Tuberculosis in Taiwan

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?????????????92?4?27?
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????????? ???????
????Murray, et.al Textbook of Respiratory
Medicine
3
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????Murray, et.al Textbook of Respiratory
Medicine
4
???? SARS??
2003?2?26?,???????????????????,???????????????????
???????????????????????????????????????(?????????)
?????????????????,????????,???????????????????,???
????????????????????????(SARS)?
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SARS????? 2003/4/27 WHO??
????(Suspect Case)?2003?2?1?????1.???(gt38?)?2.
??????????,?????????????? ????????????? a.
??????????SARS???????(??? ?SARS??,??????????????
??? ?????????) b.?????????SARS???????(????
????????????????????)
6
SARS????? 2003/4/27 WHO??
?????(Probable Case)???????X????????,?????????(Re
spiratory Distress Syndrome)??????????????????,??
????????????????????????????????????,SARS??????
???? ?????????????????????????
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?????????SARS
???
?????
SARS
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CUMULATIVE NUMBER OF REPORTED SUSPECT AND
PROBABLE CASES
Country Case(s) No Number of deaths Local transmission
China 2601 115 Yes
Canada 140 15 Yes
Singapore 195 19 Yes
Hong Kong 1510 115 Yes
Spain/Ireland/France 1 0 None
Germany 7 0 None
Taiwan 41 0 Yes
Thailand 8 2 None
UK 6 0 Yes
USA 39 0 Yes
Viet Nam 63 5 Yes
Total 4611 271 ????4/27/2003
9
??????????SARS?
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???????SARS?????
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test) 2.????????????? 3.?? 4.????????
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?????????????(SARS)?
????????(WHO)?3?15??????,?????????????????2003?2?2
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SARS??????
SARS?????????(gt38?)????????????????X???????????SAR
S?????????,?????????????????????????????
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SARS???????????
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??????????????SARS???????(?????90),?SARS???????(?
10)????????????????,???????
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SARS??????????????
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??,???????????,?????????????
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SARS???????????
???????????,????????????,????????????,?????????4?
27???,???4611??????,??????271??
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SARS????????
??????????(??????762?),???????????????????????????
?????,??????????????????????????,?????????????????
????????????????????SARS?????????????????
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,?????????????????????,??????????????
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11???,????271??????????????????????SARS?????,?????
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?
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39
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)???????????????????????,?????????????????
40
???????????????????????????????
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???????????????????????,???????
??WHO?????????,????WHO????????,???????????(www.cdc
.gov.tw)????????????????????,????????????????,???
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42
?SARS?????????????
WHO??????????????????????????,??????????????,?????
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?????????,????????????SARS????,???(??????????)?080
0-024582?????SARS?????????,??????????????,???????
?????????
43
SARS??????????????????
SARS?????????????????????,????????,??????????????
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44
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??????????(SARS, Severe Acute Respiratory
Syndrome)??????????(recombinant spike
glycoprotein)????(???)??????
????
1. ??????(Coronavirus)??????(recombinant spike
glycoprotein)????(???)??? 2. ???????????????????
??????
46
????
????????SARS??????,???????????????????????????
??, ?????????????????????????????,????????????????
???????????????????????????????????
??????RT-PCR??????????????,?DNA??????????(expressi
on plasmid),??(1) Baculovirus expression system
?Vaccinia expression system (2)
?????(3)??????????????????????????(yeast
two-hybrid system)?flow cytometry????????????,????
???????????????????,????????????????????(?????????
?)???????????????????(?ELISA,???????)??????,??????
????????????????(?PRNT?TCID50?),????????(??,?,?,?,
?,?)?????????????????????????????????????????????
???????????????
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Viral Upper-Respiratory Infection (VURI)
Coronavirus

• Pathophysiology
• Infection is of the epithelial cells and remains
  localized, due to the optimum growth temperature
  of the virus which is 33 to 35 degrees.
• Corona virus particles have been seen in electron
  micrographs of the stools of children and adults
  with diarrhea and gastroenteritis. However, an
  association with these diseases has never been
  proven.
• Molecular mimicry has been suggested to associate
  with multiple sclerosis

Membrane-associated antigens in VERO cell
cultures infected with human coronavirus OC43
48
????(Coronavirus)
??? ???
???? (Spike glycoprotein)
signal
S1 domain S2 domain
TM Cyto
15
517 560
1117 1138 1173
268 417
49
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