The mucose membrane lining of gastrointestinal tract is stratified squamous epithelium at the esophagus which slowly convert into simple columnar epithelium at the stomach until the anus it converts back into the stratified squamous epithelium at the lower half of the anal canal. The stratified epithelium is a wear and tear epithelium.
As it passes down from the small to large intestine, goblet cells increase because as it passes down water was absorb, goblet cells function to produce mucous.
This is just a rough idea, for better slides with more reference please PM the author at davidgqf@gmail.com.
Role of hrct in interstitial lung diseases pk uploadDr pradeep Kumar
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Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
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Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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3. CLINICAL
DIP is one of the “interstitial lung diseases” that show “mild
restrictive pulmonary functions”
Obstructive airway disease Restrictive airway disease
General features (Reduced lung AIRFLOW)
Increase in resistance to
airflow due to obstruction at
any level
(Reduced lung VOLUME)
Reduced expansion of lung
parenchyma
Total lung capacity (TLC) Normal / Increased Reduced
Forced Expiratory Volume in
one second (FEV1)
Markedly reduced Normal / slightly reduced
4. CLINICAL
• Subacute “gradual” dyspnea and cough
– Takes weeks – months
• Misnomer
– Originally thought to be desquamated pneumocytes
• Common in heavy smokers
– Can be seen also with pneumoconiosis
• Radiology (CT)
– Bilateral, lower lobe predominance
– Ground glass opacities
• Good response to Smoking cessation +/- Steroids (GOOD PROGNOSIS)
5. GROSS
• No specific gross features
• Smoking related gross features
– Anthracosis
– Emphysema
– Dilated bronchi with increased mucus secretions
6. MICROSCOPY
• Intraluminal accumulation of
pigmented macrophages
– Pattern: Diffuse
– Distribution: filling alveolar spaces
– Macrophages: finely granular, golden brown pigments
• Called “smokers macrophages”
7. MICROSCOPY
• Mild interstitial chronic inflammation
– Mainly lympho-plasmacytic
– Plus/minus lymphoid aggregates
– Rare eosinophils may be seen
– No granulomas or giant cells
• Mild interstitial fibrosis
– Diffuse interstitial (not bronchiolo-centric)
– Alveolar lining: Prominent type II pneumocytes hyperplasia
– No Honeycomb changes
– No fibroblastic foci
9. SPECIAL STUDIES
• Macrophages granules stain positive with Iron stains
– How to differentiate it from the hemosiderin laden macrophages ?
Hemosiderin Laden Macrophages Smokers Macrophages
Granules Coarse Fine
Vary in size and shape minimal variation
Both are Golden brown
Refractile Non-refractile
10. DIFFERENTIAL DIAGNOSIS
• Usual interstitial pneumonia
• Respiratory bronchiolitis
• Langerhans cell histiocytosis
• Hypersensitivity pneumonitis
• Other interstitial pneumonias and processes
– Acute interstitial pneumonia (diffuse alveolar damage)
– Acute fibrinous and organizng pneumonia
– Cryptogenic organizing pneumonia (BOOP)
– Lymphocytic interstitial pneumonitis
– Nonspecific interstitial pneumonia
Note that DIP-like areas also
seen around scar, tumor, or
infarction.
11. DIFFERENTIAL DIAGNOSIS
• Usual interstitial pneumonia
– Disturbed lung architecture (prominent honeycombing)
– Marked interstitial fibrosis
– Frequent fibroblastic foci (temporal heterogeneity)
– can show focal DIP-like areas
• Respiratory bronchiolitis
– Bronchiolo-centric
– Patchy pattern
– Mild type II pneumocyte hyperplasia
– Mild interstitial fibrosis (which is mainly peri-bronchiolar)
12. DIFFERENTIAL DIAGNOSIS
• Langerhans cell histiocytosis
– Frequent cystic changes (imaging – gross)
– Mainly interstitial process (not intraluminal)
– Aggregates of Langerhans histiocytes
• Convoluted / folded / grooved / kidney-shaped nuclei
• Positive CD1a
– Increased eosinophils
– can show focal DIP-like areas
• Hypersensitivity pneumonitis
– History of exposure to Antigens
– Mainly bronchiolo-centric
– Poorly formed granulomas and/or giant cells
– Intra-luminal BOOP-like plugs & interstitial fibroblastic foci
– can show focal DIP-like areas
13. DIFFERENTIAL DIAGNOSIS
• Other interstitial pneumonias and processes
– Acute interstitial diseases: Hyaline membrane or fibrin
– Cryptogenic organizing pneumonia: Bronchiolocentric - Intraluminal organization
rather macrophages
– Nonspecific interstitial pneumonia: Uniform, Diffuse interstitial inflammation/fibrosis
– few intra-alveolar macrophages
– Lymphocytic interstitial pneumonia: diffuse alveolar septa expansion by chronic
inflammatory cells - few intra-alveolar macrophages
16. DIFFERENTIAL DIAGNOSIS
• Increased intra-luminal foamy macrophages
– Following bronchiolar obstruction (localized process)
– Macrophages are not pigmented (unless smoker)
– No associated interstitial pneumonitis or fibrosis
• Pneumoconiosis (especially Asbestosis) and drug reactions should be
ruled out as it may show DIP-like areas
– History is important
– In case of Asbestosis asbestos bodies should be seen