Pathology

Acupuncture A comprehensive text

Biomedicine

감염질환

분류 크기 번식장소 예 발병질환

Prions 30–50 kD Intracellular Prion protein Creutzfeld-Jacob disease

Viruses 20–300 nm Obligate intracellular Poliovirus Poliomyelitis

Bacteria 0.2–15 μm Obligate intracellular Chlamydia trachomatis

Trachoma, urethritis

Extracellular Streptococcus pneumoniae

Pneumonia

Facultative intracellular

Mycobacterium tuberculosis

Tuberculosis

Fungi 2–200 μm Extracellular Candida albicans Thrush

Facultative intracellular

Histoplasma capsulatum

Histoplasmosis

Protozoa 1–50 μm Extracellular Trypanosoma gambiense

Sleeping sickness

Facultative intracellular

Trypanosoma cruzi Chagas disease

Obligate intracellular Leishmania donovani Kala-azar

Helminths 3 mm–10 m Extracellular Wuchereria bancrofti Filariasis

Intracellular Trichinella spiralis Trichinosis

인간의 Prion disease

•Creutzfeldt-Jakob Disease (CJD) – 노인질환, 치매등과연관지어

연구되었음 68세•인큐베이션기간이짧고

•Variant Creutzfeldt-Jakob Disease (vCJD) – Mad cow disease 와관련 28세인큐베이션기간이 14개월이상

•Gerstmann-Straussler-Scheinker Syndrome•Fatal Familial Insomnia•Kuru 뉴기니에서식인풍습

Prion : A proteinaceous infectious particle : Protein infection

감염성프리온질환은병원체가일단구강을통해감염된후림프절과비장에서일차적인증식이일어난후말초신경계에감염되며그후중추신경계로침범하는병리기전을나타내고있다.

- 자세한원인과치료법은아직…… T T

박테리아보다사이즈가작고종류마다숙주가다름특정호스트에반응하고특정단백질로막을이루고있음

Chlamydia, Herpes, Syphillis and The Clap(Gonorrhea)

우울증거북자아분열양물무서워하는악어환각을보는뱀실어증하마

페니실린HPV

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참고사이트

•페니실린에민감한것은?•테트라사이클린은어느것에사용?

A, pneumonia. gram-positive cocci in clusters (Staphylococcus aureus)B, pneumonia. Gram-positive, (Streptococcus pneumoniae) neutrophil

C, both gram-positive and gram-negative, although they are true gram-positive bacteria. D, gram-negative Klebsiella pneumoniae or Escherichia coli. E, gonorrhea. Many gram-negative diplococci (Neisseria gonorrhoeae)F, Silver stain of brain tissue Lyme disease meningoencephalitis. Two helical spirochetes (Borrelia burgdorferi)

Common cold

• S/S• Runny or stuffy nose• Itchy or sore throat• Cough• Congestion• Slight body aches or a mild

headache• Sneezing• Watery eyes• Low-grade fever (up to 102

F, or 39 C)• Mild fatigue

• 200가지가넘는바이러스중가장제일은

• Rhinovirus

• Cold virus는코와입으로도전염그러나손으로가장많이전염

• “Catch Cold”

바이러스와구구단

림프구모집

갈아타기와점액자극

활동

깨끗처리반

목이따끔거릴때왜 LU11 ?

Rhinovirus와숫자

• 수명은 2-3일

• 종류는 110가지이상

• 피부에서 3시간물건에서도 3시간생존

• 살기좋은온도 33도C

• 1400 BC 이집트에서인식한 Picornaviruses의한종류

• 봄,여름, 가을

Wind attacking /Lung Qi

• Wind Cold• An aversion to cold• shivering• low or no fever• chills predominated over

feelings of heat• no sweat• occipital headache• stiff neck• body aches• slight cough, sneezing,

running nose w/white discharge.

• Wind Heat• Fever and Chills w/Fever

predominating• slight sweating• runny nose w/yellow

discharge• Headaches, bodyaches• cough, sore throat (more

severe than wind-cold), slight thirst.

Stiff neck/ 갈근탕?

• 무균성수막염

• Viral Meningitis

• 갈근탕

• 면역이강할경우 7-10일이면완쾌

• Enterovirus

• 세균성수막염

• 심각한상태

• 갈근탕자료참고

• Meningitis 참고

Symptom Cold Allergy

Cough Usually Sometimes

General aches and pains

Sometimes Never

Fatigue Sometimes Sometimes

Itchy eyes Rarely Usually

Sneezing Usually Usually

Sore throat Usually Sometimes

Runny nose Usually Usually

Stuffy nose Usually Usually

Fever Rarely Never

감기와알러지증세비교

Whooping Cough (Pertussis) 백일해

• Runny nose

• Nasal congestion

• Sneezing

• Red, watery eyes

• A mild fever

• Dry cough

• 첫번째스테이지

• 1-2주후증상

• Bring up thick phlegm

• Provoke vomiting

• Result in a red or blue face

• Cause extreme fatigue

• End with a high-pitched "whoop" sound during the next breath of air

Wind Heat/ Lu weak

• 기침, 직접적인접촉

• 보르데텔라백일해균

• (Bordetella pertussis)에의한감염으로발생하는호흡기질환

Contagious Parotitis(Mump)유행성이하선염, 볼거리

• Fever• Fatigue• Headache• Pain below the ears• Swelling and tenderness

along the jaw and in front of and below the ear(s)

• Possible swelling of the testicles in males

• People who do not have swelling may still spread the virus to others.

• 급성, 전염성이있는바이러스질환

• paramyxovirus

Heat Toxin/ wind heat excess

• 소음- 소양경맥이동 • Complication of Mump

• Orchitis or oophoritis

• Meningitis or encephalitis

• Pancreatitis

바이러스와박테리아감염비교

• viral infections

• systemic

• 여러곳에동시에증세가나타날수있다.

• 예외 Pink eye, Herpes

• 통증이심하지않지만

• Herpes는심한통증

• Bacterial infections

• localized redness, heat, swelling and pain.

• 한곳에집중되어증세가나타남

• 감염된곳에염증이생기고 Pus

Bacterial Dysentery

• Shigellosis 세균성이질

• = Bacillary Dysentery

• 전염병 – Oral –Fecal

• 손을깨끗이

• S/S

• Acute (sudden) abdominal pain or cramping

• Acute (suden) fever

• Blood, mucus, or pus in stool

• Crampy rectal pain (tenesmus)

• Nausea and vomiting

• Watery diarrhea

살모넬라

• Gastroenteritis

• Nausea

• Vomiting

• Abdominal pain

• Diarrhea

• Fever

• Chills

• Headache

• Muscle pains

• Blood in the stool

• Typhoid fever 장티푸스

• Salmonella typhi균

• Diarrhea or constipation

• Fever over 102 F (38.8 C)

• Slightly raised, rose-colored spots on your upper chest

• Cough

• Mental confusion

• A slowing of your heartbeat

• Enlargement of your liver and spleen

Damp-Heat in ST &Intestines

Infectious Hepatitis

Hepatitis A (HAV)

• 2 - 6 weeks

• Dark urine

• Fatigue

• Itching

• Loss of appetite

• Low-grade fever

• Nausea and vomiting

• Pale or clay-colored stools

• Yellow skin (jaundice)Oral – Fecal

Hepatitis B (HBV)

• 6개월

• Appetite loss

• Fatigue

• Low-grade fever

• Muscle and joint aches

• Nausea and vomiting

• Yellow skin and dark urine due to jaundice

blood, semen, vaginal fluids, and other body fluids

Hepatitis C (HCV)

• Abdominal pain (right upper abdomen)

• Ascites• Bleeding varices (dilated veins in

the esophagus)• Dark urine• Fatigue• Generalized itching• Jaundice• Loss of appetite• Low-grade fever• Nausea• Pale or clay-colored stools• Vomiting

Blood

Hepatitis D virus (HDV)

• Hepatitis D virus (HDV) is only found in people who carry the hepatitis B virus.

• Abdominal pain• Dark-colored urine• Fatigue• Jaundice• Joint pain• Loss of appetite• Nausea• Vomiting Hepatitis B virus

Hepatitis E (HEV)

• 2–9 WEEKS (MEAN 6 WEEKS)• Jaundice• Fatigue• Abdominal pain• Nausea or vomiting• Diarrhea• Fever• Loss of appetite• Dark urine

Fecal-Oral

Sequelae of Infantile Paralysis (Polio)소아마비

• Poliomyelitis is a viral disease that can affect nerves and can lead to partial or full paralysis.

폴리오바이러스는장바이러스(enterovirus)의종류로혈청형 1, 2, 3형이있다.

• Oral-Fecal

(TCM) 소아마비 Polio

• “Atropy”

• Wind, dampness, heat invade the lungs and Stomach through the nose and mouth.

• - Heat is formed

• - This injures the channels and disrupts the Qiand Blood, leaving the muscle channels malnourished.

Polio

• S/S – 어린아이인경우

• - 90~95% No symptom

• 1 to 3 days of slight fever, malaise, headache, sore throat, and vomiting

• 3 to 5 days There are no neurologic symptoms or signs, and physical examination is unremarkable except for the presence of fever.

• Paralytic and nonparalytic

• 서양의학의발전

• 한의학에서의치료법

• 백신

소아마비

• Nonparalytic polio

• Fever• Sore throat• Headache• Vomiting• Fatigue• Back pain or stiffness• Neck pain or stiffness• Pain or stiffness in the arms or

legs• Muscle spasms or tenderness• Meningitis

• Paralytic polio

• Loss of reflexes• Severe muscle aches or

spasms• Loose and floppy limbs (acute

flaccid paralysis), often worse on one side of the body

Malaria, 학질, 3일열, 4일열

• 얼룩날개모기(Anopheles sinensis)

A. 번식작용에모기와사람이이용된다.B. trophozoiteC. SchizontD. Gametocyte

BCD는말라리아에걸린사람의적혈구검사에서발견된

Plasmodium falciparum

말라리아의감염원인은?

• protozoa of the genus Plasmodium

• Plasmodium이라는원생동물때문

참고: Protozoa는진핵원생동물예)아메바

살아가는모습 : 기생생활

모기와사람을상대로

인간의백혈구도 Protozoa의형태를띰

Plasmodium falciparum

기생원생동물

잠복기간

• 12 to 17 days for P. vivax,

• 9 to 14 days for P. falciparum,

• 16 to 18 days or longer for P. ovale, and

• about 1 mo (18 to 40 days) or longer (years) for P. malariae.

• P. vivax in temperate climates may not cause clinical illness for months to > 1 yr after infection. (한국토종말라리아)

말라리아증세

• Fever and rigor(경직)—the malarial paroxysm

• Anemia

• Jaundice

• Splenomegaly

• Hepatomegaly

• 비장, 간비대는생리학참조

malarial paroxysms 말라리아발작증세

• 특징적인말라리아의열발작• (오한, 발열, 발한후해열이반복적으로나타남)

• 오한기(cold and chilling statge) : 춥고떨린후체온이상승

• 발열기(hot statge) : 체온이 39℃~41℃이상까지상승하며피부가건조함(~90분)

• 하열기(발한기) : 침구나옷을적실정도로심하게땀을흘린후체온이정상으로떨어짐(4~6시간)

• Plasmodium의종류에따라발작의주기가달라짐• 한국에서는주로 3일열로불리었으나지금은규칙적이지않음

Filarial Elephantiasis

Wuchereria bancrofti

• 기생충

• 모기-사람-기생충

필라리아사상충감염경로

Pathology

• 1. 증세가없는기간 – 면역계의활동으로인해증세가나타나지않을수있다

• 2. 급성(염증성) – Lymphedema, fever, chills, skin infections, painful lymph nodes, and tender skin of the lymphedematous extremity

• 3. 만성 (폐색성) - thickening of the skin and elephantiasis

Eye Worm Loa loa filariasisDeer Fly, Mango Fly

Calabar swellings

Chyluria 유미뇨

• Chyluria 의원인 filariasis (parasite : Wuchereria bancrofti)

• 유미뇨는소변에유미 (chyle)나지방구가혼합되어우유와같이뿌옇게혼탁된소변

유미관 = 암죽관

• 유미관즉암죽관

• 설명해보세요.

• 퀴즈 가산점

• 10점

침구치료

• Ren 4, SP 6

• Use moderate stimulation. Treat daily or on alternating days

• 15-20 treatments constituting one course

• * 침과뜸함께사용할수있으며

• 환자에게지방이많이든음식은피하도록

Schistosomiasis 주혈흡충병

• Bilharzia 주혈흡충(住血吸蟲)

• =Blood Fluke

• Schistosoma parasite

• 오염된물에서수영

• 미국에서는찾아보기힘듬

• 여행중병에걸리기도

증세

• 만약기생충이많이있으면

• fever, chills, lymph node enlargement, and liver and spleen enlargement.

• 수영후가려움증빨간반점

• 복통, 피가포함된설사

• frequent urination, painful urination (dysuria), and blood in the urine (hematuria)

Swimmer’s Itch

Pulmonary Tuberculosis

• (TB) is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs.

• Mycobacterium tuberculosis

TB patho

• Mycobacterium tuberculosis –왁스같은표면에움직이지않고산소가많은곳을좋아하는박테리아

• 기침 – 전염 감염될확률 1/30

• 폐결핵이가장흔하나전신어느곳에도발생

• 결핵균과 T lymphocytes 의관계

• 결핵과림프관의관계

결핵

Primary infection

• Primary Focus: (aka Gohn focus) 일차병소

• Primary (Ghon) Complex = Primary focus + in volvement of regional lymph nodes

• 주로증세가나타나지않고

• 전염도되지않는다.

• 주로어릴때

Secondary Infection

성인이된후

• Reactivation of primary lesion following decrease in immunity

•감염된적이있는데다시외부의박테리아로부터감염증세나타남

•전신으로퍼지거나폐의다른부분으로전이

simon's foci

Miliary tuberculosis

• 혈관과림프관을

• 타고다른장기나

• 세포로옮기는

Scrofula 연주창

• Scrofula is a tuberculos infection of the skin on the neck

• Mycobacterium tuberculosis

연주창증세

ChillsFevers (rare)Painless swelling of lymph nodes in the neck and elsewhere in bodySores (ulceration --rare)SweatsWeight loss

정리

• 1. common cold• 2. Whooping Cough • 3. Mump• 4. Bacterial Dysentery• 5. Infectious Hepatitis• 6. Polio• 7. Malaria• 8. Filarial Elephantiasis• 9. Chyluria• 10. Schistosomiasis• 11. Pulmonary Tuberculosis • 12. Scrofula

• 바이러스• 박테리아• 곰팡이• 기생충• 원생동물