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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 王儷穎(Li-Ying Wang) | |
dc.contributor.author | Yun-Cheng Lin | en |
dc.contributor.author | 林芸琤 | zh_TW |
dc.date.accessioned | 2021-06-16T16:20:06Z | - |
dc.date.available | 2014-03-04 | |
dc.date.copyright | 2013-03-04 | |
dc.date.issued | 2012 | |
dc.date.submitted | 2013-02-01 | |
dc.identifier.citation | 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011:1-22.
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/63044 | - |
dc.description.abstract | 研究背景:放射治療(RT)對於可切除或不可切除之食道癌是常見的治療方式。進行放射治療前,需先進行治療區域定位,考量腫瘤本體、可能侵犯的範圍以及隨著呼吸造成的位移,周遭正常組織也會受到放射散射影響而造成傷害。過去研究證據顯示,除了直接造成DNA損害,放射治療可能會導致正常組織氧化壓力上升,造成細胞的DNA傷害或死亡,進而影響其正常生理功能。臨床食道癌患者進行放射治療時,橫膈肌會同時接受到部分放射線照射,但其對橫膈肌的收縮功能是否造成影響則尚未有相關研究。研究目的:本研究的主要目的是以動物實驗探討放射治療對於橫膈肌收縮功能之影響,及其可能的機制。方法:研究使用20隻8至10週Sprague-Dawley大鼠隨機分配至放射組(n=10)及對照組(n=10)。所有實驗大鼠使用腹腔注射麻醉後,先以X光模擬器進行左側橫膈區域定位,放射組及對照組分別以5 Gy及0 Gy放射劑量進行單次左半側橫膈照射。照射前先以非侵入性全體呼吸測量系統對兩組大鼠進行呼吸相關參數之測量(基線),照射完成24小時後,再以非侵入性呼吸測量(後測)加上侵入性呼吸測量系統進行肺功能相關參數之測量。之後,犧牲大鼠並取出兩組大鼠的左側橫膈,進行收縮功能測試。DNA受損以γH2AX量化。氧化壓力以抗氧化酵素CuZnSOD和MnSOD染色表現強度來進行初步評估。所有資料以SPSS進行統計分析。以線性廣義(GLM)或廣義估計(GEE)方程式來檢定相關參數在組間及組內的差異。統計顯著水平定為0.05。結果:放射組大鼠在接受照射後24小時,橫膈肌之絕對單一收縮力(p=0.03)、絕對強直收縮力(p=0.03)、標準化強直收縮力(p=0.02)均顯著低於對照組。相較於控制組,照射組的相對力量-頻率曲線則無明顯位移現象。放射照射24小時後,放射組約有58%的橫膈肌細胞仍有γH2AX的表現,顯著多於對照組(30%, p=0.01)。放射組在顯微鏡下觀察具細胞腫脹情形,CuZnSOD和MnSOD表現強度亦較對照組明顯。兩組後測之吸氣週期(p<0.0001)、呼吸頻率(p<0.0001)及每分鐘換氣量(放射組:p=0.02;對照組:p=0.03)皆顯著低於基線。結論:放射線照射會對大鼠之橫膈肌造成急性(照射後24小時)收縮功能異常,此現象可能與RT造成橫膈肌之DNA直接或間接(氧化壓力增加)受損有關。 | zh_TW |
dc.description.abstract | Background: Radiotherapy (RT) is a common treatment option for patients with esophagus cancer. Surrounding normal tissue is often receiving scatter RT dose during treatment, which might lead to tissue injuries. Previous studies showed that in addition to directly cause DNA damage, radiation therapy also cause indirect DNA damage, resulting in cell injury or death and further organ dysfunction. Diaphragm usually received certain amount of scatter radiation during RT treatment in patients with esophagus cancer, and the impact of RT on diaphragm contractile function remained to be determined. Purpose: The purpose of this study was to investigate the effect and potential mechanisms of RT on diaphragm contractile function using animal model. Methods: A total of 20 Sprague-Dawley rats were used and randomized into radiation group (RG, n=10) and control group (CG, n=10). Left diaphragms of rats in RG and CG received 5 Gy and 0 Gy (shame) irradiation, respectively, after anesthetized. Before irradiation, baseline pulmonary function (using non-invasive method) was evaluated. Twenty-four hours following irradiation, pulmonary function tests were repeated using both non- and invasive methods. The left diaphragm was removed for contractile function testing. Retention of γH2AX foci after 24 hours of irradiation was analyzed and used as an indicator for DNA damage. Preliminary oxidative stress level was analyzed using CuZnSOD and MnSOD staining methods. SPSS was used for all data analyzes. Generalized Linear Model (GLM) and Generalized Estimating Equation (GEE) model were used to detect differences of variables between and within groups when suitable. Significant α level was set at 0.05. Results: Compared to CG, 24 hours after irradiation, absolute twitch tension (p=0.03), absolute tetanus tension (p=0.03), and specific tetanus tension (p=0.02) was significantly lower in RG. Relative force-frequency curves of RG did not show significant deviation compared to CG. At 24 hours after irradiation, 58% of diaphragm muscle cells remained γH2AX positive, which was significantly higher than in CG (30%, p=0.01). Microscope observation revealed swelling of muscle cells in RG. Staining intensity of CuZnSOD and MnSOD was higher in RG compared to that of CG. Compared to baseline, inspiratory duty cycle (p<0.0001), respiratory rate (p<0.0001), and minute ventilation (RG: p=0.02; CG: p=0.03) were significantly lower after 24 hours of intervention in both groups. Conclusion: Radiation could induce acute (24 hours post irradiation) contractile dysfunction of diaphragm which might be related to RT-induced direct DNA damage and RT-related overwhelmed oxidative stress. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T16:20:06Z (GMT). No. of bitstreams: 1 ntu-101-R99428002-1.pdf: 1600962 bytes, checksum: 7407f332bfb2993a635a23a0eb53ae18 (MD5) Previous issue date: 2012 | en |
dc.description.tableofcontents | 口試委員會審定書...........................................I
致謝......................................................II 中文摘要..................................................IV Abstract..................................................VI 目錄....................................................VIII 圖目錄.....................................................X 表目錄...................................................XII 第一章、 前言.............................................1 第一節、 研究背景與目的...................................1 第二節、 研究假說.........................................3 第三節、 研究重要性.......................................3 第二章、 文獻回顧.........................................4 第一節、 放射治療簡介.....................................4 第二節、 放射治療之周邊劑量及其對周遭組織的影響...........6 第三節、 放射治療導致正常組織傷害的機制...................8 第四節、 放射治療對肌肉之影響............................14 第五節、 放射治療對呼吸肌之影響..........................16 第六節、 橫膈肌收縮功能之測量方式........................17 第七節、 以肺功能評估呼吸肌之整體換氣表現................19 第三章、 研究方法........................................22 第一節、 研究設計........................................22 第二節、 研究族群........................................22 第三節、 樣本數估計......................................22 第四節、 實驗流程........................................23 第五節、 放射照射參數....................................25 第六節、 研究工具與方法..................................26 1. 非侵入性呼吸參數測量............................26 2. 侵入性肺功能測量................................26 3. 橫膈肌收縮功能測試 ..............................28 4. DNA雙鍵斷裂指標(γH2AX)及氧化傷害(CuZnSOD、MnSOD)..................................................33 5. 橫膈肌型態及發炎浸潤反應........................36 第七節、 研究變項........................................36 第八節、 資料分析........................................38 第四章、 研究結果........................................39 第一節、 基本資料........................................39 第二節、 放射照射對橫膈肌收縮功能之影響..................40 第三節、 放射照射對肺功能之影響..........................44 第四節、 放射照射導致之橫膈肌DNA受損(γH2AX)...........50 第五節、 放射照射對橫膈肌發炎及氧化壓力之影響............51 第五章、 討論............................................53 第六章、 結論............................................61 參考文獻.................................................62 | |
dc.language.iso | zh-TW | |
dc.title | 放射治療對橫膈肌收縮功能之影響及相關機制之探討 | zh_TW |
dc.title | Effect and Mechanism of Radiation Therapy on Diaphragm Contractile Function | en |
dc.type | Thesis | |
dc.date.schoolyear | 101-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 陳裕仁(Yu-Jen Chen),吳惠東(Huey-Dong Wu),林清基(Ching-chi lin),謝忱希(Chen-Hsi Hsieh) | |
dc.subject.keyword | 放射治療,橫膈肌收縮功能,γH2AX,氧化壓力, | zh_TW |
dc.subject.keyword | Radiation therapy,Diaphragm contractile function,γH2AX,Oxidative Stress, | en |
dc.relation.page | 76 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2013-02-01 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 物理治療學研究所 | zh_TW |
顯示於系所單位: | 物理治療學系所 |
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