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박기재,최홍조,노영훈,신종석,이형식 대한대장항문학회 2007 Annals of Coloproctolgy Vol.23 No.2
Purpose: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection. Methods: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months. Results: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). Conclusions: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.
Sulindac에 의한 대장암 세포주 HT-29 세포의 세포사멸기작 연구 -미토콘드리아 통로를 중심으로-
박기재,권육,김성흔,김민찬,최홍조,김영훈,조세헌,정갑중,김성현,권혁찬 대한대장항문학회 2004 Annals of Coloproctolgy Vol.20 No.4
Purpose: This study was undertaken to reveal the molecular mechanism underlying sulindac-induced apoptosis in the human colon cancer cell line HT-29 (mutant p53). Methods: Apoptosis was determined by using Hoechst 33342 staining, and translocation of proteins was established by using immunofluorescence, immunoelectron microscopy, and Western blotting after ultra- fractionation. Results: This type of apoptosis was associated with decreased mitochondrial membrane potential, a translocation of the apoptosis-inducing factor (AIF) to the nucleus, and morphological evidence of nuclear condensation. However, DNA electrophoresis did not elucidate the ladder pattern of DNA fragments. Instead, a pulse-field gel electrophoresis showed that sulindac led to disintegration of nuclear DNA into-high- molecular-weight DNA fragments of about 100~300 kbp. Conclusions: Our findings indicate that sulindac induces large-scale DNA fragmentation, suggesting a predominantly AIF-mediated cell-death process, through translocation of the AIF to the nucleus in HT-29 cells.