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 [O 2 ] 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 No warning Contaminated milk consumed by children 28 workers died of radiation poisoning 6000 cases thyroid carcinoma, 15 fatal Japan 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 G 2 and mitosis –Less sensitive in G 0 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 B 1 Vitamin B 3 Vitamin B 12 Mineral deficiencies Iron Iodine

W.B. Saunders Company items and derived items Copyright (c) 1999 by W.B. Saunders Company 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

Nutritional disease Vitamin deficiencies Vitamin A Vitamin D Vitamin C Vitamin B 1 Vitamin B 3 Vitamin B 12 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

Alcohol and Tobacco Cocaine Amphetamines Opiates