第一週

Transcription

1 長庚大學醫學系六年級 九十七學年第二學期 課程大綱

2 上課日期 ( 起 ) 上課日期 ( 迄 ) 課程名稱 ( 一 ) ( 二 ) 麻醉科學 (Anesthesiology) ( 一 ) ( 二 ) 婦產科學 (Obstetrics and Gynecology) ( 一 ) ( 一 ) 外科學 (Surgery) ( 六 ) ( 一 ) ( 六 ) ( 五 ) ( 五 ) 醫學倫理學 (Medical Ethics) 放射治療學 (Radiation Therapy) 眼科學 (Ophthalmology) 皮膚科學 (Dermatology) 耳鼻喉科學 (Otorhinolaryngology)

3 課程名稱 : 外科學 (Surgery) 學年 :97 學期 :2 年級 :6 課程大綱教科書 : 1. Hans Troidl, Walter O. Spitzer, Bucknam McPeek, David S. Mulder, Martin F. McKneally. Principles and Practice of Research Strategies for Surgical Investigators. Springer-Verlag New York Inc., 2nd Edition, Bernard R. Glick, Jack J. Pasternak. Molecular Biotechnology- Principles and Applications of Recombinant DNA. American Society for Microbiology, 3rd Edition, 林天佑等中華現代外科學全書, 台灣商務印書館 2. Sabiston Textbook of Surery By saunders 17th Edition, 外科學原理手冊作者 : 孫長怡合記出版社 e 4. 基礎外科學問題診斷與處理作者 : 曾昱綸等編譯合記出版社 89/6 初版二刷 5. Principles of Surgery, Schwartz s 8th Edition, 參考書 : 1. Reconstructive Plastic Surgery Volume 1:General Principles By Converse 2. Surgery of the Chest 2 Vols By Sabiston Essential Neurosurgery By Kaye Churchill-Livingstone 4. Surgery of the Anus Rectum and Colon 2Vols By Keighley Textbook of Musculoskeletal Disease By Salter Lippincott 6. Fundamental of Orthopedics By Gartland 7. Essentials of Neurosurgery By Spencer & Smith 8. Pediatric Surgery By ashcraft 整體教學目標 : 教導外科疾病的診斷 治療及預防 教學方法 : 以上課為基礎, 做系統性的講解及討論 重視雙向溝通, 提昇學生的理解 中文課程簡介 : 包括外科的所有的次專科課程 : 一般外科 泌尿科 心臟外科 胸腔外科 神經外科 小兒外科 大腸直腸外科 整形外科 外傷科及骨科 英文課程簡介 : Surgery is comprised of 9 divisions:general surgery Neurosurgery Urology Orthopedics Pediatrics Plastic surgery Proctology Thoracic and Cardiovascular surgery and Traumatic surgery Surgery is comprised of 9 divisions:general surgery Neurosurgery Urology Orthopedics Pediatrics Plastic surgery Proctology Thoracic and Cardiovascular surgery and Traumatic surgery 成績考核 : 期中考 (50%)+ 期末考 (50%)

4 教學進度 項次 上課日期 / 星期 ( 四 ) ( 四 ) ( 四 ) ( 四 ) ( 四 ) ( 五 ) ( 五 ) ( 五 ) ( 五 ) ( 五 ) ( 五 ) ( 五 ) 開始 / 結束時間 時數 授課教師 教學進度 10:10-11:00 1 唐瑞平 Cancer Genomics in Surgery 11:10-12:00 1 游耀東 Clinic Evaluation and Treatment of Idopathic Constipation 13:10-14:00 1 張慧朗 Clinical Bioinformatics 14:10-15:00 1 林志鴻 15:10-16:00 1 劉會平 Lung, VATS Reconstruction for trauma disorder 16:10-17:00 1 李威震 Transplantation immunology 11:10-12:00 1 陳晃洋 Varicose vein 13:10-14:00 1 謝宏昌 Vascular Surgery 14:10-15:00 1 林炳川 An integrated approach to trauma and resuscitation 15:10-16:00 1 葉俊男 The pancreas and spleen 16:10-17:00 1 陳力輝 Degenerative disc disease of lumbar spine 9:10-10:00 1 李石增 Functional neurosurgery 10:10-11:00 1 詹益銀 The biliary system 11:10-12:00 1 沈陳石銘 Surgical complications,including infection and sepsis 13:10-14:00 1 江支銘 Disease of anus and perineum 14:10-15:00 1 王正儀 15:10-16:00 1 周逢復 Principles of preoperative preparation of the surgery patient Malabsorption syndrome, short bowel syndrome 16:10-17:00 1 李威震 liver transplantation :10-10:00 1 王植熙 Hemostasis and disorders in surgical bleeding

5 ( 一 ) ( 一 ) 10:10-11:00 1 賴勁堯 Common surgical diseases in the pediatric age ( 一 ) ( 一 ) ( 一 ) ( 一 ) ( 一 ) 11:10-12:00 1 張北葉 13:10-14:00 1 駱至誠 Paediatric surgery and anorectal malformation Introduction to pediatric surgery care for the surgical neonates 14:10-15:00 1 趙子傑 Endocrine disease 15:10-16:00 1 謝敏暲 Chest Wall, Mediastinum, Trachea 16:10-17:00 1 蔡峰鈞 Adult Cardiac Surgery ( 一 ) 17:10-18:00 1 詹益聖 Bone and Joint Infection / Hyperbaric Oxygen Therapy ( 二 ) ( 二 ) ( 二 ) ( 二 ) ( 二 ) ( 二 )) :10-10:00 1 張仁平 Aortic Surgery and CABG 10:10-11:00 1 黃燦龍 11:10-12:00 1 黃燦龍 Fluid and electrolyte management of the surgical patient Surgical nutrition and morbid obesity 14:10-15:00 1 張毓翰 Tissue engineering and stem cell 15:10-16:00 1 莊錦豪 Surgical diseases of newborns 16:10-17:00 1 朱肇基 Congenital Cardiac Surgery 10:10-11:00 1 陳敏夫 Ethics in surgical practice 11:00-12:00 1 陳敏夫 The liver :10-14:00 1 陳進勛 Diverticular diseases and chronic ulcerative colitis ( 四 ) 14:10-15:00 1 何治軍 Cervical spine degenerative 15:10-16:00 1 林萍章 Legal Aspects in Surgical Practice 16:10-17:00 1 陳文哲 Spinal deformity 張簡俊 10:10-11:00 1 Heritable colorectal cancer ( 四 ) 榮 :10-12:00 1 葉大森 Endoscopic surgery

6 ( 四 ) ( 四 ) ( 四 ) ( 四 ) ( 五 ) ( 五 ) ( 一 ) ( 五 ) ( 一 ) ( 一 ) ( 一 ) ( 一 ) ( 一 ) ( 一 ) ( 一 ) ( 二 ) ( 二 ) ( 二 ) ( 二 ) ( 二 ) ( 二 ) 13:10-14:00 1 雷大雅 Paediatric neurosurgery 15:10-16:00 1 張承能 Neurosurgical oncology 16:10-17:00 1 陳志豐 10:10-11:00 1 許文蔚 Sports injury 11:10-12:00 1 楊仁宗 14:10-15:00 1 陳訓徹 The breast Thoraco-Lumbar degenerative disease Neurosurgical emergency and infectious diseases in neurosurgery 15:10-16:00 1 林子淦 Neurosurgical vascular disorder 16:10-17:00 1 王嘉修 Surgery for the common diseases of the stomach and duodenum 10:10-11:00 1 王俊聞 Surgery for arthritis 11:10-12:00 1 吳怡成 Esophagus, Pleura, Diaphragm 13:10-14:00 1 吳基銓 14:10-15:00 1 陳孝文 15:10-16:00 1 李宗料 16:10-17:00 1 陳永仁 9:10-10:00 1 王清貞 10:10-11:00 1 施信農 Principles in the management of fractures and dislocations Pediatric urology, endourology, and laparoscopic surgery Congenital deformities in orthopedic practice Bone metabolism and metabolic bone disease Recent Advance in Orthopedic Surgery Neoplasms of musculoskeletal system 12:10-13:00 1 張承仁 Cosmetic surgery 13:10-14:00 1 徐榆堡 Response to injury 14:10-15:00 1 陳國鼎 Maxilofacial surgery, congenital or acquired 15:10-16:00 1 莊垂慶 Introduction of plastic surgery :10-17:00 1 鄭明輝 Principles of Microsurgery

7 ( 二 ) ( 四 ) ( 四 ) ( 四 ) ( 四 ) 10:10-11:00 1 林有德 Hand surgery 11:10-12:00 1 楊瑞永 13:10-14:00 1 朱聖賢 14:10-15:00 1 魏福全 Burn Wound healing Kidney disease and Renal transplantation New trends and technologies in reconstructive surgery 15:10-16:00 1 崔克宏 Geriatric Urology 16:10-17:00 1 陳昱瑞 10:10-11:00 1 謝明里 Craniofacial surgery, philosophy and art Disorders of Prostate and Andrology 11:10-12:00 1 莊正鏗 Urological Oncology 13:10-14:00 1 陳文祥 Urolithiasis, Urinary obstruction 14:10-15:00 1 陳志碩 Female urology and sexual dysfunction 10:10-11:00 1 唐瑞平 Cancer Genomics in Surgery 課程名稱 : 外科學 (Surgery) 第 1 單元授課主題 :Cancer Genomics in Surgery 教師 : 唐瑞平授課時間 :50 分鐘 PowerPoint:40 張學習目標 :Basics knowledge in Genomics especially focusing on surgery-related cancer genomics 大綱 : A. Introduction B. What is cdna microarrays and molecular state of cancer? C. Schema of cdna microarrays D. Experimental considerations of cdna microarray 1. Biological sample 2. Tissue handling 3. Tissue sampling 4. Variability 5. Data analysis

8 E. Clinical uses of Genetic expression 1. Cancer diagnosis 2. Prognosis and prediction of outcome 3. Treatment and response F. Metastasis and Genetic expression G. Conclusion and Future of personalized medicine 第 2 單元授課主題 :Clinic Evaluation and Treatment of Idopathic Constipation 教師 : 游耀東授課時間 :50 分鐘學習目標 : 學習慢性便祕的臨床診斷 大腸橫越時間的檢測 及大腸無力症的治療大綱 : A. Definition of constipation B. Pathophysiological Classification of constipation 1. Obvious causes for constipation 2. Colonic dysmotility 3. Abnormal defecation C. Series of tests 1. Colon transit time 2. Balloon expulsion test 3. Anal sphincter resting and squeeze pressures 4. Rectal sensitivity 5. Defecography D. Management of idiopathic constipation 1. pure colon dysmotility colectomy 2. pure pelvic outlet obstruction (anismus) biofeedback anal training 3. colon dysmotility combined with pelvic outlet obstruction (anismus) biofeedback anal training ± colectomy 第 3 單元授課主題 :Clinical Bioinformatics 教師 : 張慧朗授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 生物資訊的來源與用處 生物資訊的資料庫與工具 生物資訊在臨床上的應用大綱 : A. Definition of clinical bioinformatics B. Aims of clinical bioinformatics 1. Building bioinformatics databases 2. Developing tools and resources for analysis of biological data 3. Using tools to interpret the clinical results C. Bioinformatics databases

9 1. Bioinformatics: CBC NCBI EMBL-EBI CGAP DDBJ 2. Genes: GeneCards Gene Ontology Ensembl Mouse 3. Proteins: RCSB UniProt ExPASy 4. SNPs: SNP-RFLPing V-MitoSNP seesnp 5. Antibodies: Invitrogen Abcam BIOMOL 6. Pathways: KEGG 7. References: PubMed 8. Clinical Trials: ClinicalTrials D. Developing databases and tools E. Tools for analysis and interpretation of biological data 1. BLAST (Basic Local Alignment Search Tool) 2. Cluster and Tree View for microarray data analysis 3. Discovery Studio for protein analysis F. Clinical applications of clinical bioinformatics G. Personalized Medicine 第 4 單元授課主題 :Reconstruction for trauma disorder 教師 : 林志鴻授課時間 :50 分鐘學習目標 : 手的解剖 功能及重建大綱 : A. Hand anatomy B. Thumb functional anatomy 1. Thenar muscle o to metacarpal arch 3. Unique motion of circumduction C. Basic hand definition 1. Radial component 2. Ulnar component 3. Opposition 第 5 單元授課主題 :VATS and lung disease 教師 : 劉會平授課時間 :50 分鐘 PowerPoint:50 張學習目標 : A. 學習肺腫瘤及相關肺外科疾病 症狀 診斷 手術適應症及手術方法 B. 學習微創胸腔鏡手術臨床應用 大綱 : A. Benign Lung tunor: 1. Symptom / Sign

10 2. Dx & surgical indications. 3. Postoperative care B. Lung cancer: 1. Clinical staging 2. Surgical indications. 3. Postoperative care 4. Survival 5. Adjuvant therapy C. Surgical lung diseases 1. Bronchiectasis: Surgical indications and postoperative care 2. Lung abscess: Surgical indications and postoperative care D. Video-assisted thoracic surgery (VATS) : Clinical applications. 第 6 單元授課主題 :Transplantation immunology 教師 : 李威震授課時間 :50 分鐘學習目標 : A. understand immunological reaction in organ transplantation. B. understand acute rejection in transplantation C. understand how to treat acute rejection 大綱 : A. Purpose of organ or tissue transplantation B. MHC molecules in transplantation C. Classification of alloantigen presentation in transplantation 1. Direct pathway 2. Indirect pathway D. Classification of rejection 1. Hyperacute rejection 2. Acute rejection 3. Chronic rejection E. Immunological reaction in Transplantation 1. Antigen presenting cells 2. T lymphocytes reaction F. Treatment of rejection 1. Immunosuppressants 2. Mechanisms of immunosuppressive agents G. Major topics in transplantation research 第 7 單元授課主題 :Varicose vein 教師 : 陳晃洋授課時間 :50 分鐘

11 PowerPoint:40 張學習目標 : 學習靜脈曲張症狀 診斷 手術適應症及手術方法大綱 : A. Varicose vein B. Chromic venous insufficiency C. Diagnosis D. Treatment 第 8 單元授課主題 :vascular emergency 教師 : 謝宏昌授課時間 :50 分鐘 PowerPoint:45 張學習目標 : 學習血管外科急症的臨床表徵 診斷 處置及預後大綱 : A. Acute venous problems B. Acute problems with vascular dialysis access C. Acute upper extremity ischemia D. Acute leg ischemia E. Abdominal aortic aneurysms F. Vascular injuries to the neck G. Vascular injuries to the thoracic outlet area H. Vascular injuries in the arm I. Vascular injuries in the leg J. Abdominal vascular injuries 第 9 單元授課主題 :An integrated approach to trauma and resuscitation 教師 : 林炳川授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 了解外傷機轉 診斷 判斷多重外傷嚴重度 復甦原則大綱 : A. Trauma mechanism B. Primary, secondary and tertiary survey C. Management of multiple injury D. Priority of multiple injury E. Damage control resuscitation F. Damage control laparotomy 第 10 單元授課主題 :The Pancreas and spleen

12 教師 : 葉俊男授課時間 :50 分鐘 PowerPoint:48 張學習目標 : 了解胰臟及脾臟正常生理解剖及疾病的處置 大綱 : A. 胰臟正常生理解剖 B. 胰臟 : 急性胰臟炎 慢性胰臟炎 胰臟癌 C. 脾臟正常生理解剖 第 11 單元授課主題 :Degenerative disc disease of lumbar spine 教師 : 陳力輝時間 :50 分鐘 PowerPoint:48 張學習目標 : 學習腰椎退化性椎間盤病變的臨床病因 種類 診斷 治療原則大綱 : A. pathophyiology of degenerative disc of lumbar spine B. Herniation of lumbar disc 1. symptoms and signs 2. clinical diagnosis 3. treatment principle 4. surgical indications C. Lumbar spine stenosis 1. pathophyiology of sss 2. clinical presentations 3. general management D. Spondylolisthesis 1. classifications 2. clinical diagnosis 3. surgical indications and prognosis 第 12 單元授課主題 :Functional Neurosurgery 教師 : 李石增授課時間 :50 分鐘 PowerPoint:86 張學習目標 : 學習功能性神經外科之演變範圍及手術方法 大綱 : A. History of functional neurosurgery B. Method of stereotactic surgery 1. Frame system 2. Franeless system C. Target for functional Radiosurgery

13 1. Thalamus 2. Subthalamic ne 3. Globus pallidus D. Functional development of functional Neurosurgery 第 13 單元授課主題 :The biliary system 教師 : 詹益銀授課時間 :50 分鐘 PowerPoint:36 張學習目標 : 學習膽道系統之解剖 膽囊及膽道疾病之診斷, 膽石症之自然史, 膽道疾病之治療及手術適應症大綱 : A. Diagnosis of Hepatobiliary system B. Anatomy and physiology of biliary tract C. Natural history of gall stone disease D. Treatment of gall bladder stone, bile duct and intrahepatic stones E. Pre-operative evaluation of obstructive jaundice 第 14 單元授課主題 :Surgical Complication 教師 : 沈陳石銘授課時間 :50 分鐘 PowerPoint:43 張學習目標 : 外科倂發症的壞處 原因 分類 預防及處理大綱 : A. Disadvantage of Surgical Complication B. Cause of Surgical Complication C. How to prevent and minimise Surgical Complication D. Principal Categories of Surgical Complication E. Complication of any Surgical Complication 第 15 單元授課主題 :Disease of anus and perineum 教師 : 江支銘授課時間 :50 分鐘學習目標 :To learn common anal and perineal diseases 大綱 : A. Review of anus and perineum anatomy B. Inflammatory: 1. Hemorrhoid 2. Pruritus ani 3. Hypertrophy anal papilla

14 4. Coccyxdynia C. Infections disease: 1. Perianal / ischiorectal abscess 2. Anal fistula 3. Fournieur s gangrene 4. AIDS 5. Anal condyloma D. Malignancies: 1. Squamous cell carcinoma 2. Paget s disease 3. Melanoma E. Functional disease 1. Anismus 2. Paradoxical puborectalis contraction 3. Levator ani syndrome 4. Anal incontinence 5. Perineal descent syndrome 第 16 單元授課主題 :Principles of preoperative preparation of the surgery patient 教師 : 王正儀授課時間 :50 分鐘 PowerPoint:28 張學習目標 : 如何做病人手術前的評估及準備工作, 如考試前的準備愈周詳, 病人手術的成功機率增加, 減少合併症, 同時恢復也會加速 大綱 : Operation is the central action of surgical cares Surgical cares have three different stages A. Pre-operative assessments 1. History 2. The diagnosis is established from 3. Surgery or not depends on 4. Personal relationship B. Psychologic preparation 1. Anxiety 2. Fantasy 3. Rumor 4. Hearsay 5. Physician-patient relationship 6. Operative consent C. Physiologic preparation 1. Blood volume (anemia) and fluid 2. Nutrition

15 3. Infection D. Specific organs 1. Heart 2. Lung 3. Liver 4. Kidney 5. Specific systems 6. Other considerations 7. A sample preoperative checklist 第 17 單元授課主題 :Malabsorption syndrome, short bowel syndrome 教師 : 周逢復授課時間 :50 分鐘 PowerPoint:30 張學習目標 : 認識小腸之先天 手術感染引發之疾病及良性 惡性腫瘤 營養吸收及小腸切除引發之症候群 大綱 : A. Crohn s disease B. Tuberculosis enleritis C. Typhoid enleritis D. Benign lesions E. Peutz-Jegher s syndrome F. Malignant lesions G. Diverticular disease H. Small bowel fistula I. Blind loop syndrome J. Short bowel syndrome 第 18 單元授課主題 :Liver transplantation 教師 : 李威震授課時間 :50 分鐘學習目標 : A. Understand liver transplantation. B. Understand the indications of liver transplantation C. Understand prognosis and complication of liver transplantation 大綱 : A. Purpose of Liver transplantation B. Indications and contra-indications of liver transplantation C. Organ donors and Organ allocation D. Classification of liver transplantation 1. Decreased liver transplantation

16 2. live donor liver transplantation E. Liver transplantation technique 1. Whole liver transplantation 2. Split liver transplantation 3. live donor liver transplantation F. Treatment of rejection G. Complications of liver transplantation 1. Immunosuppressive adverse effects 2. Infection 3. Vascular complications H. Special topics in Liver transplantation 1. Hepatitis B 2. Hepatitis C 3. Hepatocellular carcinoma 第 19 單元授課主題 :Hemostasis and disorders in surgical bleeding 教師 : 王植熙授課時間 :50 分鐘 PowerPoint:30 張學習目標及大綱 : A. Introduction- Biology of hemostasis nevaluation of the surgical patients as a hemostatic disorders ncongenital Hemostatic disorders nacquired hemostatic disorders nblood transfusion B. Hemostasis Primary vs. Secondary vs. Tertiary Primary Hemostasis Platelet Plug Formation Dependent on normal platelet number & function Initial Manifestation of Clot Formation Secondary Hemostasis Activation of Clotting Cascade, Deposition & Stabilization of Fibrin Tertiary Hemostasis Dissolution of Fibrin Clot Dependent on Plasminogen Activation C. Primary Hemostasis An immediate (seconds to minutes) but temporary response to vessel injury. Platelets and von Willebrand factor (vwf) interact to form a primary plug, after which platelet activation occurs and blood vessels constrict, limiting flow. D. Secondary Hemostasis A slower process (minutes to hours) that results in the formation of a fibrin clot.

17 Coagulation is initiated when vascular damage exposes extravascular tissue factor to factor VII, with subsequent activation of factors V, VIII, and XI, leading to accelerated and sustained generation of thrombin, conversion of fibrinogen to fibrin, and formation of a durable clot E. Severe infections (e.g. septicemia) Malignant disease ( metastatic carcinoma, leukemia) Shock Severe burns ABO incompatibility Obstetric disorders Eclampsia Abruptio placentae Amniotic fluid embolism Retained dead fetus Intravascular hemolysis (infusion of hypotonic saline, systemic absorption of hypotonic fluid after prostatectomy) F. Volume replacement-management n 20%: crystalloid solution n20~50%: crystalloid solution + PRBC n>50%: crystalloid solution + PRBC + plasma n>50%, continued: plus FFP for citrate nelectrolytes: 3-4x lost volume ndiffusion into interstitial space G. Risks of transfusion Potentially dangerous drug Transfusion reaction Hemolytic (incompatible) transfusion Non-hemolytic (febrile and allergic) reaction antibody to WBC or plasma protein Transmission of disease Virus (HBV, HCV, HIV) and bacteria immunosuppression Embolism Over-transfusion and pulmonary edema 第 20 單元授課主題 :Common surgical diseases in the pediatric age 教師 : 賴勁堯授課時間 :50 分鐘 PowerPoint:30 張學習目標 : 學習兒童外科常見疾病的診斷 治療及預後 本部分不包含新生兒, 新生兒外科有專門一堂課 大綱 :

18 A. 兒童外科的特性 B. 兒童外科常見的門診手術 (minor operations) 1. Inguinal hernia 2. Undescended testis 3. Phimosis 4. Congenital neck cyst and fistula C. 兒童外科常見的急診手術 (emergent operations) 1. Acute appendicitis 2. Intussusception 3. Hollow organ perforation D. 兒童外科常見的住院手術 (major operations) 1. GI system (1). Gastroesophageal reflux (2). Meckel s diverticulum 2. Hepatobiliary system 3. Chest (1). Choledochal cyst (2). Biliary atresia (1). Pectus excavatum (2). Empyema (3). Pneumothorax 4. Oncology (1). Neuroblastoma (2). Wilms tumor (3). Hepatoblastoma (4). Rhabdomyosarcoma (5). Germ cell tumor 第 21 單元授課主題 :Padiatric surgery and anorectal malformation 教師 : 張北葉授課時間 :50 分鐘 PowerPoint:37 張學習目標 : 先天畸形手術的演變 ; 如何發現異常與嬰兒發展正常現象的區別 大綱 : A. Normal development of prepuce B. Pros and cons of neonatal and children circumcision C. Spectrum of imperforate anus D. Development and concept of posterior-sagittal anorectal plasty 第 22 單元授課主題 :Introduction to pediatric surgery care for the surgical neonates 教師 : 駱至誠

19 授課時間 :50 分鐘 PowerPoint:28 張 學習目標 : 認識小兒外科和成人外科的差異, 並學習如何在小兒在手術前後照護的知識 大綱 : A. Difference between pediatric and adult surgery B. The importance of prenatal diagnosis, transportation of surgical newborn C. Temperature maintains (neutral thermal zone) various kind of warmer equipment D. Intravenous fluid 1. 各個種類 IV fluid 使用的時機 2. 正確的使用量極其評估 E. Respiration monitor and respirator F. Nutrition amount and monitor, TPN 第 23 單元授課主題 :Endocrine diseases 教師 : 趙子傑授課時間 :50 分鐘 PowerPoint:45 張學習目標 : 學習內分泌疾病的診斷 外科治療及預後 大綱 : A. Thyroid diseases 1. Anatomy of thyroid gland 2. Classification of thyroid diseases 3. Diagnosis of benign and malignant thyroid diseases 4. Surgical treatment of thyrotoxicosis 5. Surgical treatment of benign nontoxic goiters 6. Surgical treatment of malignant thyroid tumors B. Parathyroid diseases 1. Anatomy of parathyroid gland 2. Classification of parathyroid diseases 3. Diagnosis of parathyroid diseases 4. Surgical treatment of parathyroid diseases C. Insulinoma 1. Diagnosis of insulinoma 2. Surgical treatment of insulinoma 第 24 單元授課主題 :Chest Wall, Mediastinum, Trachea 教師 : 謝敏暲授課時間 :50 分鐘學習目標 : 學習氣管 縱膈腔 肋膜之外科解剖, 疾病之種類, 臨床病程及診斷, 以及外科治療之術式 結果及預後

20 大綱 : A. Trachea anatomy tumor, stricture, post-trachea complication arid surgical management including stenting. B. Mediastinum anatomy. 1. tumor origin from different anatomic site has its identity. 2. myasthenia gravis classification, nature course, surgical indication and surgical approach (including Thoracoscopic, (VATS) method), result & prognosis. C. Pleura disease 1. Pleural effusion & empyema pathogenesis, staging and treatment, timing of Thoracoscopic surgery. 2. Pneumothorax, Bullous disease indication of surgery and thoracoscopic procedures. 3. Chest trauma Blunt & sharp trauma. (1) first aid management (2) pneumothorax. Hemothorax. Hemopneumothorax. Ribs Fracture. (3) Flail chest (4) Traumatic Asphyxia (5) Diaphnymatic injury (6) Esophageal injury (7) Great vessels injury (8) Cardiac injury D. Each immediate diagnosis method, management for life saving, prevent further complication. E. Indication & timing of surgery, (Thoracotomy or Mediestrotomy). 第 25 單元授課主題 :I. How to perform open heart surgery; II. Valvular heart surgery 教師 : 蔡峰鈞授課時間 :50 分鐘 PowerPoint:19 張學習目標 :I. 了解開心手術如何進行 II. 瓣膜手術的選擇與術後注意事項 大綱 : A. History of open heart surgery B. How to perform open heart surgery: 1. Cardiopulmonary bypass machine: basic equipment and function 2. Step by step open heart procedures demonstration C. Valvular surgery 1. Common pathologies in different valvular disease 2. Choices of valvular prosthesis and their indications 3. Prophylaxis of prosthetic valve endocarditis 4. Food interactions with coumdin

21 第 26 單元授課主題 :I. Aortic Dissection ; II. Coronary Artery Bypass Grafting (CABG) Surgery 教師 : 張仁平授課時間 :50 分鐘 PowerPoint:79 張學習目標 :I. 學習主動脈剝離之機轉 診斷, 臨床意涵 治療及預後 ;II. 學習冠狀動脈繞道之演進, 臨床意涵 未來發展 大綱 : I. A. Images of Aortic Dissection: 1. Type A: Intraoperative, Figure, CT, Operative movie 2. Type B: Intraoperative, Figure, CT B. Variation of Aortic Dissection rlated aortopathy and the evolving strategy: 1. Marfan syndrome with Annuloaortic Ectasia (AAE). 2. Historical views of surgery for AAE. (1). Separated valve and aortic replacement (2). Bentall operation (3). Root remodeling and reimplantation (4). Stentles bioprosthesis full roo replacement C. State of the art: EndoVascular Aortic Repair and Thoracic EVAR (TEVAR) D. Medical aspects: 1. Pathology 2. Incidence 3. Clinical pictures 4. Diagnosis 5. Managements: Medical and Surgical II. A. Anatomy of coronary arteries: 1. Gross figures 2. Coronary angiogram (CAG) B. History of CABG and the impacts of Percutaneous Coronary Intervention (PCI): 1. History of CABG 2. PCI: Trends and impacts to CABG C. Indications and Conduits for CABG D. CABG, from classic to state of the art: 1. Arrested CABG with saphenous vein graft 2. Arrested CABG with arterial grafts 3. Classic CABG and Off-Pump CAB (OPCAB) E. Coronary related diseases: 1. Postinfarct ventricular septal rupture 2. Ischemic mitral regurgitation

22 3. Left ventricular aneurysm 第 27 單元授課主題 :Bone and Joint Infection / Hyperbaric Oxygen Therapy 教師 : 詹益聖授課時間 :50 分鐘 PowerPoint:105 張學習目標 : 學習骨骼關節系統感染之機轉 診斷, 臨床及預後, 與高壓氧治療之機轉與適應症 大綱 : A. Bone Infection : Osteomyelitis 1. Classification 2. Clinical Features 3. Radiology 4. Differential Diagnosis: Trauma/ Nonspecific synovitis / Rheumatoid arthritis Osteoarthritis / Gouty arthritis / Rheumatic fever 5. Treatment method 6. Surgical indication 7. Staging system and host B definition 8. Role of antibiotic beads in chronic osteomyelitis 9. Management of soft tissue and bone defects in chronic osteomyelitis 10. Management of joint infection Antibiotics / Aspiration / Arthrotomy/ arthroscopy / Synovectomy Excisional arthroplasty / Arthrodesis 11. Total knee replacement B. Hyperbaric oxygen therapy (HBO) 1. Mechanism of HBO Action 2. Potential Mechanisms of Action of HBO in Musculoskeletal Disorders 3. Indications of Adjunctive HBO Therapy for Musculoskeletal Disorders 4. The role of HBO in the treatment of Refractory Osteomyelitis 第 28 單元授課主題 :Fluid and electrolyte management of the surgical patient 教師 : 黃燦龍授課時間 :50 分鐘學習目標 : 了解 Fluid and electrolyte 的重點及六例實例的計算大綱 : A. Fluid balance B. Dehydration C. Electrolytes imbalance D. Case 1: Surgery after laparoscopic cholecystectomy E. Case 2: Surgery after subtotal gastrecotmy

23 F. Case 3: Water Dehydration G. Case 4: Fluid and water dehydration H. Case 5: Surgery after bowel resection in a ESRD patient I. Case 6: Surgery after Whipple operation 第 29 單元授課主題 :Surgical nutrition and morbid obesity 教師 : 黃燦龍授課時間 :50 分鐘學習目標 : 了解病態性肥胖症的定義及治療大綱 : A. Definition of morbid obesity B. Medical treatment and excise C. Program of weight reduction D. Liposuction E. Intestinal bypass and its side effects F. Gastric partition G. Gastric bypass 第 30 單元授課主題 :Tissue engineering and stem cell 教師 : 張毓翰授課時間 :50 分鐘 PowerPoint:45 張學習目標 : 瞭解組織工程與幹細胞, 目前的研究成果與未來臨床應用的可能 大綱 : A. Definition of Tissue Engineering B. Aims of Tissue Engineering 1. What is Scaffold? 2. What is growth factor? 3. What is stem cells? C. Cloning 1. History 2. Regulation 3. Current Research D. Mesenchymal stem cell 1. Past, now and future 2. Pre-clinical study 3. Clinical application E. Future development of Tissue Engineering F. Discussion 第 31 單元

24 授課主題 :Surgical diseases of newborns 教師 : 莊錦豪授課時間 :50 分鐘 PowerPoint:48 張學習目標 : 學習新生兒常見先天性胸 腹腔疾病之診斷 治療與預後 大綱 : A. Two common neonatal disorders manifested with respiratory distress: esophageal atresia with distal tracheoesophageal fistula and diaphragmatic hernia. B. Newborn infants with gastrointestinal obstruction: 1. Upper GI tract: Idiopathic hypertrophic pyloric stenosis, duodenal atresia, jejunoileal atresia and malrotation. 2. Lower GI tract: Hirschsprung s disease and anorectal malformation. C. Newborn infants with abdominal wall defect: Gastroschisis and omphalocele. D. Special emphasis is on the clinical manifestations, associated anomalies, prompt diagnosis and appropriate surgical management that may change the survival rate of the patients from extremely low in the past to acceptable levels at present. 第 32 單元授課主題 :Congenital Cardiac Surgery 教師 : 朱肇基授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 先天性心臟病之分配大綱 : A. Cyanotic Heart Diseases B. Non-Cyanotic Heart Disease C. ASD (Atrial Septal Defect) D. VSD (Ventricular Septal Defect) E. T/F (Tetralogy of Fallot) F. ECD (Endocardial Cushion Defect) G. TAPVR (Total Anomalous Pulmonary Venous Return) H. TGA (Transposition of the Great Arteries) I. Truncus Arteriosus J. PDA (Patent Ductus Arteriosus) K. Coarctation of Aorta 第 33 單元授課主題 :Ethics in surgical practice 教師 : 陳敏夫授課時間 :50 分鐘 PowerPoint:42 張

25 學習目標 : 醫事倫理的回顧, 現況與展望 新藥倫理 緩和醫療 動物實驗倫理 消費者保護 法 器官移植倫理 醫療隱私權 大綱 : A. 變遷中的醫療環境 B. 醫學倫理 -- 過去與當今的情勢 1. 規範 評估 2. 個人主義 ( 以病人的利益為考慮的依據 ) 社會責任, 醫藥資源與經濟效益 3. 父親與子女 知的權利, 自主權, 醫療不當訴訟 4. 個人良知, 判斷 學會, 委員會, 或非醫事專業人員 C. 醫學倫理 -- 將來的問題 1. 電腦科技的迅速發展, 非人化, 教學模擬機訓練住院醫師, 電腦操作員 2. 後天免疫缺乏症候群, 醫師, 病人的角色 3. 基因治療, 植入物誘發突變 4. 老年人口及老年病患人術逐年增加, 醫療適應性, 社會成本, 活的遺囑 D. 醫學倫理 -- 醫病關係 1. 病患的健康將是我的首要顧念 2. 愛滋病患者需要受到稱職而具同理心的對待 3. 即使拒絕治療會導致殘障或死亡, 有自主能力的病患還是有拒絕治療的權利 4. 醫師沒有義務提供病患無效或無益的治療 5. 病患是否有權使用醫師不建議的醫療服務? 6. 必需盡量讓病患在其能力範圍內參與決定過程 7. 醫師對其病患的一切所知, 都應絕對保密, 即使在病患過世之後也不例外 8. 對於任何需要透露病患隱私的法律要求, 醫師們皆應嚴格加以檢視, 並在遵守之前, 確認遵守的理由是正當的 9. 最重要的是, 醫師絕不能放棄臨終的病患, 即使他們不可能痊癒, 仍應繼續提供富有同理心的照護 E. 臨床試驗新藥及人體試驗 倫理常規 F. 面對死亡的反應 : 庫不勒 -- 蘿絲 1969 G. 安寧緩和醫療之原則 H. 外科研究使用動物之倫理考量 1. 公平對待原則 : 人類與動物 2. 互蒙其利 3. 考慮其他取代方式 4. 接受實驗時, 動物之意識狀態, 及痛苦之處理 5. 實驗動物數目 6. 動物實驗之必需性 第 34 單元授課主題 :The liver 教師 : 陳敏夫授課時間 :50 分鐘 PowerPoint:47 張學習目標 : 學習肝臟解剖 肝臟外科相關影像學 肝癌治療現況及處理原則 肝臟切除併發症 肝硬化肝切除之問題 肝膿瘍及門靜脈高壓之處理原則 大綱 : A. Diagnostic Imaging in Liver Surgery

26 B. Surgeon s Role in Hepato-biliary Disease C. Current Treatment Modalities for HCC D. Ablation of Liver Tumors E. Complications of Hepatic Resection F. Challenges in Management of HCC G. Risks and Complications of Liver Resection in Cirrhosis H. 肝癌肝切除今昔不同 第 35 單元授課主題 :Diverticular diseases and chronic ulcerative colitis 教師 : 陳進勛授課時間 :50 分鐘學習目標 : 三種疾病之形成原因, 臨床表癥 診斷 藥物治療及外科治療之角色大綱 : A. Diverticular disease 1. Etiology 2. Symptom and sign 3. Diagnostic tool 4. Different diagnosis 5. Medical treatment 6. Surgical options 7. Operative options B. Inflammatory Bowel disease 1. CUC (chronic ulcerative colitis) (1). Etiology (2). Symptom and sign (3). How to make diagnosis (4). Extra colic manifestation (5). Surgical indication (6). Surgical evolution in CUC 2. Crohn s disease (1). Disease pattern (2). Microscopic picture (3). Gross pathology (4). Anatomic location (5). Risk of cancer (6). Differences between Crohn s and CUC (7). Treatment 第 36 單元授課主題 :Cervical spine degenerative 教師 : 何治軍授課時間 :50 分鐘

27 PowerPoint:90 張學習目標 : 學習正常頸椎的解剖及生理 頸椎退化性病變的原因和致病機轉, 產生的神經功能變化 診斷 治療和預後 大綱 : A. Normal antomy and physiology of cervical spine and cord. B. Etiology and epidemiology of degenerative cervical spine. C. Pathophysiology of degeneration. D. Diagnosis. E. Treatment. F. Prognosis. G. Prevention and education. 第 37 單元授課主題 : 外科醫師的法律責任教師 : 林萍章授課時間 :50 分鐘 PowerPoint:45 張學習目標 : 本節主要討論台灣外科醫師所面對的醫療過失的刑事 民事 與行政責任大綱 : A. 案例 B. 基礎法規 C. 外科醫師的注意義務 D. 臺灣地區醫療過失的法律責任 E. 臺灣地區醫療過失案例的實證分析 F. 案例分析 第 38 單元授課主題 :Spinal Deformity 教師 : 陳文哲授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 了解脊椎側彎的原因, 學習脊椎側彎的診斷, 背架治療, 手術治療及其預後 大綱 : A. Normal coronal and sagittal curvature and balance B. Etiology of scoliosis C. Diagnosis of scoliosis: physical and radiographic examination D. Treatment 1. Observation 2. Bracing 3. Surgical treatment E. Goals of surgical treatment F. Complications of surgical treatment G. Prognosis of bracing and surgical treatment

28 第 39 單元授課主題 :Heritable colorectal cancer 教師 : 張簡俊榮授課時間 :50 分鐘 PowerPoint:44 張學習目標 : 由遺傳性大腸直腸癌的認識, 知道對它的預防 治療以及親屬的篩檢 大綱 : A. 大腸直腸癌的發生率 機轉及重要性 B. 各種不同遺傳性大腸直腸癌的介紹 : 1. FAP 2. HNPCC 3. Familial colorectal cancer 4. Rare colon cancer syndromes:pj-syndrome, juvenial polyposis, Turcot s syndrome. C. 大腸直腸癌的預防 第 40 單元授課主題 :Endoscopic surgery 教師 : 葉大森授課時間 :50 分鐘 PowerPoint: 學習目標 : 使學生了解內視鏡 / 腹腔鏡手術之歷史沿革 優劣點 潛在之併發症及風險及未來發展方向 大綱 : A. 過去 現在 未來內視鏡 / 腹腔鏡手術之概況 B. 內視鏡 / 腹腔鏡手術之空間 設備 軟硬體 C. 上述手術適應症之擴展 D. 實例演出 第 41 單元授課主題 :Pediatric Neurosurgery 教師 : 雷大雅授課時間 :50 分鐘 PowerPoint:61 張學習目標 : 學習各種小兒神經外科病的發生原因 病理變化 診斷方法 X 光片之判讀大綱 : A. Myelomenigocele B. Meningocele C. Encephalocele D. Chiari I, II E. Tethered Cord syndrome F. Hydrocephalus

29 G. Moyamoya Disease 第 42 單元授課主題 :Neurosurgical Oncology 教師 : 張承能授課時間 :50 分鐘投影片 :45 張學習目標 : 腦瘤的分類 成因 臨床症狀 以及各種腦瘤的臨床特色, 以及各種治療方法 大綱 : 總論 A. Etiology B. Classification: 1. Pathological 2. anatomical C. Incidence D. Clinical symptoms 1. Focal sign 2. Generalized IICP sign, headache, blurred vision, nausea/vomiting 3. Hormone: eg. Pituitary 4. Non-specific 5. Pathophysiology of IICP E. Diagnosis 1. History taking 2. Images:Skull, C-T, MRI, Angio 3. Functional Image:PET, SPECT, MRS, fmri 4. Hormone study F. Treatment 1. Medical:Steroid, hypertonic solu, anti-epileptic drug, hormone 2. Surgical 3. Radiosurgery 4. Radiotherapy 5. Chemotherapy 6. Gene therapy? 7. Immunotherapy! 8. Stem cell therapy? & future! 分論 : 各種腦瘤的 Clinical s/s, image and treatment A. Glioma B. Meningioma C. Pituitary tumor D. Acoustic neuriuoma E. Others 第 43 單元

30 授課主題 :Thoracolumbar degenerative disease 教師 : 陳志豐授課時間 :50 分鐘 PowerPoint:48 張學習目標 : 學習胸腰椎退化性疾病的發生原因 病理變化 診斷方法 治療目的及預後 大綱 : A. 背部解剖構造 : B. 椎體基本解剖構造 : C. 退化原因 D. 椎體構造上的變化 E. 流行病學 F. 臨床上的表現 G. 診斷的方法 H. 病例分析 I. 手術目的 J. 術後照顧方法 K. 預後 第 44 單元授課主題 :Sports injury 教師 : 許文蔚授課時間 :50 分鐘 PowerPoint:100 張學習目標 : 讓學生瞭解運動外傷之發生或然率原因分類 臨床診斷 治療及健康原則大綱 : A. Incidence and cause, mechanism B. Classification, diagnosis C. Management and prevention 第 45 單元授課主題 :Neurosurgical emergency and infectious diseases neurosurgery 教師 : 楊仁宗授課時間 :50 分鐘 PowerPoint:49 張學習目標 : 學習腦部急症的診斷及處置大綱 : A. Normal brain B. Increased intracranial pressure (reversible) 1. signs and symptoms 2. brain CT 3. ICU monitor C. Brain herniation and brain death (irreversible) D. Head injury: recent past, present, and future

31 E. Guideline of hemorrhagic stroke F. Status epilepticus 第 46 單元授課主題 : The Breast 教師 : 陳訓徹授課時間 :50 分鐘 PowerPoint : 50 張學習目標 : 乳房疾病大綱, 乳癌診治原則, 國內現況分析大綱 : A. 乳癌發生機轉 B. 高危險群篩檢等略 C. 國內外乳癌異同 D. 乳癌治療大綱,NCCN 及本院治療準則 E. 乳癌外科治療 ( 保留手術 前哨淋巴 腫瘤整形手術 ) F. 乳癌輔助療法 ( 化學治療 荷爾蒙及標靶治療 ) G. 乳癌的預防策略 H. 乳癌特殊狀況 : 原位癌處理 局部嚴重型乳癌 第 47 單元授課主題 :Neurosurgical vascular disorder 教師 : 林子淦授課時間 : 50 分鐘 PowerPoint : 50 張學習目標 : 了解常見及重要的神經系統血管病變, 及其臨床表現和外科治療 大綱 : A. Concise cerebrovascular anatomy & physiology B. Spontaneous subsrachnoid hemorrhage: 1. Clinical presentation, classification, and diagnosis 2. Common complications and their treatments C. Intracranial arteriovenous malformation: Clinical presentation and treatment D. Dural aeteriovenous fistula: Clinical presentation, classification, and treatment E. Carotid endarterectomy for stenosis: Diagnosis and treatment F. Supratentorial large infarction: Clinical presentation and surgical indication G. Spontaneous intracerebral hematoma: Common location, hematoma measurement, and treatment strategy 第 48 單元授課主題 :Surgery for the common diseases of the stomach and duodenum 教師 : 王嘉修授課時間 : 50 分鐘 PowerPoint : 學習目標 : 認識胃和十二指腸有外科手術適應症的重要疾病 幽門螺旋桿菌致病的機轉 術

32 前的評估, 手術治療的策略, 介紹各種手術的病態生理基礎, 和手術方法的選擇和術後照顧 大綱 : 上半堂講授良性疾病的手術主要以消化性潰瘍為主, 下半堂課講授惡性疾病以胃癌為主 A. 消化性潰瘍手術 1. Surgical indication 2. Preoperative assessment 3. Choice of operative procedures for peptic ulcer perforation 4. Simple procedures or local treatment in peptic ulcer surgery 5. Definite procedures of peptic ulcer surgery 6. Postoperative care B. 胃癌 1. Classifications of gastric neoplasm 2. Workup studies for gastric cancer 3. Surgical treatment of gastric cancer 4. Detail of surgical treatment 5. Treatment of early gastric cancer 第 49 單元授課主題 :Surgery for Arthritis 教師 : 王俊聞授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 學習膝關節炎致病原因 機轉 臨床檢查 放射線診斷 實驗室診斷及骨科治療方法 大綱 : A. Clinical diagnosis of knee arthritis B. Radiological and laboratory diagnosis of knee arthritis C. Mechanism and biomechanics of knee arthritis D. Osteoarthritis, rheumatoid arthritis, crystal-induced arthritis, pyogenic arthritis and posttraumatic arthritis E. Surgery of knee arthritis including corrective osteotomy, joint debridement, arthrodesis and arthroplasty. 第 50 單元授課主題 :Esophagus, pleura diseases 教師 : 吳怡成授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 學習食道癌 氣胸及膿胸的診斷, 臨床意涵 治療及預後 大綱 : A. Definition of pneumothorax & empyema thoracis B. Classification and causes of pneumothorax 1. primary spontaneous pneumothorax

33 2. secondary spontaneous pneumothorax C. Surgical indication of spontaneous pneumothorax 1. recurrence 2. prolong air leak 3. association with complication 4. large bullae 5. lung collapse D. Pathophysiology of empyema thoracis 1. exudate phase 2. fibrinopurulent phase 3. chronic organized phase E. Symptoms and signs of empyema thoracis F. Surgical indication of sponta empyema thoracis G. Epidemiology of esophageal cancer H. Treatment choice of esophageal cancer I. Surgical resection of esophageal cancer & reconstruction of esophagus J. Prognosis factors in esophageal cancer 第 51 單元授課主題 :Principles in the management of fractures and dislocations 教師 : 吳基銓授課時間 :50 分鐘 PowerPoint:34 張學習目標 : 骨折與脫臼發生之原因及機轉, 診斷, 分類, 治療原則及方法 大綱 : A. Mechanism of fractures or dislocations: B. Diagnosis of fractures or dislocations: 1. symptoms and signs 2. radiograph 3. bone scan or CT C. Initial management of fractures or dislocations: D. Complications associated with fractures or dislocations: 1. neurovascular injury 2. fat embolism 3. compartment syndrome E. Classification of fractures: F. Principles of treatment of fractures or dislocations:: 1. factors favoring fracture healing 2. definite management of fractures or dislocations 3. methods for enforcing fracture healing G. Complications related to fracture treatment: 第 52 單元

34 授課主題 : Pediatric Urology 教師 : 陳孝文授課時間 : 50 分鐘 PowerPoint: 45 張學習目標 : 了解小兒泌尿異常之特徵, 與遺傳學之關係及臨床診斷之依據 大綱 : A. Urinary tract infection in children B. Congenital abnormalies of urinary tract 1. Vesicoureteral reflux 2. Duplex collecting system 3. Urethral valve syndrome 4. Ureteropelvic obstruction 5. Voiding dysfunction C. Congenital abnormalies of genital tract 1. Undescended testis or nonpalpable tests 2. Inguinal hernia and acute scrotum 3. Hypospadias 4. Intersex 第 53 單元授課主題 :Congenital deformities in orthopedic practice 教師 : 李宗料授課時間 :50 分鐘 PowerPoint:65 張學習目標 : 骨骼先天性疾病臨床評估的重點 要項及主要常見的疾病 大綱 : A. 骨骼肌肉系統在胚胎發育的回顧 B. 先天性骨骼肌肉功能的問題 : 1. 何謂先天性的骨骼肌肉疾病 2. 臨床評估的重點 : 外觀性問題 功能性問題 發育性問題 退化性問題 C. 先天性骨骼肌肉疾病上肢功能的臨床評估要點 D. 先天性骨骼肌肉疾病下肢功能的臨床評估要點 E. 先天性脊椎疾病功能的評估要點及例項 F. 上肢先天性骨骼肌肉疾病臨床分項及例項 G. 下肢先天性骨骼肌肉疾病臨床分項及例項 第 54 單元授課主題 :Bone metabolism and metabolic bone disease 教師 : 陳永仁授課時間 :50 分鐘 PowerPoint:60 張學習目標 :metabolic bone disease: Etiology, Pathomechanism, Treatment, Prognosis

35 大綱 : A. Normal physiology in bone metabolism B. Hormonal regulation of cell differentiation C. The role of vitamin D in calcium regulation D. Sex steroid / estrogen in bone density E. Osteoporosis: etiology, clinical symptom, treatment F. Ricket, and vitamin deficiency G. Renal osteodystrophy, chronic renal failure, with multiple disorders of bone metabolism H. Paget s disease: familial pattern of aggregation, increasing bone resorption, abnormal osteoclast 第 55 單元授課主題 :Recent advance in orthopedic surgery 教師 : 王清貞授課時間 :50 分鐘 PowerPoint:40 張學習目標 : 學習最新骨科知識, 包括人工關節置換, 微創運動外傷手術, 脊椎內固定新知, 基因治療和體外震波等, 以全人工關節置換的最新演變為主題 大綱 : A. Overview 最新骨科新知的發展 B. 全人工膝關節置換的演變 手術技術的細節與術後結果的關聯性 強調 alignment,stability 及 range of motion 等正確手術技巧對術後預期後果有直接關係 C. 全人工膝關節設計及材質的演變, 從 fixed bearing 到 mobile bearing,uni-tka 到 TKA,high flex TKA 等 傳統的 polyethylene 到 high cross-linked insert 等等 抗生素及血栓預防措施及使用 D. 失敗原因 : 1. 感染 - 急性與慢性, 治療方式不同, 大多的慢性感染都用 two-stage reimplantation, 早期診斷早期治療為妙 2. 鬆動 (aseptic loosening), 主因 polyethylene wear 而產生 debris 而造成 osteolysis 及 prosthesis loosening 等,Revision TKA 既複雜又困難 3. 其他原因包括 periprosthetic fracture, arthrofibrosis 等, 要個案處理 E. Minimal invasive endoscopic ligament reconstruction provides faster recovery and less postoperative complications. 第 56 單元授課主題 :Neoplasms of musculoskeletal system 教師 : 施信農授課時間 :50 分鐘學習目標及大綱 : A. 認識各類骨腫瘤及軟組織肉瘤

36 B. 性骨腫瘤之分期 C. 治療骨腫瘤的目的 D. 各類骨腫瘤的重建手術法 E. 惡性骨腫瘤之治療療程 F. 軟組織肉瘤之治療原則 第 57 單元授課主題 :Cosmetic surgery 教師 : 張承仁授課時間 :50 分鐘 PowerPoint:45 張學習目標 : 解剖美學 整形美容手術 大綱 : A. Anatomy B. Face 1. Hair transplants 2. Brow lift for ptosis of eyebrows or excessive forehead wrinkles 3. Blepharoplasty for excessive eyelid skin and/or periorbital fat 4. Rhinoplasty for nasal deformity (broad tip, dorsal hump, etc.) 5. Facelift for facial and neck sagging 6. Otoplasty for prominent ears 7. Lasers for facial wrinkles C. Breast 1. augmentation 2. Mastopexy to reposition ptotic breasts D. Trunk and Extremities 1. Liposuction 2. Abdominoplasty E. Discussion 第 58 單元授課主題 :Response to Injury 教師 : 徐榆堡授課時間 : 50 分鐘 PowerPoint:45 張學習目標 : 學習外傷初始評估及處置, 胸腹部挫傷及穿刺傷處置原則, 腹部挫傷非手術治療原則, 肢端外傷處置原則 大綱 : A. ATLS guideline 1. Primary survey 2. Secondary survey B. Chest Injury 1. Blunt trauma

37 2. Penetrating trauma C. Abdominal Injury 1. Blunt trauma 2. Non-operative management and pitfalls 3. Penetrating trauma D. Musculo-skeletal Injury 1. General principle of management 2. Compartment syndrome 第 59 單元授課主題 :Maxilofacial surgery, comgenital or acquired 教師 : 陳國鼎授課時間 :50 分鐘學習目標 & 大綱 : A. What are Craniomaxillofacial surgery dealing with? 1. Congenital craniofacial anomalies Cleft lip/palate, hemifacial microsomia, craniosynostosis, craniofacial dysostosis, rare facial clefts, benign tumors(hemangioma, lymphangioma, neurofibroma ). 2. Acquired craniofacial anomalies Facial trauma, dentofacial anomalies, Contour problems B. What is the etiology of congenital craniofacial anomalies? Genetic factors, environmental factors C. The related problems of craniofacial anomalies 1. Cleft lip/palate 2. Craniosynostosis D. Team approach to craniofacial anomalies E. Timing of treatment 1. Principles of soft tissue management 2. Principles of bony surgery F. Timing of bony surgery in different parts of the craniofacial skeleton 第 60 單元授課主題 :Introduction of Plastic Surgery 教師 : 莊垂慶授課時間 :50 分鐘 PowerPoint:50 張學習目標 : A. the brief history of Plastic Surgery; B. wound approach and management from the plastic surgeon's point of view; C. categories of plastic surgery 大綱 : A. history of Plastic Surgery, what plastic surgeons are; meanings of plastic

38 surgery B. skin surgery, techniques of wound incision and closure, knowing different skin lines, rest-tension skin line, scars concern, Z-plasty, V-Y plasty, W-plasty C. skin graft for wound coverage D. concept of skin flap: including axial flapvs VS. randamized flap, local flap VS. distant flap, pedicled flap vs. free flap; advanced flap, rotation flap, transposition flap, transpolated flap, jumping flap et cetera concept of muscle flap, musculocutaneous flap, osseous flap, osseocutaneous flap, osseomyocutaneous flap, functioning free muscle transplantation, and other composite flap E. replantation, transplantation, vascular surgery, lymphatic surgery, nerve transfer, nerve graft et cetera F. categories: craniofacial, micro-, burn, general plastic surgery, traumatic plastic surgery, cosmetic surgery 第 61 單元授課主題 :Principles of Microsurgery 教師 : 鄭明輝授課時間 :50 分鐘 PowerPoint:30 張學習目標 :Knowing the history, definition, and operative principles of microsurgery and its application. 大綱 : A. Introduction Microsurgery uses the operating room microscope or high-powered loupe magnification to aid in the techniques of microvascular surgery to anastomose small vessels and nerves. B. History of the procedures 1. The term of microvascular surgery: described by vascular surgeon, Jules Jacobson, of the University of Vermont in Rabbit ear replantation: Buncke in Great toe to hand transfer: Buncke in 1966 C. Indication: Reconstruction ladder: depending on the type of tissue required and the size and location of the defect. D. Free tissue transfer 1. First done in the early 1970s and has become a popular "one-stage" (single operation) procedure for many surgical reconstructive applications. 2. Common flaps: Myocutaneous flap Axial flap Perforator flap E. Replantation: Restoring blood flow through arteries and veins

39 F. Transplantation: Allowing reconstruction of small arteries in clinical organ transplantation G. Preoperative details 1. History: past medical history, past surgical history, previous history with anesthesia, and current medications. 2. Social history: substance or tobacco use 3. Physical examination: assessment of general condition and to identifying the current defect. H. Intraoperative details 1. Outline the plan 2. Prepare the proper equipment 3. Position the patient properly 4. Microsurgical anastomosis I. Postoperative details 1. Pain control 2. Adequate fluid hydration and body temperature maintain 3. Flap monitoring J. Complications: 1. Circulation compromised due to vein or artery thrombosis 2. Hematoma with pedicle compromise and need for transfusion 3. Infection 4. Wound dehiscence 5. Donor side wound complication 6. Systemic complications or associated with anesthesia 7. Deep vein thrombosis and pulmonary emboli K. Conclusion: Reconstructive microsurgery is now in a new stage Basic principles of microsurgery 1. Select patients carefully. 2. Develop a careful preoperative plan. 3. Obtain full patient consent. 4. Pay attention to intraoperative details. 5. Perform meticulous microsurgical technique. 第 62 單元授課主題 :Hand surgery 教師 : 林有德授課時間 :50 分鐘 PowerPoint:61 張學習目標 : 了解手外科之基本概念大綱 : A. Congenital Hand Radial deficiency

40 Syndactyly Polydactyly B. Traumatic Hand 1. Fractures 2. Dislocation and ligament injury 3. Tendon rupture C. Open injuries 第 63 單元授課主題 :Burns 教師 : 楊瑞永授課時間 :25 分鐘 Power Point:46 張學習目標 : 學習燒燙傷深度及面積的判斷, 水份流失的機轉, 輸液治療的方法, 特殊傷害, 如吸入性灼傷 電傷 化學性灼傷 幼兒及老人燙傷的處置 大綱 : A. Burn Depth B. Total Burn Surface Area (TBSA) C. Inhalation injury 1. CO intoxication 2. Bronchoscope findings in parenchyma injury D. Fluid Resuscitation 1. Mechanism 2. Fluid therapy E. Burn wound treatment 1. Topic agents 2. Wound closure F. Electrical injury 1. Mechanism 2. Complications 3. Managements G. Chemical burn 1. Initial treatment 2. Antidote H. Burn Complication Burn wound sepsis 第 64 單元授課主題 :Wound Healing 教師 : 楊瑞永授課時間 :25 分鐘 Power Point:43 張學習目標 : 瞭解傷口癒合機轉, 病態癒合的原因, 疤痕形成的原因及處置, 慢性傷口的處理,

41 傷口癒合的將來 大綱 : A. Definition of wound healing B. The role of various cells in wound healing 1. Platelet 2. WBC 3. Lymphocyte 4. Macrophage 5. Mast cell 6. Fibroblast C. Collagen and other matrix D. Hypertrophic scar and keloid E. Chronic wound F. Wound dressing G. Fetal wound healing H. Aftercare after wound healing 第 65 單元授課主題 :Renal Transplantation 教師 : 朱聖賢授課時間 :50 分鐘 PowerPoint:34 張學習目標 : 學習腎移植與血液透析治療末期腎衰竭的優 缺點 腎臟捐贈與腎移植的適應條件, 及臨床的問題 大綱 : A. Brief history of organ transplantation B. Advantage and disadvantage of renal transplantation and hemodialysis. C. Indication and contraindication to cadaveric donation D. Indication and contraindication to cadaveric and living relative renal transplantation. E. The surgical procedures of cadaveric donor and renal transplantation F. The complication of renal transplantation 第 66 單元授課主題 :New trends and technologies in reconstructive surgery 教師 : 魏福全授課時間 :50 分鐘學習目標 : 了解目前在國際整形外科界的新技術 新趨式大綱 : 認識自體移植與異體移植世界上自體與異體組織移植之現況自體與異體組織移植之發展異體組織移植之問題及瓶頸

42 異體組織移植之未來 第 67 單元授課主題 :Geriatric Urology 教師 : 崔克宏授課時間 :50 分鐘 PowerPoint:30 張學習目標 : 高齡泌尿疾病, 良性攝護腺肥大症之發生率, 診斷及治療 大綱 : A. Definition of geriatric urology B. Aims of Geriatric incontinence 1. How to definition 2. How to diagnosis 3. Treatment guideline C. Aims of Benign Prostate Hyperplasia 1. How to definition 2. How to diagnosis 3. Flow chart of diagnosis 4. Treatment guideline 5. Future study for BPH research D. Developing flow chart of geriatric disease E. Developing clinical guideline for geriatric urology F. Research for BPH and incontinence G. Personalized Medicine 第 68 單元授課主題 :Craniofacial surgery, philosophy and art 教師 : 陳昱瑞授課時間 :50 分鐘 PowerPoint:80 張學習目標 :the principles, applications, effectiveness and psychosocial influence of craniofacial surgery and craniofacial anomalies 大綱 : A. Definition and principles of craniofacial surgery and craniofacial anomalies B. Applications or scope of craniofacial surgery 1. Congenital anomalies 2. Traumatic deformities 3. Benign tumors: craniofacial fibrous dysplasia, neurofibromatosis 4. Developmental maxillofacial anomalies C. Facial evaluation and facial aesthetics 1. Facial midline 2. Facial symmetry 3. Facial proportion

43 4. Facial function D. Congenital craniofacial anomalies 1. Craniofacial synostosis, non-syndromatic 2. Syndromes : Crouzon, Apert 3. Rare Facial Clefts (other than common cleft lip/palate and hemifacial microsomia) E. Developmental maxillofacial (dentofacial) anomalies 1. Mandible prognathism (Class III malocclusion) 2. Mandible retrognathism (Class II malocclusion) 3. Maxillary protrusion (exess), Bimaxillary protrusion 4. Maxillary retrusion (deficiency) 5. Facial asymmetry F. Psychosocial effect of craniofacial anomalies 第 69 單元授課主題 :Disorders of prostate and Andrology 教師 : 謝明里授課時間 :50 分鐘 PowerPoint:50 張學習目標 : 了解前列腺常見的疾病, 包括 BPH, prostatic Ca 及前列炎的診斷及治療, 另外能對男性生殖系統疾病有進一步了解 大綱 : A. What is Andrology B. Benign prostatic disorders: 1. Anatomy and function of prostate gland 2. The etiology and management of prostatitis 3. BPH : prevalence, diagnosis and treatment options C. Maligant prostatic diseases: 1. Prostatic cancer diagnosis and staging 2. Prostatic Ca treatment guidline 3. prognostic factors and evaluation D. Male infertility: 1. Definition 2. Etiology and Classification 3. Clinical evaluation and Treatment modality 第 70 單元授課主題 :Urological Oncology 教師 : 莊正鏗授課時間 :50 分鐘 PowerPoint:60 張學習目標 : 認識腫瘤之生成 致病因子 預後因素以及泌尿腫瘤 ( 包括攝護腺癌 膀胱癌 腎細胞癌 上泌尿道泌尿上皮細胞癌 ) 之診斷 分期 治療

44 大綱 : A. The development of the cancer B. Classification, staging of renal cell carcinoma C. Current treatment of renal tumor radical nephrectomy, nephron-sparing surgery, cryoablation and targeted therapy D. Diagnosis of prostate cancer E. Treatment of prostate cancer.. radical prostatectomy, high dose rate brachytherapy, IMRT, hormone therapy and management of castration-resistant prostate cancer F. Urothelial carcinoma: diagnosis and management of bladder tumor G. Urine-based molecular markers 第 71 單元授課主題 :Urolithiasis 教師 : 陳文祥時間 :50 分 PowerPoint:25 張學習目標 : 了解尿路結石成因及治療大綱 : A. Pathophysiology of urolithiasis B. Stone analysis C. Evaluation of stone former D. Clinical symptoms of urolithiasis E. Management of Urolithiasis F. Stone prevention 第 72 單元授課主題 :Female urology and sexual dysfunction 教師 : 陳志碩時間 :50 分 PowerPoint: 學習目標 : 學習膀胱過動症 婦女尿失禁與骨盆脫垂的機轉 臨床症狀與治療 學習男性性功能障礙與早洩的機轉 診斷 與治療方法 大綱 : A. Pelvic floor anatomy B. Classification of incontinence and pelvic organ prolapse C. Clinical presentation and differentiation of urine incontinence D. Conservative and surgical treatment of urine incontinence E. Mechanism of penile erection and premature ejaculation F. Diagnosis of erectile dysfunction G. Medical and surgical treatment for erectile dysfunction

45 課程名稱 : 皮膚科學 (Dermatology) 學年 :97 學期 :2 年級 :6 課程大綱教科書 :1. Color Atlas & Synopsis of Clinical Dermatology (2005): Common & Serious Diseases, Fitzpatrick, McGraw-Hill. 2. Rouburgh's Common Skin Diseases (1996), r. Marks, Champion & Hall Medical. 參考書 : 1. Clinical Dermatology (2002), Hunter/Savin/Dabl, Blackwell Science. 2. Dermatology in Practice, 1990, Anthony du vivier, Mosby-Wolf. 整體教學目標 : 1. 認識基礎皮膚解剖學 皮膚生理學 皮膚病理學 2. 熟悉常見皮膚疾病 3. 了解不同內科疾病在皮膚上的表現 4. 認識各種皮膚疾病的治療方法教學方法 : 1. 以系統性的幻燈片及講義教學建立學生對皮膚科學的概念 2. 輔佐以實際教案讓學生加深印象及學習臨床鑑別診斷的能力 3. 病理切片配合臨床表現, 讓學習更加具體化 4. 經由門診教學, 培養學生思考 推理並做鑑別診斷能力 5. 床邊教學的參與, 搭配學生以書寫病例報告的方式, 來深入瞭解病程變化及治療過程, 及醫病互動關係之培養中文課程簡介 : 課程內容除涵蓋有一般皮膚生理學 成人皮膚疾病 兒童皮膚病外, 也包括了皮膚外科 皮膚美容 職業性皮膚病 指甲毛髮疾病 白斑及色素異常 女性外陰皮膚疾病等特殊領域 醫學生以分組方式參與與一般門診 臨床治療來學習常見皮膚疾病, 至於每日住院病人的床邊教學, 則著重在慢性皮膚病及嚴重疾病, 如乾癬 水皰病 藥物疹等, 而學生在見習期間也將由指導老師指定參與一至兩位病患照顧與病例寫作, 實地體驗皮膚科全貌 另外, 課堂教學的部份, 則是以系統性的幻燈片及講義教學建立學生對皮膚科學的整體概念 至於每週舉辦皮膚臨床病理研討會, 則是將課堂教學與臨床病例做一完整的介紹英文課程簡介 : The course of dermatology, including dermatological surgery, cosmetic dermatology, occupational dermatology, nail and hair disorder, vitiligo/pigmentation disorder, and vulvar skin diseases in addition to general skin physiology, and adult and pediatric dermatology. Each medical student is given the learning opportunity in the outpatient clinic and the treatment room for a better understanding of common dermatologic diseases. During bed side teaching in in-patient ward rounds, student acquires knowledge of chronic and critical dermatological illnesses, such as psoriasis, bullous diseases, and drug eruptions. Under the supervision of senior residents, medical clerks are responsible for the care and chart writing of 1 to 2 patients and thus gain a more