METASTASIS

The term metastasis connotes the developement of secondary implants discontinuous with the primary tumor,possibly in the remote tissues.However not all tissues have the ability to metastasize.The notable exceptions are basal cell carcinoma of the skin and most primary tumors of the central nervous system.Extremely small cancers are known to metastasize and large ugly lession may not have spread.

SHOCK..

Shock often loosely called vascular collapse.Shock constitutes of widespread hypoperfusion of cells and tissues due to reduction in the blood volume or cardiac output.
Shock may be induced by any insult to the body,such as hemorrhage,severe trauma or burns,extensive myocardial infarction,or uncontrolled bacterial sepsis.

Types Of Shock

1.Cadiogenic shock.
2.Hypvolemic shock.
3.Septic shock.
4.Neurogenic shock.

SMALLPOX VIRUS.

Small pox virus,is the agent of smallpox the only disease that has been eradicated from the face of the earth.Eradication is due to the vaccine.The virus contain DNA-depandant RNA polymeraser.This enzyme is required because replication occur in cytoplasm.It has single stable serotype.

GRANULOMATOUS INFLAMATION......

Granulomatous inflamation is adistinctive pattern of choronic inflamation charecterized by accumulation of modified macrophages(epitheloid cells)and initiated by a variety of infectious and noninfectious agent.Large giant cells are often found at the periphery or sometimes in the centre of granuloma.
Examples;tuberculosis,leprosy,cat scratch disease,syphilis.

Chronic Inflammation Histologic Features

In contrast to acute inflammation, which is manifested by vascular changes, edema, and largely neutrophilic infiltration, chronic inflammation is characterized by:

1.Infiltration with mononuclear cells, which include macrophages, lymphocytes, and plasma cells, a reflection of persistent reaction to injury.

2.Tissue destruction, largely induced by the inflammatory cells.

3.Attempts at healing by connective tissue replacement of damaged tissue, accomplished by proliferation of small blood vessels and fibrosis.

Causes of Chronic Inflammation

Chronic Inflammation arises under the following settings:

1.Persistent infections by certain microorganisms, such as tubercle bacilli, Treponema pallidum and certain fungi.

2.Prolonged exposure to potentially toxic agents, either exogenous or endogenous.

3.Autoimmunity: Under certain conditions, immune reactions are set up against the individual's own tissues, leading to autoimmune diseases.

Chronic Inflammation

Chronic Inflammation is considered to be inflammation of prolonged duration in which active inflammation, tissue destruction, and attempts at repair are proceeding simultaneously.

Chronic Inflammation frequently begins insidiously, as a low-grade, smoldering, often asymptomatic response. This latter type of chronic inflammation includes some of the most common and disabling human diseases, such as rheumatoid arthritis. atherosclerosis, tuberculosis, and chronic lung diseases.

Galactosemia

Galactosemia is an autosomal recessive disorder of galactose metabolism. Normally, lactose, the major carbohydrate of mammalian milk, is split into glucose and galactose in the intestinal microvilli by lactase. Galactose is then converted to glucose in three steps. Two variants of galactosemia have been identified. In the more common variant, there is a lack of galactose-1-phosphate uridyl transferase involved in reaction 2. The rare variant arises from a deficiency of galactokinase, involved in reaction 1.

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Neoplasia

Neoplasia literally means "new growth", and the new growth is neoplasm. Oncology (Greek oncos = tumor) is the study of tumors or neoplasm. Cancer is the common term for all maligant tumors.
Although all physisians know what they mean when they use the term neoplasm, it has been suprisingly difficult to develop an accurate definition. The eminent British oricologist Willis has come closest: "A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of stimuli which evoked the change."

Morphology

The morphologic consequences of immune complex injury are dominated by acute necrotizing vasculitis, with deposits of fibrinoid and intense neutrophilic exudation permeating the entire arterial wall. Affected glomerull are hypercellular because of swelling and proliferation of endothelial and mesangial cells, accompanied by neutrophilic and monocytic infiltration. The complexes can be seen on immunofluoresence microscopy as granular lumpy deposits of immunoglobulin and complement and on electron microscopy as electron dense deposits along the glomerular basement membrane.

Mutations

A mutation can be defined as a permanent change in the DNA. Based on the extent of genetic change, mutations may be classified into three categories:

Genome mutations:
Genome mutations involve loss or gain of whole chromosomes, giving rise to monosomy or trisomy.

Chromosome mutations:
Chromosome mutations result from rear rangement of genetic material and give rise to visible structural changes in the chromosome.

Point mutations:
Point mutations (single base substitution) may alter the code in a triplet of bases and lead to the replacement of one amino acid by another in the gene product.

Plasma Proteases

A variety of phenomena in the inflammatory response are mediated by three interrelated plasma-derived factors: the complement, kinin, and clotting systems.

Complement System:
The complement system consists of 20 component proteins, which are found in greatest concentration in plasma. This system functions in both innate and adaptive immunity for defense against microbial agents, culminating in lysing microbes by the so-called membrane attack complex (MAC).

Kinin System:
This system generates vasoactive peptides from plasma proteins called kininogens by specific proteases called kallikreins. The kinin system results in the ultimate release of the vasoactive nonapeptide bradykinin, a potent agent that increases vascular permeability.

Clotting System:
The clotting system and inflammation are intimately connected processes. The clotting system is divided into two pathways that converge, culminating in the activation of thrombin and the formation of fibrin.

Atrophy

Shrinkage in size of the cell by loss of cell substance is known as Atrophy. Atrophy can be physiologic or pathologic. The common causes of atrophy are the following:

1. Decreased workload (atrophy of disuse).
2. Loss of innervation (denervation atrophy).
3. Diminished blood supply.
4. Inadequate nutrition.
5. Loss of endocrine stimulation.
6. Aging (senile atrophy).
7. Tissue pressure.

Heart Attack

HEART ATTACK:
Heart Attack is one of most common disease of our society.And it rate is increasing day by day so we have to take measures to prevent this health hazard.

PROTECTION AGAINST HEART ATTACK:

Lowering your risk factors for coronary artery disease (CAD) can help you prevent a heart attack. (See "Who Is At Risk for a Heart Attack?") Even if you already have CAD, you can still take steps to lower your risk of heart attack.

Reducing the risk of heart attack usually means making healthy lifestyle choices. You also may need treatment for medical conditions that raise your risk.
HEALTHY LIFESTYLE.

Healthy lifestyle choices to help prevent heart attack include:

* Following a low-fat diet rich in fruits and vegetables. Pay careful attention to the amounts and types of fat in your diet. Lower your salt intake. These changes can help lower high blood pressure and high blood cholesterol.
* Losing weight if you're overweight or obese.
* Quitting smoking.
* Doing physical activity to improve heart fitness. Ask your doctor how much and what kinds of physical activity are safe for you.

Fever

Also called: Pyrexia
A fever is a body temperature that is higher than normal. It is not an illness. It is part of your body's defense against infection. Most bacteria and viruses that cause infections do well at the body's normal temperature (98.6 F). A slight fever can make it harder for them to survive. Fever also activates your body's immune system.
Infections cause most fevers. There can be many other causes, including
Medicines
Heat exhaustion
Cancers
Autoimmune diseases

Treatment depends on the cause of your fever. Your health care provider may recommend using over-the-counter medicines such as acetaminophen or ibuprofen to lower a very high fever. Adults can also take aspirin, but children with fevers should not take aspirin. It is also important to drink enough liquids to prevent dehydration.

Eye Cancer

Cancer of the eye is uncommon. It can affect the outer parts of the eye, such as the eyelid, which are made up of muscles, skin and nerves. If the cancer starts inside the eyeball it's called intraocular cancer. The most common intraocular cancers in adults are melanoma and lymphoma. The most common eye cancer in children is retinoblastoma, which starts in the cells of the retina. Cancer can also spread to the eye from other parts of the body.
Treatment for eye cancer varies by the type and by how advanced it is. It may include surgery, radiation therapy, freezing or heat therapy, or laser therapy.

Allergy

Also called: Hypersensitivity
An allergy is a reaction of your immune system to something that does not bother most other people. People who have allergies often are sensitive to more than one thing. Substances that often cause reactions are
Pollen
Dust mites
Mold spores
Pet dander
Food
Medicine
Venom

How do you get allergies? Scientists think both genes and the environment have something to do with it. Normally, your immune system fights germs. It is your body's defense system. In most allergic reactions, however, it is responding to a false alarm.
Allergies can cause a runny nose, sneezing, itching, rashes, swelling or asthma. Symptoms vary. Although allergies can make you feel bad, they usually won't kill you. However, a severe reaction called anaphylaxis is life-threatening.Which is related to the systemic shock and bronchospasm.
National Institute of Allergy and Infectious Disease.

Skin Cancer

Skin cancer is the most common form of cancer in the United States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, neck, hands and arms. Another type of skin cancer, melanoma, is more dangerous but less common.
Anyone can get skin cancer, but it is more common in people who
Spend a lot of time in the sun or have been sunburned
Have light-colored skin, hair and eyes
Have a family member with skin cancer
Are over age 50
You should have your doctor check any suspicious skin markings and any changes in the way your skin looks. Treatment is more likely to work well when cancer is found early. If not treated, some types of skin cancer cells can spread to other tissues and organs.
National Cancer Institute
Start Here
Skin Cancer(Patient Education Institute)
Also available in Spanish
Skin Cancer Risk: Understanding the Puzzle(National Cancer Institute)
What You Need to Know about Skin Cancer(National Cancer Institute).

Bird Flu

Also called: Avian flu, Avian influenza, H5N1
Birds, just like people, get the flu. Bird flu viruses infect birds, including chickens, other poultry and wild birds such as ducks. Most bird flu viruses can only infect other birds. However, bird flu can pose health risks to people. The first case of a bird flu virus infecting a person directly, H5N1, was in Hong Kong in 1997. Since then, the bird flu virus has spread to birds in countries in Asia, Africa and Europe.
Human infection is still very rare, but the virus that causes the infection in birds might change, or mutate, to more easily infect humans. This could lead to a pandemic, or a worldwide outbreak of the illness.
During an outbreak of bird flu, people who have contact with infected birds can become sick. It may also be possible to catch bird flu by eating poultry that is not well cooked or through contact with a person who has it. Bird flu can make people very sick or even cause death. There is currently no vaccine.

Lung Cancer

Also called: Bronchogenic carcinoma
Lung cancer is one of the most common cancers in the world. It is a leading cause of cancer death in men and women in the United States. Cigarette smoking causes most lung cancers. The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. High levels of pollution, radiation and asbestos exposure may also increase risk.
Common symptoms of lung cancer include
A cough that doesn't go away and gets worse over time
Constant chest pain
Coughing up blood
Shortness of breath, wheezing, or hoarseness
Repeated problems with pneumonia or bronchitis
Swelling of the neck and face
Loss of appetite or weight loss
Fatigue
There are many types of lung cancer. Each type of lung cancer grows and spreads in different ways and is treated differently. Treatment also depends on the stage, or how advanced it is. Treatment may include chemotherapy, radiation and surgery.
National Cancer Institute.

Bone Cancer

Cancer that starts in a bone is rare. Cancer that has spread to the bone from another part of the body is more common.
There are three types of bone cancer:
Osteosarcoma - develops in growing bones, usually between ages 10 and 25
Chondrosarcoma - starts in cartilage, usually after age 50
Ewing's sarcoma - begins in nerve tissue in bone marrow of young people, often after treatment of another condition with radiation or chemotherapy
The most common symptom of bone cancer is pain. Other symptoms may vary depending on the location and size of the cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy and radiation.
National Cancer Institute.

Measles

Also called: Rubeola
Measles is an infectious disease caused by a virus. It spreads easily from person to person. The main symptom of measles is an itchy skin rash. The rash often starts on the head and moves down the body. Other symptoms include
Fever
Cough
Runny nose
Conjunctivitis (pink eye)
Sometimes measles can lead to serious problems. There is no treatment for measles, but the measles-mumps-rubella (MMR) vaccine can prevent it. You may have heard of "German measles", also known as rubella, which is a different illness altogether.
Centers for Disease Control and Prevention.

Liver Cancer

Also called: Hepatocellular carcinoma
Your liver is the largest organ inside your body. It filters harmful substances from the blood, digests fats from food and stores the sugar that your body uses for energy. Primary liver cancer starts in the liver. Metastatic liver cancer starts somewhere else and spreads to your liver.
Risk factors for primary liver cancer include
Having hepatitis
Having cirrhosis, or scarring of liver
Being male
Low weight at birth
Symptoms can include a lump or pain on the right side of your abdomen and yellowing of the skin. However, you may not have symptoms and the cancer may not be found until it is advanced. This makes it harder to treat. Treatment options include surgery, radiation, chemotherapy or liver transplantation.
National Cancer Institute

Dengue

Also called: Break-bone fever, Dengue fever
Dengue is an infectious disease caused by a virus. You can get it if an infected mosquito bites you. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States.
Symptoms include a high fever, headaches, joint and muscle pain, vomiting and a rash. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. Sometimes dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening.
To lower your risk when traveling in dengue-prone countries
Wear insect repellent with DEET
Wear clothes that cover your arms, legs and feet
Close unscreened doors and windows
National Institute of Allergy and Infectious Diseases.

Bacterial Infections

Bacteria are living things that have only one cell. Under a microscope, they look like balls, rods or spirals. They are so small that a line of 1,000 could fit across a pencil eraser. Most bacteria won't hurt you - less than 1 percent makes people sick. Many are helpful. Some bacteria help to digest food, destroy disease-causing cells and give the body needed vitamins. Bacteria are also used in making healthy foods like yogurt and cheese.
But infectious bacteria can make you ill. They reproduce quickly in your body. Many give off chemicals called toxins, which can damage tissue and make you sick. Examples of bacteria that cause infections include Streptococcus, Staphylococcus, and E. coli.
Antibiotics are the usual treatment. When you take antibiotics, follow the directions carefully. Each time you take antibiotics, you increase the chances that bacteria in your body will learn to resist them. Later, you could get or spread an infection that those antibiotics cannot cure.
National Institute of Allergy and Infectious Diseases.

Cough

Coughing is a reflex that keeps your throat and airways clear. Although it can be annoying, coughing helps your body heal or protect itself. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks. Acute coughs are the kind you most often get with a cold or flu. Chronic coughs last longer than 2 to 3 weeks. Causes of chronic cough include
Asthma
Allergies
COPD (chronic obstructive pulmonary disease)
GERD (gastroesophageal reflux disease)
Smoking
Throat disorders, such as croup in young children
Some medicines
Water can help ease your cough - whether you drink it or add it to the air with a steamy shower or vaporizer. If you have a cold or the flu, antihistamines may work better than non-prescription cough medicines. Children under four should not have cough medicine. For children over four, use caution and read labels carefully.

Breast Cancer

Breast cancer is the moct common cancer among women.Breast cancer affects one in eight women during their lives. Breast cancer kills more women in the United States than any cancer except lung cancer. No one knows why some women get breast cancer, but there are a number of risk factors. Risks that you cannot change include
Age - the chance of getting breast cancer rises as a woman gets older
Genes - there are two genes, BRCA1 and BRCA2, that greatly increase the risk. Women who have family members with breast or ovarian cancer may wish to be tested.
Personal factors - beginning periods before age 12 or going through menopause after age 55
Other risks include being overweight, using hormone replacement therapy, taking birth control pills, drinking alcohol, not having children or having your first child after age 35 or having dense breasts.
Symptoms of breast cancer may include a lump in the breast, a change in size or shape of the breast or discharge from a nipple. Breast self-exam and mammography can help find breast cancer early when it is most treatable. Treatment may consist of radiation, lumpectomy, mastectomy, chemotherapy and hormone therapy.
Men can have breast cancer, too, but the number of cases is small.
National Cancer Institute

AIDS AND HIV

WHAT IS HIV?

Human immunodeficiency virus (HIV) is the causative agent for AIDS. The most common type is known as HIV-1 and is the infectious agent that has led to the worldwide AIDS epidemic. There is also an HIV-2 that is much less common and less virulent, but eventually produces clinical findings similar to HIV-1. The HIV-1 type itself has a number of subtypes (A through H and O) which have differing geographic distributions but all produce AIDS similarly. HIV is a retrovirus that contains only RNA.

HIV is a sexually transmitted disease. Infection is aided by Langerhans cells in mucosal epithelial surfaces which can become infected. Infection is also aided by the presence of other sexually transmitted diseases that can produce mucosal ulceration and inflammation. The CD4+ T-lymphocytes have surface receptors to which HIV can attach to promote entry into the cell. The infection extends to lymphoid tissues which contain follicular dendritic cells that can become infected and provide a reservoir for continuing infection of CD4+ T-lymphocytes. HIV can also be spread via blood or blood products, most commonly with shared contaminated needles used by persons engaging in intravenous drug use. Mothers who are HIV infected can pass the virus on to their fetuses in utero or to infants via breast milk.

When HIV infects a cell, it must use its reverse transcriptase enzyme to transcribe its RNA to host cell proviral DNA. It is this proviral DNA that directs the cell to produce additional HIV virions which are released.

The genome of HIV contains only three major genes: env, gag, and pol. These genes direct the formation of the basic components of HIV. The env gene directs production of an envelope precursor protein gp160 which undergoes proteolytic cleavage to the outer envelope glycoprotein gp120, which is responsible for tropism to CD4+ receptors, and transmembrane glycoprotein gp41, which catalyzes fusion of HIV to the target cell's membrane. The gag gene directs formation of the proteins of the matrix p17, the "core" capsid p24, and the nucleocapsid p7. The pol gene directs synthesis of important enzymes including reverse transcriptase p51 and p66, integrase p32, and protease p11.

NOW WHAT IS AIDS?

When the CD4 lymphocyte count drops below 200/microliter, then the stage of clinical AIDS has been reached. This is the point at which the characteristic opportunistic infections and neoplasms of AIDS appear. Listed below are some of the more common complications seen with AIDS with images that illustrate gross and microscopic pathologic findings.

The organ involvement of infections with AIDS represents the typical appearance of opportunistic infections in the immunocompromised host--that of an overwhelming infection--that makes treatment more difficult. The strategies employed in AIDS patients to meet this challenge consist of (1) preserving immune function as long as possible with antiretroviral therapies, (2) using prophylactic pharmacologic therapies to prevent infections (such as Pneumocystis carinii pneumonia), and (3) diagnosing and treating acute infections as soon as possible.

THE TWO MOST COMMON DISEASES ASSOCIATED WITH HIV.

1.KAPOSI'S SARCOMA.

Kaposi's sarcoma (KS) is the most common tumor in HIV-infected patients. The appearance of this tumor in young homosexual men in 1981 was one of the first signals of the AIDS epidemic. Caused by a gammaherpes virus called Kaposi's sarcoma-associated herpes virus (KSHV), it often appears as purplish nodules on the skin, but can affect other organs, especially the mouth, gastrointestinal tract, and lungs.

2.PNEUMONIA.
Pneumocystis pneumonia (originally known as Pneumocystis carinii pneumonia, and still abbreviated as PCP, which now stands for Pneumocystis pneumonia) is relatively rare in healthy, immunocompetent people, but common among HIV-infected individuals. It is caused by Pneumocystis jirovecii.

TRANSMISSION.

The three most common transmission routes of HIV are sexual contacts,exposure to infected body fluid and it can also be transmited by mother to fetus.

PREVENTION.

1.Use of condoms during intercourse.
2.Not sharing needles.
3.Discard donated blood that is contaminated with HIV.
4.Circumcision reduce HIV infections.

TREATMENT.

The current choice of treatment is a regimen consisting of two nucleoside inhibitors(zidovudine and lamivudine) and a protease inhibitor(indinavir).This combination is known as HAART.It is very effective in prolonging life but doesnot cure HIV infection.

VACCINE.

No vaccine for human use is available.