Inflammation II - pau.lf1.cuni.cz · Meningitis purulenta CSF Jaroslava Du ková ... Jaroslava Du...

General Pathology

Inflammation II

Healing processes

-----------

Classification

Jaroslava Dušková

Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague

Jaroslava Duško

vá

Inflammation II - table of contents

Healing of Inflammation

Progressive changes - definition Regeneration (restitution) Reparation (substitution) Hypertrophy Hyperplasia Metaplasia Adaptation

Classification of inflammationsuperficial

skin serous membranes mucous membranes

intersticialaccording to the type of exudate

serous non purulent purulent fibrinous gangrenous

Jaroslava Duško

vá

Healing of Inflammation

Jaroslava Duško

vá

Progressive Changes

Def.:

processes leading to

lost or damaged tissue substitution

or

adaptation to the changed conditions in the organism or environment

Jaroslava Duško

vá

Progressive Changes

Regeneration (restitution)

Reparation (substitution)

Hypertrophy

Hyperplasia

Metaplasia

Adaptation

Jaroslava Duško

vá

Progressive changes 1.

Regeneration - restitution of former status

Reparation – substitution with a less specialised

tissue

Hypertrophy – enlargement of the organ through

cell enlargementJarosla

va Dušková

Cell Proliferation in

the Gastrointestinal

Tract

a Oesophagus

b Stomach

c Sm Bowel

d L Bowel

e Anus

Jaroslava Duško

vá

Angiogenesis

Endogenous Promotors

VEGF - A,B,C,D

Angiopoietins

Angiogenin

Basic fibroblast growth factor bFGF

Hepatocyte Growth Factor HGF

Interleukin-8

PDGF

Transformation Growth Factor ß TGF ß

TNF

Jaroslava Duško

vá

Angiogenesis

Endogenous Inhibitors

Angiostatin

Brain Angiogenesis Inhibitor 1 BAI1

Endostatin

Interferons

Platelet factor-4 cleavage products

Prolactin fragment (16kd)

Thrombospondin-1

VEG I

Vasostatin

Jaroslava Duško

vá

Progressive changes 2.

Hyperplasia – enlargement of the organ

through cell multiplication

Metaplasia – transformation of one

differentiated tissue into another differentiated

tissue

Adaptation - functional adjustment

It is done by means of metaplasia, hypertrophy,

hyperplasia, metalaxia, (rebuilding)

Jaroslava Duško

vá

Jaroslava Duško

vá

Healing Processes 1. wounds

– per primam intentionem – primary union

(wounds without infection, dislocation, foreign bodies)

– per secundam intentionem- secondary union

hematoma organisation

thrombus organisation (possible recanalisation)

Jaroslava Duško

vá

Proliferation - steps

dissolution of exsudate & necrotic tissue

granulation tissuefibronectin formation, fibroblasts &

endothelia organisation

collagen production

scar maturation

scar contraction myofibroblasts

Jaroslava Duško

vá

Wound Healing – Steps-

Timing

Day 0: fibrin –

fibronectin gel

Day 1: neutrophils

Day 1-2: macrophages

Day 2-4: fibroblasts,

myofibroblasts,

capillaries

Jaroslava Duško

vá

Deposition and Remodeling of Connective

Tissue

PDGF from: mf, endoth., platellets

causes: fbl proliferation, proteosynthesis

Transforming GF from: mf, epithelia

causes: fbl proliferation, angiogenesis

IL- 1from: mf, epithelia

causes: fbl proliferation, endogenous pyrogen

TNF αfrom: mf

causes: endothelial growth, killing bacteria, cachexia

Jaroslava Duško

vá

Deposition and Remodeling of Connective

Tissue

Extracellular matrix proteins – matrix metaloproteinases MMPs dependent on Zinc ions

MMPs are deactivated by tissue inhibitors of metaloproteinases - TIMPs

Jaroslava Duško

vá

Wound Healing - I.

Jaroslava Duško

vá

Wound Healing - II.

Jaroslava Duško

vá

Healing Processes 2.

ischemic and traumatic

necroses

foreign bodies healing

bone fracturesJarosla

va Dušková

Jaroslava Duško

vá

Factors Influencing Wound Healing

age

nutrition status – protein deficit

vitamins A,C – collagen, epithelisation

Zinc – enzyme function

steroids

local factors infection necrosis foreign bodiespatient´s motilityarterial perfusionvenous drainage

Jaroslava Duško

vá

Inflammation - Classification:

According to the dominant

phase:

alterative

EXSUDATIVE

proliferative

Jaroslava Duško

vá

Inflammation - localisation

superficial

mucous

membranes

serous

membranes

skin

interstitial

Jaroslava Duško

vá


Type of exsudate: serous

nonpurulent –lymphoplasmocellular

purulent

fibrinous

gangrenous

Jaroslava Duško

vá

Herpes zoster

Jaroslava Duško

vá

H. zoster

Jaroslava Duško

vá

Epidermolysis bullosa staphylococcica

Jaroslava Duško

vá

Pericarditis serosa (CMV)

Jaroslava Duško

vá

Jaroslava Duško

vá




purulent

fibrinous

gangrenous

Jaroslava Duško

vá

Jaroslava Duško

vá

Sinusitis chronica

Jaroslava Duško

vá

Jaroslava Duško

vá

Metaplasia intestinalis mucosae ventriculi

Jaroslava Duško

vá

Urocystitis chronica

metaplasia squamocellularis

Jaroslava Duško

vá




purulent

fibrinous

gangrenous

Jaroslava Duško

vá

Impetigo

Jaroslava Duško

vá

Acne conglobata

Jaroslava Duško

vá

Jaroslava Duško

vá

Meningitis purulenta

CSF

Jaroslava Duško

vá

CSFMeningitis

purulenta

Jaroslava Duško

vá

Cholelithiasis. Empyema vesicae felleae chronicum.

Jaroslava Duško

vá

Jaroslava Duško

vá

Osteomyelitis purulenta

Jaroslava Duško

vá

Sepsis puerperalis

Jaroslava Duško

vá

Jaroslava Duško

vá

Diverticulitis

Jaroslava Duško

vá

Jaroslava Duško

vá




purulent

fibrinous

gangrenous

Jaroslava Duško

vá

Jaroslava Duško

vá

Fe

Pericarditis serofibrinosohaemorrhagica

Jaroslava Duško

vá

Jaroslava Duško

vá




purulent

fibrinous

gangrenous

Jaroslava Duško

vá

Interstitial fibrinose inflammation

fibrin exsudation & fibrinoid change of

the collagen containing connective

tissue

Jaroslava Duško

vá

Fibrinoid Change of

Collagen vessels and connective tissue damage

plasmorrhagia (leakage of plasma)

deposits of Ag-AB complexes

staining characteristics fibrin - likeJaroslava Duško

vá

Granulomatosis Wegeneri

Jaroslava Duško

vá

Polyarteritis nodosa

Jaroslava Duško

vá

Significance of Fibrinoid

Change

diminished quality of the collagen ( firmness, permeability)

tendency to thrombosis in the

vessels, aneurysms formationJaroslava Duško

vá

Rheumatic Heart Disease

acute myocarditis –Aschoff nodules/bodies

Jaroslava Duško

vá




purulent

fibrinous

gangrenous

Jaroslava Duško

vá

Gangrenous Inflammation

tends to be interstitial

putrefactive bacteria

severe alteration

Jaroslava Duško

vá

Appendicitis

gangraenosa

Jaroslava Duško

vá

Jaroslava Duško

vá

Inflammation II - pau.lf1.cuni.cz · Meningitis purulenta CSF Jaroslava Du ková ... Jaroslava Du...

Documents

Transcript of Inflammation II - pau.lf1.cuni.cz · Meningitis purulenta CSF Jaroslava Du ková ... Jaroslava Du...