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ECFMG: Educational Commission for Foreign Medical Graduate

http://www.ecfmg.org/. ECFMG: Educational Commission for Foreign Medical Graduate 米国医師国家試験（ USMLE ：　 United States Medical Licensing Examination ) Step 1 Pathology , Pharmacology , Physiology , Microbiology , Biochemistry , Anatomy , Behavioral sciences , Step 2 CK: clinical knowledge

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ECFMG: Educational Commission for Foreign Medical Graduate

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  1. http://www.ecfmg.org/ • ECFMG:Educational Commission for Foreign Medical Graduate • 米国医師国家試験（USMLE：　United States Medical Licensing Examination) • Step 1 • Pathology,Pharmacology,Physiology,Microbiology,Biochemistry,Anatomy,Behavioral sciences, • Step 2 • CK: clinical knowledge • CS: clinical skills • Step 3 • Exam at the end of the first year of residency

  2. B-1 cells Express T cell marker CD5+ (B-1a cells), but B cell marker B220 (CD45) low No memory, no somatic mutation Self-renewing in the peritoneal and mucosal sites Limited repertoire of V genes and far less junctional diversity than conventional B cells do Natural antibody against polysaccharide antigens (blood group epitopes), phosphatidylcholine, phosphorylcholine, thymocyte, LPS, apoptotic cells, influenza virus Mostly IgM class. In the lamina propria, IgA-secreting cells As it is selected by self-antigen, B-1 cells tends to be autoreactive Autoimmune hemolytic anemia in NZB mice, murine lupus, Sjögren syndrome, rheumatoid arthritis

  3. 6-9 T cell independent antibody response • T cell-independent (TI) antibody response • Rapid, within 48 hours of infection • Natural antibody, IgM • B1 cells and marginal zone B cells • TI-1 antigen: LPS • TI-2 antigen: polysaccarides

  4. Natural Antibodies • Encoded by Ig genes in germ line configuration • Encoded by rearranged antibody genes with no somatic hypermutation • Arise independently of antigen stimulation • Produced by B-1 cells and marginal zone B cells • Mostly IgM • Polyreactive • Involved in innate immune responses to pathogens (Streptococcus pneumoniae) and in autoimmunity • Multiple sclerosis patients have higher levels of natural autoantibodies in their cerebrospinal fluid (CSF) (Ann Inst Pasteur/Immunol 139:99, 1988)

  5. “IL-8” not “CCL8”

  6. BRS Microbiology Page 250 Wrong: Should be “chemokine IL-8 ≠ Chemokine IL-8 CCL8 = chemokine MCP-2 (monocyte chemoattractantprotein 2)

  7. antigen (Fab’)2 CH1 lattice

  8. full term, term: the end of gestation or point at which birth is imminent; "a healthy baby born at full term" a full-term 1-day-old infant a term gestation, 1-day-old neonate

  9. (α2λ2 )2 α2κκ2 or α2λ2

  10. + - Alternative pathway mg% = mg/100 ml = mg/dL e.g. 900 mg% = 900 mg/100 ml = 9 mg/ml

  11. http://tsunodalaboratory.blog.fc2.com/blog-entry-127.html Ikuo Tsunoda visited Dr. Grisham https://docs.google.com/file/d/0B0yuTN7BHBulNi1EdHZ4bHQwMjg/edit?pli=1

  12. Complement mediated cell lysis of foreign organisms by the MAC • Although the effect of the MAC is dramatic experimentally, the significance of the MAC in host defense is limited. • Deficiency in complement components C5-C9 is associated with susceptibility only to Neisseria species. • MAC is important only for the killing of Neisseria • Thus, opsonizing and inflammatory actions of the earlier components of the complement cascade are more important for host defense against infection (Janeway’s Immunobiology 8th edition, p66) • It is unclear why patients with a deficiency of one of the late-acting components suffer a particular predisposition to Neisseia infections (Nelson Textbook of Pediatrics, 18th ed, p922) • Most pathogens have thick cell walls or capsules that impede access of the MAC to their cell membranes • MAC is critical for defense against only a few pathogens that are unable to resist MAC insertion, such as infections by bacteria of the genus Neisseria that have very thin cell walls (Abbas et al Cellular and Molecular Immunology 7th ed, p289)

  13. The “a” subunits (C3a and C5a) attract (chemotactic factors) phagocytic and inflammatory cells to the site. Murray Medical Microbiology, p47

  14. E-mail: itsunoda@hotmail.com http://tsunodalaboratory.web.fc2.com/ Slow Viral Diseases http://news.nationalgeographic.com/news/2014/06/140604-world-mad-cow-disease-health-death/ September 3, 2015 Microbiology & Infectious Diseases (MID) # 99 Ikuo Tsunoda, MD, PhD, Associate Professor Department of Microbiology and Immunology, LSUHSC-Shreveport

  15. TSP = HAM deterioration

  16. Neurodegeneration with brain iron accumulation type I or pantothenate kinase-associated neurodegeneration

  17. http://tsunodalaboratory.blog.fc2.com/blog-entry-44.html

  18. “Wegener’s granulomatosis” has been renamed “Granulomatosis with polyangitis” in 2011 Dr. Friedrich Wegener was a member of the Nazi party before and during World War II

  19. http://tsunodalaboratory.blog.fc2.com/blog-entry-127.html Ikuo Tsunoda visited Dr. Grisham https://docs.google.com/file/d/0B0yuTN7BHBulNi1EdHZ4bHQwMjg/edit?pli=1

  20. Visna is caused by lentivirus infection

  21. Measles: definition (Harrison’s Internal Medicine) Measles (rubeola) is a highly contagious, acute, exanthematous respiratory disease. definition (Stedman’s dictionary) An acute exanthematous disease, caused by measles virus (genus Morbillivirus)

  22. Latent infection An infection in which infectious virus is not demonstrable until activated. The classic example is that of Human herpesvirus 1 infection of the dorsal root ganglia between episodes of “cold sores’.

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