Before infection

1
??
2

• ??? ??
• ?? ??

3

• ??? ??
• Before infection
• ???? ??? ??? ???? ??
• ??? ???? ???? ??? ??? ??
• ????
• Epithelia, antimicrobial substance,
• phagocytic cell, NK cell, blood protein

4

• ?? ??
• ??? ?????? ???? ???
• ???? ??
• Specificity for distinct macromolecules
• Ability to remember
• ?? ???? ???? ??? ? ?? ??
• ????
• lymphocyte

5
??? ?? ??? ?? ??
6
?? ??? ??

• 1. ??? (specificity)
• 2. ??? (diversity)
• 3. ?? (memory)
• 4. ??? (specialization)
• 5. ?? ?? (self limitation)
• 6. ???? ?? ????
• (nonreactive to self)

7

• 1. ??? (specificity)
• ?? ?? ??? ??
• ?? ???? ??? ? ?? ????
• ?? ???
• 2. ??? (diversity)
• ?? ? ???? ?? ?? ???? ?? ?

8

• 3. ?? (memory)
• ??? ??? ??? ????, ???? ??
• ??? ??????
• 4. ??? (specialization)
• ???? ?? ???? ?? ??? ???
• ???? ??

9

• 5. ?? ?? (self-limitation)
• ?? ?? ? ?? ??? ??? ?? ???
• ???
• 6. ???? ?? ????
• ?? ??? ???? ???? ?? ????
• ?? ??? antigenic substance? ????
• ??? ??? ??

10
?? ??? ??

• Humoral immunity (??? ??)
• Cellular immunity (??? ??)

11
??-??? ??
?? ??? ?? 6??
??
??? ??
?? ??
??? (Lymphocyte)
??? ??
??? ??
12
B, T- cell ???

• B-cell, B lymphocyte
• Antibody? ???? ??? ??
• ??? ??? ?? ??? ??? ??
• Antibody-secreting cell
• ??? ??? ???

13
(No Transcript)
14

• T-cell, T lymphocyte
• ?? ??? ????? ?? ??
• ?? -gt ?? -gt ?? ????
• CD4 helper T cells
• CD8 cytotoxic T cells
• Suppressor T lymphocytes

15
(No Transcript)
16

• ?? 6-2

17

• ?? 6-3

18
??

• ??? ?? ??? ?????
• ?? ??? ??? ?? ?? ??

19
??
Recognized microbial antigen specifically Neutroli
ze the infectivity of microbe Microbe for
elimination by various effector mechanism

• ?? ? ?? ??
• ?????? ??? ??
• ?? ??, ??? ??, ??
• ??? ???

IgG IgM IgA IgE IgD
20
??-??? ??
?? ??? ?? 6??
??
??? ??
?? ??
??? (Lymphocyte)
??? ??
??? ??
21
??? ??

• B lymphocyte? ?? ?????
• antibody? ??? ??
• ??? ??? ??? ???? ??? ??
• ??? defense mechanism

22
(No Transcript)
23
??? ??

• T lymphocyte? ?? ??
• Intracellular microbes? ??? ??
• antibody? ?? ?? ??? phagocyte
• ??? ???? ??
• -gt phagocyte? ???? ???? ??? ??? ??

24
(No Transcript)
25
??? ?? vs. ??? ??
26
? ???
27
???????
28
????
29
????
30
???? ??? ??

• ? I ? ????
• ? II ? ????
• ? III ? ????
• ? IV? ????

31
? I ? ???? (???????)

• ??? ??? ??? ?? ????
• ?? ?? ???? ???? (mast cell)?
• ???? ?? ??? ???? ???
• ??? ? ? ? ??? ????
• ??? ??

32
(No Transcript)
33

• ?? ??
• ?? ??
• ?? ????
• ??????
• ???

34
? II ? ????

• ??? ?? ??? ??? ????
• ??? ?? ??? ??? ??

35
?? ??? ?? ????? ???? ???? ??-??? ???? ??
36

• ????, ??????
• ????? ????
• ??? ???
• ?? ?? ??
• ??????
• ?? ????..

37
? III ? ????

• ??-?? ?????? ??
• ???? ???? ?????
• ??? ??

38
(No Transcript)
39
? IV ? ????

• ???? ??? T-???? ?? ??
• CD4 T-??? ?? ????
• ??? ???
• CD8 T-??? ?? ????
• T-?? ??? ???? ??

40

• Fig 6-21

41
Type I Type II Type III Type IV
Antibody IgE IgG, IgM IgG, IgM None
Antigen Exogenous Cell surface Soluble Tissues organ
Response time 15-30 m Minutes- hours 3-8hrs 48-72hrs
histology Basophils and eosinophil Antibody and complement Complement and neutrophils Monocytes and lymphocyts
Transferred with Antibody Antibody Antibody T-cells
42
??

• Type I hypersensitivity
• Type II hypersensitivity
• Type III hypersensitivity
• Type IV hypersensitivity

43
? I ? ???? Anaphylaxis Asthma Allergies
? II ? ???? Autoimmune hemolytic anemia Goodpature syndrome
? III ? ???? SLE Serum sickness Arthus reaction
? IV ? ???? Contact dermatitis Tuberculosis Transplant rejection
44
????

• (??, ??, ??, ?, ?, ??, ??, ??? ??)

45
??????? ??

• ??? ??? ??? ???(non-self, fereign)? ??????
  ????, ??? ??? ??? ????? ????? ?????, ????? ?? ???
  ??? ??? ?? ??? ????
• ?? ??? ??

46
????? ????

• T-?? ????
• ?? ????

47
(No Transcript)
48
????? ????
49

• Major Histocompatibility molecules
• HLA (human leukocyte antigen)
• ???

50

• MHC??
• In human, the genes encoding the most important
  histocompatibility molecules are clustered on a
  small segment of chromosome 6

51

• MHC class I
• - expressed on all nucleated cells
• and platelets
• MHC class II
• - present exogenous antigen
• (extracellular microbes, soluble proteins)

52
HLA (human leukocyte antigen)?
53

• MHC class I CD8 T cells
• MHC class II CD4 T cells

54

• MHC class I
• - HLA-A, HLA-B, HLA-C
• MHC class II
• - HLA-DQ, HLA-DP, HLA-DR

55

• Fig 6-9

56

• ??
• 30? ??

57

• 3????? ?? ??
• ???? ??? ??? ?? ????
• ? ??? ??? ??? 500,000/mm3

58
(No Transcript)
59
(No Transcript)
60

• ?? ?? ??? ???
• Chronic myeloid leukemia

61
(No Transcript)
62
(No Transcript)
63
HLA? ?? ????.
64
GVHD (Graft versus host disease)
65

• HLA ?? ??? ??? ????.

66

• ?? ??? ???? ???

67
???? ??

• ??? ??

?? ??
?? ??
68
???? ???
69
????
70
???? ??
71
???? ?????

1. The presence of an autoimmune reaction
2. Evidence that such a reaction is not secondary to
   tissue damage
3. The absence of another well-defined cause of the
   disease

72

• ??? ??
• (?? ?? ???? ????? ??)
• ??? ??? (??? ????)
• ?? T?? ??? ??
• ????? ??
• ??? ??

73
Organ-specific Systemic
Hashimoto thyroditis SLE
Autoimmune hemolytic anemia Rheumatoid arthritis
Autoimmune atrophic gastritis of pernicious anemia Sjogren syndrome
Multiple sclerosis Reiter syndrome
Autoimmune orchitis Inflammatory myopathies
Goodpasture syndrome Systemic sclerosis
Autoimmune thrombocytosis Polyarteritis nodosa
Insulin-dependent diabetes melitus
Myasthenia gravis
Graves disease
Autoimmune hepatitis
Primary biliary cirrhosis
Ulcerative colitis
??? ??
74

• SLE (???????)

75

• The prototype of a multisystem disease
• of autoimmune origin, characterized by
• a bewildering array of autoantibodies,
• particulary antinuclear antibodies

76
SLE (???????)
Malar rash
Discoid rash
Photosensitivity
Oral ulcer
Arthritis
Serositis
Renal disorder
Neurologic disorder
Hematologic disorder
Immunologic disorder
Antinuclear antibody
77
(No Transcript)
78
(No Transcript)
79
(No Transcript)
80
(No Transcript)
81
??

• Systemic lupus erythematous
• Multisystem disease of autoimmune origin
• Antigen-antibody complexes

82
????
83
???????
84
(No Transcript)
85
?? ?????

• X-linked agammaglobulinemia
• Common variable immunodeficiency
• Selective immunoglobulin deficiency
• DiGeorge syndrome
• Severe comined immunodeficiency
• Wiskoff-Aldrich syndrome

86
?? ???

• ?? ?? ????? ???
• ??? ?? ?????

87
AIDS

• Fig 6-45

88

• Fig 6-47

89

• Fig 6-48

90
AIDS
91
AIDS- Pneumocystis pneumonia
92
AIDS- HIV encephalopathy
93
AIDS- CMV infection
94
AIDS- Kaposi sarcoma
95
??

• ???????
• ?????
• AIDS

96
???? ???
97
??
98
Fig 10-5
99
?? ????? ???? ???
100
????
101
??? ???? ???

• ??? ??
• ?? ?? ???? ????? ??
• ???
• ???? ???? ????
• ??? ???
• ??????? ?? ??? ??

102
??? ?????
103
Oligohydramnios sequence

• Fig 10-3

104
(No Transcript)
105
ALCOHOL

• Perhaps the most widely used agent today,
• is teratogen.
• Growth retardation
• Microcephaly
• Atrial septal defect
• Short palpebral fisures
• Maxillary hypoplasia

106
?? ????
32? ???
107

• Hyaline membrane disease
• Necrotizing enterocolitis
• Sepsis
• Intraventricular hemorrhage
• Long term complication

108
??? ???????
109
(No Transcript)
110
??.
Sign 0 1 2
Heart rate Over 100
Respiratory effort Good, crying
Muscle tone Active motion
Response to catheter in nostril Cough or sneeze
Color Completely pink
5??? 1?? 5?? ??
111
??? ??? ?? ?? ???
112
???? ?? ??
113
??????? (erythroblastois fetalis)

• O? ??? A or B? ??
• Rh- ??? Rh ??

114
(No Transcript)
115
(No Transcript)
116
? ?????
117
??????? (sudden infant death syndrome)

• ??? ???
• 90? 6?? ???

118

• ??
• 20? ??
• ??
• ??
• ??

?? Brain stem abnormality ??? ??
?? Prone sleep position ??? ?? ??
????
119
??? ??? ? ???
120
0 - 14? ? ???
121
0 4?
??? Leukemia
?????? Retinoblastoma
?????? Neuroblatoma
????? Wilm tumor
122
?????
123

• ?? ??? ??? ?? 500,000/mm3
• (??? 4,000-10,000/mm3)

124
???

• ?? ???? ??? (ALL)
• ?? ???? ??? (AML)
• ????? ??? (MDS)
• ?? ??? ??? (CML)

125

• ?? ???? ??? (ALL)
• Type L1, L2, L3
• 80

126
?????? (retinoblastoma)

• ??

127
(No Transcript)
128

• 13q14 ? ??? Rb ???

129
?????? (neuroblastoma)
130
(No Transcript)
131

• ????
• ???
• ????? ???? ???
• ???
• ??
• ???

132
(No Transcript)
133
????? (Wilm tumor)
134
(No Transcript)
135

• ??? ??