CPC CASE(NO: A2-1)

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• ? ?

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CPC CASE(NO A2-1)

• A five year old boy drank from a bottle that was
  being used to store sodium hydroxide (NaOH). The
  fluid burned his mouth and legs. He has come to
  the emergency department of your hospital.

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(No Transcript)
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(No Transcript)
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• What has happened to this child?
• How can these events be explained?

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• ??(Repair )
• ???????????????????
• ??(regeneration)
• ??????,?????????
• ??????????
• ????????,??????????

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????(regeneration)

• (?)?????
• 1?????(complete regeneration)???????????????????
  ???????????
• ????
• (1)???????
• (2)?????,??????

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2??????(incomplete regeneration)

• ???????????????(?????????)??????????????
  ???
• ????
• (1)?????????
• (2)?????,??????

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(?)???????

• ????????????,????????????????
• ??????????????????
• 1??????(labile cells)????????????????,????????????
  ?????????????,????????????????????,????????????

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• 2?????(stable cells)
• ?????????,??????????,???????????????????????????,?
  ???????????????
• 3??????(Permanent cell)
• ?????????????????????????????

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(?)???????

• 1??????
• ???????????
• ??/?????????????
• ???????????,????????,?????????,?????????

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• 2????????
• ?????? ??
• ??????? ????? ????
• 3????????
• ??????????????????
• ?????????????
• ???????????

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??????????
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??????????????????????
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• 4??????
• ?????????????????????
• 5???????
• ??????????????
• ???????????????????????
• ?,??????
• 6????????????
• ???????????
• 
  ?????
• ??????????????????
• 
  ?????
• ?????????

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Fracture Repair. Left An X-ray showing
fracture callus. Center Histology of fracture
callus showing cartilaginous tissue. Right
Transformation of cartilage into actively
remodeling bone.
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(?)?????

• 1???????????
• ????????????????
• 2??????????????
• ?????????????????????????????????????????????

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• 3?????????????
• ????????????????(cell growth factor),????????
• 1) ??????(epodermal growth factor,EGF)
• 2) ?????????
• (platelel derived growth factor,PDGF)
• 3) ?????????(fibroblast growth factor,FGF)
• 4) ??????(transforming growth factor,TGF)
• 5) ????( cytokines)?????????

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???????

• (?)????(granulation tissue)
• ????????????????????????
• ???
• ?????????????????????????????????????,?????

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• ?????????
• 1???????
• ???(???????),??,????
• 2??????
• 3???????????????????????????????
• ???????
• 1??????????
• 2??????????????????
• 3?????????????

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Granulation tissue ???? (Provided by prof.
Song W.Wong)
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Scar tissue????(??)
Scar tissue????(??)
(Provided by prof. Orr)
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(?)????(scar tissue)

• ????????????
• ????
• ?????
  ???
• ?
  ???????? ??? ???
• ? ???? ????????
  ???
• ? ?????????????????????????????
• ?
• ???????
• ????
• ????????,????,????,?????
• ????(keloid)????????,????????????????????????????
  ??,???????,??????????

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??????(Wound healing)

• ?????????/??????
• ???????????????
• (?)????(?????????)
• 1????????
• ???????????????

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• 2?????
• ????????????????,?????
• ?????????(myofibroblast)??????(???????????????????
  ?????????????????????????
• 3?????????????
• ???????
• (1)???????????(??????????)?
• (2)?????????????(?????????????????????)?
• 4???????????

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(?)???????

• 1?????(healing by first intention)
• ?????????????/?????????/?????
• ?????????????,?????,??????

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healing by first intention????
(????? ???,1998 ?? )
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• 2?????(healing by second intention)
• ????????????????
• ???????????,????
• ??????????
• ?????,??????
• 3?????(healing ubder scar)
• ?????????????????????????,??????/????????

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healing by second intention????
(????? ???,1998 ?? )
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(?)?????????

• ?????
• ??????? ?? ?????
• ????? ?????
• ??,???????????,?????,???????
• 1?????
• (1)??
  (2)??(??aa,vc,zn)
• (3)???(??) (4)??
• 2?????
• (1)?????(???????) (2)?????
• (3)????
  (4)???????

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???

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