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實作課程


本頁翻譯進度

燈號說明

審定:無
翻譯:黃永杰(簡介並寄信)
編輯:邱富敏(簡介並寄信)

本課程將包含十二個實驗操作,每一次大約兩個小時。

There will be 12 laboratory sessions in the course, each lasting approximately 2 hours.
實驗編號 學習主題
實驗一:細胞與組織 – 第一部分
Lab 1: Cells and Tissues - Part I
認識細胞以及次細胞結構。
To develop a basic understanding of cells and major subcellular structures.

分辨電子顯微鏡底下主要的次細胞結構。
To be able to identify major subcellular structures on an electron micrograph.

熟悉「日常」光學顯微鏡底下的細胞型態。
To become familiar with the appearance of cell on "routine" light microscopy.
實驗二:細胞與組織 – 第二部分
Lab 2: Cells and Tissues - Part II
觀察典型的上皮組織的結構與功能。
To examine the structure and function of representative epithelial tissues.

觀察常見的上皮組織損傷與疾病的型態。
To examine common patterns of epithelial injury and disease.
實驗三:感染與免疫
Lab 3: Infection and Immunity
感染性疾病經常是造成「正常」個體發病與死亡的元兇,更是免疫失調者(包含器官移植接受者)一個重要的臨床問題。藉由一系列在器官移植上的簡介,這個實驗將會介紹一些常見感染疾病的組織病理學。
Infectious diseases are extremely common causes of morbidity and mortality in "normal" individuals, and an even more important clinical problem in immunocompromised hosts, including organ transplant recipients. Through a set of small clinical vignettes in the setting of organ transplantation, this lab will introduce you to the histopathology of some common infectious diseases.
實驗四:器官移植與生物材料
Lab 4: Transplantation and Biomaterials
實驗五:心臟
Lab 5: The Heart
心臟是一個雙幫浦運作,在成人平均每分鐘可以輸送四公升的靜脈血到肺臟(右心)與等量的充氧血到體內循環(左心)。雖然心臟的細部研究不在本實驗的範圍內,一些心血管的結構與功能的基礎認識對於了解主要心血管疾病的型態與過程將是非常重要。
The heart is a duplex pump that in an average adult delivers ~4 liters/min of venous blood to the lungs (the right heart) and an equal amount of oxygenated blood to the systemic circulation (the left heart). Although detailed study of the heart is beyond the scope of this course, a basic understanding of cardiac anatomy and function is essential for understanding the patterns and consequences of major cardiac diseases.
實驗六:腎臟與血管
Lab 6: Kidneys and Blood Vessels
腎臟是結構複雜的器官,是設計為(1)排除新陳代謝後的廢物(2)調節體內鹽分與水分(3)調節pH值,與(4)分泌荷爾蒙與其他調節性物質
Kidneys are structurally complex organs that are designed to (1) excrete metabolic waste, (2) regulate body salt and water content, (3) regulate pH, and (4) secrete hormones and other regulatory substances.

腎臟的疾病正如它的結構一樣複雜。不過在這個實驗中,我們將只著重在典型的腎小球異常。這個實驗結束時,你應該要能夠分辨正常的腎小球與其結構,並建構典型腎小球疾病中腎小球損傷型態的基本認識。
Diseases of the kidney are as complex as its structure. In this lab, however, we will focus only on the classical abnormalities of the glomeruli. By the end of this lab, you are expected to be able to identify the normal glomerulus and its structural components, and develop a basic understanding of the patterns of glomerular damage in classical diseases of the glomerulus.
實驗七:肺臟與肝臟
Lab 7: Lungs and Liver
這些實驗的主要目標是強調肝臟中主要疾病型態。
The goal of these labs is to highlight the major patterns of disease in the liver.
實驗八:腸胃道
Lab 8: The Gastrointestinal Tract
這些實驗的主要目標是強調腸胃道中主要疾病型態。
The goal of these labs is to highlight the major patterns of disease in the GI tract.
實驗九:紅血球與白血球
Lab 9: Red and White Blood Cells
骨髓是生產血液血球的地方,許多影響血液或是網狀內皮組織系統的病理發展都會在骨髓處顯露。這個實驗的目的是介紹骨髓的生長型態,並強調識別骨髓異常的基本方法。
The bone marrow is the site of production of the cellular blood elements, any many pathological processes that affect the blood or the reticuloendothelial system have morphological manifestations in the bone marrow. The goal of this lab is to introduce you to the basic morphology of the bone marrow, and to highlight a basic approach for identification of bone marrow abnormalities.
實驗十:神經系統
Lab 10: The Nervous System
先不論中樞神經系統的極端複雜性,有些最常見的腦部異常可以藉由簡單的臨床病理關聯來了解。這個實驗的目的,是藉由以上課講義為基礎來展示一些常見的中樞神經系統失調病理。因為如此,你只需要對於構成腦部的各種細胞型態有基礎認識。
In spite of the enormous complexity of the CNS, some of the most common abnormalities of the brain can be understood with simple clinicopathological correlation. The goal of this lab is to build on the material presented in lectures to demonstrate the pathology of some common CNS disorders. For this purpose, you will only need a basic understanding of the morphology of the cell types that constitute the brain.
實驗十一:臨床實驗
Lab 11: The Clinical Laboratories
參觀臨床實驗室,將包含血液病理學、微生物學、化學和大體病理實驗室。
Site visit to the clinical laboratories, including hematology, microbiology, chemistry and anatomic pathology labs.
實驗十二:屍體解剖會議
Lab 12: Autopsy Conference
在屍體解剖會議上,將會與其他參與的醫院,討論兩到三個近期的檢體。
An autopsy conference in which 2-3 recent autopsies are presented and discussed in one or more of the participating hospitals.


前兩個實驗是設計來使你熟悉常見的細胞與組織,接下來八個實驗室針對特定器官與系統的病理學,而最後兩個實驗是設計來介紹兩個專精而重要的臨床病理學領域。每次實驗的講義在對應的實驗上課之前才會放在網路上,不過在之後的學期期間依然可以使用。

The first two laboratories are designed to familiarize you with the common structures of cells and tissues, the subsequent eight laboratories are focused on specific organs and organ systems pathology, and the final two laboratories are designed to introduce you to two specialized and important areas of hospital pathology. The web-based materials for each lab will be posted just-in-time for the corresponding lab, but will remain available through the course Web site for the remainder of the course.

雖然這些網路上的實驗講義主要是表單驅動式,學生應該要能使用這些資料來組織自己的想法與問問題。學生主動與實驗室老師互動非常的重要。只要學生肯思考並且問問題,將可發現講義內的圖片、案例與其他資料內所蘊藏的豐富資訊。

Although the web-based laboratories are largely "menu-driven," you are expected to use the materials presented to you to formulate your own thoughts and to ask questions. It is extremely important that you actively interact with the faculty during the laboratories. The images, cases and other materials presented to you contain a wealth of information that will only be accessible to you if you wonder and ask questions!


小型教案
Minicases

小型教案是指一些設計過的小案例研討,幫助學生統整課堂上與自行閱讀的資料。學生應該要在上課前先讀過小型教案並整理出對於每個案例的看法。雖然學生並不用繳交每一個小型教案的問題回答,但學生應該要花足夠的時間來準備每一個案例,才有辦法在課堂上參與案例討論。每一次的小型教案會在上課前大約一週時發下。

The minicases are small case-studies designed to help you integrate the materials covered in class and in your readings. You are expected to review the minicases ahead of time and to formulate your opinion about each case. Although you are not expected to hand-in your responses to questions posed in each minicase, you should have spent enough time on each case to be able to participate in class discussions about each case. The minicases will be distributed approximately 1 week before each scheduled session.

這些練習的目的是要給你一個機會在一個真實臨床爭論中來思考疾病的型態與機制。你不需執著定要找出特定的臨床指標、症狀或是實驗結果。你首要的責任是要試著去了解一種特定疾病病程是如何影響人體的正常組織與功能,以及這些改變會如何使疾病自身在診療測試中顯露。

The purpose of these exercises is to give you an opportunity to consider mechanisms and morphology of disease in an actual clinical contest. You should not dwell on trying to find out the exact meaning of particular clinical signs, symptoms or lab results. Your primary responsibility is to try to understand how a particular disease process interferes with normal structure and function of the body, and how these changes may manifest themselves in diagnostic tests.

小型教案編號 病狀描述
案例一
Case 1
一位五十歲男性護士對醫生描述,他發現自己在短期體能活動後越來越容易產生呼吸不順。他的身體狀況不錯,沒有已知心血管風險因子。他自述呼吸困難是幾個星期前才開始,沒有發燒、寒顫、胸口痛或是其他明顯的症狀。醫生在理學檢查中沒有發現明顯的異常。醫師處方開出氣管擴張劑吸入器備用,並告知病患在數月後回診追蹤。
A 50-year-old nurse presents to his physician because he has noticed becoming more and more breathless after short periods of physical exercise. He is in generally good physical condition with no known cardiovascular risk factors. He explains that his shortness of breath started only a couple of weeks ago, and he denies having had fevers, chills, chest pain, or any other significant symptoms. The physician finds no significant abnormalities on physical exam. He prescribes a bronchodilating inhaler to be used as needed, and instructs the patient to return for a follow-up in a couple of months.
案例二
Case 2
一位二十五歲男性病患因為急性嚴重胸口疼痛被送到急診室。這位病患喘氣不止並咳出泡沫狀帶血痰。病患過度虛弱以致無法告知發生什麼事情,而在照過緊急胸部X光後病患呼吸停止必須插管。
A 25-year-old man is brought to the ER with severe, acute onset chest pain. The patient is short of breath and and is coughing up large amounts of frothy, blood-tinged sputum. He is too sick to tell you about what happened, and right after an emergency chest X-ray he goes into respiratory arrest and must be intubated.
案例三
Case 3
一位五十五歲女性病患因為近期左手臂持續無力而前來就診。她最近亦間斷的感覺暈眩,但其他方面的健康狀況不錯。在理學檢查中,病患體重稍過重,並且確實左手臂無力。另外,病患臉部稍微不對稱(左邊臉部略為低於右邊)。她的血壓稍微升高,而且她自青少年起就開始抽煙。
A 55-year-old women seeks medical attention for recent onset weakness in her left arm. She has also experienced recent episodes of dizziness, but is otherwise is reasonably good health. On physical exam, she appears somewhat overweight, and she does indeed have left arm weakness. In addition, her face appears somewhat asymmetrical (the left side of her face is a little lower than the right). Her blood pressure is mildly elevated, and she has been smoking since she was a teenager.
案例四
Case 4
一位六十五歲造船廠退休男性工人向他的醫生抱怨說有持續數星期的咳嗽與生痰。再追問下,他表示他是嚴重煙癮者,並且五六年來呼吸困難的情形不斷加重。在理學檢查中,雙肺敲擊後呈現鈍聲(意即,輕叩聲音不會經由肺部區域產生回音)並且呼吸音不正常。咳嗽時,會帶有大量濃厚的痰汁。痰汁已送去培養並已取得胸部X光照片。
A 65-year-old retired shipyard worker presented to his doctor complaining of several weeks of increasing coughs and sputum production. On further questioning, he reveals that he is a heavy smoker and that has become increasingly short of breath over the past 5-6 years. On physical examination, both his lungs are dull to percussion (i.e., tapping sounds do not resonate over his lung fields) and he has abnormal breath sounds. On coughing, he brings up copious amounts of thick sputum. The sputum is sent for culture and a chest X-ray is obtained.

 
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