requiring pancreaticoduodenectomy. However, prognoses were more favorable after curative resection in patients without advanced lymph node stages (N2, N3a, and N3b), an encircling type of gastric tumor, or pancreatic invasion. We propose a novel therapeutic strategy for patients with T4b gastric cancer.

Effect of bisphosphonates on bone mineral density and fracture prevention in gastric cancer patients after gastrectomy.

GOAL: To evaluate the effectiveness of bisphosphonates in preventing fractures in gastric cancer patients by increasing bone mineral density (BMD). BACKGROUND: The effectiveness of bisphosphonates is questionable in gastric cancer patients who have undergone gastrectomy, although they display a high prevalence of osteoporosis. STUDY: Forty-seven gastric cancer patients with osteoporosis were retrospectively analyzed. All patients were supplemented with calcium and vitamin D. Twenty-four patients were treated with bisphosphonate (bisphosphonate group) and 23 patients were untreated (control group). Fractures, severe bone pain, and adverse effects of bisphosphonates were monitored. BMD of the lumbar spine and femoral neck were measured before and 1-year treatment with bisphosphonates by dual-energy X-ray absorptiometry. RESULTS: During a 1-year follow-up, 7 of the 47 (15%) patients developed new fractures. The bisphosphonate-treated group had a significantly lower fracture rate than the control group (n=1 vs. 6, P<0.05). Lumbar spine BMD increased in both groups (0.047 ± 0.03 vs. 0.021 ± 0.03 g/cm², respectively), whereas femoral neck BMD increased only in the bisphosphonate group (0.032 ± 0.03 vs. -0.004 ± 0.02 g/cm², respectively). Furthermore, the bisphosphonate group showed greater increases in lumbar spine and femoral neck BMDs than the controls (P<0.05). No difference was found between alendronate and risedronate in terms of BMD at follow-up. CONCLUSIONS: Therapy using bisphosphonates might be effective at increasing BMD and reducing fracture risk in gastric cancer patients after gastrectomy. Further well-designed randomized controlled trials are needed for confirmation.

Synthesis and properties of a water-soluble ionic conjugated polymer with carboxylic acids.

A new water-soluble ionic conjugated polymer, poly[N-(carboxymethyl)-2-ethynylpyridinium bromide], was prepared by the activated polymerization of 2-ethynylpyridine by using bromoacetic acid. This polymerization proceeded well in mild reaction conditions without any additional initiator or catalyst. The polymer structure was characterized by various instrumental methods to have a conjugated polymer backbone system with the designed functional groups. The photoluminescence spectrum of polymer showed that the PL peak is located at 603 nm corresponding to the photon energy of 2.06 eV. The cyclovoltammograms of polymer exhibited the irreversible electrochemical behaviors between the oxidation and reduction peaks. The oxidation current density of polymer versus the scan rates is approximately linear relationship in the range of 30 mV/sec-150 mV/sec. It was found that the kinetics of the redox process of polymer is almost controlled by the reactant diffusion process from the oxidation current density of polymer versus the scan rates.