• Radiation Oncology Journal
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• 제14권3호
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• pp.221-228
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• 1996

목적 : 난소 미분화세포종의 임상적 특징과 치료 방법, 국소 제어율, 치료 실패 양상, 생존율 등 치료 성적을 분석해 보고, 가임력을 보존하기 원하는 병기 13 환자들에서의 적절한 치료 방침을 찾아보고자 본 연구를 시행하였다. 대상 및 방법 : 1975년 1월부터 1990년 12월까지 연세 의대 신촌 세브란스병원, 연세암센터에서 진단 및 치료를 받은 34명의 난소 미분화세포종 환자를 대상으로 하였다. 이중 2예의 gonadoblastoma(46,XY)와 3예의 혼합 배세포종(mixed germ cell tumor)을 제외하고 나머지 순수 미분화세포종(pure dysgermlnoma) 환자 29예만을 연구 대상으로 하여 치료 방법에 따라 두군으로 나누어 성적을 분석하였다. 1군은 수술후 보조적 방사선치료를 받은 환자로 21예였고, 2군은 수술후 보조적 방사선치료를 하지 않은 군으로 8예였다. 대상 환자의 연령 분포는 8-39세였고 중앙치는 23세였다. 진단 시 임상 증상은 촉지되는 복부 골반부 종괴가 가장 호발하였다. 병기는 I이 23명으로 $89.3\%$로 다수를 차지하였다. 방사선치료는 병기 I, II에서는 전복부조사 20-25 Gy, 골반부에 축소하여 10-15 Gy 추가 조사하였고 종격동과 쇄골 상부의 방사선치료는 대부분 II기 이상의 진행된 병기에서 20-26 Gy 조사하였다. 환자들의 추적 관찰 중앙치는 80개월(13-201개월)이었다. 결과 : 수술후 보조적 방사선치료를 받은 환자인 1군(21예)은 전원 국소제어 및 무병 생존중이었다. 2군은 수술후 보조적 방사선치료를 하지 않은 8예인데 이중 6예에서 국소 재발지 발생하여 4예는 구제 목적의 방사선치료를 받았고 1예는 항암화학요법을 1예는 재수술만 시행 받았다. 구제 치료 결과 방사선치료를 받은 4예중 3예, 항암화학요법 받은 1예 및 재수술을 받은 1예는 완치되었으나, 1예만 암종증(carcinomatosis)으로 진행되어 방사선치료후 11개월에 사망하였다. 그러므로 29예 전체의 5년 국소 제어율 및 5년 생존율은 $96.6\%$(28/29)였다. 일측 난소에 국한된 병기 la 환자 13예 중 7예는 수술 및 수술후 방사선치료를 받았고 이들은 전원 국소제어 되어 20-201개월간(중앙치 80개월) 무병 추적 관찰 중이나, 수술로 일측 난소난 관절제술 후 방사선치료 없이 지내던 6예의 환자 중 5예에서 재발하였으나 이들 모두 방사선치료, 항암화학요법, 재수술 등의 구제치료에 성공하였다. 즉 13예의 병기 la 환자 전원이 20-201개월간 무병 생존 중이다. 결론 : 난소 미분화세포종의 치료에 있어서 수술후 보조적 방사선치료를 부가함으로 종양의 크기, 병기, 수술법에 관계없이 $100\%$ 국소 제어율 및 $100\%$ 5년 생존율을 획득하였다. 수술후 재발한 경우라도 암종증(carclnomatosis)이나 복부 이외의 장기에 원격 전이가 없다면 방사선치료, 항암화학요법 또는 재수술로 구제될 가능성이 매우 높다. 그러므로 가임력을 보존하기 원하는 병기 la 환자에서는 보존적 수술인 일측 난관난소절제술만 시행하고 추적 관찰하는 것도 치료 방법으로 고려될 수 있겠다.

• Radiation Oncology Journal
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• 제16권3호
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• pp.291-301
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• 1998

목적 : 국한성 병기 소세포폐암으로 복합 화학요법과 방사선치료를 받은 환자들에서 통상적 방사선치료와 다분할 방사선치료 간의 종양 관해율, 생존율, 재발율 및 부작용에 대해 비교분석하고자 하였다. 대상 및 방법 : 1989년 11월부터 1996년 12월까지 충남대학교 병원 치료방사선과에서 국한성병기 소세포폐암으로 치료받았던 78명 환자 중 고식적 방사선치료 및 재발성 병변으로 치료받았던 10명을 제외한 68명을 대상으로 후향성 분석을 하였다. 대상환자 중 통상적 방사선치료군(A군)은 26명, 다분할 방사선치료군 (B군)은 42명 이었다. 전체 환자의 연령, 성별 및 ECOG 활동지수는 각각 32-75세 (중앙값 58세), 남자 58명 여자 10명, ECOG 0-1이 58명 2 이상이 10명 이었으며 두군 간에 유사한 분포를 보였다. 방사선치료로서 A군은 총 조사선량 5040-6940 cGy (중앙값 5040 cGy), 180 cGy/fx 로 치료하였고 B군은 총 조사선량 4320-5100 cGy (중앙값 4560 cGy)으로 29명 (69$\%$)은 120 cGy/fx 로, 13명 (31$\%$)은 150 cGy/fx 로 1일 2회 조사하였다. 화학요법은 전체 68명 중 65명에서 VPP (cisplatin 60 mg/$m^2$, etoposide 100 mg/$m^2$) 요법과 CAV (cytoxan 1000 mg/$m^2$, adriamycin 40 mg/$m^2$, vincristine 1 mg/$m^2$) 요법을 교대로 시행하였으며, 화학요법 횟수는 A군 3-10회 (중앙값 6회), B군은 1-11회 (중앙값 6회) 시행하였다. 화학요법 시기는 A군에서 23명이 연속 화학요법을, B군에서는 39명이 동시 화학요법을 시행하였다. 예방적 전뇌조사는 두군 모두에서 완전관해 후 시행하였는데 A군 8명, B군 16명에서 조사선량 2500 cGy/10fx 로 조사하였다. 추적기간은 2-99개월 (중앙값 14개월)였다. 결과 : 종양 관해는 완전관해율, 부분관해율이 각각 A군 35$\%$ (9/26), 54$\%$ (14/26), B군 43$\%$ (18/42), 55$\%$ (23/42)(p=0.119) 였다. 중앙생존기간 및 2년 생존율은 전체환자에서 15개월, 26.8$\%$였고, A군 17개월, 26.9$\%$, B군 15개월, 28$\%$ 0=0.51)였다. 전체환자 중 완전관해 및 부분관해 환자의 2년 생존율은 각각, 35$\%$ 와 24.2$\%$ (p=0.05)였다. 실패양상으로 두 군간에 국소재발 및 원격전이의 통계적인 차이는 없었다 (p=0.125, 0.335). 방사선치료중 발생한 급성합병증으로 RTOG criteria상 중등도 이상의 식도염 및 백혈구 감소가 B 군에서 더 높게 나타났다 (p=0.028, 0.003). 결론 : 국한성 병기 소세포폐암의 복합 화학요법과 방사선치료시 종양의 부분관해 이상의 반응율이 연속화학요법을 받은 통상적 방사선 치료군과 동시화학요법을 받은 다분할 방사선 치료군 모두에서 높게 나타났다. 그러나 두 군간의 생존율에는 통계적인 차이를 보이지 않았다. 급성합병증으로서 식도염과 백혈구 감소가 동시화학요법을 받은 다분할 방사선치료군에서 더 높게났지만, 국한성 병기 소세포폐암에서 동시화학요법과 다분할 방사선치료가 적절한 치료의 한 방법이 될 수 있을 것으로 사료된다. 그러나 국한성 병기 소세포폐암에서 다분할 방사선치료의 장점을 밝히기 위하여 좀더 많은 대상환자와 추적관찰이 필요할 것으로 사료된다.

• Radiation Oncology Journal
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• 제36권1호
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• pp.17-24
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• 2018

Purpose: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. Materials and Methods: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. Results: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. Conclusion: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.

• 인지과학
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• 제24권3호
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• pp.271-300
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• 2013

사람과 동물은 수량(numerosity)의 대략적인 많고 적음에 대한 직관적 판단 능력을 가지고 태어난다. 이를 대략적 수 감각(이하, 수 감각, number sense)이라 한다. 수 감각은 오래 전부터 동물의 수렵, 채취, 사냥 및 생존에 필수적인 능력으로 진화된 것으로 추정된다. 선행 연구에 따르면, 수학 발달 장애를 가진 아동은 수 감각이 정상적인 아동에 비해 매우 둔감하다. 반대로, 수 감각이 민감한 사람들은 수학적 성취도가 더 높다. 이러한 결과는 생애 초기부터 발달하는 수 감각 표상의 정확도가 학령기 이후 숫자에 기반한 수학적 인지 발달의 근간이 된다는 가설을 뒷받침한다. 최근 연구들은 수 감각 훈련을 통해 수학 성취도의 향상과 수학 관련 뇌 기능의 변화를 가져올 수 있는지를 검증하고 있다. 한편, 수량은 불연속적인 양(discrete quantity)으로서 길이, 면적, 시간 등 연속적인 양(continuous quantity)과 밀접한 관계가 있을 것으로 기대할 수 있다. 이와 같은 관점에서 수, 시간, 공간 등 다양한 차원의 양적인 표상의 정보처리는 후측 두정엽(posterior parietal cortex), 특히 두정 내 고랑(intraparietal sulcus, IPS)에 위치한 공통의 뇌 기제(common brain mechanism)에 기반한다는 가설이 대두되었다. 이 가설을 검증하는 실험적 증거와 후속 연구의 방향을 소개한다.

• Radiation Oncology Journal
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• 제12권3호
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• pp.301-305
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• 1994

Purpose :. To investigate the effect of aqueous extract of Ganoderma lucidum(G.I.) on the surival of tumor cells in vitro and on the growth of tumors in vivo. Materials and Methods : Dried G.I. was made into powder, extracted with distilled water, filtered and diluted from a maximum concentration of 100 mg/ml in sequence. The cytotoxicity of G.I, in vitro was evaluated from its ability to reduce the clonogenicity of SCK tumor cells. For the tumor growth delay study, about $2{\times}10^5$$ of SCK tumor cells were subcutaneously inoculated in the legs of A/J mice. The first experimental group of mice were injected i.p. with 0.2ml of 250 mg/kg of G.I. from the first day after tomor inoculation for 10 days. The second experimental group of mice were injected i.p. with 0.2ml of 250 mg/kg of G.I. either once a day for 10 days or twice a day for 5 days beginining from the 7th day after tumor inoculation Results : 1. Cytotoxicity in vitro;survival fraction, as judged from the curve, at G.I. concentration of 0.5, 1,5, 10, 25, 50 and 100 mg/ml were 1.0, $0.74{\pm}0.03$, $0.18{\pm}0.03$, $0.15{\pm}0.02$, $0.006{\pm}0.002$, 0.015 and 0.0015, respectively. 2. Tumor growth delay in vivo; a) the time required for the mean tumor volume to grow to $1,000mm^3$ was 11 days in the control group and 14 days in the experimental group. b) the time required for tumor volume to increase 4 times was 11 days in the control group while it was 10.5 and 12 days in the groups injected with G.I. once a day and twice a day from the 7th day after tumor inoculation respectively. Conclusion : Aqueous extracts of G.I. showed a marked cytotoxicity on the SCK mammary cells in vitro. Tumor growth delay was statistically signiricant when G.I. in-jection was started soon after tumor inoculation, but it was not significant when injection was started after the tumors were firmly established.

• The Korean Journal of Physiology and Pharmacology
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• 제22권2호
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• pp.163-172
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• 2018

PRF001 is a fragmented DNA polymer extracted from the testes of salmon. The purpose of this study was to assess the anti-inflammatory effect of PRF001 in vitro as well as the protective effect of PRF001 intake against arthritis in a rat model. In vitro, cell survival and inflammatory markers after $H_2O_2$ treatment to induce cell damage were investigated in CHON-001 cells treated with different concentrations of PRF001. In vivo, osteoarthritis was induced by intra-articular injection of monosodium iodoacetate (MIA) into the knee joints of rats. After consumption of PRF001 (10, 50, or 100 mg/kg) for 4 weeks, inflammatory mediators and cytokines in articular cartilage were investigated. In vitro, the levels of inflammatory markers, $IL-1{\beta}$, $TNF-{\alpha}$, COX-2, iNOS, and PGE2, were significantly suppressed by PRF001 treatment. In vivo, the inflammatory mediators and cytokines, $IL-1{\beta}$, p-Erk1/2, $NF-{\kappa}B$, $TNF-{\alpha}$, COX-2, and PGE2, as well as MMP3 and MMP7, which have catabolic activity in chondrocytes, were decreased in the MIA-induced osteoarthritic rats following intake of PRF001. Histological analysis revealed that PRF001 had a protective effect on the articular cartilage. Altogether, these results demonstrated that the anti-inflammatory property of PRF001 contributes to its protective effects in osteoarthritis through deregulating $IL-1{\beta}$, $TNF-{\alpha}$, and subsequent signals, such as p-Erk1/2, $NF-{\kappa}B$, COX-2, PGE2, and MMPs.

• Journal of Chest Surgery
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• 제23권6호
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• pp.1180-1190
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• 1990

96 patients underwent cardiac valve replacement for valvular heart diseases consecutively between February 1986 to February 1990 in the Department of Thoracic and Cardiovascular Surgery of Yeungnam University Hospital. The follow up period was between 6 months and 4.5 years postoperatively[mean 23.4$\pm$13.1 months]. 75 cases got mitral valve replacement, 6 cases, aortic valve replacement, 15 cases, double valve replacement. 30[31.2%] patients were male and 66[68.8%] were female and the age ranged from 14 to 66 years old. Early hospital death within 30 days postoperation were 5 patients[5.2%], consisting of by low cardiac output in 2, infective endocarditis in 1, multiple organ failure with sepsis in 1 patient. There was no late postoperative death. Most common early postoperative complication was wound disruption [8.7%] and then low cardiac output, pneumothorax, pleural effusion in order. Most common late postoperative complications were minor bleeding episodes[8.7%] related to anticoagulant therapy which were consisted of frequent epistaxis in 3, gum bleeding in 2, hemorrhagic gastritis in 1, hypermenorrhea in 1, hematoma in right arm in 1 patient. Valve-related complications included valve thrombosis [1.6%/ patient-year], valve failure due to pannus formation[1.1% /patient-year], prosthetic valve endocarditis[1, 1%o/patient-year] and minor anticoagulant hemorrhage[4.4% /patient-year]. 5 cases of reoperations were performed in 4 patients due to valve failure and all of them were in the mitral positions[2.7% /patient-year]. Cardiothoracic ratios in the chest X-ray decreased at the 6th month and 1st year postoperation in all patients. But in New York Heart Association[NYHA] functional class IV, no change in cardiothoracic ratio was found between 6 months and 1 year postoperation. In the echocardiogram, the size of the cardiac chambers decreased, but ejection fraction increased postoperatively in each functional class. In the electrocardiogram, decreases were found in the incidence of atrial fibrillation, left atrial enlargement, left ventricular hypertrophy with right bundle branch block increasing postoperatively in each functional class. The actuarial survival rate was 98.4% for all patients, 98.7% for mitral valve replacement, 83.8% for aortic valve replacement, and 80% for double valve replacement at the end of a 4.5 year follow up period. Meanwhile the actuarial freedom rate was 91.5% for prosthetic valve endocarditis, 91.6% for thromboembolism, 89.0% for prosthetic valve failure and 83.7% for minor anticoagulant hemorrhage. Preoperative NYHA class III and IV were 75% of all patients, but 95% of all patients were up graded to NYHA class I and II postoperatively.

• Journal of Chest Surgery
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• 제49권3호
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• pp.165-170
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• 2016

Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. Results: The mean age of the patients was $71.15{\pm}8.60years$. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was $56.9{\pm}9.93$. The CPB time was $96.51{\pm}41.27minutes$ and the cross-clamping time was $60.85{\pm}27.08minutes$. The intubation time was $8.95{\pm}4.19hours$, and the intensive care unit and hospital stays were $2.89{\pm}1.42days$ and $7.86{\pm}1.42days$, respectively. The mean quantity of drainage from chest tubes was $407.69{\pm}149.28mL$. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was $687.24{\pm}24.76days$. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

• Molecules and Cells
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• 제39권8호
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• pp.594-602
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• 2016

Alkyl hydroperoxide reductase subunit C from Pseudomonas aeruginosa PAO1 (PaAhpC) is a member of the 2-Cys peroxiredoxin family. Here, we examined the peroxidase and molecular chaperone functions of PaAhpC using a site-directed mutagenesis approach by substitution of Ser and Thr residues with Cys at positions 78 and 105 located between two catalytic cysteines. Substitution of Ser with Cys at position 78 enhanced the chaperone activity of the mutant (S78C-PaAhpC) by approximately 9-fold compared with that of the wild-type protein (WT-PaAhpC). This increased activity may have been associated with the proportionate increase in the high-molecular-weight (HMW) fraction and enhanced hydrophobicity of S78C-PaAhpC. Homology modeling revealed that mutation of $Ser^{78}$ to $Cys^{78}$ resulted in a more compact decameric structure than that observed in WT-PaAhpC and decreased the atomic distance between the two neighboring sulfur atoms of $Cys^{78}$ in the dimer-dimer interface of S78C-PaAhpC, which could be responsible for the enhanced hydrophobic interaction at the dimer-dimer interface. Furthermore, complementation assays showed that S78C-PaAhpC exhibited greatly improved the heat tolerance, resulting in enhanced1 survival under thermal stress. Thus, addition of Cys at position 78 in PaAhpC modulated the functional shifting of this protein from a peroxidase to a chaperone.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1693-1697
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• 2012

Objective: To explore the effect on radiosensitivity of arsenic trioxide ($As_20_3$) in conjunction with hyperthermia on the esophageal carcinoma EC-1 cell line. Method: Inhibition of EC-1 cell proliferation at different concentrations of $As_20_3$ was assessed using the methyl thiazolyl blue colorimetric method (MTT method), with calculation of $IC_{50}$ value and choice of 20% of the $IC_{50}$ as the experimental drug concentration. Blank control, $As_20_3$, hyperthermia, radiotherapy group, $As_20_3$ + hyperthermia, $As_20_3$ + radiotherapy, hyperthermia + radiotherapy and $As_20_3$ + hyperthermia + radiotherapy groups were established, and the cell survival fraction (SF) was calculated from flat panel colony forming analysis, and fitted by the 'multitarget click mathematical model'. Flow cytometry (FCM) was used to detect changes in cell apoptosis and the cell cycle. Results: $As_20_3$ exerted inhibitory effects on proliferation of esophageal carcinoma EC-1 cells, with an $IC_{50}$ of 18.7 ${\mu}mol/L$. After joint therapy of $As_20_3$ + hyperthermia + radiotherapy, the results of FCM showed that cells could be arrested in the $G_2$/M phase, and as the ratio of cells in $G_0/G_1$ and S phases decreased, cell death became more pronounced. Conclusion: $As_20_3$ and hyperthermia exert radiosensitivity effects on esophageal carcinoma EC-1 cells, with synergy in combination. Mechanistically, $As_20_3$ and hyperthermia mainly influence the cell cycle distribution of EC-1 esophageal carcinoma cells, decreasing the repair of sublethal damage and inducing apoptosis, thereby enhancing the killing effects of radioactive rays.