Study, draw and describe the slide

N° 55 — calcified capsule of the thyroid gland (stained with hematoxylin and eosin). Pay attention to the staining with hematoxylin of the large focus of the sclerotised and hyalinated capsule of the thyroid gland. Which type of calcinosis is it?

Study the electronogram

Calcified metastases in the myocardium, x 12 000. Determine the organelles in which calcium salts are deposited.

Test

1. Name the processes in which calcium salts take place: a)..., b)..., c)..., d)....

2. Name the types of calcinosis according to the mechanisms by which they are produced: a)..., b)..., c)....

3. List the forms of Wilson's disease: a)..., b)..., c)....

4. Name the types of urolithiasis according to the chemical components: a)..., b)..., c)..., d)..., e)....

5. An adolescent presents with lassitude, jaundice, fever, hypersplenism, and Kayser-Fleischer rings.Which disorder is most likely?

Answers: 1. a) regulation of the acid-alkaline balance, b) blood clotting, c) cell membrane penetration, d) skeleton formation, e) neuro-muscular excitation. 2. a) dystrophic b) metastatic c) metabolic. 3. a) hepatic, b) lenticular, c) hepartolenticular. 4.a) urea, b) oxallates, c) phosphates, d) cysteinic, e) xanthynic. 5. Wilson's disease.

Questions to control the knowledge

1. Name the role of microelements for the organism.

2. Which processes do calcium salts takes place in?

3. What is calcium metabolism regulated in the organism by?

4. Name the types of calcification according to their mechanisms.

5. In which organs does petrification often occur?

6. In which organs does deposition of calcium salts occur during metastatic calcification?

7. Name the diseases, which are accompanied by hyper-and hypokalemia.

8. Types of Wilson's disease.

9. Name the general and local causes of stone formation.

10. Name the types of cholelithiasis according to the chemical components.

11. Name the types of uric stones according to theirs components.

12. Outcomes of urolithiasis.

Terminology

Osteoporosis, osteomalacia, calcinosis, petrification, ossification, microlith, macrolith, lithopedion, caprolith, sialolith, broncholith, arteriolith, phlebolith, cholelithiasis, nephrolithiasis, hypercalciemia, gout, calcifilaxia.

NECROSIS

Necrosis is death of cells and tissues in a living organism.

Necrosis can be caused by various factors such as hypoxia (ischaemia), chemical and physical agents, microbial agents, immune injury, disturbances of nervous trophism. Two essential changes bring about irreversible cell injury, cell digestion by lyitic enzymes and denaturation of proteins. These processes are morphologically identified by characteristic cytoplasmic and nuclear changes in necrotic cells. Microscopic study demonstrates characteristic changes both in the nucleus and cytoplasm of the cell and intracellular substance.

Nuclear changes. At first nucleus becomes wrinkled, the process is called karyopicnosis. After that karyorrhexis develops. Karyorrhexis is decomposition of the nucleus into small grains. And after that karyolysis develops, when the nucleus dissolution is observed.

In the cytoplasm, protein denaturation and coagulation, or hydration and colliquation take place. Coagulation completes in plasmorhexis. Plasmorhexis, that is when cytoplasm decomposition into lumps are

observed. Then plasmolysis takes place. Plasmolysis is hydrolytic fusion of cytoplasm. Sometimes we can observe vacuolization and calcification in the cytoplasm.

In the interstitial (base) substance of the intercellular space depolymerization with glucosamine glycane and saturation with blood plasma proteins develops. As a result interstitial substance becomes swollen and fuses. The same happens to the collagen fibers. Elastic fibers are fused (elastolysis). Reticular fibers are preserved longer than the other structures. Then they dissociate to lumps.

There are several stages in necrosis morphogenesis:

1) paranecrosis reversible changes; as a rule, reversible degeneration;

2) necrobiosis irreversible degenerative changes;

3) cell death;

4) cell autolysis decomposition of dead ultra-structures with hydrolytic enzymes.