• Journal of Chest Surgery
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• 제49권1호
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• pp.59-62
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• 2016

A 12-month-old boy was diagnosed with agenesis of the right lung. Mediastinal deviation progressed to the diseased side as the patient matured; therefore, tracheal distortion developed. As a result, tracheal compression developed between the vertebral body and aorta. The patient was repeatedly admitted to the hospital because of recurrent pulmonary infection and combined severe respiratory distress. Diaphragm translocation was performed to treat the patient. The postoperative course was favorable, and computed tomography scan findings and symptoms had improved at 1 year after surgery.

• Radiation Oncology Journal
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• 제35권1호
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• pp.65-70
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• 2017

Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ${\leq}2cm$) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. Results: The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Conclusion: Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

• Childhood Kidney Diseases
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• 제8권2호
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• pp.138-148
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• 2004

목적: 단백뇨 질환에서 볼 수 있는 사구체 상피세포(glomerular epithelial cells, GEpC) 족돌기(foot process)의 병리학적 변화에 있어서 GEpC사이의 세극막(slit diaphragm)과 세포골격을 연결하는 ZO-1 단백의 당뇨조건에 따른 변화를 알아보고자 하였다. 방법: 백서 GEpC을 배양하고 고농도의 당과 후기당화합물(advanced glycosylation enduroducts, AGE)를 적용하여 당뇨병 환경에 가까운 조건을 설정한 후, ZO-1 단백양은 Western 분석으로, 분포 변화는 공초점 현미경으로, 유전자 표현의 변화는 RT-PCR로 관찰하였다. 실험군은 당의 농도를 5 또는 30 mM로, AGE와 BSA를 첨가하고 osmotic control로서 당 5 mM에 mannitol 25 M을 섞은 것을 조합하여 A5, A30, B5, B30, Aosm로 하였다. 결과: 공초점 현미경 상 ZO-1은 정상적인 환경인 B5에서 B30, A5, 가장 병적인 A30 환경으로 진행할수록 세포질의 바깥에서 안쪽으로 이동하는 양상을 보였다. ZO-1 단백양은 B5 결과를 대조군으로 비교하여 당을 첨가한 B30에서 11.1%, AGE를 추가한 조건인 A5에서 2.3% 감소하였나 통계적 유의성은 없었고, 당과 AGE가 동시에 첨가된 A30에서는 19.0%의 유의한 감소를 보였다. mRNA의 발현도 A30에서만 12.0%의 의의 있는 감소를 보였다. 이러한 단백질과 mRNA의 감소 소견은 osmotic control (Aosm)에서는 관찰할 수 없었다. 결론: 고농도의 당과 AGE에 의한 GEpC의 ZO-1의 분포 변화와 유전자 수준에서의 억제로 단백의 생성 감소를 초래함으로써, 장기간 당뇨 환경체서 족돌기의 형태학적 변화를 설명할 수 있으며, 추후 이의 변화 기전에 대한 연구가 필요할 것으로 사료된다.