(18.204.227.34) 您好!臺灣時間:2021/05/19 08:55
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:劉慈安
研究生(外文):TZU-AN, LIU
論文名稱:從敗血症中所分離出之肺泡巨噬細胞有不同的細胞凋亡比例
論文名稱(外文):SUBSETS OF ALVEOLAR MACROPHAGES FROM SEPTIC LUNGS UNDERGO DIFFERENT DEGREES OF APOPTOSIS
指導教授:盧敏吉盧敏吉引用關係
指導教授(外文):MING-CHI, LU
學位類別:碩士
校院名稱:中國醫藥學院
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:113
中文關鍵詞:敗血症巨噬細胞細胞凋亡
外文關鍵詞:SEPTICMACROPHAGESAPOPTOSIS
相關次數:
  • 被引用被引用:0
  • 點閱點閱:177
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
重症病患或加護病房住院病人約有百分之五十的比例會感染敗血症病導致死亡,且約有百分之五十的比例會有急性肺傷害的產生。肺泡巨噬細胞對於肺臟的防禦及免疫調節中扮演著相當重要的角色,所以本篇研究探討急性肺傷害以及肺泡巨噬細胞的關係。在之前的研究發現晚期的敗血症肺泡巨噬細胞數量比起早期是減少的(0.73×107 ± 0.1×107 vs. 1.0×107 ± 0.05×107; p<0.05),即假設敗血症中晚期的肺泡巨噬細胞數量減少是因為細胞凋亡,因此,以盲腸穿孔及結紮的方式引起Sprague-Dawley白鼠的敗血症,手術後三小時、九小時和二十小時分別代表敗血症的更早期、早期以及晚期。以支氣管灌流方式分離肺泡巨噬細胞,純度皆大於95%。以流式細胞儀分析肺泡巨噬細胞,以相對細胞大小及顆粒性區分出兩個細胞族群,相對細胞較大者為RB,相對細胞較小者為RS,九小時的敗血組RB和RS的細胞凋亡比例分別為33.5±4.4 % and 8.2±1.4%,p<0.05 and p<0.05,皆較對照組高(17.8± 5.2% and 5.1±1.3%),二十小時的RB和RS的細胞凋亡比例分別為15.4±2.3% and 5.8±2.5%,亦較其對照組高(35.4±2.3% and 22.7±1.1%; p<0.01 and p<0.01)。結果顯示在敗血症的早期或是晚期RB和RS的細胞凋亡比例皆較其對照組高。結果顯示RS族群可能是在敗血症所引起的急性肺傷害中最容易受的損傷的細胞,而RB族群不論是早期或晚期敗血症中的細胞凋亡比例皆類似,推測可能與敗血症終非特異性的發炎反應較有關,而且應是作用很快速的細胞。RB和RS的吞噬功能則沒有差異。
因為RB族群在敗血症更早期時即有大量的細胞凋亡比例,推測應與引起RS族群的細胞凋亡有關,所以,降低RB族群在敗血症更早期帶來的傷害,可能可以降低急性肺傷害所帶來的損傷。

Acute lung injury (ALI), such as acute respiratory distress syndrome, frequently follows the occurrence of sepsis not only in various animal models but in human. However, the mechanism(s) of ALI are not fully established. In the lungs, alveolar macrophages (AM) play an important role in defenses and immunoregulation. In our previous studies, the number of AM was significantly decreased in late phase of cecal ligation and puncture (CLP)-induced sepsis. We hypothesized that the death of AM, probably via apoptosis, is responsible for sepsis-induced ALI. In the present study, Sprague-Dawley rats were employed to investigate the percentage of AM apoptosis. At 3h, 9 h and 20 h, i.e., very early, early and late phases of sepsis, respectively, CLP- and sham -operated (control) animalswere sacrificed and lungs were removed. Alveolar macrophages (AM) were isolated by bronchoalveolar lavage (BAL) with phosphate-buffered saline. The AM obtained were labeled with Annexin-V and the percentage of apoptosis was determined by a flow cytometer. The results showed that the number of AM in late phase of sepsis (0.73×107± 0.1×107) is less than that of early phase (1.0×107± 0.05×107), p<0.02. The purity of AM, as stained by Giemsa, from both groups was >95%. Based on cell size and granularity, two subsets of AM, a big (RB) and a small (RS) ones, were identified by using a flow cytometer. At 9 h after CLP, more percentages of apoptotic cells were detected in RB than in Rs from septic rats (33.5±4.4% vs. 11.8±2.2%), both of which were much more than those of corresponding control subsets (17.8±5.2% and 5.1±1.3%; p<0.05 vs. p<0.05). Likewise, the apoptotic percentages of RB and RS AM from 20 h control rats were, 15.4±2.3% vs. 5.8±2.5%, respectively. The cells from 20 h septic rats (35.4±2.3% and 22.7±1.1%; p<0.01 vs. p<0.01) died by apoptosis to a greater degree an those from the corresponding ones. These data revealed that more baseline apoptosis was found in RB than in RS. At early and late sepsis phases, as compared to the control groups, cells of Rs suffered from 2- and 4-fold, respectively, increases in apoptosis, while those of RB only 2-fold. The phagocytotic abilities of control and septic group had no difference in 3h, 9h and 20 h. It is likely that, not the whole populations of lung macrophages, but rather Rs subset of AM was among the most liable cells of septic lung injury. Considering that AM of small size and granularity presumably represents young in-situ lung macrophages with optimal functions, these results suggested that the defensive ability of septic lungs might be reduced and could explain, at least in part, the increased susceptibility of septic lung to superimposed infections and to the occurrence of ARDS.

致謝-------------------------------------------1
中文摘要--------------------------------------3
目錄-------------------------------------------5
表目錄----------------------------------------7
圖目錄----------------------------------------8
專有名詞中英文對照-------------------------10
第一章總論----------------------------------13
一 敗血症概論-------------------------------13
第一節 敗血症的定義與臨床症狀-----------13
第二節 敗血症的致病機轉------------------17
第三節 誘發敗血症的實驗模型-------------22
二 敗血症與肺傷害-------------------------25
第一節 肺臟防禦機轉----------------------25
第二節 急性肺傷害------------------------26
第三節 巨噬細胞的分類-------------------27
第四節 肺泡巨噬細胞在敗血症所引起的急性肺傷害中所扮演的角色--------------------30
三 細胞凋亡-------------------------------31
第一節 細胞凋亡形態: 壞死與自然凋亡--31
第二節 細胞腫脹壞死---------------------31
第三節 細胞自然凋亡---------------------32
第四節 影響細胞凋亡的因素-------------35
第五節 不當的細胞凋亡將引起疾病------36
第二章材料與方法--------------------------39
第一節 敗血症動物模型之誘發-------------39
第二節 分離肺泡巨噬細胞-----------------42
第三節 細胞形態與細胞計數---------------46
第四節 細胞凋亡的偵測--------------------48
第五節 偵測細胞的吞噬功能---------------51
第六節 統計方法---------------------------56
第三章結果---------------------------------57
一 敗血症白鼠之外觀----------------------57
二 支氣管灌流液的回收率-----------------58
三 經灌流所捯之肺泡巨噬細胞數目-------58
四 肺泡巨噬細胞的型態與比例------------59
五 肺泡巨噬細胞的分群-------------------60
六 RT肺泡巨噬細胞之細胞凋亡比例 -----60
七 RB肺泡巨噬細胞之細胞凋亡比例------61
八 RS肺泡巨噬細胞之細胞凋亡比例------62
九 敗血症對於肺泡巨噬細胞吞噬功能之影-----------------------------------------63
第四章討論---------------------------------77
第五章結論---------------------------------88
第六章參考文獻----------------------------90
英文摘要-----------------------------------113

1.Aabsolom DR. (1986) Basic methods for the study of phagocytosis. Methods Enzymol. 132: 95.
2.Alnemri ES, Livingston DJ, Nicholson DW, Salvesen G, Thornberry NA, Wong WW, Yuan J. (1996) Human Ice/Ced-3 Protease Nomenclature. Cell. 87: 171.
3.Allen RT. Hunter WJ 3rd. Agrawal DK. (1997) Morphological and biochemical characterization and analysis of apoptosis. [Review] [68 refs] Journal of Pharmacological & Toxicological Methods. 37(4): 215-28.
4.Akira S, Taga T, Kishimoto T. (1993) Interkeukin-6 in biology and medicine. Adv immunol. 54: 1-78.
5.Astiz ME, Rackow EC. (1998) Septic Shock. Lancet. 351: 1501-1504.
6.Azzeddine D, Philomena MK, Richard GH. (1988) Permissiveness of Guinea Pig Alveolar Macrphage Suppopuoations to Acute Respiratory Syncttial Virus Infection In vitro. Chest. 1681-1688.
7.Baggiolini M, Dewald B, Walz A. Interoeukin-8 and related chematactic cytokines. pp. 247-263. In: Gallin JI, Goldstein IM, Snyderman eds. Inflammation: basic principles and clinical correlates. R nw york raven press. 1992.
8.Bigatello LM, Zapol WM. (1996) New Approaches To Acute Lung Injury. Br J Anaesth. 77: 99-109.
9.Burn Buission C, Doyon F, Carlet J. (1996) Bacteremia and severe sepsis in adults: a multicenter prospective survey in ICUs and wards of 24 hospitals. Am j respir crit care med. 154: 617-624.
10.Bone RC. (1992) Phosphlipids And Their Inhibitors: A Critical Evaluation Of Their Role In The Treatment Of Sepsis. Crit Care Med. 20: 884-890.
11.Brain JD, Beck BD. (1985) Bronchoalveolar Lavege. In: Witschi Hp, Brain JD, Eds. Handbook Of Experimental Pharmacology. Vol. 75. Berlin: Springer-Verlag: 203-226.
12.Brun Buisson C, Doyon F, Carlet J. Bacteremia And Severe Sepsis In Adults: A Multicenter Prospective Survey In Icus And Wards Of 24 Hospitals. Am J Respir Crit
13.Bone RC. (1992) Towards an epidemiology and matural distory of SIRS (systemic inflammatory response syndrome). JAMA. 268: 3452-3455.
14.Bone RC, Balk RA, Cerra FB, et al. (1992) Definitions For Sepsis And Organ Failure And Guidelines For The Use Of Innovative Therapies In Sepsis. Chest 101: 1644-1655.
15.Bone RC. (1992) Phospholipids and their inhibitors: a critical evaluation of their role in the treatment of sepsis. Crit Care Med.115: 457-469.
16.Bone RC. (1991) Sepsis, The Syndrome, Multi-Organ Failure: A Plea For Comparable Definitions. Ann Intern Med. 114: 332-333.
17.Boldin MP, Goncharov TM, Goltwev YV, Wallach D. (1995) Involvement of Nach, Novel Mort1/Fadd-Interacting Proteasem In Fas/Apo-1- And Contains A Sequence Motif Related To The Death Domain. J Boil Chem. 270: 7795-7798.
18.Bulter LD, Layman NK, Cain RL et al. (1989). Interleukin-1, induced pathophysiology: induction of cytokines development of hidtopathologic changes, and immunopharmacologic intervention. Clin Immunol Immunopathal .53: 400-421.
19.Bone RC, Balk R, Slotman G et al. (1992) Aards Equence and Importance of Development of Multiple Organ Failure. Chest .101: 320-326.
20.Bone RC, Groszin CJ, Balk RA. (1997) Sepsis: A New Hypothesis for Pathogenesis of the Disease Process. Chest. 112: 235-243.
21.Brune B, von Knethen and Sandau KB. (1999). Nitroc oxide (NO): an effector of apoptosis. 6(10): 969-975.
22.Bursch W, Paffe S, Putz G. Barthel G, Schulte-Hermann R. (1990) Determination of the length of the histological stages of apoptosis in normal liver and in altered hepatic foci of rats. Carcinogenesis. 847-853.
23.Crowl RM, Stoller JT, Conrnoy RP, Stoner CR. Induction of Phospholipase A2 Gene Expression in Human Hepatoma Cells by Mediators of the Acute Phae Response. (1991). J Biol Chem. 226: 2647-2651
24.Collany, Mcdowell EM, Trump BF. (1981). Studies In The Pathogenesis If Ischemia Cell Injury. Vi. Mitochondrial Flocculent Densities in Autolysis. Virchows Archiv[B], 35:189-199.
25.Cerretti DP, Kozlodky CJ, Mosley B, Nelson N, Vanness K, Greenstreet TA, March CJ, Kronheim SR, Druck T, Cannizzaro LA, Huebner K, Black RA. (1992). 256: 97-100.
26.Curzen NP, Griffiths MJD, Evans TW. (1994). Role of Endothelium in Modulating the Vascular Response to Sepsis. Clin Sci. 86: 259-374.
27.Cross AS, Opal SM, Sadoff JC, Gemski P. (1993). Choice of Bacteria in Animal Models of Sepsis. Infect immune. 61: 2741-2747.
28.De Boer JP, Creasey AA, Chang A et al. (1993). Activation of the Complement System in Baboons Challenged With Live E. Coli: Correlation With Mortality and Evidence for a Biphasic Activation Pattern. Infect Immune. 61: 4293-4301.
29.Duan H, Chinnaiyan AN, Hudsin PL, Wing JP, He W-W, Dixit, VM. (1996). Ice-Lap3, a Novle Mammalian Homologue of the Caenorhabditis Slsgans Cell Death Protein Ced-3 Is Acrivated During Fas-And Rumor Cevrosis Factor-Infuced Apoptosis. J Boil Chem. 271: 1621-1625.
30.Duh RW, Wang LS, Liu CY, Chen DL, Wang FD, Tsai IK. Bacteremia/Fungemia at Veterans General Hospital. I. Etiology and epidemiology (unpublished data)
31.Dziarski R. (1991). Peptidoglycan and Lipopolysaccharide Bind to the Same Binding Site on Lymphocytes. J Biol Chem. 266: 4719-4725.
32.Ellis RE, Yuanj, Horvitz HR. (1991). Mechanisms and Functions of Cell Death. Ann Rev Cell Biol.7: 663-698.
33.EsmOn CT. (1987). The Regulation of Natural Anticoagulant Pathways. Science. 235: 1348-1352.
34.Ertel W, Morrison MH, Wang P, Ba ZF, Ayala A, Chaudry IH. (1991). The Conpliz Pattern of Cytokines in Sepis. An surg. 214: 141-148.
35.Fischer W. (1990). Bacterial Phosphoglucolipids and Lipoteichoic Acids. In: Kates M, ed. Handbook of Lipid Research. New York: plenum press, pp.123-234.
36.Fujii Y, Goldberg P, hussain SN. (1998). Contribution of Macrophages to Polmonaty Nitric Oxide Production in Septic Shock. Ame J of Respiratory & Critical Care Medicine. 157(5 pt 1): 1645-1651.
37.Fels AOS, Cohn ZA. (1986). The Alveolar Macrophage. J appl physiol. 60: 353-369
38.Fernandes-Alnermri T, Litwacl G, Alnemri ES. (1994). Mch2, a New Member of the Apoptotic Ced-3/Ice Systeine Protease Family. Cancer Res. 55: 2737-2742.
39.Fantuzzi G, Zheng H, Ffaggioni R et al. (1996). Effect of Endotoxin in IL-1β-Deficident Mice. J Immunol. 157: 291-296.
40.Faucheu C, Dir A, Chan AWE, Blanchet A-M, Miossec C, Herve F, Collard-Dutilleul V, GU Y, Aldape RA, Lippke JA, Rocher C, Su Ms-S, Livingston DJ, Hercend T, Lalanne J-L. (1995). A Novel Human Protease Similar to the Interleukin-1β-Converting Enzyme Induces Apoptosis in Trasfected Cells. 14: 1914-1922.
41.Fernandes-Alnemri T, Takahachi A, Armstrong R, Krebs J, Fritz L, Tomaselli KJ, Wang L, Yu Z, Croce CM, Salvesen G. (1995). Mch3, a Novel Human Apoptotic Cysteine Protease Highly Related To Cpp32. Cancer Res. 55: 6045-6052.
42.Girarkin E, Grau GE, Dayer JM et al. (1998). Tumor Necrosis Factor and Interleukin-1 in the Serum of Children With Severe in Factious Purpura. N EnglJj Med. 319-397.
43.Goyert SM. Ferrero E. Rettig WJ. Yenamandra AK. Obata F. Le Beau MM. (1988). The CD14 Monocyte Differentiation Antigen Maps to a Region Encoding Growth Factors and Receptors. Science. 239(4839): 497-500.
44.Harada A, Sekido N, Akahoshi T, Wada T, Mukaida N, matsushima K. (1994). Essential Involvement of Interleukin-8(IL-8) in Acute Inflammation. J Leukocyte Biol. 56: 559-564.
45.Hance AJ. Douches S. Winchester RJ. Ferrans VJ. Crystal RG. (1985). Characterization of mononuclear phagocyte subpopulations in the human lung by using monoclonal antibodies: changes in alveolar macrophage phenotype associated with pulmonary sarcoidosis. J of Immunol. 134(1): 284-92.
46.Jack E, Alan DS, Kelvin G, Paul C, Milton DR, Patrick JL, Ronald PD. Differential Interleukin-1 Elaboration by Unfractionated and Density Fractionated Human Alveolar Macrophages and Blood Monocytes: Relationship to Cell Maturity.
47.Khadom NJ, Dejier JF, Viso M. (1985) Bovine alveolar macrophage: a review. Ann rech vet. 16: 175-183.
48.Koltai M, Hosford D, Braquet PG. (1993) Platelet-Activating Factor in Septic Shonk. Crit Care Med. 1: 87-88.
49.Kumar S, Tomooka Y, Noda M. (1992) Identigication of a Set Of Genes With Developmentally Down-Regulated Expression In The Mouse Brain. Biochem Biophys Res Commun. 185: 1155-1161.
50.Kamens J, Paslind M, Hugunin M, Talanian Rv, Allen H, Banach D, Bump N, Hackett M, Johnston CG, Li P, Mankovich JA, Terraanova M, Ghayur T. (1995) Identification and Characterization of Ich-2, a Novel Member of the Interleukin-1β-Converting Enzyme Family of Cysteine Proteases. J Boil Chem. 270: 1520-1556.
51.Kieft H, Hoepilman AL, Zhor W, Rozunberg-arska M, Struyvenberg A, Verhoef J. (1993) The Sepsis Syndrome in a Dutch University Hospital. Clinical Observations. Arch intern med. 153: 2241-2247.
52.Kelbourn RG, Gross SS, Jubarn A et al. (1990) Reversal of Endotoxin-Mediated Shock by Ng-methyl-L-Arginine Inhibitor Tumor Necrosis Factor-αInduced Hypotension: iIplications for the Involvement of Nitric Oxide. Proc Natl Acad Sci USA. 87: 3692-3632.
53.Kerr JFR, Wyllie AH, Currie AR. (1972) Apoptosis: a Basic Biological Phenomenon with Wide-Ranging Implications in Tissue Kinetics. [Review] [68 refs] Br. J. Cancer. 68: 239-257.
54.Kruger C, Schutt C, Obertacke U. (1991) Serum CD14 Levels in Polytraumatized and Severely Burned Patients. Clin exp immunol. 85: 297-301.
55.Lamy M, Deby-Dupont G. (1995) Is Sepsis a Mediator-Inhibitor Mismatch? Intensive Care Med.; 21: S250-S257.
56.Lewis RA, Austen KF, Soberman RJ. (1990) Leukotrinenes and Other Products of the 5-Lipoxyginase Pathway. Biochemistry and Relation to Pathobiology in Human Diseases. N Engl J med.; 323: 645-655.
57.Lynn WA, Cohen J. (1995) Adjunctive Therapy for Septic Shock: a Review of Experimental Approaches. Clin Infect Dis; 20: 143-158.
58.Lane P, Gross SS. (1999). Cell Signaling by Nitric Oxide. Seminars in nephrology. 19(3): 215-219.
59.Larrick JW, Kunkel SL. (1988). The Role of Tumor Necrosis Factor and Interleukin-1 in the Immunoinflammatory Response. Pharmacol Res. 5: 129.
60.Lewis RA, Austen KF, Soverman RJ. (1990). Leukotrienes and Other Prodicts of the 5-Lipoxugenase Pathwat. Biochemistry and Relation to Pathobiology in Human Diseases. N Engl J Med. 323: 645-655.
61.Li J, Billiar TR. (2000). The Role of Nitric Oxide in Apoptosis. Seminars in perinatology. 24(1): 46-50.
62.Liu L, Stamler JS. (1999) NO: an Inhibitor of Cell Death. Cell Death & Differentration. 6(10): 937-947.
63.Loren HS, Joyce M, Devlin RR et al. (1992) Modulation Of Eicosanoid Production by Human Alveolar Macrophages Exposed To Silica in Vitro. Environ Health Persp. 97: 77-83.
64.Maliszewski CR. (1991) CD14 and Immune Response to Lipopolysaccharide. [letter; comment]. Science. 252(5010):1321-2.
65.Martich GD, Danner RL, Ceska M, Suffredini AF. (1991) Detection of IL-8 and TNF in Normal Humans After Intravenous Endotoxin: the Effect of Anti-Inflammatory Agents. J exp med. 173: 1021-1024.
66.Mohr C, Davis GS, Graebmere Hemenway DR, Gemsa D. (1992) Enhanced Release of Prostaglandin E2 From Macrophages of Rat With Silicosis. Am J Respir Cell Mor Boil. 6: 390-396.
67.Majnog, Joeis I (1995) Apoptosis, Oncosis, and Necrosis. An Overview of Cell Death. New York: Wiley-Liss, Inc., pp 167-180.
68.Marks JD, Marks CB, Luce JM et al. (1990) Plasma Tumor Necrosis Factor in Patients with Septic Shock: Mortality Rate, Incidence of Adult Respiratory Distress Syndrome. Am Rev Respir Dis. 141: 94.
69.Monte SM. Wands JR. (2001) Alzheimer-associated neuronal thread protein-induced apoptosis and impaired mitochondrial function in human central nervous system-derived neuronal cells. J of Neuropathology & Exp Neuro. 60(2):195-207.
70.Munday NA. Vaillancourt JP. Ali A. Casano FJ. Miller DK. Molineaux SM. Yamin TT. Yu VL. Nicholson DW. (1995) Molecular cloning and pro-apoptotic activity of ICErelII and ICErelIII, members of the ICE/CED-3 family of cysteine proteases. J of Bio Chem. 270(26): 15870-15876.
71.Montgomery AS, Stager MA, Carrico CJ et al.Caises PF ,Prta;Out OM (1985) Causes of Mortality in Patients with the Adult Respiratory Distress Syndrome. Am Rev of Re Dis. 132(3): 485-9.
72.Mcbabe WR, Jackson GG. (1962) Gram-Negative Bacteremia. Etiology And Ecology. Arch Intern Med. 110:847-855.
73.Mcbabe WR, Jackson GG. (1962) Gram-Negative Baceremia LL. Clinical, Laboratory, And Therapeutic Observations. Arch Intern Med. 110: 856-864.
74.Morabito F, Prasthofer EF, Junlalp NE et al. (1987) Expression of Myelomonocytic Antigens on Chronic Lymphocytic Leukemia B Cells Correlates with Their Ability to Produce Interleukin 1. Blood.70: 1750-1757
75.Mason RJ, Williams MC. (1991) Alveolar Type II Cells. in: Crystal RG, Weat JB, eds. The Lung: Scientigic Goundations. New York: Raven, 235.
76.Miura M, Zhu H, Rotello R, Hartwieg EA, Uran J. (1993) Induction of Apoptosis in Fibroblasts by IL-1 Beta-Converting Enzyme, a Mammalian Homolog of the C. elegans Cell Death Gene ced-3. Cell 75, 653-660.
77.Michie HR, Majogue LR, Sprigs DR, et al. (1988) Detection Of Circulating Tumor Necrosis Factor After Endotoxin Administration. N Engl J Med. 318: 1481-1486.
78.Ono S, Mochizuki H, Tamakuma S. (1996) A Clinical Study on the Signidicance of Platelet-Activating Factor in the Pathophysiology of Septic Disseminated Intravascular Coagulation In Surgery. Am J Surg.171: 409-415.
79.Parsons P. (1996) Compliment, Endotoxin and Acute Lung Injury. In: evans TW, Haslett c, eds. ARDS: Acute Respiratory Distress in Adults. Lindon: Chapman & Hall Medical.
80.Petrak RA, Balk RA, Bone RC. (1989) Prostaglandins, Cyclooxygenae Inhibitors in the Pathogenesis of Multiple Systems Organ Failure. Crit Care Clin. 5: 303-314.
81.Ono S, Mochizuki H, Tamakuma S. (1996) A Clinical Study on the Significance of Platelet-activating Factor in the Pathophysiology of Septic Disseminated Intravascular Coagulation in Surgery. Am J Surg. 171: 409-415.
82.Randal BC, Thomas GB, Marc BB, Marc PG. (1988) Altered Expression and Localization of 5-Lipoxygenase Accompany Macrophage Differentiation in the Lung. Am J Physiol. 275: L303-L310.
83.Remick DG, Strieter RM, eskandari MK et al. (1990) Role of Tumor Necrosis Factor-Alpha in Lipopolysaccharide-Induced pathologic alterations. Am J Pathol.136: 49-60.
84.Reunolds HY. (1987) Bronchoalveolar Lavage. Am Rev Respir Dis. 135: 250-263.
85.Rietschel ET, Brade H. (1992) Bacterial Endotoxins. Sci Am. 267: 26-31.
86.Rock CS, Lowry SF. (1991) Tumor Vecrosis Factor-Alpha. J Surg Res. 51: 434-445.
87.Root RK et al. (1996) Septicemia and Septic Shock. Harrisio’s Princoplies of Internal medicine. 12th edition. New York: MC Graw-Hill.
88.Schottmuller H. Wesen and Behandlung Der (1914) Sepsis. Verhandl Dtsch Kongress Inner Med. 31: 257-280.
89.Schumann R, Leony S, Flags G et al. (1990) Structure and Function of Lipopolysaccharide Binding Protein. Science. 249: 1429.
90.Sufferdini AF, Fromm RE, Parker MM et al, (1989) The Cardiovascular Response of Normal Humans To The Administration of Endotoxin. N Engl J Med. 31: 280-287.
91.Simionescu M. Lung Endothelium: Structure-Function Correlates. In: Crystal Rg, West JB, eds. (1991) The Lung: Scientigic Foundations. New York: Raven: 301.
92.Shapiro BA, Cane RD, Harrison RA. (1983) Positive and Expiratory Pressure Therapy in Ali. Chest. 83: 558-563.
93.Savill J. (1996) Phagocyte Recognition of Apoptotic Cells. [Review] [29 refs] Biochem Society Transactions. 24(4): 1065-1069.
94.Srinavasula SM, Fernandes-Alnemri T, Zangrilli J, Robertson N, Armstrong RC, Wang L, Trapani JA, Tomaselli KJ, Litwack G, Elnemri ES. (1996) The Ced-3/Inerleukin-1βConverting Enzyme-Like Homolog Mch6 and the Lamin-Cleaving Enzyme Mch2αare Substrates for the Apoptotic Mediator Cpp32. J Boil Chem.271: 27099-27106.
95.Strieter RM, Kich AE, Antony VB, Fick RB JR, Standigord RJ, Kunkel SL. (1994) The Immunopathology of Chemotactic Cytokines: the Role of Interleukin-8 and Monocyte Chemoattractant Protein-1. J Lab Clin Med. 123: 183-197.
96.Sulston JE, Schierenberg E, White JG, Thomson N. (1983) The Embryonic Cell Lineages of the Nematode Caenorhabdites Elegans. Dev Boil.100: 64-119.
97.Sulston HE, Horvitz HR. (1977) Post-Embryonic Cell Lineages Of The Nematode Caenorhabdites Elegans. Dev Boil .110-156.
98.Sriskandan S, Cohen J. (1995) The pathgenesis of septic shock. J infect. 30: 201-206.
99.Tracey KJ, Lowry SF, Cerami A. (1998) Cachectin/TNF-alpha in septic shock and septic adult respiratory distress syndrome. [Editoria]. Am Rev Resp Dis. 138: 1377-1379.
100.Trump BF, Gin FL. The Pathogenesis Of Subcellular Reaction To Lethal Injury. In Bajusz E, Gasmin G. (1969) Methods And Achievements in Experimental Pathology Volume Iv. Basel: Karger, pp 1-29.
101.Trump BF, Arstila AU. Cell Injury And Cell Death .In Lavia MF, Hill RB, Jr. Principles Of Pahtobiology. New York: Oxford University Press, pp 9-95; 1971
102.Trump BF, Berezesky IK: Cellular And Molecular Pathobiology Of Reversible And Irreversible Injury. In Tyson Ca, Frazier Jm: Methods in Toxicology, Vol.1b, In Vitro Toxicity Indicators, San Diego: Academic, pp 1-22.
103.Thornberry NA, Bull HG, Calaycay JR, Chapman KT, Howard AD, Kostura MJ, Miller DK, Molineaux SM, Weidner JR, Aunins J, Elliston LO, Ayala JM, Casano FJ, Chin J, Ding Gj-F, Egger LA, Gaffney EP, Limjuco G, Paluha OC, Raju SM, Rolando AM, Salley JP, Yamin T-T, Lee Td, Shivellly JE, Maccross M, Mumford RA, Schmidt JA, Tocci MJ. (1992) A Novel Heterodimeric Cysteine Protease Is Required For Interleukin-1βprocessing in Monocytes.Nature. 356: 768-774.
104.Wang L, Miura M, Begeron S, Zhu H, Yuan J. (1994). Ich-1, An Ice/Ced-3-Rekated Gene, Encodes Bith Positive And Negtive Regulators Of Programmed Cell Death. Cell. 78: 739-750.
105.Wendt C, Herwalat LA. (1997) Epidimics identification and Management in: Prevention and Control of Nosonimila Infections, 3rd. ed. Baltimore: Williams & Wilkins. 175-213.
106.Wheeler AP. Bernard GR. (1999) Treating Patients With Severe Sepsis. New Eng J Med.340: 207-214.
107.Wenzel RP. Pppinsky MR, Ulevitch RJ, Young L. (1996) Current Understanding of Sepsis. Clin Infect Dis. 22: 407-412.
108.Wenzel RP. (1998). The Mortality of Hospital-Acquired Blood Stream Infections: Need for a New Vital Statistic. Int J Epidemiol. 17: 225-227.
109.Wenzel RP. (1992). Anti-Endotoxin Monoclonal Antibodies- a Second Look. N Engl J Med. 326: 1151-1153.
110.Wright SD. (1986). Methods for the Stydy of Receptor-Mediated Phagocytosis. Methods Enzymol. 132:204.
111.Wright S, Ramos R, Hermanowski-Vasatka A et al. (1991). Activation of the Adhesive Capacity of CR3 on Neutrophils by Endotoxin: Dependence on Lipopolysaccharide-Binding Protein and CD-14. J Exp Med. 173: 1281.
112.Wyllie AH, Kerr JFR, Currie AR. (1980). Cell Death: the Significance of Apoptosis. [Review] [257 refs] Int. Rev. Cytol. 68:251-306.
113.Wenzel RP, Pinsky MR, Ulevitch RJ, Young L. (1996). Current Understaning of Sepsis. Clin Infect Dis. 22: 407-412.
114.Wellis HM, Horvitz HR. (1986) Genetic control of programmed cell death in the nematode C. elegans. Cell 44. 817-829.
115.Vincenz C, Dixit VM. (1997) Fas-Associated Death Domain Protein Interleukin-1β-Converting Enzyme 2 (Flice2), An Ice/Ced-3 Homologuem Is Proximally Involved In Cd95- And P55-Mediated Death Signaling. J Boil Chem.272: 6578-6583.
116.Vincent JL, Bihari DJ, Suter PM, Eu Al. (1995). The Prevalence Of Nosocomial Infection In Intensive Care Units In Europe. Results of the European Prevalence Of Infection In Intensive Care (Epic) Study. 274: 639-344.
117.Ungar J JR, Wilson GR. (1935). Monocytes as a Source of Alveolar Phagocytes. Am J Pathol; 11:681-691.
118.Ucker DS. (1991) Death by suicide: one way to go in mammalian cellular development? [Review] [45 refs] New Boil. 3, 103-109.
119.Ucker DS, Hebshi LD, Blomquist JF, Torbett BE. (1994) Physiological T-cell death: susceptibility is modulated by activation, aging, and transformation, but the mechanism is constant. [Review] [180 refs] Immunol Rev. 142, 273-299.
120.Yuan J. (1995) Molecular Control of Life and Death. [Review] [35 refs] Curr Opin Cell Boil. 7: 211-214.
121.Yuan J, Shaham S, Ledoux S, Ellis HM, Horvitz HR. (1993)The C. elegans Cell Death Gene ced-3 Encodes a Protein Similar to Mammalian Interleukin-1 Beta-Converting enzyme. Cell 75. 641-652.
122.Ziegler-Heitbrock HWL, Passlick B, Flieger D. (1988)The Monoclonal Antimonocyte Antibody My4 Stains B Lymphocytes and Two Distinct Monocyte Subsets in Human Peripheral Blood. Hybridoma; 7: 521-527.
123.林春珠,盧柏梁,黃高彬,蔡季君,陳彥旭,李怡慧,黃樹樺,吳淑萍,吳淑卉,陳田柏.某醫學中心1985年至1996年院內感染致病源之變遷與分析. 院內感染控雜誌.1990; 第十卷第五期.

QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
1. 陳寶山(民83)。教師進修活動的具體作法。教師天地,68期,頁35-40。
2. 張清濱(民85)。教師進修-邁向專業化的途徑。研習資訊,13(6),頁2-9。
3. 高博銓(民88)。淺談教師終身學習體系的建構策略。教育實習輔導,5(1),頁14-16。
4. 李柏圍(民83)。有效的教師在職研習初探。教師天地,68期,頁45-48。
5. 李宜珍(民83)。「需要評析」對教學與教職員在職進修的意義。教師天地,68期,頁56-58。
6. 呂錘卿(民80)。談國民小學教師在職進修與現況。國教輔導,30(4),頁11-21。
7. 歐用生(民85)。教師即師資培育者。研習資訊,13(6),頁10-15。
8. 吳政達(民87)。國小教師在職進修教育的需求評估與績效評鑑方法。國教月刊,44(5.6),頁23-27。
9. 謝文全(民77)。他山之石,可以攻錯--美國的教師在職進修教育。國教之友,40(1),頁4-7。
10. 楊國賜(民83)。我國教師在職進修制度改進芻議。教師天地,68期,頁13-16。
11. 謝水南(民83)。師資培育法與教師在職進修。中學教育學報,1期,頁9-13。
12. 吳明隆(民81)。高雄市國小教師在職進修教育的調查研究。教育資料文摘,173期,頁133-161。
13. 何雲光(民85)。從終生教育的意涵單教師在職進修的理念。研習資訊,13(6),頁31-34。
14. 王家通(民83)。突破教師進修的瓶頸。教師天地,68期,頁23-27。
15. 楊思偉、梁恆正(民83)。中學教師在職進修的理念與做法。高市鐸聲,5(1),頁7-21。