ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﻃﺐ ﺍﻟﻤﻌﺎﻣﻞ ﺗﻘﺪﻳﻢ ﺍﻟﺪﻛﺘﻮﺭ ﻣﺤﻤﺪﻛﺎﻣﻞﺣﺴﻦ ﻣﺪﺭﺱ

ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﻃﺐ ﺍﻟﻤﻌﺎﻣﻞ ﺗﻘﺪﻳﻢ ﺍﻟﺪﻛﺘﻮﺭ/ﻣﺤﻤﺪﻛﺎﻣﻞﺣﺴﻦ ﻣﺪﺭﺱ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﻟﺤﻴﻮﻳﺔ ﻭ ﺍﻟﺒﻴﻮﻟﻮﺟﻴﺎ ﺍﻟﺠﺰﻳﺌﻯﺔ ﻛﻠﻴﺔ ﺍﻟﻌﻠﻮﻡ- ﺟﺎﻣﻌﺔ ﺑﻮﺭﺳﻌﻴﺪ

ﻃﺐ ﺍﻟﻤﺨﺘﺒﺮﺍﺕ/ﺍﻟﻤﻌﺎﻣﻞ ﺍﻟﻄﺒﻴﺔ ﻫﻮ ﺩﺭﺍﺳﺔ ﻛﻴﻔﻴﺔ ﺍﺟﺮﺍﺀ ﺍﻟﺘﺤﺎﻟﻴﻞ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟﻤﻨﺎﺳﺒﺔ ﻟﻠﻤﺴﺎﻫﻤﺔ ﻓﻲ ﺍﻟﻌﻼﺝ Ø ﻭﺍﻟﻤﺴﺎﻫﻤﺔ ﻓﻲ ﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻻﻣﺮﺽ ﺃﻴﻀ Ø ﻭﺍﻟﺘﺄﻜﺪ ﻣﻦ ﻧﺘﺎﺋﺞ ﺍﻟﺘﺤﺎﻟﻴﻞ ﻭﺭﺑﻄﻬﺎ ﺑﺎﻟﺤﺎﻟﺔ Ø ﺍﻟﻤﺮﺿﻴﺔ v ﺇﺩﺍﺭﺓ ﺍﻟﻤﺨﺘﺒﺮ v ﻭﻭﺿﻊ ﺍﻟﻬﻴﻜﻞ ﺍﻟﺘﻨﻈﻴﻤﻲ ﻟﻪ v ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﺿﻤﺎﻥ ﺍﻟﺠﻮﺩﺓ ﺍﻟﻨﻮﻋﻴﺔ ﻟﻠﻤﺨﺘﺒﺮ v ﻭﺃﻴﻀ ﺗﺤﺴﻴﻦ ﻭﺗﻄﻮﻳﺮ ﺍﻻﺧﺘﺒﺎﺭﺍﺕ ﻭﺍﻟﺘﺤﺎﻟﻴﻞ ﺍﻟﺘﻲ ﻳﻘﻮﻡ ﺑﻬﺎ ﺍﻟﻤﺨﺘﺒﺮ

ﺃﺨﺼﺎﺋﻲ ﺍﻟﻤﺨﺘﺒﺮ ﻫﻮ ﺍﻟﺸﺨﺺ ﺍﻟﺬﻱ ﻳﻘﻮﻡ ﺑﺄﺪﺍﺀ ﺍﻟﻔﺤﻮﺻﺎﺕ ﺍﻟﻤﺨﺒﺮﻳﺔ ﺍﻟﻼﺯﻣﺔ ﺩﺍﺧﻞ ﺍﻟﻤﺨﺘﺒﺮ ﺍﻟﻤﻌﺎﻫﺪ ﺍﻟﻤﺘﺨﺼﺼﺔ ﺩﺑﻠﻮﻣﺎﺕ ﻣﺘﺨﺼﺼﺔ ﻛﻠﻴﺔ ﺍﻟﻌﻠﻮﻡ ﺍﻟﺘﻘﻠﻴﺪﻳﺔ ﺑﻜﻠﻴﺔ ﺍﻟﻌﻠﻮﻡ ﺍﻟﻄﺒﻴﺔ ﺍﻟﺘﻄﺒﻴﻘﻴﺔ )ﻗﺴﻢ ﻃﺐ ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ( ﺗﻌﺪ ﺧﺮﻳﺠﻴﻬﺎ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺩﺭﺟﺔ ﺍﻟﺒﻜﺎﻟﻮﺭﻳﻮﺱ ﻓﻲ ﻃﺐ ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ﻳﻌﻄﻰ ﺍﻟﻤﺘﺨﺮﺝ ﻣﺴﻤﻰ )ﺃﺨﺼﺎﺋﻲ ﻣﺨﺘﺒﺮ(

ﺩﻭﺭﺃﺨﺼﺎﺋﻲ ﺍﻟﻤﺨﺘﺒﺮ: ﻣﺴﺎﻋﺪﺓ ﺍﻟﻄﺒﻴﺐ ﻓﻲ ﺍﺧﺘﻴﺎﺭ ﺃﻮ ﺗﺤﺪﻳﺪ ﺍﻟﺘﺸﺨﻴﺺ ﺍﻟﻤﻨﺎﺳﺐ ﻟﻤﺮﺽ ﻣﻌﻴﻦ ﻣﻦ ﻗﺎﺋﻤﺔ ﺍﻟﺘﺸﺨﻴﺼﺎﺕ ﺍﻟﻤﻄﻠﻮﺑﺔ ﺃﻮ ﻹﺛﺒﺎﺕ ﺗﺸﺨﻴﺺ ﺳﺮﻳﺮﻱ

ﻃﺒﻴﻌﺔ ﻋﻤﻞ ﺍﺧﺼﺎﺋﻲ ﺍﻟﻤﺨﺘﺒﺮ ﺍﻭ ﻓﻨﻰ ﺍﻟﻤﻌﻤﻞ ü ﺍﺟﺮﺍﺀ ﺍﻟﺘﺤﺎﻟﻴﻞ ﺍﻟﻼﺯﻣﺔ ﻟﻠﻜﺸﻒ ﻋﻦ ﺍﻷﻤﺮﺍﺽ ﻭ ﻣﺴﺒﺒﺎﺗﻬﺎ ﻋﻦ ﻃﺮﻳﻖ ﻓﺤﺺ ﻋﻴﻨﺎﺕ ﻣﻦ ﺟﺴﻢ ﺍﻟﻤﺮﻳﺾ ﻣﺜﻞ ﻋﻴﻨﺎﺕ ﺍﻟﺪﻡ , ﺍﻟﺒﻮﻝ ﻭ ﺍﻟﺒﺮﺍﺯ , ﺍﻷﻨﺴﺠﺔ ﺍﻟﺤﻴﻮﻳﺔ ﻭ ﺳﻮﺍﺋﻞ ﻭ ﺇﻓﺮﺍﺯﺍﺕ ﺍﻟﺠﺴﻢ.

ﺍﻻﻥ ﻃﺒﻴﻌﺔ ﻋﻤﻞ ﺍﺧﺼﺎﺋﻲ ﺍﻟﻤﺨﺘﺒﺮ ﺍﻭ ﻓﻨﻰ ﺍﻟﻤﻌﻤﻞ ﻟﺘﻄﻮﺭ ﺍﻟﻤﺴﺘﻤﺮ ﺑﺎﻟﻄﺐ + ﺍﻛﺘﺸﺎﻑ ﺍﻟﻜﺜﻴﺮ ﻣﻦ ﺍﻷﻤﺮﺍﺽ = ﺍﻟﺤﺎﺟﺔ ﺇﻟﻰ ﻭﺳﺎﺋﻞ ﺣﺪﻳﺜﺔ ü ﻳﺴﺘﺨﺪﻡ ﺍﻷﺨﺼﺎﺋﻲ ﺍﻟﻤﺠﺎﻫﺮ ﻭﺍﻷﺠﻬﺰﺓ ﺍﻟﻤﺨﺒﺮﻳﺔ , ﺍﻟﻤﻮﺍﺩ ﺍﻟﻜﻴﻤﻴﺎﺋﻴﺔ ﻭ ﺃﺠﻬﺰﺓ ﺍﻟﻜﻤﺒﻴﻮﺗﺮ ﻷﺪﺍﺀ ﺇﺟﺮﺍﺀﺍﺕ ﺍﻟﻤﺨﺘﺒﺮ ü ﺍﻋﺪﺍﺩ ﺍﻟﺘﻘﺎﺭﻳﺮ ﻟﻸﻄﺒﺎ ﺍﻟﺴﺮﻳﺮﻳﻴ ﻭ ﺍﻟﺘﻲ ﺗﺴﺎﻋﺪﻫﻢ ﻋﻠﻰ ﺗﺸﺨﻴﺺ. ü ﻣﺘﺎﺑﻌﺔ ﻭﺗﻘﻴﻴﻢ ﺩﺭﺟﺔ ﺍﻟﺘﻐﻴﺮ ﻓﻲ ﻫﺬﺍ ﺍﻟﻤﺮﺽ ﻭ ﻣﻦ ﺛﻢ ﺇﻋﻄﺎﺀ ﺍﻟﻌﻼﺝ ﺍﻟﻤﻨﺎﺳﺐ ﻟﻠﻤﺮﻳﺾ ﺍﻟﺬﻱ ﻳﺴﻬﻢ ﻓﻲ ﺗﺤﺴﻨﻪ.

ﺍﻟﻤﺨﺘﺒﺮﺍﺕ ﺍﻟﻌﻤﻠﻴﺔ: 1 ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﺍﻟﻜﻴﻤﻴﺎﺀ ﺍﻟﺤﻴﻮﻳﺔ. 2 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﻭﻇﺎﺋﻒ ﺍﻷﻌﻀﺎﺀ. 3 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﺍﻟﻜﺎﺋﻨﺎﺕ ﺍﻟﺪﻗﻴﻘﺔ/ ﺍﻟﻤﻴﻜﺮﻭﺑﻴﻮﻟﻮﺟﻰ. 4 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﺍﻟﺪﻡ ﻭﺍﻟﻤﻨﺎﻋﺔ. 5 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﺍﻷﺪﻭﻳﺔ ﻭﺍﻟﺴﻤﻮﻡ. 6 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﻋﻠﻢ ﺍﻟﻄﻔﻴﻠﻴﺎﺕ. 7 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﻋﻠﻢ ﺍﻷﻤﺮﺍﺽ ﻭﺍﻷﻨﺴﺠﺔ. 8 - ﻣﺨﺘﺒﺮ ﻗﺴﻢ ﺍﻟﻮﺭﺍﺛﺔ ﺍﻟﻄﺒﻴﺔ. 9 - ﻣﺨﺘﺒﺮﺍﺕ ﻗﺴﻢ ﺍﻟﺘﺸﺮﻳﺢ )ﺍﻟﻤﺸﺮﺣﺔ(.

ﺗﻨﻮﻉ ﺍﻗﺴﺎﻡ ﺍﻟﻤﻌﺎﻣﻞ ﺍﻟﻄﺒﻴﺔ ﻋﻠﻢ ﺍﻟﺪﻡ ﻭﺃﻤﺮﺍﺽ ﺍﻟﺪﻡ. ﺍﻟﻜﻴﻤﻴﺎﺀ ﺍﻟﺴﺮﻳﺮﻳﺔ )ﻛﻴﻤﻴﺎﺀ ﺍﻷﻤﺮﺍﺽ(. ﺑﻨﻚ ﺍﻟﺪﻡ ﻭﻧﻘﻞ ﺍﻟﺪﻡ. ﺗﺨﺜﺮ ﺍﻟﺪﻡ ﻭﻣﺸﺘﻘﺎﺕ ﺍﻟﺪﻡ. ﺍﻷﺤﻴﺎﺀ ﺍﻟﺪﻗﻴﻘﺔ ﺍﻟﻄﺒﻴﺔ ﻭﺗﺸﻤﻞ ﻋﻠﻮﻡ ﻭﺃﻤﺮﺍﺽ ﺍﻟﺒﻜﺘﻴﺮﻳﺎ ﻭﺍﻟﻔﻄﺮﻳﺎﺕ ﻭﺍﻟﻄﻔﻴﻠﻴﺎﺕ ﻭﺍﻟﻔﻴﺮﻭﺳﺎﺕ. ﺍﻟﻤﻨﺎﻋﺔ. ﻋﻠﻢ ﺍﻷﻤﺮﺍﺽ ﻭﺍﻷﻨﺴﺠﺔ ﻭﺍﻟﺨﻼﻳﺎ ﺍﻟﻤﺘﺴﺎﻗﻄﺔ. - ﺍﻟﻮﺭﺍﺛﺔ ﺍﻻﻛﻠﻴﻨﻴﻜﻴﺔ.

ﻃﻠﺐ ﺍﻟﻄﺒﻴﺐ ﺗﺠﻤﻴﻊ ﺍﻟﻌﻴﻨﺔ ﺍﻟﺘﻘﺎﺭﻳﺮ ﺍﻻﺧﺘﺒﺎﺭﺍﺕ ﺍﻟﻤﻌﻤﻠﻴﺔ ﺗﺠﻬﻴﺰ ﺍﻟﻌﻴﻨﺔ

ﺍﻟﺘﺸﺨﻴﺺ ﺍﻟﺠﺰﻯ ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ ﺍﻻﺧﺘﺒﺎﺭﺍﺕ ﺍﻟﻤﻌﻤﻠﻴﺔ ﺍﺍﻟﻄﻔﻴﻠﻠﻴﺎﺗﺎ ﺍﻟﺪﻡ ﻛﻴﻤﻴﺎﺀ ﻛﻴﻨﺘﻚ ﺍﻟﻘﻮﺍﻧﻴﻦ ﻭ ﺍﻟﻘﻮﺍﻋﺪ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﺘﻜﻨﻮﻟﻮﺟﻴﺎ ﻓﻰ ﺍﻟﻘﻴﺎﺱ

Some things will remain the same, continued… ﺭﺑﻤﺎ ﺳﻨﻈﻞ ﻧﻠﺘﻒ ﺣﻮﻝ ﻃﺎﻭﻟﺔ ﺍﻣﻴﻜﺮﻭﺳﻜﻮﺏ ﻣﺘﻌﺪﺩ ﺍﻟﻌﺪﺳﺎﺕ The matching blue chairs finally around the multiheaded microscopes in Anatomical Pathology unlikely to change. ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺍﻟﺸﺮﻳﺤﺔ ﺧﻴﺮ ﺷﺎﻫﺪ. The Slide is a Witness ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺗﻘﻨﻴﺔ ﺍﻟﺼﺒﺎﻏﺔ ﺍﻟﻤﻨﺎﻋﻴﻯﺔ Immuno-staining • ﻓﻜﺮﺓ ﺍﻟﻌﻤﻞ • ﺗﻄﺒﻴﻘﺎﺗﻬﺎ • ﺩﻭﺭﻫﺎ

Virtual Microscopy ﺍﻟﻤﻴﻜﺮﻭﺳﻜﻮﺏ ﺍﻻﻓﺘﺮﺍﺿﻰ ﺗﻄﻮﺭ ﺍﻟﻤﻴﻜﺮﻭﺳﻮﺏ ﺍﻟﻜﻼﺳﻴﻜﻰ Traditional Microscopy ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ Virtual Microscopy

Hold On! – Wait A Minute! • Where algorithms taking us? – “Digital Imaging? ” – Diagnosis by computer? • Can this be accomplished better/faster/cheaper… – – – Without a microscope? Without a laboratory? Without a specimen? Without a technologist? Without a pathologist? Without me? 15 15

Diagnostic Workstation Diagnostic path report LIS Path Specialist Team: Produces slides and images and inputs them to the LIS. Integrated lab, imaging, and test data Real time consult via teleconference. If the other party has a similar workstation, the pathologist can share information and images directly. Informed, connected patient, reports symptoms and answers question from pathologist. Symptom information from patient and questions about symptoms from pathologist. EHR or EMR ? ? Historic Intelligent Standardized External Resources: Immediately accessible databases and tools. Patient History and other data Knowledge databases Decision report Medical literature Epidemiology Internet Consultation: Diagnosis Treatment Prognosis Chief diagnostician and clinical advisor, a physician bringing unique and distinctive skill to the patient care team. Clinician: Connected to the system and the pathologist from workstation or wireless handheld. 16

Physically there three types of DNA B-DNA; right handed helix. A- DNA; right handed helix Z-DNA; is left handed helix with a zegzag P/S backbone. ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

PCR Invented by Kary Mullis and Faloona, 1987. Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction Nobel Prize 1993 .

“I was working for Cetus, making oligonucleotides. They were heady times. Biotechnology was in flower and one spring night while the California buckeyes were also in flower I came across the polymerase chain reaction. I was driving with Jennifer Barnett to a cabin I had been building in northern California. She and I had worked and lived together for two years. She was an inspiration to me during that time as only a woman with brains, in the bloom of her womanhood, can be. That morning she had no idea what had just happened. I had an inkling. It was the first day of the rest of my life. ” - from Karry Mullis’s autobiography at the Nobel e-Museum

PCR Specifically targets and amplifies a SINGLE sequence from a complex mixture of DNA. PCR is DNA replication in a test tube ﻣﻀﺎﻋﻔﺔ ﺟﺰﺀﻣﻌﻴﻦ ﺍﻟﺤﻤﺾ ﺍﻟﻨﻮﻭﻯ ﻣﻦ ﺑﻤﺴﺎﻋﺪﺓﺍﻧﺰﻳﻢﺍﻟﺒﻠﻤﺮﺓ ﻭﺍﻟﺒﺎﺩىﺀ

Steps in PCR reaction – denaturation ﺍﻟﺘﺨﺜﺮ – annealing ﺍﻟﺘﺤﺎﻡ ﺍﻟﺒﺎﺩﻯﺀ – extension ﺍﻻﻣﺘﺪﺍﺩ – cycle through 25 -35 times

PCR Cycles

Steps in PCR Target sequence By using Specific primers To the target Sequence

Steps in PCR ﺍﻟﺨﻄﻮﺍﺕ Target sequence By using Specific primers To the target Sequence

Now repeat cycle over and over Get huge number of DNA copies enough that you can now study The gene The basic process Thermocycling - 94 degrees - 55 degrees - 70 degree

Extraction of DNA for PCR Place 5µl of patient sample and 95µl of master mix in vials and place these vials in a PCR panel, which will then be placed in thermocycler for the DNA amplification cycles.

Polymerase Chain Reaction (PCR) ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﻧﺘﻴﺠﺔ ﺍﻟﺘﻔﺎﻋﻞ Detection of PCR product High mol. W ﺍﻟﻮﺯﻥ ﺍﻟﺠﺰﻯ ﺍﻟﻌﺎﻟﻰ Low mol. W ﺍﻟﻮﺯﻥ ﺍﻟﺠﺰﻯ ﺍﻟﻤﻨﺨﻔﺾ ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ PCR • ﺍﻟﻜﺸﻒ ﻋﻦ ﺍﻟﻔﻴﺮﻭﺳﺎﺕ ﻣﻦ ﻧﻮﻉ ﺍﻝ DNA ﺟﻴﻦ ﺧﺎﺹ ﺑﺎﻟﻔﻴﺮﺱ ﺟﻴﻦ ﺍﺳﺎﺳﻰ ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ ﺍﻟﻜﺸﻒ ﻋﻦ ﺍﻟﻔﻴﺰﻭﺳﺎﺕ ﺍﻟﺘﻤﻴﻴﺰ ﺑﻴﻦ ﺍﻻﺟﻨﺎﺱ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻣﻦ ﺍﻟﻤﻴﻜﺮﻭﺑﺎﺕ ﻣﺜﻞ ﺍﻻﻳﻜﻮﻻﻯ ﺍﻟﺘﻤﻴﻴﺰ ﺑﻴﻦ ﺍﻟﺒﺼﻤﺎﺕ ﺍﻟﻮﺭﺍﺛﻯﺔ ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ ﺍﻟﻜﺸﻒ ﻋﻦ ﺍﻟﻔﻴﺮﻭﺳﺎﺕ ﻣﻦ ﻧﻮﻉ RNA Result DNA Rt-PCR RNA ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ PCR • ﺍﻟﻜﺸﻒ ﻋﻦ ﺍﻟﻔﻴﺮﻭﺳﺎﺕ ﻣﻦ ﻧﻮﻉ ﺍﻝ DNA ﺟﻴﻦ ﺧﺎﺹ ﺑﺎﻟﻔﻴﺮﺱ ﺟﻴﻦ ﺍﺳﺎﺳﻰ ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ q ﺍﻟﻜﺸﻒ ﻋﻦ ﺍﻟﻔﻴﺮﻭﺳﺎﺕ ﻋﺪ ﻧﺴﺦ RNA ﻟﻠﻔﻴﺮﻭﺱ ﺑﺎﺳﺘﺨﺪﺍﻡ ﺗﻘﻨﻴﺔ Real Time PCR ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

R Forward primer 3’ 5’ 5’ Taq. Man probe Q 3’ 5’ 5’ 5’ 3’ Reverse primer Polymerization and Strand Displacement R Forward primer 3’ Q 3’ 5’ 5’ 3’ Reverse primer R Forward primer 3’ Probe Cleavage (release of reporter dye) Fluorescence occurs when reporter dye and quencher dye are no longer in close proximity Q 5’ 5’ 5’ Reverse primer 5’ 3’ Completion of Polymerization

ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ q ﺍﻟﺘﻤﻴﻴﺰ ﺑﻴﻦ ﺍﻟﺒﺼﻤﺎﺕ ﺍﻟﻮﺭﺍﺛﻴﺔ ﻟﻼﺷﺨﺎﺹ q ﺍﻟﺘﻤﻴﻴﺰ ﺑﻴﻦ ﺍﻻﺟﻨﺎﺱ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻣﻦ ﺍﻟﻤﻴﻜﺮﻭﺑﺎﺕ ﻣﺜﻞ ﺍﻻﻳﻜﻮﻻﻯ ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

RAPD: randomly amplified polymorphic DNA Size sorted ﺍﻟﺒﺎﺛﻮﻟﻮﺟﻰ

AFLP: amplified fragment length polymorphism ﻗﻄﻊ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻮﺭﺍﺛﻴﺔ ﻟﺤﺎﻡ ﺍﻻﻃﺮﺍﻑ ﺑﻘﻊ ﻣﻌﻴﻨﺔ ﺗﺴﻬﻞ ﺗﻔﺎﻋﻞ ﺍﻟﺒﻠﻤﺮﺓ ﺗﻔﻌﻞ ﺍﻟﺒﻠﻤﺮﺓ PCR

RFLP • Restriction Fragment Length Polymorphism • ﺗﻌﻨﻰ ﻗﻄﻊ ﺍﻟﻤﺎﺩﺓ ﺍﻟﺮﺍﺛﻴﺔ ﺑﻨﻔﺲ ﺍﻟﻨﺰﻳﻤﺎﺕ ﺍﻟﻘﻄﻊ ﻭ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻃﻮﺍﻝ ﻣﺨﺘﻠﻔﺔ ﻣﻦ ﺷﺨﺺ ﻻﺧﺮ Starting DNA sequence: 5’-TAATTTCCGTTAGTTCAAGCGTTAGGACC 3’-ATTAAAGGCAATCAAGTTCGCAATAATGG Enzyme X 5’-TTC 3”-AAG 5’-TAATTT 3’-ATTAAA Enzyme X 5’-TTC 3”-AAG- 5’-CCGTTAGTT 3’-GGCAATCAA 5’-CAAGCGTTAGGACC 3’-GTTCGCAATAATGG

Gel placed here Figure 14. 6, J. M. Butler (2005) Forensic DNA Typing, 2

FMBIO III Gel Imager System Penta D Penta E FGA CSF 1 PO D 18 S 51 D 16 S 539 TPOX D 7 S 820 D 8 S 1179 D 21 S 11 D 13 S 317 TH 01 VWA D 5 S 818 D 3 S 1358 Amelogenin Power. Plex 16 BIO

ﺜﻠﺔ ﻟﻠﺠﺪﻳﺪ ﻓﻰ ﺗﻄﺒﻴﻘﺎﺕ ﻫﺬﺍ ﺍﻟﺘﻔﺎﻋﻞ • ﺍﻟﻜﺸﻒ ﻋﻦ ﺗﺘﺎﺑﻊ ﺍﻟﺠﻴﻨﺎﺕ ﻓﻰ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻮﺭﺍﺛﻴﺔ

DNA Sequence Determination ﺍﻟﻤﻨﺘﻬﻰ PCR ﺑﺎﺳﺘﺨﺪﺍﻡ ﺗﻘﻨﻴﺔ ﺍﻝ • Fragments are sized by electrophoretic migration § ﻓﺼﻞ ﻛﻬﺮﺑﻰ ﻟﻨﻮﺍﺗﺞ PCR

Automated DNA Sequencing ● ● Laser dyes Capillary gel electrophoresis ● Fluorescent detection ﺻﺒﻐﺔ ﻓﻠﻮﺭﻭﺳﻴﻨﻴﺔ ● ﺍﻻﻥ ﻭ ﺑﺎﺳﺘﺨﺪﺍﻡ ﺟﻬﺎﺯ ﻣﺪﻋﻢ ﺑﺎﻟﻠﻴﺰﺭ

(a) (b) (c)

Capillary Detection window Heat plate Syringe (with polymer) Gel block electrode Samples Outlet buffer reservoir Inlet buffer reservoir Sample tray Autosampler

Mechanical pump (with polymer) Detection window Capillary array Fan Lower gel block electrodes Polymer bottle Outlet buffer reservoir Inlet buffer reservoir Oven Sample tray Autosampler

(a) ABI 3100 (b) ABI 3130 xl Mechanical pump (for polymer delivery) Dual syringes (for polymer delivery) Polymer bottle Outlet buffer reservoir

Oven door Mechanical pump (with polymer) Outlet buffer Polymer reservoir pack (with RFID) Capillary array (behind oven door) Inlet buffer reservoir Autosampler

… New science ﻣﺎﺫﺍ ﻋﻦ ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﻫﺬﺍ ﺍﻟﻌﻠﻢ ﻣﺎ ﺍﻟﺬﻯ ﻳﺤﻤﻠﺔ ﻣﺴﺘﻘﺒﻞ ﻫﺬﺍ ﺍﻟﻌﻠﻢ

ﺟﻬﺎﺯ ﻋﺰﻝ ﺍﻟﻤﺎﺩﺓ ﺍﻟﻮﺭﺍﺛﻴﺔ ﺩﻭﻥ ﺍﻟﻠﻤﺲ

ﺍﺳﺘﺨﺪﺍﻡ ﺍﻻﺟﻬﺰﺓ ﻓﻰ ﺍﻋﺪﺍﺩ ﻭ ﺗﺠﻬﻴﺰ ﺍﻟﻌﻴﻨﺎﺕ ﺩﻭﻥ ﻟﻤﺴﻬﺎ ﻣﻘﻄﻊ ﻣﻦ ﺍﻟﻴﺔ ﻋﻤﻞ ﺟﻬﺎﺯ ﺍﻟﻜﺸﻒ ﻋﻦ. . . . .

CHEMISTRY - ﺍﻟﻜﻴﻤﻴﺎﺀ • Mostly automated-can do sorting • Needs to understand: » Cellular metabolisms » Hormonal interactions » Immune responses » Anatomy Single Cell Analyses ﺗﺤﻠﻴﻼﺕ ﺍﻟﺨﻼﻳﺎ ﺍﻟﻤﻔﺮﺩﺓ

ﺍﻟﺪﻡ

ﻣﺎ ﺳﻮﻑ ﻳﺤﺪﺙ ﻫﻮ v ﺍﻟﻄﺐ ﺳﻮﻑ ﻳﺤﺎﻭﻝ ﻋﻼﺝ ﺍﻟﻤﺮﺽ ﻓﻰ ﺍﻟﻤﺮﺍﺣﻞ ﺍﻻﻭﻟﻰ v ﻓﺴﻮﻑ ﻳﺤﺎﻭﻝ ﺍﻟﻤﻌﻤﻞ ﺗﻘﺪﻳﻢ ﺍﻻﺩﻟﺔ ﻋﻠﻰ ﺫﻟﻚ v ﺍﻟﺒﺼﻤﺔ ﺍﻟﻤﺮﺿﻴﺔ ﻟﻠﺸﺨﺺ v ﺣﺘﻰ ﺍﻻﺩﻭﻳﺔ ﺳﻮﻑ ﺗﺤﺎﻭﻝ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﺍﻟﺒﺼﻤﺎﺕ ﺍﻟﻤﺮﺿﻴﺔ

ﺍﻟﺒﺼﻤﺔ ﺍﻟﻤﺮﺿﻴﺔ = ﺗﻐﻴﺮﺍﺕ ﺟﺰﻳﺔ Normal Human System 100 trillion cells 6 billion basepairs of genetic information 30, 000 genes 10 million different proteins 60 K reactions/cell/minute 100, 000’s of molecular events 216 stem cell lineages 50 organs and organ systems ﻛﺸﻒ ﺍﻟﻤﺮﺽ • Increased Drug Pipeline • Improved Diagnostics • New Predictive Biomarkers • Decrease Adverse Events • Increase profitability • Improve Clinical Outcome • Better Treatment Monitoring • Fewer Errors & Misdiagnoses • Predict Disease Onset • Prevent Disease • Improved Lifestyle Counseling • Reduce Health Care Costs ﻗﺮﺍﺭ ﺍﻟﻌﻼﺝ ABNORMALITIES Multiplex Measurements Computer Integration

ﻫﻜﺬﺍ ﺳﻮﻕ ﻳﻌﻤﻞ ﺍﻟﻤﻌﻤﻞ ﺍﻟﻄﺒﻰ ﻓﻰ ﺍﻟﻤﺴﺘﻘﺒﻞ Symptoms Transitional States ﺑﺼﻤﺔ ﺍﻟﺠﺴﻢ ﺑﺪﻭﻥ ﻣﺮﺽ • ﺗﺘﻐﻴﺮ ﺍﻟﺒﺼﻤﺔ ﻋﻨﺪ ﺣﺪﻭﺙ ﻣﺮﺽ ﺩﻭﻥ ﺍﻋﺮﺍﺽ • • Often occur long before people realize they are sick ﺗﻐﻴﺮﺍﺕ ﻛﻴﻤﻴﺎﺀﻳﺔ ﺗﺼﺎﺣﺐ ﺍﻟﻤﺮﺽ • ﺗﻘﺎﺭﻥ ﺍﻟﺘﻐﻴﺮﺍﺕ / ﺩﻻﻻﺕ ﻟﻠﺸﺨﺺ ﺑﺤﺎﻟﺔ ﻧﻔﺲ ﺍﻟﺴﺨﺺ ﻭ ﻫﻮ ﻣﻌﺎﻓﻰ • Good Guy = healthy Bad Guy = sick ﻳﺒﻘﻰ ﺍﻟﺘﺤﺪﻯ ﺍﻯ ﺍﻟﺪﻻﻻﺕ ﻳﻤﻜﻦ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻴﻬﺎ ﻓﻰ ﺍﻟﻄﺐ ﺍﻟﺸﺨﺼﻰ Wellness

ﺍﻟﺠﺪﻳﺪ ﻓﻰ ﻗﻮﺍﻧﻴﻦ ﺍﻟﻤﻌﺎﻣﻞ ﺍﻟﻄﺒﻴﺔ • ﺗﻮﺻﻴﺎﺕ ﻣﺆﺘﻤﺮ ﻃﺐ ﺍﻟﻤﻌﺎﻣﻞ • ﻋﻮﺍﻣﻞ ﺍﻻﻣﺎﻥ

- ﻋﻠﻰ ﺍﺧﺼﺎﺋﻰ ﺍﻟﻤﻌﻤﻞ ﺍﻥ. . . . . § ﻳﺸﻐﻒ ﻟﻠﻌﻠﻮﻡ ﺍﻟﻄﺒﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ- ﻃﻮﺍﻝ ﺍﻟﻮﻗﺖ § ﻳﻜﻮﻥ ﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻟﺘﻮﺍﺻﻞ § ﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﻻﺳﺎﺳﻰ ﻟﻠﻜﻤﺒﻴﻮﺗﺮ § ﻳﻜﻮﻥ ﻟﺪﻳﻪ ﺍﻟﺮﻏﺒﺔ ﺩﺍﺋﻤﺎ ﻋﻠﻰ ﻣﺴﺎﻋﺪﺓ ﺍﻟﻐﻴﺮ