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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 孫嘉棟(Chia-Tung Shun) | |
| dc.contributor.author | Su-Wei Liao | en |
| dc.contributor.author | 廖書緯 | zh_TW |
| dc.date.accessioned | 2021-06-15T06:46:04Z | - |
| dc.date.available | 2011-10-11 | |
| dc.date.copyright | 2011-10-11 | |
| dc.date.issued | 2011 | |
| dc.date.submitted | 2011-06-23 | |
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Receiver operating characteristic analysis of glycogenated nuclei in liver biopsy specimens: quantitative evaluation of their relationship with diabetes and obesity. Hum Pathol 1994; 25:1063-1068 84. Emile JF, Sebagh M, Ferray C, et al. The presence of epithelioid granulomas in hepatitis C virus-related cirrhosis. Hum Pathol 1993; 24:1095-1097 85. Vakiani E, Hunt KK, Mazziotta RM, et al. Hepatitis C-associated granulomas after liver transplantation: morphologic spectrum and clinical implications. Am J Clin Pathol 2007; 127:128-134 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/48093 | - |
| dc.description.abstract | 法醫師往往會接觸到血液傳染性疾病，因此瞭解司法解剖案例中血液傳染性疾病的盛行率以及相關危險因子，可以提供生物安全防護上重要的資訊。本研究收集台灣北部205個司法解剖案例的血液或胸腔液，利用臨床使用的快速篩檢試劑對人類免疫缺乏病毒的Anti-HIV(Determine HIV-1/2)、B型肝炎的HBsAg(Determine HBsAg)和C型肝炎的Anti-HCV(QuickPac OneStep HCV Test)進行篩檢，結果呈現至少一項陽性的48個檢體再進行HIV-RNA、HBV-DNA和HCV-RNA的即時定量聚合酶鏈鎖反應做為確認有病、無病的黃金準則，同時觀察和分析相關的肝臟病理組織變化和危險因子。本研究也對上述三種快速篩檢試劑在司法解剖案例中的適用性進行評估。我們發現HIV、HBV和HCV在台灣北部司法解剖案例中的盛行率各約為0.4%、5.8%和7.3%，且上述三種病毒核酸於死後仍可被偵測到的最久時間各可達244天(HIV)、405天(HBV)和361天(HCV)；快速篩檢試劑中，Anti-HCV不論在敏感度(sensitivity:100.0%)、特異度(specificity:81.8%)、陽性預測值(positive predictive value:71.4%)或陰性預測值(negative predictive value:100.0%)都優於Anti-HIV或HBsAg；肝臟病理組織變化顯示淋巴球狀聚集可在86.7%感染HCV的案例中被發現，而在感染HBV的死者當中則約佔33.3%；毒品前科、刺青、肝硬化和同性戀這些過去被認為是上述三種血液傳染性疾病的危險因子則與本次研究結果不相違背。複雜的司法解剖在台灣常常必須在短時間內完成，因此若能利用便宜又省時的快速篩檢試劑來提前膫解死者血液傳染性疾病的情形，相信不僅可以提升法醫師、檢察官、相關在場人員或後線實驗室人員的生物安全，更可以做為公共衛生的指標。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2021-06-15T06:46:04Z (GMT). No. of bitstreams: 1 ntu-100-R95452007-1.pdf: 3176402 bytes, checksum: 9fb448afd25aa4f763626e4fcb1335a3 (MD5) Previous issue date: 2011 | en |
| dc.description.tableofcontents | 中文摘要 I
Abstract II 目錄 III 圖目錄 VI 表目錄 VII 第一章 前言 1 第二章 文獻探討 2 第一節 人類免疫缺乏病毒(Human immunodeficiency virus, HIV) 2 第二節 B型肝炎病毒(Hepatitis B virus) 3 第三節 C型肝炎病毒(Hepatitis C virus) 5 第四節 司法解剖中的血液傳染性疾病 6 第三章 實驗方法與材料 8 第一節 實驗設計流程 8 1.1 實驗設計流程圖 8 第二節 實驗材料 9 第三節 實驗方法 10 3.1 快速篩檢檢測 10 3.2 即時定量聚合酶鏈鎖反應檢測 12 3.3 肝臟病理組織切片觀察 13 3.4 結果分析 14 第四章 實驗結果 15 第一節 檢體基本資料 15 1.1所有樣本之基本資料 15 1.2篩檢至少一項陽性之基本資料 15 1.3即時定量聚合酶鏈鎖反應呈現陽性之基本資料(篩檢呈現陽性之檢體) 15 第二節 快速篩檢檢測結果(表4) 15 2.1 Anti-HIV陽性 16 2.2 HBsAg陽性 16 2.3 Anti-HCV陽性 16 2.4 Anti-HIV與HBsAg皆陽性 16 2.5 Anti-HIV與Anti-HCV皆陽性 16 2.6 HBsAg與Anti-HCV皆陽性 17 2.7 Anti-HIV、HBsAg與Anti-HCV皆陽性 17 第三節 即時定量聚合酶鏈鎖反應檢測結果(表5) 18 3.1 HIV陽性 18 3.2 HBV陽性 18 3.3 HCV陽性 18 3.4 HIV與HBV皆陽性 18 3.5 HIV與HCV皆陽性 18 3.6 HBV與HCV皆陽性 18 3.7 HIV、HBV與HCV皆陽性 19 第四節 快速篩檢試劑適用性評估 19 4.1實驗結果與檢體品質 19 4.2快速篩檢試劑的效度(validity) 21 4.3快速篩檢檢驗在時間間隔上的再現性(reproducibility) 22 4.4快速篩檢稀釋倍數在時間間隔上的差異 23 第五節 肝臟病理組織切片觀察結果 24 5.1 HIV 24 5.2 HBV 24 5.3 HCV 24 第六節 血液傳染性疾病與危險因子(表20) 25 第五章 實驗討論與建議 26 第一節 流行病學與盛行率 26 第二節 快速篩檢的適用性 27 第三節 共病情形 29 第四節 病毒存活時間 30 第五節 肝臟病理組織變化 31 第六節 血液傳染性疾病與死因和人身鑑別的關聯 33 第七節 實驗限制與建議 35 第八節 傳染病通報 37 第六章 結論 38 參考文獻 39 附錄 48 | |
| dc.language.iso | zh-TW | |
| dc.subject | 鏈鎖反應 | zh_TW |
| dc.subject | 司法解剖 | zh_TW |
| dc.subject | B型肝炎病毒 | zh_TW |
| dc.subject | C型肝炎病毒 | zh_TW |
| dc.subject | 人類免疫不全病毒 | zh_TW |
| dc.subject | 快速篩檢試劑 | zh_TW |
| dc.subject | 即時定量聚合酶 | zh_TW |
| dc.subject | Hepatitis B virus | en |
| dc.subject | Real-Time PCR | en |
| dc.subject | Rapid test kit | en |
| dc.subject | Human immunodeficiency virus | en |
| dc.subject | Forensic autopsy | en |
| dc.subject | Hepatitis C virus | en |
| dc.title | 司法解剖案例中血液傳染性疾病(HIV、HBV和HCV)篩檢方法的可行性 | zh_TW |
| dc.title | The Availability of Screening Method of Blood-Borne Infectious Disease (HIV, HBV and HCV) in Forensic Autopsy Cases | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 99-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 方中民(John-Ming Fong),郭宗禮(Tsung-Li Kuo) | |
| dc.subject.keyword | 司法解剖,B型肝炎病毒,C型肝炎病毒,人類免疫不全病毒,快速篩檢試劑,即時定量聚合酶,鏈鎖反應, | zh_TW |
| dc.subject.keyword | Forensic autopsy,Hepatitis B virus,Hepatitis C virus,Human immunodeficiency virus,Rapid test kit,Real-Time PCR, | en |
| dc.relation.page | 78 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2011-06-23 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 法醫學研究所 | zh_TW |
| 顯示於系所單位： | 法醫學科所 | |
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