Dear listeners! Warning: this course contains shocking materials and is not recommended for viewing to persons with weak psyche, minors and pregnant women. The course describes subject and methods of Pathophysiology, its place within system of biomedical sciences and history. It includes General Nosology (concept of health and disease, general etiology and pathogenesis, pathological processes and states, role of causal factors, conditions, reactivity and somatotype in pathology). It gives systematic of locally and centrally driven typical pathological processes: arterial, venous and combined hyperemiae, stasis, inflammation, immunopathological processes (including allergy and autoimmune disorders) acute phase response, fever, stress, shock, etc. Course deals with functional, metabolic and informational aspects of typical pathologic processes, like disorders of signaling, reception, post – receptor translation, programming and program archiving, conflicts of programs in living systems. It contains the consequent analysis of the injury and defensive responses as regards separate cells, organs and tissues and the whole organism. The lectures based on author’s original three-volumed textbook and workshop in Pathophysiology republished in Russia many times.
1_5 "Pathophysiology as Systemic Pathobiology in Medical Knowledge"
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Del curso dictado por Saint Petersburg State University
General Pathophysiology
21 calificaciones
De la lección
Pathophysiology as a Science
Conoce a los instructores
Churilov Leonid PavlovichAssociate Professor, Full Member of International Academy of Sciences (Health and Ecology)
Department of Pathology, Faculty of Medicine
Step by step, pathophysiology broadens the scope of its attention
and comes closer and closer to anatomic pathology and other medical disciplines.
And, now, I would like to tell you about pathophysiology
as systemic pathobiology in medical knowledge.
First of all, look at this person.
He was one of the first who understood that in future pathophysiology will
add also pathochemistry and include many other areas.
It is Bernhardt Naunyn from Konigsberg.
He and his disciples were the first who
concentrated their experimental pathophysiological studies on metabolism,
on metabolic disorders, on biochemical and even genetical aspects of pathophysiology.
Closest disciple of Naunyn, Oskar Minkowski,
have developed the first experimental model of
sugar diabetes in history by means of dog pancreatectomy.
He also established the fact that uric acid is produced exclusively in
liver and made very many other biochemical discoveries by biochemical methods.
But because he was involved in modelling of metabolic disorders in animals,
he obviously was pathophysiologist and one of the first pathochemists.
So these persons Naunyn,
Minkowski and other were
first who understood that the field of biochemical,
the field of genetical methods is not alien for pathophysiology.
These are founders of pathochemistry.
Russia was also in the first ranks of these pioneers.
You can see here, Sergei Mikhailovich Lukyanov,
prominent Russian pathophysiologist, schoolmate of Ivan Pavlov by the way.
And this person who was head of pathology department in Warsaw University, he said,
"Behind morphological structure, always is a lurking physical and chemical structures."
So he was absolutely sure that in the future,
there will be conference of
morphological and functional approach on the chemical and physical basis.
Step by step, integrity for all of pathophysiology in medicine became clear
and this integrity for all is analogous to that of
systemic pathobiology among non-medical life sciences.
There are different medical sciences.
Some of them are constructed around certain method like radiology,
for example, around X-ray diagnosis.
Some of them are constructed around certain organ or
system and problems of that system like neurology,
cardiology but pathophysiology is universal.
It is not constructed around method or around organ.
It is constructed around central idea.
Which is central idea of pathophysiology?
Pathophysiology is a science about
technical faults and technological defects in living systems,
and pathophysiology deals with functional and molecular sequels
of the organisms' technological imperfection.
So the main idea of pathophysiology is imperfection of our body.
And everything which deals with etiology of diseases,
pathogenesis of disease and models of diseases,
or pathological processes of which diseases are constructed,
everything which deals with that is pathophysiological knowledge.
Famous Russian medical doctor, Sergei Botkine,
once determined the goal of pathophysiology as follows.
Pathophysiology, in Botkine's opinion,
is natural science located by patient's bedside.
Now dear colleagues, look at this picture.
It is not a ball for playing football.
It is a position of pathophysiology within the system of medical knowledge.
Once, I took colored pencils and draw it on a sheet of paper,
and you can see that position of pathophysiology is central.
Of course, you know that every bird praises it's own nest.
I am pathophysiologist, and I positioned pathophysiology in the center.
But look at this, in life sciences,
in biology, in non-clinical,
non-medical biology, long ago exist a branch named systemic biology.
And who is systemic biologist?
It is very respectable guy.
He knows a little bit of zoology,
a little bit of botanics,
some portion of genetics,
some portion of biochemistry,
a little bit of physiology,
a little bit of immunology.
Systemic biologist is universal, versatile like octopus.
Of course, he is less skillful in genetics than the professional geneticist.
He is less aware about all facets of physiology than professional physiologists are.
But he is a single guy in the whole biology who is able to intermingle,
to put together the pieces of mosaic from different
Areas of modern biology.
In medical science, the function of systemic pathobiologist belongs to pathophysiologist.
And you can see that pathophysiologist is not so
skillful in immunology like immunologists.
Not so informed in all facets of biochemistry like professional biochemists.
But, he's able to combine and to display systemic approach to the problem of disease.
Its reasons, its mechanisms and its modelling.
That's why in the center of this picture, we have pathophysiology,
systemic pathobiology of medical science and
in close relation you have pathomorphology, immunopathology, pathochemistry,
medical genetics, and even exotic branches of Pathoinformatics and pathobiophysics,
and to periphery on the longer distance,
we have clinical disciplines.
And pathophysiology is like a nail,
putting all of them together.
Now I would like to go into details with Pathoinformatics,
as an element of pathophysiology.
Informatics is well known word.
Everyone knows that informatics is something
correlated to computers and computer science.
But believe me, informatics exists not only in computer,
living cell is programmed machine.
And living cells function on
weak constant electric current of mitochondrial biological oxidation.
And these living cells,
they have their own natural informatics,
not only they have their biochemistry,
their physiology, because every living cell is programmed machine.
It does not give any reactions which have no programmed basis.
Look at this picture.
The cell is portrayed here as a small computer.
We have governing signals.
Mostly these are chemical signals, different hormones, neurotransmitters,
autacoids, antibodies, ions and even substrates.
These gathering signals are like fingers,
they press button of cell receptor on the keyboard of cell surface,
and after that, information goes inside the cell.
There is post receptor transmission,
there is a program inside the cell nucleus and we can retrieve
that program or we can archive
that program and even there is possible conflict of programs.
If you have a computer,
your computer may work perfectly but sometimes,
your computer may give glitches and misfunctions.
And you know, the misfunctions and glitches of computer are
related either to hardware or to software.
Absolutely similar situation within the cell.
The cell also has hardware and software.
And disease can result from problems with hardware,
like somebody has broken your central processor
or someone split hot coffee on your keyboard.
But also disease can be resulted from the problems with software.
When the whole hardware is absolutely perfect, but doesn't function.
Like your computer can be absolutely perfect as regards to hardware,
but misfunctioning because of the conflict of programs.
Some working program has a conflict with some computer game for the same memory resource,
for the same utility,
or for the same command.
So, the conclusion is that part of pathophysiology is in fact
pathocybernetics or parthoinformatics because
the nature of every pathological process is dualistic.
It has hardware and it has software.
Organism or cell may suffer from informational software problems, with signalling,
reception, translation, mimicry of signals,
archiving of programs, retrieving of programs, conflicts of programs.
For every indictee, we can find
examples in the world of diseases and pathological processes.
So because we still have no departments of pathoinformatics in medical school,
pathophysiologists must take these barrow
and teach pathoinformatics also and we will do it.
Now after such a long talk,
I have to give you canonic strict definition of pathophysiology.
Subject of pathophysiology: pathophysiology is
an integrative experimental biomedical science of body imperfection.
It deals with technical errors and technological faults in organism
revealed in natural mechanisms of our body by diseases.
Next thing deals with the methods of pathophysiology.
You can see the methods here.
The main method is experimental in broad sense.
Different kinds of experiments.
First kind of experiment is synthetic when you wish to reproduce
the whole disease as close to national disease as it is possible.
This is modelling of diseases.
It is performed in vivo with animals.
Another thing is analytical experiment.
When you just take a part of disease,
an element of disease,
and try to explore it separately as a rule in vitro,
it is exploration of the elements of diseases,
analytical experimentation in vitro.
Also in clinical pathophysiology,
we have clinical functional tests and clinical chemical tests,
they're both kinds of tests belong to
clinical pathophysiology and in fact it, is clinical experimentation.
And finally, every medical doctor,
when he thinks about diagnosis,
relies upon clinical and lab data,
he creates conceptual model of a disease,
of a concrete case of the disease in his mind,
and that concept of modeling also belong to pathophysiologist.
So, every medical doctor,
if it is good doctor is a little bit pathophysiologist.
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