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Chapter Two  adaptation and injury
Adaptation & Cellular Injury : ,[object Object],[object Object],[object Object],[object Object]
Irreversible Injury   (cell death)   Reversible Injury   adaptation  normal   When cells encounter physiological stresses or pathological stimuli, they undergo adaptation, achieving a new a steady state and preserving viability.  If the adaptive capacity is exceeded, cell injury develops.  Within certain limits, injury is reversible. with severe and persistent stress, irreversible injury results.
adaptation ,[object Object]
General principles ,[object Object]
Incomplete occlusion of coronary artery  Complete or prolonged occlusion hypertesion Prolonged starvation
General principles ,[object Object]
[object Object],[object Object],[object Object]
General principles ,[object Object]
 
General principles ,[object Object],[object Object],[object Object],[object Object],4. four intracellular systems are particularly vulnerable.
 
 
 
 
General biochemical mechanisms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Section A
Types of adaptation
CELLULAR ADAPTATION ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
ATROPHY  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],malnutrational Denervative endocrine Disuse compressive Aging
Morphology of atrophy ,[object Object],[object Object],[object Object],[object Object]
Fig 2-5
Cerebral atrophy - Alzheimers:
Atrophy of Brain ,[object Object]
 
 
 
 
Hydropic change in ischemic - kidney Microvilli
Muscle ischemic atrophy:
 
 
 
 
Hydronephrosis
 
 
 
[object Object],[object Object],HYPERTROPHY
Fig 2-6
 
 
Heart hypertrophy in hypertension: Left Ventricle
 
 
HYPERPLASIA
HYPERPLASIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],female breast and uterus at puberty and pregnancy.
[object Object]
PARTIAL HEPATECTOMY Priming Proliferation Growth lnhibition GROWTH FACTORS AND CYTOKINES HGF  TGF-  EGF TNF-  IL-6 Others ADJUVANTS Norepinephrine Insulin Glucagon Thyroid hormone GROWTH INHIBITORS TGF-    Others Growth factors Adjuvanis Matrix degradation
 
 
Metaplasia ,[object Object],[object Object],[object Object]
Intestinal glandular  epithelium ,[object Object],[object Object],[object Object],Bronchial epithelia Epithelia in bile duct Cervical epithelia Epithelial metaplasia  Columnar epithelium   Squamous epithelium Squamous epithelium Gastric glandular epithelium Barrett esophagitis
[object Object],[object Object],[object Object],[object Object],Osteocytes Chondrocytes mesenchymal metaplasia
 
 
 
 
 
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Section B
Causes of cell injury and disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
HYPOXIA ,[object Object],[object Object],[object Object],[object Object]
HYPOXIC INJURY ,[object Object],[object Object],[object Object],[object Object],[object Object]
Four biochemical themes ,[object Object],[object Object],[object Object],[object Object]
PHYSICAL AGENTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
CHEMICAL AGENTS AND DRUGS ,[object Object],[object Object],[object Object],[object Object],[object Object]
MECHANISMS OF CHEMICAL INJURY ,[object Object]
[object Object],MECHANISMS OF CHEMICAL INJURY
[object Object]
FREE RADICAL INITIATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cell injury caused by free radicals through ,[object Object],[object Object],[object Object]
INFECTIOUS AGENTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CELLS REACT TO ADVERSE INFLUENCES ,[object Object],[object Object],[object Object]
CELL INJURY AND NECROSIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Irreversible Injury   Reversible Injury   adaptation   normal
Types of cell injury  ,[object Object],[object Object],necrosis apoptosis
Reversible injury ,[object Object],[object Object],[object Object]
Cellular swelling
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FATTY CHANGE
[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
[object Object],[object Object],[object Object],Hyaline changes (degeneration)
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Intracellular hyaline changes
 
 
 
 
Hyaline change of the central artery of the spleen (spleen of hypertension disease) ,[object Object]
[object Object],[object Object]
mucoid degeneration
[object Object],[object Object],[object Object],[object Object],[object Object],AMYLOIDOSIS
 
Chemical nature of amyloid fibrils Two major forms: AL (amyloid light chain protein) AA (amyloid-associated protein):   Derived from serum AA (12kd)  synthesized in liver and elevated in  inflammatory states.
Minor forms of amyloid fibrils: Transthyretin (TTR): A mutant form of a  serum protein in familial amyloid  polyneuropathy. A variant of TTR in aging. Beta-2-microglobulin (the component of  class I MHC molecules) in long-term hemidialysis.
Minor forms of amyloid fibrils:   Beta-2-amyloid protein forms the core of  cerebral plaques and deposits within  cerebral vessel walls in Alzheimer disease, deriving from a transmembrane glycoprotein precursor.
Minor forms of amyloid fibrils: Transthyretin (TTR): A mutant form of a  serum protein in familial amyloid  polyneuropathy. A variant of TTR in aging. Beta-2-microglobulin (the component of  class I MHC molecules) in long-term hemidialysis.
Minor forms of amyloid fibrils:   Beta-2-amyloid protein forms the core of  cerebral plaques and deposits within  cerebral vessel walls in Alzheimer disease, deriving from a transmembrane glycoprotein precursor.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical forms of amyloidosis Systemic  amyloidosis:
[object Object],[object Object],[object Object],[object Object],[object Object],Localized amyloidosis
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pigmentation
 
 
 
 
 
 
[object Object],[object Object],Pathologic calcification
[object Object],[object Object],[object Object],Dystrophic calcification
[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Metastatic calcification Hypercalcimia
Metastatic calcification Affecting Interstitial tissue of gastric mucosa Kidneys Lungs Pulmonary veins  Systemic arteries
Section C CELL DEATH
TYPES OF CELL DEATH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Common type of necrosis after exogenous  stimuli.
NECROSIS The sum of the morphologic changes that follow cell death in living tissue and organ: ,[object Object],[object Object],[object Object]
[object Object],AUTOLYSIS HETEROLYSIS ,[object Object]
[object Object],[object Object],[object Object],Normal cell Chromatin margination karyorrhexis pyknosis karyolysis Nuclear Alteration of Necrosis
1)Three pattern of nuclear changes Karyolysis (DNase activity) Pyknosis (DNA condensation) Karyorrhexis (fragmentation of pyknotic nucleus)
[object Object],[object Object],[object Object]
 
[object Object],[object Object],The Necrosis of heptocytes
[object Object],Coagulative Necrosis Liquefactive Necrosis Fibrinoid Necrosis Necrosis Gangrenous Necrosis
Morphologic appearance of necrosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Coagulation necrosis Denatures of both structural and  enzymatic proteins by injury or the  subsequent increasing intracellular  acidosis.
Renal Infarction - Coagulative
Splenic Infarction - Coagulative necrosis
Infarction -  Adrenal gland:
 
Caseous necrosis A subtype of coagulation necrosis White and cheesy Tuberculosis Completely obliterated tissue  architecture
Caseous necrosis of kidney ,[object Object]
 
Extensive  Caseous necrosis Tuberculosis
 
[object Object],[object Object],[object Object],[object Object]
Liver abscess: Liquifactive necrosis
Stroke- Liquifactive necrosis
 
 
[object Object],[object Object],[object Object]
Fat necrosis(Steatonecrosis) ,[object Object]
[object Object],[object Object],[object Object],[object Object]
Fibrinoid Necrosis ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Caseous necrosis - Tuberculosis
Gangrene - Amputated Diabetic foot
 
 
Gangrene Intestine - Thrombosis.
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fates of necrosis
 
 
 
 
 
 
Section D APOPTOSIS
APOPTOSIS  (Programmed cell death)   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MORPHOLOGICAL FEATURES OF APOPTOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Necrosis   Apoptosis Stimuli   Hypoxia  Physical Toxins  Pathological Histology   Cell swelling  Single cell  Coagulation N  Chromatin Disruption of  condensation organelles  Apoptotic bodies DNA   Random  Internucleosomal breakdown   Diffuse
Necrosis   Apoptosis Mechanism  ATP depletion  Gene activation Membrane  Endonuclease injury Free radicals Tissue  Inflammation  No inflammation   reaction   Phagocytosis of  apoptotic bodies
[object Object]
 
Biochemical features of apoptosis 1.PROTEIN CLEAVAGE:   Caspases (cysteine protease) Nuclear scaffold Cytoskeletal protein 2.PROTEIN CROSS-LINKING:   Transglutaminase Cytoplasmic protein  shrunken shalls  apoptotic bodies Biochemical features of apoptosis
3. DNA breakdown:   50-300 kb pieces Ca2+, Mg2+ dependent endonucleases DNA oligonucleosomes DNA ladders (also seen in necrosis) 4. PHAGOCYTIC RECOGNITION   Receptors on macrophages for the  surface  components  (phosphatidylserine, thrombospondin)  on apoptotic bodies.
[object Object]
[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
normalcell Cellular swelling, chromatin cluping Membrane damage Nuclear chromatin condensation and fragmentation Cytoplasmic budding and apoptosisi body Phagocytosisi of apoptosis body The sequential ultrastructual changes in necrosis and apoptosis
Apotosis of hepatocytes
Comparison of cell death by apoptosis and necrosis
Terminology: ,[object Object],[object Object],[object Object]
Types of Necrosis: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ageing: ,[object Object],[object Object],[object Object]
Factors affecting Ageing: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cellular mechanisms of ageing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Telomerase in ageing: Germ Cells Somatic Cells
Ageing –changes: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathology of elderly
Factors affecting ageing: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Tissue Injury

  • 1. Chapter Two adaptation and injury
  • 2.
  • 3. Irreversible Injury (cell death) Reversible Injury adaptation normal When cells encounter physiological stresses or pathological stimuli, they undergo adaptation, achieving a new a steady state and preserving viability. If the adaptive capacity is exceeded, cell injury develops. Within certain limits, injury is reversible. with severe and persistent stress, irreversible injury results.
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  • 6. Incomplete occlusion of coronary artery Complete or prolonged occlusion hypertesion Prolonged starvation
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  • 24. Cerebral atrophy - Alzheimers:
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  • 30. Hydropic change in ischemic - kidney Microvilli
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  • 44. Heart hypertrophy in hypertension: Left Ventricle
  • 45.  
  • 46.  
  • 48.
  • 49.
  • 50. PARTIAL HEPATECTOMY Priming Proliferation Growth lnhibition GROWTH FACTORS AND CYTOKINES HGF TGF-  EGF TNF-  IL-6 Others ADJUVANTS Norepinephrine Insulin Glucagon Thyroid hormone GROWTH INHIBITORS TGF-  Others Growth factors Adjuvanis Matrix degradation
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  • 81. Irreversible Injury Reversible Injury adaptation normal
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  • 101. Chemical nature of amyloid fibrils Two major forms: AL (amyloid light chain protein) AA (amyloid-associated protein): Derived from serum AA (12kd) synthesized in liver and elevated in inflammatory states.
  • 102. Minor forms of amyloid fibrils: Transthyretin (TTR): A mutant form of a serum protein in familial amyloid polyneuropathy. A variant of TTR in aging. Beta-2-microglobulin (the component of class I MHC molecules) in long-term hemidialysis.
  • 103. Minor forms of amyloid fibrils: Beta-2-amyloid protein forms the core of cerebral plaques and deposits within cerebral vessel walls in Alzheimer disease, deriving from a transmembrane glycoprotein precursor.
  • 104. Minor forms of amyloid fibrils: Transthyretin (TTR): A mutant form of a serum protein in familial amyloid polyneuropathy. A variant of TTR in aging. Beta-2-microglobulin (the component of class I MHC molecules) in long-term hemidialysis.
  • 105. Minor forms of amyloid fibrils: Beta-2-amyloid protein forms the core of cerebral plaques and deposits within cerebral vessel walls in Alzheimer disease, deriving from a transmembrane glycoprotein precursor.
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  • 121. Metastatic calcification Affecting Interstitial tissue of gastric mucosa Kidneys Lungs Pulmonary veins Systemic arteries
  • 122. Section C CELL DEATH
  • 123.
  • 124.
  • 125.
  • 126.
  • 127.
  • 128. 1)Three pattern of nuclear changes Karyolysis (DNase activity) Pyknosis (DNA condensation) Karyorrhexis (fragmentation of pyknotic nucleus)
  • 129.
  • 130.  
  • 131.
  • 132.
  • 133.
  • 134. Coagulation necrosis Denatures of both structural and enzymatic proteins by injury or the subsequent increasing intracellular acidosis.
  • 135. Renal Infarction - Coagulative
  • 136. Splenic Infarction - Coagulative necrosis
  • 137. Infarction - Adrenal gland:
  • 138.  
  • 139. Caseous necrosis A subtype of coagulation necrosis White and cheesy Tuberculosis Completely obliterated tissue architecture
  • 140.
  • 141.  
  • 142. Extensive Caseous necrosis Tuberculosis
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  • 154. Caseous necrosis - Tuberculosis
  • 155. Gangrene - Amputated Diabetic foot
  • 156.  
  • 157.  
  • 158. Gangrene Intestine - Thrombosis.
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  • 171. Necrosis Apoptosis Stimuli Hypoxia Physical Toxins Pathological Histology Cell swelling Single cell Coagulation N Chromatin Disruption of condensation organelles Apoptotic bodies DNA Random Internucleosomal breakdown Diffuse
  • 172. Necrosis Apoptosis Mechanism ATP depletion Gene activation Membrane Endonuclease injury Free radicals Tissue Inflammation No inflammation reaction Phagocytosis of apoptotic bodies
  • 173.
  • 174.  
  • 175. Biochemical features of apoptosis 1.PROTEIN CLEAVAGE: Caspases (cysteine protease) Nuclear scaffold Cytoskeletal protein 2.PROTEIN CROSS-LINKING: Transglutaminase Cytoplasmic protein  shrunken shalls  apoptotic bodies Biochemical features of apoptosis
  • 176. 3. DNA breakdown: 50-300 kb pieces Ca2+, Mg2+ dependent endonucleases DNA oligonucleosomes DNA ladders (also seen in necrosis) 4. PHAGOCYTIC RECOGNITION Receptors on macrophages for the surface components (phosphatidylserine, thrombospondin) on apoptotic bodies.
  • 177.
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  • 183. normalcell Cellular swelling, chromatin cluping Membrane damage Nuclear chromatin condensation and fragmentation Cytoplasmic budding and apoptosisi body Phagocytosisi of apoptosis body The sequential ultrastructual changes in necrosis and apoptosis
  • 185. Comparison of cell death by apoptosis and necrosis
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  • 191. Telomerase in ageing: Germ Cells Somatic Cells
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