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لطفا نظرات خود را برای ما ارسال کنید : 👇🏻 @Takmililab این کانال به همت چندین فلوشیپ و فارغ التحصیل دکتری تخصصی راه اندازه شده است . در این کانال سعی بر آن است تا از 0 تا 100 با شما باشیم دکتر شکوه امیری : فلوشیپ دکتر محمد نژاد : فلوشیپ

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

فرصت را از دست ندهید! لیستی از بهترین کانال های ارشد وزارت بهداشت ،آزمایشگاهی ،استخدامی ،پرستاری،پزشکی💥 تا دقایقی دیگر لیست حذف می‌شود.
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سریع‌تر عضو شوید و از مزایا بهره‌مند شوید!👆👆🌺🌺

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

اطلاعیه شماره 3: ثبت نام آزمون ورودی دوره تکمیلی تخصصی علوم آزمایشگاهی (1404/04/11) (جدید)
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93)
Given valence conditions that allow the formation of large aggregates, the size of the antigen–antibody complexes that form depends critically on the relative molar concentrations of the two reactants. If an excess of antigen or antibody is present, large complexes are unlikely to form (Fig. 47.2). This property is crucial to understanding seemingly paradoxical reactions in some immunoassays that depend on antigen–antibody complex formation. For example, a vast excess of antigen can completely saturate all antibody-binding sites, leading to a negative signal (i.e., no agglutination). This phenomenon is sometimes referred to as the prozone effect. The prozone effect remains a potential problem for modern assay systems, including syphilis testing, in which extremely high-titer antibodies can be missed unless the specimen is tested at dilutions (Smith & Holman, 2004) and even in immunofixation electrophoresis (see later discussion, Fig. 47.6E). The prozone effect, or hook effect, occurs in many different immunoassays, particularly those based on sandwich formation involving a capture antibody (usually solid phase) that binds antigen plus a second reporter antibody (typically labeled with an enzyme, fluorescent or chemiluminescent dye, or radioactivity) also directed against the antigen. When antigen is present in excess, it can saturate both capture and reporter antibodies, thereby preventing sandwich formation. This situation is analogous in part to the right side of Figure 47.2, where signal strength diminishes at high antigen concentration.
اما
Specimen Matrix Effects
Common biochemical analytes—such as electrolytes, small molecules, enzymes, and so on—are generally distributed in the water phase of plasma or serum. Consequently, specimens with reduced water phase due to hyperproteinemia (e.g., from very high concentrations of a myeloma protein) or hyperlipidemia (e.g., high chylomicron content) can have reduced content of those solvent analytes even though other properties, such as ionic activities in those specimens, may be within normal physiologic range. This phenomenon is termed the solvent exclusion effect, referring to the exclusion of water and small molecules in the aqueous phase when more volume within a specimen is occupied by protein or lipid that excludes water. The content of small molecules per volume is the osmolarity (which is the measurement that can be erroneous), whereas the physiologically important aspect, such as ionic activities, is the osmolality. If excess lipids are the cause, they may be removed by ultracentrifugation. If interference is due to excess protein, an alternative mode of analysis, such as ion-selective electrode in undiluted specimen, can be employed to yield correct electrolyte activity (i.e., equivalent of osmolality). Matrix effects from very high or very low concentrations of proteins and other constituents may be problematic when dealing with other body fluids, especially when the specimens are highly viscous or otherwise atypical. In those situations, it may be necessary to qualify results in the report to indicate the site of the body fluid and possible limitations in accuracy of measurement.

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

91) Fluorescent immunoassays (FIAs) use fluorophores as labels. Fluorophores require optimal wavelength light energy for their excitation to produce detectable emission light. FIA sensitivity is likely to decrease because of the nonspecific background fluorescence present in biological specimens. Fluorophores that have a delayed fluorescence emission time of 100 ns (nanoseconds) are suitable for application on time-resolved FIA.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

90) Hairy Cell Leukemia
HCL is often readily diagnosed based on its cytologic features, pattern of bone marrow infiltration, and characteristic immunophenotype (Swerdlow et al., 2017). Occasionally however, HCL can be difficult to distinguish from other small B-cell neoplasms, particularly splenic MZL. In these difficult cases, molecular analysis for BRAF Val600Glu mutation
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

87) This mirrors the clinically defined subsets of patients who were most likely to respond to EGFR TK inhibitors. NSCLC patients whose tumors present with EGFR TK–activating mutations show better overall response, longer progression-free survival, and overall survival after chronic gefitinib or erlotinib treatment, as compared to those without these activating mutations (Gazdar, 2009). Acquired resistance
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TP53. TP53 is located at chromosome 17p13 and encodes a transcription factor that acts as a tumor suppressor through induction of apoptosis or growth arrest (see also Chapter 77). TP53 is upregulated in response to a variety of cellular proliferative stress and DNA damage signals (Junttila & Evan, 2009; Kato et al., 2003; Willis, et al., 2004). P53 protein activity or its loss from mutation or other mechanisms has complex effects on normal hematopoiesis (Pant et al., 2012). Somatic TP53 mutations are seen in approximately 5% to 10% of patients with MDS, with 25% showing high-grade diseases, 10% of de novo AML, and half of therapy-related myeloid neoplasms. TP53 mutations often coexist with complex karyotypes with a high frequency of del(5q) and 17p loss of heterozygosity (LOH). These mutations confer chemoresistance and poor prognosis in myeloid neoplasms regardless of clinical or pathological diagnoses
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

82)
MICROARRAY FABRICATION
3′-End functionalization (i.e., chemical modification) of nucleic acids—oligonucleotides, PCR products, cDNAs, or peptide nucleic acid oligomers— is required for covalent immobilization on either glass or polypropylene surfaces (Matson et al., 1995; Beier & Hoheisel, 1999). For example, treatment of glass slides with silane allows amino-covered glass to bind amino-linked probes, using bifunctional molecules such as a dialdehyde or a diisothiocyanate (Case-Green & Southern, 1994; Guo et al., 1994). Alternatively, glass coating with a polycation (e.g., polylysine) allows direct charge-coupled binding of polyanionic DNA probes (Maskos & Southern, 1993a); an ultraviolet photo-cross- linking step adds covalent bonds to the ionic interaction. Covalent binding is essential to permit stringent washes and therefore accurate discrimination of hybridized species. Several protocols have been published to address surface activation (Maskos & Southern, 1992; Beattie et al., 1995; Matson et al., 1995; Beier & Hoheisel, 1999). An interesting alternative consists of deposition of small patches of activated polyacrylamide to which presynthesized oligonucleotides are attached by microinjection (Khrapko et al., 1991; Yershov et al., 1996; Guschin et al., 1997). The packing density
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

A phenotypic male with an XX sex chromosome complement may also result from a cryptic translocation between the X and Y chromosomes. The distal ends of the short arms of the X and Y chromosomes are homologous and comprise what is termed the pseudoautosomal regions (see Fig. 71.23). This is the primary site of X and Y chromosome pairing during meiosis, and recombination may occur between X and Y alleles. Rarely, a recombination event outside the boundaries of the pseudoautosomal region takes place, resulting in the transfer of unique Y loci, including SRY, to the tip of the X chromosome. The amount of chromosome material involved in such an exchange is extremely small and cannot be cytogenetically detected. In a male with such a balanced translocation, there would be no clinical abnormalities, because the genes are all present, although in alternate locations. However, if this male transmits his rearranged X chromosome to an offspring who has received an X from the mother, the resultant child will have an apparent XX chromosome complement but a phenotype that is male or Klinefelter male due to the presence of the TDF protein that triggers the male developmental pathway.
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

one or more globin chains with hundreds of sequence variants known, and their diagnosis at the molecular level is correspondingly more complex than that of sickle cell anemia. α-Thalassemia is the more straightforward because it is usually caused by deletion of either or both of the two contiguous α (HBA) genes on one or the other or both chromosomes 16. This can be detected by Southern blot, MLPA, or quantitative PCR, allowing differentiation of the silent carrier state (one α gene missing) from the very severe hydrops fetalis (all four genes missing) and the two intermediate states (Zhou et al., 2013). For the minority of cases caused by point mutations, Sanger sequencing or allele-specific probe hybridization can be used
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

در صفحه 1388 از کتاب تکس هنری داریم :
Nested Polymerase Chain Reaction
Nested PCR was developed to increase both the sensitivity and specificity of PCR (Haqqi et al., 1988). It employs two pairs of amplification primers and two successive rounds of PCR. Typically, one primer pair is used in the first round of PCR of 15 to 30 cycles. The products of the first round of amplification are then subjected to a second round of amplification using the second set of primers, which anneal to a sequence internal to the sequence amplified by the first primer set. The increased sensitivity arises from the high total cycle number. The increased specificity arises from the annealing of the second primer set to sequences found only in the first-round products, verifying the identity of the first-round product. In hemi-nested PCR, one of the primers in the second PCR is identical to the first. The major disadvantage of nested PCR is the high rate of contamination that can occur during the transfer of first-round products to the second tube for the second round of amplification. This can be avoided either by physically separating the first-and second-round amplification mixtures with a layer of wax or oil or by designing closed-tube amplification and detection protocols.

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : هپاتیت های ویروسی -HEV
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : ویروس های عامل گاستروانتریت - جدول
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : عفونت‌های ویروسی مادرزادی و perinatal - ویروس روبلا (سرخچه - ویروس شناسی
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : کرونا ویروس- ویروس شناسی
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

💥قبولی  در آزمون لیسانس پزشکی آسان شد.......
❌حذف شرط سن
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

اطلاعیه شماره 3: ثبت نام آزمون ورودی دوره تکمیلی تخصصی علوم آزمایشگاهی (1404/04/11) (جدید)
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

پاسخ سوال 92)
Figure 46.6

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پاسخ سوالات ایمنی شناسی 👇

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

88) Recent advances in immunotherapy appear to be able to identify predictive biomarkers of responsiveness to immunotherapy. NGS has made the determination of tumor burden possible. Tumor burden is defined as the rate of peptide-changing single-nucleotide variants per million pairs. Hypermutated tumors have an increased tumor burden and a higher rate of somatic mutations. This is associated with the development of neoantigens as well as responsiveness to immune checkpoint inhibitors. Along with exogenous and endogenous mutagens, microsatellite instability (MSI) is a leading mechanism resulting in hypermutation. Detection of MSI is vital in the assessment of hypermutation, particularly in colorectal and gastric cancers (Nagahashi, 2019).
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85)
X AND Y CHROMOSOME MARKERS
Sex determination is commonly performed using the amelogenin locus (see Fig. 74.1). The primer for this locus amplifies an X-specific
band (Xp22.1 to 22.3) and a Y-specific band (Yp11.2). This locus is coamplified and coanalyzed with most multiplexed STR systems designed for human identity testing. Sex determination marks a departure from all other routine identity markers, in that it provides specific phenotypic information about the source individual (i.e., male or female). It may also be important in the investigation of potential suspects as well as in the categorization of specimens as originating from a victim or suspect. Although polymorphic Y chromosome markers (Fig. 74.3) are not used for sex determination, they are extremely useful in the typing of casework when there is a mixture of a male and female and a mixture of males. For example, an excellent use of Y-STRs is sexual assault evidence that displays a mixture of both the female epithelial cell DNA and male sperm DNA. When the quantity of male DNA is much less than the female DNA, Y-STRs are excellent in obtaining a profile of the male subject with no interference from the female subject since Y-STR results are only obtained from males. They also are used to characterize the paternal lineage in human remains identifications (Box 74.3). A haplotype is generated from Y-STRs versus a phenotype in autosomal STRs; haplotypes do not afford the same level of discrimination as autosomal STR profiles.

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Cytogenetic Findings
Several large CNVs were reported, most notably deletions on both
15q13.3 and 1q21.1. Subsequently, large-scale “mega-analysis” in the PGC confirmed this and showed a more or less specific increase in burden in genes with synaptic function as well as those implicated in animal models of illness. Furthermore, a number of specific loci showed significant enrichment in CNVs, including 1q21.1, 2p16.3 (neurexin1), 3q29, 7q11.2, 15q13.3, 16p11.2, and 22q11.2 (Marshall et al., 2017).

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81)
ARRAY TECHNOLOGY IN CLINICAL DISEASE
Microarray technology has provided the ability to screen genes that are differentially regulated in experimental and clinical disease and allow further correlation of select genes with their function. For example, Ji and colleagues (2003) used microarray technology to screen for genes that are upregulated in the early stage of acute pancreatitis using two different experimental models of the disease. Many genes were upregulated in both experimental systems, suggesting their importance in the human condition. However, one gene in particular, EGR1, further analyzed through classical approaches (gene knockout), was shown to be a key regulator that may be important in the development of early acute pancreatitis. Others (Iacobuzio-Donahue et al., 2003) have performed a comprehensive evaluation and comparison of gene expression profiles of 39 samples of pancreatic cancer and identified between 6 and 40 genes that were highly expressed when examined by multiple methods (oligonucleotide arrays, cDNA arrays, or SAGE). These may eventually be translated into clinically useful targets for therapy or diagnosis.

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سوال79 ) در صفحه 1430 داریم
Miller-Dieker syndrome clearly illustrates the overlap between microdeletion and contiguous gene syndromes. The disorder has been associated with a microdeletion of the distal short arm of chromosome 17 (17p13.3), and the cardinal clinical features are lissencephaly (smooth brain) and craniofacial anomalies. Isolated lissencephaly has also been recognized as an independent entity, so Miller-Dieker syndrome is a more complex presentation that couples the brain defect with characteristic facial features. Molecular analysis has shown there are at least two genes involved in Miller-Dieker syndrome, so it is a true contiguous gene syndrome resulting from a microdeletion. A smaller deletion of the LIS1 gene only would result in isolated lissencephaly (Ledbetter et al., 1992).
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

DUCHENNE MUSCULAR DYSTROPHY
This X-linked progressive myopathy was the first disorder whose causative gene was isolated by the process of positional cloning (Rowland, 1988). Before that discovery, the only tests that could be offered to at-risk families were detection of some female carriers by the finding of elevated serum creatine phosphokinase levels, followed by prenatal sex determination with the option to terminate a male fetus (even though 50% of these pregnancies would be normal). Genetic counseling was rendered even more problematic because about one-third of cases of DMD arise from new mutations. Even after its discovery, translation to clinical application was not easy because the gene, dubbed dystrophin, proved to be one of the largest yet discovered, spanning 2.4 million bp and composed of 79 exons (Ahn & Kunkel, 1993). Use of full-length or partial cDNA probes to detect the variety of deletions accounting for two-thirds of cases was labor intensive and time-consuming (Darras et al., 1988; Prior, 1991). It was only with the advent of multiplex PCR, described in Chapter 69, that a system was developed for rapid and inexpensive identification of more than 98% of dystrophin deletions and their localization to specific exons of the gene (Beggs et al., 1990; Multicenter Study Group, 1992). In this system, a deletion is identified by absence of one or more of the multiple expected amplicons on ethidium bromide–stained electrophoresis gels or capillary electrophoresis instruments (because a target gene deletion will abolish the hybridization site[s] of one or more primers, causing PCR failure; Fig. 72.2). Such fine-structure mapping combined with sequencing has also revealed important insights into the molecular pathogenesis of DMD and the milder allelic variant, Becker muscular dystrophy (BMD). Both are most often caused by large dystrophin deletions, but those in BMD typically preserve the
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

پاسخ سوالات ژنتیک 👇

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : ویروس های عامل نئوپلازی - جدول

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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : عفونت‌های ویروسی مادرزادی و perinatal - ویروس روبلا (سرخچه - تظاهرات بالینی
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : کرونا ویروس- پیامد های بالینی (مدیریت و درمان)
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فلوشیپ یا دوره تکمیلی علوم آزمایشگاهی

درسنامه ویروس شناسی هنری : ویروس‌های آنفلوآنزا - پیامد های بالینی (مدیریت و درمان)
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