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- 저자 : 허정욱 (검색결과 358 건)
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허정욱,이우용,김석형,박윤아,조용범,윤성현,김희철,박희철,최두호,박준오,박영석,전호경 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.1
Purpose: The expression of p53 in patients with rectal cancer who underwent preoperativechemoradiationand and its potential prognostic significance were evaluated. Materials and Methods: p53 expression was examined using immunohistochemistryin pathologic specimens from 210 rectal cancer patients with preoperative chemoradiotherapy and radical surgery. All patients were classified into two groups according to the p53 expression: low p53 (<50% nuclear staining) and high p53 (≥50%) groups. Results: p53 expression was significantly associated with tumorlocation from the anal verge (p=0.036). In univariate analysis, p53 expression was not associated with disease-free survival (p=0.118) or local recurrence-free survival (p=0.089). Multivariate analysis showed that tumor distance from the anal verge (p=0.006), ypN category (p=0.011), and perineural invasion (p=0.048) were independent predictors of disease-free survival; tumor distance from the anal verge was the only independent predictor of local recurrence-free survival. When the p53 groups were subdivided according to ypTNM category, disease-free survival differed significantly in patients with ypN+ disease (p=0.027) only. Conclusion: Expression of p53 in pathologic specimens as measured by immunohistochemical methods may have a significant prognostic impact on survival in patients with ypN+ rectal cancer with preoperative chemoradiotherapy. However, it was not an independent predictor of recurrence or survival.
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허정욱 대한소화기내시경학회 2003 Clinical Endoscopy Vol.27 No.2
고립성 직장결핵은 소장과 결장에는 병변이 없고 직장에만 국소적으로 결핵병변이 있는 것으로 정의하며 그 빈도는 드물다. 임상증상은 항문출혈이 가장 많고 설사, 변비, 후중감 및 열, 식욕부진, 체중감소 등의 전신증상이 나타나며 주로 젊은 연령층의 남자에서 나타난다. 대장내시경적 형태는 궤양형, 비후형, 궤양비후 혼합형으로 나타나고 궤양형이 주된 형태이다. 궤양의 크기는 다양하며 변연은 불규칙하고 부종, 발적, 소결절을 동반하고 궤양저는 백색 혹은 황색의 삼출물로 덮여 있으며 과립상을 보인다. 진단을 위해서는 궤양변연과 심층부위에서 6군데 이상 생검이 필요하며 육아종성 염증, 건락성 괴사, 항산균 증명이 필요하다. 저자는 항문출혈을 주소로 내원한 38세 남자에서 시행한 대장내시경검사 결과 직장에 결절성 비후를 동반한 고립성 궤양이 있었고 생검에서 육아종성 염증소견이 있어 궤양변연과 기저부에서 10편의 반복생검을 실시하여 육아종과 항산균염색 결과 양성을 보인 고립성 직장결핵을 경험하여 보고하는 바이다. Isolated rectal tuberculosis is defined as focal lesions of the rectum in the absence of demonstrable lesions in the small and large bowel, and it is a very rare form of intestinal tuberculosis. Common presenting features are rectal bleeding, diarrhea, constipation, tenesmus, and constitutional symptoms. Of them, rectal bleeding is the most common symptom. There are ulcerative, hypertrophic and combined types in the colonoscopic classification. Ulcerative type is the most common findings. The size of the ulcers are variable. The margins of the ulcer are irregular, swollen, erythematous and nodular. The base is covered with whitish to yellowish exudates and shows a granular appearance. For diagnosis of rectal tuberculosis it is important to obtain specimens at more than 6 regions in the base and margins of the ulcer. Important histologc findings are granuloma and demonstration of acid fast bacilli. I report a case of isolated rectal tuberculosis confirmed by colonoscopic study and histology. (Korean J Gastrointest Endosc 2003;27:92-95)
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Current Status of “Watch-and-Wait” Rectal Cancer Treatment in Asia-Pacific Countries
허정욱,Kotaro Maeda,Zheng Liu,Xishan Wang,April Camilla Roslani,이우용 대한대장항문학회 2020 Annals of Coloproctolgy Vol.36 No.2
Purpose: Current acceptance of the watch-and-wait (W&W) approach by surgeons in Asia-Pacific countries is unknown. An international survey was performed to determine status of the W&W approach on behalf of the Asia-Pacific Federation of Coloproctology (APFCP). Methods: Surgeons in the APFCP completed an Institutional Review Board-approved anonymous e-survey and/or printed letters (for China) containing 19 questions regarding nonsurgical close observation in patients who achieved clinical complete response (cCR) to neoadjuvant chemoradiotherapy (nCRT). Results: Of the 417 responses, 80.8% (n = 337) supported the W&W approach and 65.5% (n = 273) treated patients who achieved cCR after nCRT. Importantly, 78% of participants (n = 326) preferred a selective W&W approach in patients with old age and medical comorbidities who achieved cCR. In regard to restaging methods after nCRT, the majority of respondents based their decision to use W&W on a combination of magnetic resonance imaging results (94.5%, n = 394) with other test results. For interval between nCRT completion and tumor response assessment, most participants used 8 weeks (n = 154, 36.9%), followed by 6 weeks (n = 127, 30.5%) and 4 weeks (n = 102, 24.5%). In response to the question of how often responders followed-up after W&W, the predominant period was every 3 months (209 participants, 50.1%) followed by every 2 months (75 participants, 18.0%). If local regrowth was found during follow-up, most participants (79.9%, n = 333) recommended radical surgery as an initial management. Conclusion: The W&W approach is supported by 80% of Asia-Pacific surgeons and is practiced at 65%, although heterogeneous hospital or society protocols are also observed. These results inform oncologists of future clinical study participation.
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