Purpose: This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Materials and Methods: Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 em from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. Results: After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were downstaged to the T stage and N stage, respectively, when comparing the postradiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. Conclusion: For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance.
The aim of the study was to investigate the effects of dietary supplementation of zinc (Zn) sources (zinc oxide and Zn-methionine) on performance, organ weights, blood biochemical profiles, and digestive enzymes of the pancreas and small intestine in Korean native chicks (KNC). A total of 144 KNC (n=6) were fed a basal diet (CON, 100 ppm of Zn), a basal diet supplemented with 50 ppm of Zn with ZnO (ZNO), or a basal diet supplemented with 50 ppm of Zn with Zn-methionine (ZMT) for 28 days. There was no significant difference in body weight, gain, feed intake, and feed conversion ratio among the three groups. The relative weights of the liver, spleen, and intestinal mucosa were unaffected by the dietary source of Zn, whereas pancreas weight in the ZNO group decreased (P<0.05) compared with that in the CON and ZMT groups. Blood biochemical components including aspartate aminotransferase, and alanine aminotransferase were unaffected by dietary Zn supplementation. Pancreatic trypsin activity in the ZNO and ZMT groups was significantly (P<0.05) enhanced compared with that in the CON group. However, the activities of ${\alpha}$-amylase and carboxypeptidase A were not altered by dietary Zn supplementation. The activities of maltase and sucrase were unchanged, whereas the activity of leucine aminopeptidase tended (P=0.08) to be increased by dietary Zn supplementation. In conclusion, the supplementation with 50 ppm of ZnO or Zn-methionine resulted in an activation of protein digestive enzymes in the pancreas and small intestine without affecting animal performance in KNC.
Choi, Yun Ju;Kim, Ji Eun;Lee, Su Jin;Gong, Jeong Eun;Jin, Yu Jeong;Lee, Jae Ho;Lim, Yong;Hwang, Dae Youn
Journal of Life Science
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v.32
no.7
/
pp.532-541
/
2022
Obesity induced by high-fat diet (HFD) is verified as a strong risk factor and negative prognostic factor for prostate cancer in several genetically engineered mice although it was not examined in the normal mice. To investigate whether HFD-induced obesity can affect the development and progression of cancer in the prostate of normal mice, alterations in the weight and histological structure of the prostate as well as the expression of cancer-related proteins were analyzed in obese C57BL/6N mice fed with 60% HFD for 16 weeks. First, HFD-induced obesity, including an increase in organ weight, body weight, fat accumulation, and serum lipid profile, was successfully induced in C57BL/6N mice after HFD treatment. The total weight of the prostate significantly increased HFD-induced obesity in the model mice compared with the control group. Among the four lobes of the prostate, the weight of the ventral prostate (VP) and anterior prostate (AP) were higher in HFD-induced obesity model mice than in the control group, although the weights of the lateral prostate (DLP) and seminal vesicle (SV) were constantly maintained. In addition, the incidences of hyperplasia and non-hodgkin's lymphoma (NHL) in the histological structure were remarkably increased in HFD-induced obesity model mice, while the epithelial thickness was higher in the same group. A significant increase in the phosphorylation levels of key proteins in the AKT (protein kinase B) signaling pathway was detected in HFD-induced obesity model mice. Therefore, these results suggest that HFD-induced obesity can promote hyperplasia and NHL in the prostates of C57BL/6N mice through the activation of the AKT signaling pathway.
The SO4 in the jarosite structure can be substituted by other oxyanions, and therefore, the transition of jarosite to goethite plays a very important role in controlling the behavior of oxyanions. In this study, the phase change according to the species of the oxyanion in jarosite and the related behavior of the oxyanion was studied by mineralogical and geochemical methods when jarosite, which is coprecipitated with various oxynions, undergoes a phase change by a reductive dissolution. Jarosite substituted by five oxyanions by 5 mol% was used in this study. The mineral phase change induced by reductive dissolution using ammonium oxalate was investigated, and the order of phase transition rate of jarosite to goethite was MoO4-jarosite ≥ SeO4-jarosite ≥ CrO4-jarosite > pure jarosite > SeO3-jarosite > AsO4-jarosite, showing that the transition rates vary depending on the substituted oxyanion. The resultant concentration of the leached Fe was slightly different depending on the type of oxyanion and time but did not show a noticeable difference. The concentration of each oxyanion leached according to the change of the mineral phase showed that the order of concentration of oxyanions was Mo > Se(SeO3) > As > Se(SeO4) > Cr in general, and showed a slight increase with time. This trend was related to the species of oxyanions rather than mineral phase change. The results of this study showed that the phase transition of jarosite to goethite was affected by the species of oxyanions, but this tendency did not affect the concentrations leached oxyanions.
Precipitation and phase transition of iron minerals in mine drainage greatly affect the behavior of trace elements. However, the precipitation of ferrihydrite, one of the major iron minerals precipitated in drainage, and the related behavior of trace elements have hardly been studied. In this study, the effects of pH change and time on mineral precipitation characteristics in mine drainage from the Munkyeong coal mine were investigated, and the behavioral changes of trace elements related to the precipitation of these minerals were studied. In the case of precipitated mineral phases, goethite was observed at pH 4, and 2-line ferrihydrite mixed with small amount of 6-line ferrihydrite was mainly identified at pH 6 or higher. In addition, it was observed that the precipitation of calcite additionally increased as the pH increased in the samples at pH 6 or higher. The occurrence of goethite was probably due to the phase change of initially precipitated ferrihydrite within a short time under the influence of low pH. Our results showed that the concentration of trace elements was strongly influenced by pH and time. With increasing time, Fe concentration in the drainage showed a abrupt decrease due to the precipitation of iron minerals, and the concentration of As existing as oxyanions in the drainage, also decreased rapidly like Fe regardless of the pH values. This decrease in As concentration was mainly due to co-precipitation with ferrihydrite, and also partly to surface adsorption on goethite at low pH in drainage. Contrary to this observation, the concentration of other trace elements, such as Cd, Co, Zn, and Ni was greatly affected by the pH regardless of the mineral species. The lower the pH value, the higher the concentration of these trace elements were observed in the drainage, and vice versa at higher pH. These results indicate that the behavior of trace elements present as cations is more greatly affected by the mineral surface charge influenced by the pH values than the type of the precipitated mineral.
[ $\underline{Purpose}$ ]: We performed a retrospective non-randomized clinical study of locally advanced rectal cancer, to evaluate the anal sphincter preservation rates, down staging rates and survival rates of preoperative chemoradiotherapy. $\underline{Materials\;and\;Methods}$: From January 2002 to December 2005, patients with pathologically confirmed rectal cancer with clinical stage T2 or higher, or patients with lymph node metastasis were enrolled in this study. A preoperative staging work-up was conducted in 36 patients. All patients were treated with preoperative chemoradiotherapy, and curative resection was performed for 26 patients at Hallym University Sacred Heart Hospital. Radiotherapy treatment planning was conducted with the use of planning CT for all patients. A total dose of $45.0{\sim}52.2\;Gy$ conventionally fractionated three-dimensional radiotherapy was delivered to the whole pelvis. Chemotherapy was given at the first and fifth week of radiation therapy with continuous infusion i.v. 5-FU (Fluorouracil) and LV (Leucovorine). Surgical resection was performed 2 to 4 weeks after the completion of the chemoradiotherapy regimen. $\underline{Results}$: The complete resection rate with negative resection margin was 100% (26/26). However, a pathologically complete response was not seen after curative resection. Surgery was done by LAR (low anterior resection) in 23 patients and APR (abdomino-perineal resection) in 3 patients. The sphincter preservation rate was 88.5% (23/26), down staging of the tumor occurred in 12 patients (46.2%) and down-sizing of the tumor occurred in 19 patients (73%). Local recurrence after surgical resection developed in 1 patient, and distant metastasis developed in 3 patients. The local recurrence free survival rate, distant metastasis free survival rate, and progression free survival rate were 96.7%, 87% and 83.1%, respectively. Treatment related toxicity was minimal except for one grade 3, one grade 4 anemia, one grade 3 leukopenia, and one grade 3 ileus. $\underline{Conclusion}$: Preoperative concurrent chmoradiotherapy for locally advanced rectal cancer seems to have some potential benefits: high sphincter preservation and down staging. Treatment related toxicity was minimal and a high compliance with treatment was seen in this study. Further long-term follow-up with a larger group of patients is required.
Background : Pain is one of the most feared consequences of cancer. $65{\sim}85%$ of cancer patients experienced severe pain, and sometimes high dose morphine is used to these patients. But many doctors still have 'opioid-phobia' and hesitate to use high dose morphine. We investigated the morphine therapy in terminal cancer patients during the last 1 week to death, and found any differences according to the morphine dosage. Methods : 93 patients admitted to National Health Insurance Corporation Ilsan Hospital, department of family medicine for hospice care between September 2000 and the end of October 2001 and lived more than 1 week entered in the study. We investigated the demographic data, laboratory tests and sufficient dosage of morphine for pain control. According to the calculated dosage by OME(oral morphine equivalent), patients were divided into low dosage group (${\leq}150mg/day$) and high dosage group (>150 mg/day). The chi-squared test were used to evaluate the influence of age, gender, tumor sites, metastasis and adverse effects of morphine. Results : Mean age was $65.0{\pm}13.1year$ in low dosage group and $59.9{\pm}11.6year$ in high dosage group. 32 men (50.0%) and 32 women (50.0%) were included in low dosage group and 15 men (51.7%) and 14 women (48.3%) in high dosage group. Stomach was the most frequent tumor site and lung was the next. Metastasis were found 58 (90.6%) in low dosage group and 28 (96.6%) in high dosage group. In other palliative radiotherapy and adverse effects, there were no differences in both group. Conclusion : During the last 1 week to death in cancer patients, there were no difference according to the morphine dosage. So we don't have to have 'opioid-phobia' in treating the terminal cancer patients.
Tae Ryeol Kim;You Jeong Jin;Ji Eun Kim;Hee Jin Song;Yu Jeong Roh;Ayun Seol;Eun Seo Park;Ki Ho Park;Su Jeong Lim;Su Ha Wang;Yong Lim;Dae Youn Hwang
Journal of Life Science
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v.34
no.2
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pp.113-121
/
2024
Endoplasmic reticulum (ER) stress responses are markedly induced during toxic responses caused by various chemical substances, including difenoconazole, but no research has been conducted on 1,2,3-trichloropropane (TCP), a chemical that is generally used in agriculture and industry, which induces hepatotoxicity. Therefore, in this study, the changes in indicators for hepatotoxicity, apoptosis, and ER stress were analyzed in TCP-treated Sprague Dawley (SD) rats to study the regulatory mechanism of ER stress during the hepatotoxicity. The TCP-treated group decreased in body weight and dietary intake compared to the vehicle-treated group, and necrosis and vacuolation increased significantly in liver histology. In addition, the expression of apoptosis-related factors, including Bax/Bcl-2 and cleaved caspase (Cas)-3/Cas-3 increased significantly in the TCP-treated group compared to the vehicle-treated group. In the analysis of ER stress response indicators, the expression of C/EBP homologous protein (CHOP), phospho-eukaryotic translation initiation factor 2 alpha subunit (eIF2α), and phospho-inositol-requiring enzyme 1α (IRE1α) increased only in the TCP100-treated group and decreased in the TCP200-treated group. However, the transcriptions of growth arrest and DNA damage-34 (GADD34) increased in the TCP200-treated group, while Spliced X-box binding protein-1 (XBP1s) and unspliced XBP1(XBP1u) decreased in the same group. These results suggest that the ER stress response is successfully triggered during the hepatotoxicity induced by TCP treatment through the alternative regulation of the unfolded-protein response (UPR) pathway.
Purpose : To conduct a nationwide survey on the principals in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. Materials and Methods : We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were Inputted to the web based PCS system by each investigators in 19 institutions. Results : Informations on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59 : 41, and the most common location of tumor was lower rectum ($46\%$). Preoperative CEA was checked in $79\%$ of cases and its value was higher than 6 ng/ml in $32\%$. Pathologic stage were I in $1.5\%$, II in $32\%$, III in $53\%$, and IV in $1.6\%$. Low anterior resection was the most common type of surgery and complete resection was peformed in $95\%$ of cases. Distal resection margin was less than 2 cm in $30\%$, and number of lymph node dissected was less than 12 in $31\%$. Chemotherapy was peformed in $91\%$ and most common regimen was 5-FU and leucovorine ($59\%$). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique ($65.0\%$), and there was no AP-PA parallel opposing field used. Patient position was prone in $81.2\%$, and the boost field was used in $61.8\%$. To displace bowel outward, pressure modulating devices or bladder filling was used in $40.1\%$. Radiation dose was prescribed to isocenter in $45.3\%$ and to isodose line in 123 cases ($39.8\%$). Percent delivered dose over $90\%$ was achieved in $92.9\%$. Conclusion : We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to institutions and the variations of radiation dose and field arrangement were within acceptable range.
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