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Chronic Conditions Leading to Natural Disease • Radiation injury • Pollutants • Nutritional diseases Radiation • Non-ionizing electromagnetic waves – Radio waves, microwaves, ultraviolet waves • Ionizing electromagnetic waves – X-rays – Gamma rays • High energy particles – Alpha particles (He nucleus, Rn) – Beta particles (e-) Radiation • Factors influencing radiation absorption – Energy – Mass and charge – Radiodensity of tissue • Mechanisms of action (point or frame shift) – Direct damage to DNA – Indirect damage by formation of O radicals (depends on [O2] and richness of blood supply) Radiation Biological doses measured in rads 1 rad of radiation delivers 100 ergs of energy per gram of target tissue Radiation Whole body irradiation • Acute Radiation sickness • Chronic Carcinogenesis Russia Japan • No warning • Contaminated milk consumed by children • 28 workers died of radiation poisoning • 6000 cases thyroid carcinoma, 15 fatal • Warning • Milk destroyed; foods being screened • 5 workers died (cause unstated) • ? Radiation Why is 2000 rads lethal, but we treat patients with 5000 rads without killing them? Radiation Biologic effects • Dose per unit time critical – Higher dose yields greater effect – Lower dose allows time for cellular DNA repair • Radiosensitivity of cells – Most sensitive in G2 and mitosis – Less sensitive in G0 and non-dividing cells Radiation Histologic appearance of irradiated tissue • Cytoplasmic swelling, vacuolization • Nuclear swelling, pleomorphism Radiation • • • • • • Microvasculature (constriction, necrosis) GI tract (N&V, C&D, scarring) Lungs (ARDS, scarring) CNS (progressive deficits, pleomorphism) Hematopoietic (pancytopenia, leukemia) Gonads (germ cell destruction, both sexes) Pollutants • Industrial Dust and gases • Personal Medications, tobacco, alcohol Pollutants Pneumoconiosis – disease caused by dust in lungs and reaction of lungs to dust Development depends upon • Amount of dust retained in lungs • Size and shape of particles (~10 μm) • Solubility and physiochemical reactivity Pollutants Pneumoconioses • Silicosis (tunneling, sand blasting) • Coal worker’s pneumoconiosis (mining) • Asbestosis (exposure to buildings) – Fibrous plaques – Bronchogenic carcinoma – Mesothelioma Pollutants Tobacco – Emphysema (10-15%) – Carcinoma (10%) – Accelerates atherosclerosis Pollutants Alcohol – Acute accidental deaths (overdose, MVAs) – Chronic cirrhosis, nutritional deficits Nutritional disease • Caused by – Ignorance and poverty – Alcoholism – Illness (malignancies, HIV, Crohn’s, anorexia) • Malnutrition – Marasmus – Kwashiorkor – Anorexia nervosa Nutritional disease Vitamin deficiencies • Vitamin A • Vitamin D • Vitamin C • Vitamin B1 • Vitamin B3 • Vitamin B12 Mineral deficiencies • Iron • Iodine Slide 10.29 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Slide 10.30 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Slide 10.31 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Slide 10.33 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Slide 10.32 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Slide 10.36 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Slide 10.37 W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company Nutritional disease Vitamin deficiencies • Vitamin A • Vitamin D • Vitamin C • Vitamin B1 • Vitamin B3 • Vitamin B12 Mineral deficiencies • Iron • Iodine Forensic Pathology • Medical subspecialty concerned with – Identification of remains – Cause of death – Manner of death Violent Injuries • • • • • • • Blunt Force Sharp Force Gunshot Wounds Asphyxia Burns Electrocution Drug Abuse Drug Abuse • Alcohol and Tobacco • Cocaine • Amphetamines • Opiates