Surgical Treatment of Klippel-Feil Syndrome with Cervical Spondylosis

We report a case of Klippel-Feil syndrome. The patient was a 37-year-old man who developed progressive motor weakness and on C4-5 and C6-7 segments combined with severe cervical stenosis, basilar impression and C1 assimilation. He showed progressive quadriparesis and respiratory difficulty. He had combined congenital anomaly of right side facial palsy of peripheral type and right side sensorineural hearing loss. In May 2002, we performed, via transoral approach, anterior fusion with Harm's mesh and hydroxyapatite from the clivus to the C3. But, one month after the operation, Harm's mesh with hydroxyapatite slipped anteriorly due to non-union. So, we removed the mesh and reoperated with fibular bone graft from the clivus to the C3. Simultaneously, posterior approach was performed with on-lay autologous rib bone graft and wiring from the occiput to the C2,3,4. One year after the operation, his motor weakness has been gradually improved and there is minimal difficulty in self-respiration.ope

Surgical Treatment of Degenerative Lumbar Spine Disease in Geriatric Patients Over 70 Years Old: A Review of Two Decades

OBJECTIVE: The aim of this study is to evaluate the transition of lumbar spinal treatments for geriatric patients over 70 years old over two decades. METHODS: We retrospectively assessed 730 patients who were 70 years and older and underwent lumbar surgery. We analyzed the number of diseases, operation methods and complications with 5-year intervals from 1987 to 2006. RESULT: The number of patients older than 70 years who underwent lumbar surgery increased according to our analysis of the period spanning from 1987 to 2006. Thirty-two (1%), 77 (1.7%), 232 (4.4%), and 389 (8.2%) patients over 70 years underwent lumbar spine surgeries. Among them, the 8, 29 and 45 patients had one level degenerative spondylolisthesis for the periods 1992-1996, 1997-2001 and 2002-2006. Twenty-four, 29 and 58 patients had lumbar stenosis during all these time periods. Over time, we performed a larger variety of operations as well as more aggressive operations. From January 2002 to December 2006, a total of 308 patients were over 70 years old and had lumbar spine surgeries performed on them. Among them, the ASA class I was 58 (19%), the ASA class II was 213 (69%) and the ASA class III was 37 (12%). During that period, PLIFs and PS fixations were performed on 69 patients. Among them, 8 patients were ASA III. Large numbers of lumbar arthorodesis have been performed in geriatric patients over the age of 70 years in our series. CONCLUSION: The surgical treatment of degenerative spine disease in the elderly patients was increased due to improved surgical technique and advances in medical treatment including anesthesia. The authors suggest that fusion surgery can be done safely in elderly patients even though they have high-grade ASA classificationope

Technical Strategies and Surgical Results of C1 Lateral Mass-C2 Pedicular Screw Fixation in Atlantoaxial Disorders

OBJECTIVE: There are various posterior fusion techniques in managing C1-2 instability. The aim of this study is to evaluate surgical techniques and clinical results including complications of the C1 lateral mass and C2 pedicle screw fixation (C1-2 LMPSF) in atlantoaxial disorders. METHODS: From February 1997 to July 2008, 24 patients were performed C1-2 LMPSF due to C1-2 instability. Pathway of vertebral artery was classified into three groups by 3D-angiogram. Diameter of C1 lateral mass and C2 isthmus on the plain X-ray and CT was measured before operation. Surgical method was divided into four groups according to fixation site (bilateral or unilateral) and bone graft (with or without graft). Stability of C1-2 fixation was postoperatively evaluated by flexion and extension cervical lateral films. We reviewed clinical data, imaging studies and old chart retrospectively as sources for analysis. RESULTS: Among 24 patients, os odontoideum was the most common cause (16 out of 24). Four patients had anomalous vertebral artery. Mean diameters of C1 lateral mass was 9.9(range 4.2~16.4) mm at right side, 10.3 (range 3.4~14.2) mm at left side. Mean diameter of C2 isthmus was 5.8 (range 1.0~10.1) mm at right side and 5.8(range 2.1~8.2) mm at left side. Two patients showed very narrow C2 isthmus. As a result, unilateral C1-2 LMPSF was performed on 6 patients (4 for anomalous vertebral arteries and 2 for narrow C2 isthmus). 12 of 18 patients were with C1-2 interlaminar bone graft and 6 patients without bone graft. All patients showed stable C1-2 fixation by flexion and extension cervical lateral X-ray films taken at least 6 months after surgery. Five out of 8 patients who had preoperative radiculopathy only showed improved symptoms. However, Seven out of 8 patients who had myelopathy showed little neurological improvement . CONCLUSION: For C1-2 LMPSF, preoperative 3D CT-angiogram study is mandatory to identify abnormal vertebral artery and narrow C2 isthmus. Bilateral C1-2 LMPSF without bone graft is enough to obtain stable C1-2 fixation. If there is an abnormal vertebral artery or narrow C2 isthmus, unilateral C1-2 LMPSF with bone graft and wiring is alternative successful methodope

SIVmac-macaque 모델에서 다항원성 DNA 프라이밍과 아데노 바이러스 부스팅에 의한 바이러스 역가 감소

Maste

시스템 안정성과 QoS를 고려한 파운틴 코드 기반의 P2P 스토리지 클라우드 시스템

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E-Cadherin 돌연변이 상태에 따른 위암 모델의 표현형 분석

학위논문(석사) -- 서울대학교대학원 : 의과대학 의과학과, 2023. 8. 정기훈.위암은 전세계적으로 높은 사망률을 보이는 주요 질병 중 하나로, 화학요법, 면역요법, 면역관문억제제 등의 치료 전략이 존재하지만, 종양내 미세환경을 포함한 다양한 요소에 의해 제한적인 약효성을 보인다. CDH1은 E-Cadherin을 암호화하는 유전자로, 미만형 위암 환자에서 빈번한 돌연변이를 보이는데, 미만형 위암은 낮은 치료 반응률을 포함하여 부정적인 예후를 보이는 것으로 알려져 있다. 이 연구에서는 두 마우스 유래 위암, Tcon과 Dcon 종양의 표현형적 차이에 대해 연구하였다. Tcon은 종양내 미세환경의 과도한 콜라겐 섬유의 축적으로 인해 심각한 종양섬유화가 발생하여 경도가 높은 종양체를 형성하였다. 종양섬유화는 암-연관 섬유아세포에 의해 촉진되는 것으로 알려져 있으며, 종양진행 및 약물 전달 억제에 기여한다. 정밀한 유세포 분석을 통해, 종양 섬유화에 기여하는 αSMA 단일-양성 암-연관 섬유아세포와 면역억제기전에 중요한 기능을 수행할 수 있을 것으로 추측되는 PD-L1을 발현하는 암-연관 섬유아세포가 Tcon 종양에서 Dcon 종양에 비해 높은 비율로 포진함을 알 수 있었다. 또한, Tcon 종양의 경우, Dcon 종양에 비해 종양내 혈관의 발달이 부진하였으며, 낮은 약물 전달률로 인한 치료 반응률의 저하가 예상되었다. 반면, Dcon 종양의 경우, T 세포를 포함한 각종 면역세포의 침습 또한 Tcon 종양에 비해 높은 수준으로 이루어짐을 확인할 수 있었으며, 특히 T 세포 중 TNFα, Granzyme B, Perforin, Interferon-γ와 같은 항-종양성 사이토카인을 생산하는 비율이 높아, 항-종양성 면역체계가 보다 활성화되었음을 알 수 있었다. 추가적으로, Dcon 종양을 이식한 마우스는 종양으로 인해 발생한 빈혈과 더불어 비장의 비대화를 보였으며, 비장 내부에서는 골수성 면역세포와 적아세포의 비정상적인 증식을 확인할 수 있었는데, 이러한 세포들은 종양 내부로 침습하여 면역억제기전 및 친종양성 기능을 수행할 것으로 기대된다. 위와 같은 연구를 통해 두 종류의 위 종양의 표현형적 특징에 대한 통찰을 제공할 수 있었으며, 더불어 임상 적용으로의 가능성을 제시함으로써 위암 환자의 치료 접근성을 향상시킬 수 있었다.Gastric cancer(GC) is a major health concern with high mortality rates globally. Therapeutic options for gastric cancer include chemotherapy, immunotherapy and immune checkpoint blockade, however, limited response rates have been observed due to various factors, including tumor-protective microenvironment(TME). In this study, we investigated the distinct phenotypes of two murine gastric tumors, Tcon (Triple-conditional mutation) and Dcon(Double-conditional mutation. The results show that Tcon tumors, display severe desmoplasia characterized by the excessive accumulation of collagen fibers in the TME, which contributed to the stiffness and rigidity of the tumor mass. The desmoplastic reaction, facilitated by cancer-associated fibroblast(CAF)s, is a crucial factor in promoting tumor progression and hindering the delivery of therapeutic agents. My study also found that certain CAF subtypes, including αSMA single-positive CAFs, which contribute to tumor fibrosis, and CAFs expressing PD-L1, which may play a role in immunosuppression, were highly enriched in Tcon tumors compared to Dcon tumors. Furthermore, Tcon tumors exhibited compressed blood vessel with low functionality, indicating that Tcon tumors may exhibit lower therapy response rate due to worse drug delivery. Meanwhile, Dcon tumors displayed high immune cell infiltration, particularly CD4+ and CD8+ T cells producing TNFα, Granzyme B, Perforin and Interferon-γ, indicating that Dcon tumors possess potentials for better anti-tumor immunity than Tcon tumors. Additionally, Dcon tumor-bearing mice showed splenomegaly, enriched with myeloid cells and erythroblasts due to severe anemia. The enriched cells in the spleen were also expected to infiltrate into Dcon tumors and exert immunosuppressive and/or pro-tumoral effects. Our findings provide important insights into the distinct phenotypes of two gastric tumors and clinical implications for improving the therapeutic accessibility of gastric cancer patients.Abstract i Introduction 1 Materials and Methods 9 Results 15 Tables 30 Figures 34 Discussions 50 References 57 Abstract in Korean 72석

Data Retrieval and Privacy Enhancing Hybrid P2P-Cloud Storage System

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병목모형과 결합된 대기행렬모형을 이용한 김포공항의 혼잡료 부과에 관한 연구

학위논문(석사)--서울대학교 대학원 :항공우주공학과,1999.Maste

A Fountain Codes-based Hybrid P2P and Cloud Storage System

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A Study on Roles of spinster during Embryogenesis of Drosophila and Development of Experimental Inquiry Activity on Regulation of Gene Expression in Drosophila

국문초록 이 연구에서는 초파리 spinster (spin) 유전자가 초파리의 신경계 형성에 어떤 영향을 미치는지 알아보았고, 이 연구에서 나타나는 과학지식 생성과정을 분석하고 이를 적용한 유전자 발현 조절 탐구 활동을 개발하고 하였다. 이 연구의 첫 번째는 초파리의 신경계 형성에 관여하는 새로운 유전자의 기능을 밝히는 연구이다. spin은 초파리 배아 발생의 이른 시기부터 신경계의 중요한 세포 중에 하나인 교세포에서 발현되는 것이 확인 되었다. 배아 발생과정에서 spin의 기능을 확인하기 위해서 spin 기능이 상실된 돌연변이와 spin 유전자를 다른 장소에 발현시킨 기능 획득 돌연변이를 이용하였다. 이들 돌연변이에서 신경 발달에 미치는 영향을 확인한 결과, spin 기능 상실 돌연변이에서는 교세포의 수의 증가와 말초신경의 과도한 성장이 관찰되었다. 또한 spin 유전자를 교세포에서 과량 발현시키면 교세포에 싸여있는 신경축색돌기에 손상이 일어나는 것이 관찰되었다. 이를 결과를 바탕으로 우리는 spin이 초파리의 배아단계부터 발현하고, 신경계의 형성에 영향을 미친다는 것을 확인할 수 있었다. 두 번째 연구에서는 과학자의 실제 과학 탐구에서 나타나는 과학지식 생성과정을 학교 과학 탐구에 적용하고자 하였다. 이를 위해 먼저 연구자가 수행한 초파리 spin 유전자의 기능 연구에 관한 프로토콜을 생성하고, 이를 분석하여 과학자의 실제 과학 탐구과정에서 나타나는 과학지식 생성과정을 조사하였다. 초파리 spin 유전자의 기능 연구에서 나타난 과학지식 생성과정은 귀납적 사고과정, 귀추적 사고과정, 연역적 사고과정이 반복적으로 나타났으며, 특히 귀추적 사고과정에서 생성된 인과적 의문을 검증하기위한 연역적 사고과정이 반복적으로 나타나는 것을 확인할 수 있었다. 그리고 학교 과학 탐구에 적용하기 적합한 주제를 찾기 위해 제 7차 교육과정의 생물 교과서와 2009년 개정 교육과정의 생명과학 교과서에서 유전단원의 탐구활동 유형과 주제를 분석하였다. 그 결과 2009년 개정 교육과정의 생명과학Ⅱ 교과서에서는 이전 생물Ⅱ 교과서에서 다루지 않았던 진핵 생물의 유전자 발현조절 부분이 유전자와 유전공학 단원에 포함되어 있는 것을 알 수 있었다. 하지만 생명과학Ⅱ 교과서의 유전자 발현 조절에 대한 새로운 탐구활동은 대부분 제시된 실험결과를 바탕으로 자료를 해석하는 형태로 과학지식 생성과정을 충분히 담고 있지 못했다. 이에 연구 2에서는 과학지식 생성과정을 기반으로 초파리를 활용한 유전자의 발현 조절에 관한 탐구활동을 개발하고자 하였다. 개발된 탐구활동은 유전자 발현 조절을 통해 초파리 eyeless 유전자의 기능을 확인하는 실험으로 전체 3차시로 구성되어 있다. 개발된 탐구활동을 고등학교 과학반 학생 15명에게 시험 적용한 결과 학교 과학 탐구활동으로 적용 가능한 것으로 나타났다.ABSTRACT This study evaluated Drosophila spinster (spin) expression in detail and its possible roles during embryogenesis and developed experimental inquiry activities on the regulation of gene expression in Drosophila. These inquiry activities are based on process of scientist science knowledge generation. The first part of this study aims to examine the functions of spin during embryogenesis. Spin is known as a gene encoding a lysosomal membrane protein, which is required for cell death in forming a nervous system or neuro-muscular junction synapse during post-embryogenesis. However, the roles of spin during embryogenesis has not been investigated yet. The double staining of spin and repo showed that spin is expressed in surface glia including subperineurial glia, channel glia, and exit glia while not in neuron. Mutation in spin caused the increased number of surface glia. Over- or ectopic expression of spin led to progressive degeneration of exit glia and peripheral nerve. The ectopic expression of spin in the CNS also caused the degeneration of fasciclin axons. Taken together, these results indicate that spin functions in regulating embryonic neurogenesis via the regulation of neural degradation. The second part of the study tried to adapt the process of scientist science knowledge generation which scientists use in an authentic science inquiry to school science inquiry. To do this, first, a protocol for A Study on Roles of Spin during the Embryogenesis of Drosophila was created and performed in a scientists laboratory. And then with the analysis of that, the process of scientist science knowledge generation was investigated. The process of scientist science knowledge generation shown in the Study on Roles of Spin during the Embryogenesis of Drosophila contained repeated inductive thinking, abduction thinking and deductive thinking. Especially, the deductive thinking repeatedly showed to verify causal questions which had been formed in the abduction thinking. And to search for an appropriate topic to adapt to the school science inquiry, the types and topics of genetics in highschool Biology textbooks I and II in accordance to the Koreas 7th Curriculum and highschool Life Science textbooks I and II in accordance to the Curriculum revised in 2009. As a result, it was found that the regulation of gene expression in eukaryote was included in the Highschool Life Science Textbooks I and II in accordance to the Curriculum revised in 2009, which had not been included in the former highschool Biology textbooks. However, the new experimental inquiry activities about regulation of gene expression in the highschool Life Science textbooks I and II in accordance to the Curriculum revised in 2009 required only the interpretation of the given scientific results and did not ask for the process of scientist science knowledge generation. Thus, this study tried to develop the experimental inquiry activities about the regulation of gene expression using Drosophila. The newly developed experimental inquiry activities that consist of 3 steps are an experiment to ascertain the functions of eyeless gene of Drosophila through the gene expression regulation. We applied the experimental inquiry activities to fifteen high school students, which were proven to be applicable as school science inquiry activities.Docto