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The formation of new lesions at sites of trauma good bad cholesterol foods list cheap pravachol 20mg on line, referred to as the Koebner phenomenon high cholesterol foods chart purchase pravachol 20mg, is also present cholesterol hdl ratio canada purchase pravachol with mastercard. In patients with psoriasis cholesterol in liquid eggs order 10mg pravachol with amex, trauma may cause thickening of the epidermis (acanthosis), downward regular elongation of the rete ridges, hyperkeratosis, and parakeratosis. These changes may be related to faulty -adrenergic receptors and decreased activity of adenyl cyclase in the lower epidermis. Because the keratinocyte turnover time is faster, there is no granular cell layer. These areas within the epidermis are slightly spongiotic, but no bullae are formed. Lymphocytes below a zone of degenerated collagen in the superficial dermis are found in lichen sclerosis, not psoriasis. These vesiculobullous diseases include pemphigus vulgaris, bullous pemphigoid, and dermatitis herpetiformis. Pemphigus vulgaris is a chronic, severe, possibly fatal skin disease that is characterized by the formation of large bullae in the skin and oral mucosa. Pemphigus vulgaris is characterized by acantholysis (separation of the keratinocytes) that produces intraepidermal (suprabasal) bullae. Clinically the bullae are large, flaccid, and easily ruptured because of their thin roof. Verruca vulgaris, the most common type of wart, may occur anywhere on the body, but most commonly is located on the dorsal surfaces of the hands. The pho- 472 Pathology tomicrograph reveals characteristic features of verrucae vulgaris, including hyperkeratosis, papillary hyperplasia of the epidermis, and numerous large keratohyalin granules within the epidermal cells. Epidermodysplasia verruciformis is an autosomal recessive disease associated with impaired cellmediated immunity and the widespread development of multiple flat warts. The superficial mycoses are characterized by infection of the superficial layers of the skin. The most common type is pityriasis versicolor (tinea versicolor), an infection of the upper trunk that is caused by M. Clinically, there are multiple groups of macules (discolorations) with a fine peripheral scale. These macules are hyperpigmented (dark) in white-skinned races but hypopigmented (light) in dark-skinned races. The fragments of hyphae are the "spaghetti," while the round yeast cells are the "meatballs. Examination of his peripheral blood reveals leukoerythroblastosis with numerous target cells. Abnormal "tunneling" of osteoclasts into bone trabeculae Abnormal osteoclasts that lack the normal ruffled border Decreased calcification of osteoid matrix Decreased cartilage cell proliferation at epiphyseal plates of long bones Defective synthesis of type I procollagen 448. A 4-year-old boy presents with a history of numerous fractures that are not related to excessive trauma. Physical examination reveals evidence of previous fractures along with abnormally loose joints, decreased hearing, and blue scleras. Osteopetrosis Osteoporosis Osteomalacia Osteogenesis imperfecta Osteitis deformans 473 Copyright 2002 the McGraw-Hill Companies. Physical examination reveals severe kyphosis, while an x-ray of her back reveals a compression fracture of a vertebral body in the lumbar area along with marked thinning of the bones. Serum calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels are all within normal limits. Osteopetrosis Osteoporosis Osteomalacia Osteitis fibrosa cystica Osteitis deformans 450. Sections of bone showing normal-sized trabeculae that are only partially calcified with enlarged seams of uncalcified osteoid are most likely the result of a. Failure of bone remodeling Failure of bone mineralization Failure of osteoid formation Reactive bone formation Reduction in the amount of normally mineralized bone 451. A section of bone shows prominent osteoid seams, very large osteoclasts with more than 12 hyperchromatic nuclei, and viral-type inclusion particles.

The powder of pyrethrum flowers shows the presence of parenchymatous tissues are high cholesterol foods bad purchase pravachol discount, with aggregate crystals cholesterol mg per day purchase 10 mg pravachol overnight delivery, sclerenchymatous tissues cholesterol medication for triglycerides buy pravachol mastercard, t-shaped hairs cholesterol levels elevated best buy for pravachol, spherical pollen grains and tracheas. Dried flowers or powder should be stored in wellclosed container, protected from air and light and should not be kept for more than two years. Biological Source Pyrethrum consists of the dried flower heads of Chrysanthemum cinerariaefolium (Trev. Geographical Source Pyrethrum is indigenous to Balkan areas of Dalmatia, Herzegovina and Montenegrow. The alcohol component of the pyrethrin present in the form of keto-alcohol pyrethrolone and that of cinerine as cinerolone. The flowers of pyrethrum also consist of a triterpene alcohol pyrethrol and sesquiterpene lactones, pyrethrocin. Other constituents includes pyretol, pyrethroloxic acid, chrysenthemine and chrysathemumic acid. Pyrethrum brings about its pesticide activity by an instantaneous knock down action on insects within few seconds. It has no appreciable effect on insects as a stomach poison but acts by contact, producing a characteristic effect on the nervous system that results in muscular excitation, convulsion and paralysis. The synthetic pyrethrin-like compound, allethrin, also shows the potential insecticidal activity but its activity is not synergistic when combined with synergists available at present. Pyrethrum is widely used in domestic and agricultural insecticidal sprays, dusting powders and aerosol preparations for controlling a variety of garden pests and fleas, lice and ticks on pets. A noninflammable preparation is used as a spray in aircraft to kill insect vectors and so prevent the transmission of insect borne diseases. These components occur in the oleoresin secretion of certain floral parts, known as achenes. The concentrated extracts are usually diluted with kerosene to a pyrethrin strength of about 0. Pyrethrin assays are based on the total chrysanthemum acid and the total pyrethrin acid; therefore, the content of pyrethrums is in effect the content of pyrethrins, cinerins and jasmolins. It consists of short but thick brown coloured pieces with numerous longitudinal wrinkles, transverse cracks and circular lenticels. The transversely cut surface of roots shows thick cork followed by rings of sclerenchyma containing strands of phloem. Microscopy the transverse section of the derris root consists of the layers of cork cells followed by phelloderm and pericyclic parenchyma with numerous groups of lignified sclereids and starch grains. Phloem parenchyma contains longitudinal small cells and prismatic crystals of calcium oxalate. Two types of xylem vessels of larger and smaller size are present in groups of two to six. It is especially useful for application to vegetable near the time of harvest when certain other insecticides cannot be used because of potentially excessive residues. Derris and rotenoids are also useful in controlling insect parasites of animals such as cattle, grubs, lice, fleas and ticks on pets and live stocks. It is irritant to eyes and mucosa and may cause convulsions and stupor if inhaled. Rotenoids are generally harmless to mammals but are extremely toxic to fish and used to kill unwanted fish in a pond to restocking. Biological Source Lonchocarpus consists of the dried roots of Lonchocarpus utilis, L. It is colourless to brownish crystalline compound or a white to brownish white odourless tasteless crystalline powder. It is insoluble in water but soluble in alcohol, acetone and other organic solvents. The overall evaluation of drug depends both on rotenone content and on the amount of chloroform extractive that the root yields.

A 34-year-old male presents with multiple large cholesterol range for female order pravachol 10 mg mastercard, sharply defined cholesterol ratio calculator 2015 cheap 10mg pravachol amex, silver-white scaly plaques on the extensor surfaces of his elbows and knees and on his scalp cholesterol ketogenesis generic pravachol 20 mg with mastercard. Lifting of one of the scales on his elbows produces multiple minute areas of bleeding (positive Auspitz sign) cholesterol test normal generic 20mg pravachol with visa. Subepithelial bullae Regular elongation of the rete ridges Liquefactive degeneration of the basal layer of the epidermis Increased granular cell layer Chronic inflammation below a zone of degenerated collagen 444. A 52-year-old male presents with multiple tense bullae that involve his skin but not his oral mucosa. Physical examination finds that none of the bullae have ruptured, and the Nikolsky sign is negative. Pemphigus vulgaris Bullous pemphigoid Dermatitis herpetiformis Psoriasis Lichen planus 462 Pathology 445. The photomicrograph below is from a small papillary lesion found on the dorsal surface of the left hand of a 18-year-old. Acute necrotizing hemorrhagic vasculitis Aggregates of epidermal cells with molluscum bodies Dermal edema and mild superficial perivascular mixed inflammation Hyperkeratosis, papillomatosis, and prominent keratohyalin granules Intraepidermal vesicle, multinucleated giant cells, and Cowdry A inclusions Skin 463 446. A 19-year-old male presents with a rash that involves a large, irregular portion of his trunk. Examination reveals several annular lesions that have a raised papulovesicular border with central hypopigmentation. Malassezia furfur Molluscum contagiosum Sarcoptes scabiei Staphylococcus aureus Trichophyton rubrum Skin Answers 430. A lentigo consists of melanocytic hyperplasia in the basal layers of the epidermis along with elongation and thinning of the rete ridges. Increased numbers of melanocytes may form clusters located at the tips of the rete ridges in the epidermis (junctional nevus), within the dermis (intradermal nevus), or both at the tips of the rete ridges and within the dermis (compound nevus). A blue nevus is composed of highly dendritic melanocytes that penetrate more deeply into the dermis. The Spitz tumor (epithelioid cell nevus) is a benign lesion composed of groups of epithelioid and spindle melanocytes and is found in children and young adults. A freckle (ephelis) is a pigmented lesion caused by increased melanin pigmentation within keratinocytes of the basal layer of the epidermis. Seborrheic keratoses are benign, elevated ("stuck-on") lesions that usually occur in older individuals. Histologically, these lesions reveal hyperkeratosis with horn and pseudohorn cyst formation. The sudden development of large numbers of seborrheic keratoses (Leser-Trelat sign) may occur in association with malignancy. This association with malignancies may also be seen with the malignant type of acanthosis nigricans, which consists of hyperpigmented areas of skin in the groin and axilla. The histologic appearance can make differentiating keratoacan464 Skin Answers 465 thomas from squamous cell carcinomas on a histologic basis quite difficult. The clinical history of rapid development within several weeks is very helpful in making the correct diagnosis. Verrucae vulgaris histologically reveal hyperkeratosis, papillomatosis, and koilocytosis. Actinic (solar) keratoses, found on sun-damaged skin, microscopically show hyperkeratosis, parakeratosis, atypia of the epidermal keratinocytes, and degeneration of the elastic fibers in the dermis. These lesions are in fact carcinomas in situ since there is no invasion into the underlying dermis. If invasion were present, the lesion would be diagnostic of a squamous cell carcinoma. The most common polyp of the skin is called an acrochordon (skin tag), which histologically reveals a large polyp lined by squamous epithelium. Epidermal inclusion cysts are keratin-filled cysts that are lined by squamous epithelium having a granular cell layer.

Groups of 20 rats receive in addition to carbon tetrachloride cholesterol panel generic 10mg pravachol with mastercard, the compound under investigation in various doses by gavage twice daily (with the exception of the weekends cholesterol test at home hdl ldl buy cheap pravachol 20 mg line, when only one dose is given) on the basis of the actual body weight cholesterol levels us vs canada pravachol 10 mg mastercard. At the end of the experiment (8 weeks) cholesterol levels lab results 10 mg pravachol with mastercard, the animals are anaesthetized and exsanguinated through the caval vein. The liver, kidney, aortic wall, and tail tendons are prepared for determination of hydroxyproline. For histological analysis, three to five pieces of the liver weighing about 1 g are fixed in formalin and Carnoy solution. Hepatitis in Long-Evans Cinnamon Rats the Long-Evans Cinnamon strain of rats has been recommended as a useful model to study genetically transmitted hepatitis and chronic liver disease. It has been speculated that this strain of rats is prone to liver diseases due to excessive copper accumulation in the liver. Long-Evans Cinnamon rats are housed in temperature and humidity controlled rooms at a 12:12 light/dark cycle. Drugs are applied via mini-pumps intraperitoneally implanted under ether anaesthesia. The occurrence of jaundice is easily observable as the time when the ears and tail turn yellow and the urine becomes bright orange, staining the fur in the lower abdominal region. Tiny and short septa of connective tissue without influence on the structure of the hepatic lobules. Large septa of connective tissue, flowing together, and penetrating into the parenchyma; tendency to develop nodules. Galactosamine-induced Liver Necrosis A single dose or a few repeated doses of D-galactosamine causes acute hepatic necrosis in rats. The rats are sacrificed at various time intervals and the livers excised and evaluated by light microscopy and immunohistology using antibodies against macrophages, lymphocytes, and the extracellular matrix component. The values of all the parameters of the test group are compared with the control group using suitable statistical methods. The control group receives 1% gum acacia as vehicle, corn oil (1 ml/100 g/day), and glucose isocaloric to the amount of alcohol. The rats are sacrificed and the livers dissected out for histopathological analysis. The value of the test is compared with the control using suitable statistical analysis. Bile Duct Ligation-induced Liver Fibrosis in Rats Ligation of the bile duct in rats induces liver fibrosis, which can be evaluated histologically and by determination of serum collagen parameters. Albino rats are anaesthetised and laparotomy is performed under aseptic conditions. A midline incision in the abdomen is made from the xiphosternum to the pubis, exposing the muscle layers and the linea alba, which is then incised over a length corresponding to the skin incision. The edge of the liver is then raised and the duodenum pulled down to expose the common bile duct, which pursues an almost straight course of about 3 cm from the hilum of the liver to its opening into the duodenum. There is no gall bladder, and the duct is embedded for the greater part of its length in the pancreas, which opens into it by numerous small ducts. A blunt aneurysm needle is passed under the part of the duct selected, the pancreas is stripped away with care, and the duct is double ligatured with cotton thread. The peritoneum and the muscle layers as well as the skin wound are closed with cotton stitches.

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