Acute and Chronic Inflammation is a lecture about the definition, cellular events, vascular events, patterns, and outcomes of acute and chronic inflammation. Acute inflammation is defined as the initial rapid response to infections or tissue damage that typically develops within hours or days and aims to eliminate the offending agent. It involves vasodilation, increased vascular permeability, and leukocyte emigration. Chronic inflammation develops if the acute response fails to clear the stimulus and is associated with more tissue destruction and the presence of lymphocytes and macrophages. Outcomes of acute inflammation include complete resolution, healing by fibrosis, progression to chronic inflammation, or abscess formation.
inflammation is the body's immune system's response to an irritant. The irritant might be a germ, but it could also be a foreign object, such as a splinter in your finger.
inflammation is the body's immune system's response to an irritant. The irritant might be a germ, but it could also be a foreign object, such as a splinter in your finger.
describes the vascular and cellular events of acute inflammation. The process involves diapedesis and phagocytosis. The various chemical mediators involved in the process have been discussed. Fate of acute inflammation and conversion into chronic inflammation is described.
describes the vascular and cellular events of acute inflammation. The process involves diapedesis and phagocytosis. The various chemical mediators involved in the process have been discussed. Fate of acute inflammation and conversion into chronic inflammation is described.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
4. Definition
• Inflammation is a response of vascularized
tissues to infections and tissue damage that
brings cells and molecules of host defense
from the circulation to the sites where they are
needed, to eliminate the offending agents
• Rapid host response that serves to deliver
leucocytes and plasma proteins such as
antibodies to sites of infection or tissue
injury.
5. Inflammation is a war
• Coordinated response to eliminate the cause
and consequence of injury or infection
(noxious agent)
• Involves immune (cellular events) and
vascular systems (Vascular events)
6. Inflammatory process
• Inflammation
• Purpose is 3 d’s:
Destroy
Dilute
Dam-off
• Desired result is healing
Regeneration (hyperplasia)
Fibrosis (scarring)
• Collateral damage may occur
7. CARDINAL SIGNS OF INFLAMMATION
Rubor (redness)
Tumor (swelling)
Calor (heat)
Dolor (pain)
Functio laesa (loss of function)
8. Inflammatory stimuli
Infective agents like bacteria, viruses and their toxins, fungi,
parasites
Immunological agents like cell-mediated and antigen-antibody
reactions
Physical agents like heat, cold, radiation, mechanical trauma
Chemical agents like organic and inorganic poisons
Inert materials such as foreign bodies
9. The typical inflammatory reaction develops through a
series of sequential steps:
• The offending agent, which is located in extravascular
tissues, is recognized by host cells and molecules.
• Leukocytes and plasma proteins are recruited from the
circulation to the site where the offending agent is located.
• The leukocytes and proteins are activated and work
together to destroy and eliminate the offending substance.
• The reaction is controlled and terminated.
• The damaged tissue is repaired.
13. Acute Inflammation
• The initial, rapid response to infections and tissue
damage is called acute inflammation.
• It typically develops within minutes or hours and is of
short duration, lasting for several hours or a few days.
• Acute inflammation is a stereotyped response (unlearned behavioral reaction of an organism to some environmental
stimulus)to recent or ongoing injury
Chronic Inflammation
• If the initial response fails to clear the stimulus, the
reaction progresses to a protracted type of
inflammation that is called chronic inflammation.
• Chronic inflammation may follow acute inflammation
or arise de novo (From beginning).
• It is of longer duration and is associated with more
tissue destruction, the presence of lymphocytes and
macrophages, the proliferation of blood vessels, and
fibrosis.
14. ACUTE INFLAMMATION
Acute inflammation has three major
components:
(1) dilation of small vessels, leading to an
increase in blood flow,
(2) increased permeability of the
microvasculature, enabling plasma proteins and
leukocytes to leave the circulation, and
(3) emigration of the leukocytes from the
microcirculation, their accumulation in the focus
of
injury, and their activation to eliminate the
offending
agent
15. Reactions of Blood Vessels in Acute
inflammation
(Acute Vascular Changes)
• The vascular reactions of acute
inflammation consist of changes in the flow
of blood and the permeability of vessels,
both designed to maximize the movement
of plasma proteins and leukocytes out of
the circulation and into the site of infection
or injury.
• Definitions
• An exudate?
• Transudate?
• Edema?
16. Acute vascular changes
• Transient arteriolar constriction (seconds)
• Nerve reflex, endothelin
• Like the immediate first step of hemostasis
• Vasodilation of arterioles (until resolution)
• Histamine, bradykinin mediate rapid response
• Sustained by prostaglandins and NO
• Hyperemia, erythema
• Transudation increases blood viscosity, slows flow
• Stasis and congestion in venules allows cells to contact
endothelium
• Vascular leakage (minutes to hours to days)
• Histamine, bradykinin mediate rapid response
• Sustained by C3a, C5a, PAF, leukotrienes
• Exudation results in local edema
17.
18. Increased vascular permeability
• Contraction of vascular endothelium—rounding
of cells and widening of intercellular spaces
Immediate, transient response (15-30 min)
• Stimulated by histamine, bradykinin, substance P
• venules of 20 – 60 um diameter respond
Delayed prolonged leakage (radiation burns)
• begins after 2 – 12 h delay, lasts hours – days
• stimulated by cytokines and apoptotsis of injured skin cells
• venules and capillaries respond
Immediate, sustained response (days)
• caused by direct damage to vasular endothelium
• venules, capillaries, arterioles respond
• ended by hemostasis, thrombosis, regeneration
Neutrophil-induced damage (days)
• caused when neutrophils adhere and emigrate
19. Leukocyte extravasation
• Margination, rolling
• Decreased flow rate and volume push WBCs
toward vascular walls
• Intermittent binding of selectins with glycoproteins
causes rolling
• Adhesion, pavementing
• mediated by integrins on leukocytes, activated by
cytokines
• integrin ligands VCAM-1, ICAM-1 on endothelial
cells induced by TNF and IL-1
• Transmigration or diapedesis
• chemokines stimulate adherent leukocytes to
migrate through interendothelial spaces
20. • The journey of leukocytes from the vessel lumen to
the tissue is a multistep process that is mediated
and controlled by adhesion molecules and
cytokines.
• This process can be divided into phases, consisting
first of adhesion of leukocytes to endothelium at
the site of inflammation, then transmigration of
the leukocytes through the vessel wall, and
movement of the cells toward the offending
agent.
21. Leukocyte Adhesion to
Endothelium
• Normally, Leukocytes are pushed out toward
the wall of the vessel, but the flow prevents the
cells from attaching to the endothelium
• As the blood flow slows early in inflammation
(stasis), hemodynamic conditions change (wall
shear stress decreases),and more white cells
assume a peripheral position along the
endothelial surface. This process of leukocyte
redistribution is called margination.
22. • By moving close to the vessel wall, leukocytes are
able to detect and react to changes in the
endothelium. If the endothelial cells are activated by
cytokines and other mediators produced locally, they
express adhesion molecules to which the leukocytes
attach loosely.
• These cells bind and detach and thus begin to tumble
‘somersaults’ on the endothelial surface, a process
called rolling.
• The cells finally come to rest at some point where
they adhere firmly (resembling pebbles over which a
stream runs without disturbing them).
23. • The attachment of leukocytes to endothelial
cells is mediated by complementary adhesion
molecules on the two cell types whose
expression is enhanced by cytokines.
• The two major families of molecules involved in
leukocyte adhesion and migration are the
selectins and integrins.
• These molecules are expressed on leukocytes
and endothelial cells, as are their ligands.
• Selectins mediate the initial weak
interactions between leukocytes and
endothelium.
• Firm adhesion of leukocytes to endothelium
is mediated by a family of leukocyte surface
24. Leukocyte Migration Through
Endothelium
• After being arrested on the endothelial surface,
leukocytes migrate through the vessel wall
primarily by squeezing between cells at
intercellular junctions
• This extravasation of leukocytes, called
transmigration, occurs mainly in postcapillary
venules, the site at which there is maximal
retraction of endothelial cells
Further movement of leukocytes is driven by
chemokines produced in extravascular tissues,
which stimulate leukocytes to travel along a
chemical gradient
25. • After traversing the endothelium, leukocytes
pierce the basement membrane, probably by
secreting collagenases, and they enter the
extravascular tissue.
• Typically, the vessel wall is not injured during
leukocyte transmigration
26. Chemotaxis of Leukocytes
• After exiting the circulation, leukocytes move in the
tissues toward the site of injury by a process called
chemotaxis.
• Chemotaxis :is defined as locomotion along a
chemical gradient.
• Both exogenous and endogenous substances can act
as chemoattractants, including the following:
• Bacterial products, particularly peptides with
Nformylmethionine
termini
• Cytokines, especially those of the chemokine family
• Components of the complement system, particularly C5a
• Products of the lipoxygenase pathway of arachidonic
acid (AA) metabolism, particularly leukotriene B4 (LTB4)
NB: These chemoattractants are produced by microbes
and by host cells in response to infections and tissue
damage and during immunologic reactions.
27. Which types of leukocytes respond
• Neutrophils are generally the first types of leukocytes to
respond in acute (non-viral) inflammation or to necrosis
• Lymphocytes are usually the first cells to respond to viral
infections or autoimmune diseases
lymphocytes and plasma cells also participate in most chronic
inflammation, regardless of the inciting cause
• Macrophages begin to appear a few days after the onset
of inflammation from almost any cause, and increase in
numbers over time
activated macrophages may develop abundant cytoplasm, called
epithelioid macrophage
macrophages merge to create giant cells with multiple nuclei
• Eosinophilic inflammation is highly suggestive of a
response to helminths, arthropods, or allergens
28. Acute inflammation
• Immediate, early response
Vasodilation
Vascular permeability
Emigration of leukocytes into tissues
• Reactions of leukocytes in inflammation
Recognition of microbes and dead tissues
Removal of the offending agents
Macrophage activation
Leukocyte-mediated tissue injury
29. Actions of activated neutrophils
• Recognition of microbes or dead cells induces several responses in leukocytes that are
collectively called leukocyte activation
• The Leukocytes must be activated to perform their functions.
• Phagocytosis has three steps
recognition and attachment of the particle to
be ingested
engulfment, with subsequent formation of a
phagocytic vacuole
killing or degradation of the ingested material
• Initiation of repair
stimulate the proliferation of endothelial cells
and fibroblasts
stimulate synthesis of collagen and enzymes
that remodel connective tissues
30.
31. • Several types of inflammation vary in their
morphology and clinical correlates.
• Why?
The severity of the reaction
specific cause
the particular tissue
site involved
Morphologic Patterns of Acute
Inflammation
32. Morphologic Patterns of Acute
Inflammation
• serous inflammation
• fibrinous inflammation
• suppurative or purulent inflammation
• ulcers
33. Patterns of Acute Inflammation
• SEROUS INFLAMMATION:
Serous inflammation is marked by the
outpouring of a thin fluid
e.g. the skin blister resulting from a burn or
viral infection represents a large accumulation
of serous fluid
34.
35.
36. • FIBRINOUS INFLAMMATION
more severe injuries and more greater
vascular permeability, larger molecules such
as fibrinogen pass the vascular barrier, and
fibrin is formed and deposited
Morphologic Patterns of Acute Inflammation
37. A fibrinous exudate is characteristic of
inflammation in the lining of body cavities, such as
the meninges, pericardium and pleura
Bread and butter apperance
Morphologic Patterns of Acute
Inflammation
FIBRINOUS INFLAMMATION
38. • FIBRINOUS INFLAMMATION
Fibrinous exudates may be removed by
fibrinolysis
But when the fibrin is not removed, it may
stimulate the ingrowth of fibroblasts and blood
vessels and thus lead to scarring
Morphologic Patterns of Acute Inflammation
39. SUPPURATIVE OR PURULENT INFLAMMATION
characterized by the production of large
amounts of pus or purulent exudate
consisting of neutrophils, necrotic cells,
and edema fluid
Certain bacteria (e.g., staphylococci)
produce this localized suppuration and are
therefore referred to as pyogenic (pus-
producing) bacteria
Morphologic Patterns of Acute Inflammation,
40. Suppurative inflammation. A, A subcutaneous bacterial abscess with
collections of pus. B, The abscess contains neutrophils, edema fluid, and
cellular debris.
42. Abscesses : localized collections of
purulent inflammatory tissue caused by
suppuration buried in a tissue, an organ,
or a confined space
SUPPURATIVE OR PURULENT INFLAMMATION
46. Morphologic Patterns of Acute
Inflammation –
ULCERS
An ulcer is a local defect of the surface of an
organ or tissue that is produced by the
sloughing (shedding) of inflammatory necrotic
tissue
47. ULCERS
encountered in:
1) inflammatory necrosis of the mucosa of the
mouth, stomach, intestines, or genitourinary
tract
2) subcutaneous inflammation of the lower
extremities in older persons who have
circulatory disturbances
Morphologic Patterns of Acute
Inflammation
48. Ulceration can occur only when tissue necrosis and
resultant inflammation exist on or near a surface
Epithelial Defect
Fibrinopurulent exudates
Granulation tissue
Fibrosis
Necrotic base
49. Termination of acute response
• Inflammation declines spontaneously
Mediators of inflammation are produced in rapid bursts only
while the stimulus persists
Mediators have short half-lives and are degraded after their
release.
Neutrophils also have short half-lives in tissues and die by
apoptosis within a few hours after leaving the blood
• Active termination mechanisms include
Switch from pro-inflammatory leukotrienes to anti-inflammatory
lipoxins
Release of anti-inflammatory cytokines, including transforming
growth factor-β (TGF-β) and IL-10, from macrophages
production of anti-inflammatory lipid mediators, called resolvins
and protectins, derived from polyunsaturated fatty acids
neural impulses (cholinergic discharge) that inhibit the
production of TNF in macrophages
52. • Acute inflammation may have one of the
four outcomes:
Complete resolution
Healing by connective tissue replacement
(fibrosis)
Progression of the tissue response to chronic
inflammation
Abcess formation
Outcomes of Acute Inflammation
53. Complete resolution
When?
1) the injury is limited or short-lived
2) there has been little tissue destruction
3) the damaged parenchymal cells can
regenerate
Outcomes of Acute Inflammation
54. Complete resolution
Mechanism:
Neutralization and removal of chemical
mediators
Normalization of vascular permeability
halting of leukocyte emigration
Clearance of edema (lymphatic drainage) ,
inflammatory cells and necrotic debris
(macrophages).
Outcomes of Acute Inflammation
56. • Healing by connective tissue replacement
(fibrosis):
• This occurs after substantial tissue destruction
the inflammatory injury involves tissues that are incapable of
regeneration
there is abundant fibrin exudation.
The destroyed tissue is reabsorbed and
eventually replaced by fibrosis.
Outcomes of Acute Inflammation
57. • Progression of the tissue response to
chronic inflammation:
occurs when the acute inflammatory response
cannot be resolved
WHY?
Due to: 1. the persistence of the injurious agent
2. some interference with the normal
process of healing
Outcomes of Acute Inflammation
58. End of acute inflammation
More is Lost by Indecision than Wrong Decision