Dr. Mangum has created many youtube videos throughout his education, aimed at teaching undergraduate students principles of medicine. Please enjoy these free videos.
This video discusses some basic concepts of pathology. It’s video #1 of a series of basic pathology videos. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
How does a Cell react to stress? Physiological and Pathological Adaptation. Hypertrophy and Hyperplasia concepts are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
How does a Cell react to stress? Physiological and Pathological Adaptation. Atrophy and Metaplasia concepts are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What is the difference between necrosis and apoptosis? This is the 4th video in the Basic Pathology video series. Concepts of necrosis and apoptosis are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
There are 8 main ways by which cells can become injured. They can either adapt of die via apoptosis or necrosis. This is video 5 of the basic pathology video series. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What do cells look like when they are dying, and what happens to them? these questions are answered in this and the next few videos. This is video #6. Cellular swelling. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What do cells look like when they are dying, and what happens to them? these questions are answered in this and the next few videos. This is video #7. cellular swelling, nuclear condensation, apoptotic bodies. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Concepts of karyolysis, pyknosis, karyorrhexis, Coagulative necrosis, Liquefactive necrosis, and gangrenous necrosis are explained. This is video #8. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video explains Caseous necrosis, fat necrosis, and Fibrinoid necrosis. It also reviews the other gangrene, wet gangrene, Liquefactive necrosis, and Coagulative necrosis. Watch video #8 for further explanation. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Depletion of ATP, Damage to Mitochondria, Influx of Calcium are explained. The most important targets of injurious stimuli are (1) mitochondria, the sites of ATP generation; (2) cell membranes, on which the ionic and osmotic homeostasis of the cell and its organelles depends; (3) protein synthesis; (4) the cytoskeleton; and (5) the genetic apparatus of the cell. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Free radicals are explained. Reactive oxygen species, superoxide dismutases, Glutathione, vitamins E, A, and C, and β-carotene, Lipid peroxidation of membranes, Cross-linking of proteins, and DNA fragmentation are also discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Examples of Ischemia, Hypoxia, Ischemia-Reperfusion Injury, Chemical (Toxic) Injury are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Causes of Apoptosis, Apoptosis in Physiologic Situations, Apoptosis in Pathologic Conditions, apoptotic bodies, Mechanisms of Apoptosis, Mitochondrial (Intrinsic) Pathway of Apoptosis, The Death Receptor (Extrinsic) Pathway of Apoptosis, and TNF are all explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
A normal process but an inadequate metabolism of product can lead to Intracellular Accumulations. A normal or an abnormal endogenous substance accumulates because of genetic or acquired defects in its folding, packaging, transport, or secretion. An abnormal exogenous substance is deposited and accumulates because cell can’t excrete it or break it down. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Under some circumstances cells may accumulate abnormal amounts of various substances, which may be harmless or associated with varying degrees of injury. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Pathologic calcification is a common process in a wide variety of diseases. Dystrophic Calcification and metastatic calcification are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014.
Cellular aging is the result of a progressive decline in the proliferative capacity and life span of cells and the effects of continuous exposure to exogenous factors that cause accumulation of cellular and molecular damage. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Inflammation is a protective response intended to eliminate the initial cause of cell injury as well as the necrotic cells and tissues. leukocytes are the main cells that respond. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Changes in blood vessels begin rapidly after infection or injury but may develop at variable rates, depending on the nature and severity of the original inflammatory stimulus. Two important aspects of acute inflammation are Vascular permeability and Vasodilation. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
An important function of the inflammatory response is to deliver leukocytes to the site of injury and to activate them. This video explains how the body delivers leukocytes to an injured area, so they can help destroy the pathogen. margination, diapedesis, selectin family of adhesion molecules, E-selectin, P-selectin, and chemotaxis are all explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Once leukocytes have been recruited to the site of infection or tissue necrosis, they must be activated to perform their functions. There are several ways that activation occurs. They include microbes, products of necrotic cells, and several chemical mediators. Leukocytes express on their surface different kinds of receptors that sense the presence of microbes. Leukocyte-Induced Tissue Injury is also explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Leukocytes play a central role in the body’s defense, it is not surprising that defects in leukocyte function, both acquired and inherited, lead to increased susceptibility to infections and compromises our immune function. The pathogenesis of Leukocyte adhesion deficiency type 1 (LAD-1), Leukocyte adhesion deficiency type 2 (LAD-2), chronic granulomatous disease, and Chédiak-Higashi syndrome are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What does the process of inflammation look like? Serous inflammation, Fibrinous inflammation, effusion, and Suppurative (purulent) inflammation are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Tissue macrophages, mast cells, and endothelial cells at the site of inflammation, as well as leukocytes that are recruited to the site from the blood, are all capable of producing different chemical mediators of inflammation. The two vasoactive amines histamine and serotonin are stored as pre-fabricated molecules in mast cells and other cells and are among the first chemicals to be released in acute inflammatory reactions. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video discusses the chemicals Arachidonic acid, Prostaglandins, Leukotrienes, Lipoxins, and Thromboxanes. It also discusses the enzyme pathways of phospholipases, Cyclooxygenase that stimulates the synthesis of prostaglandins and thromboxanes, and lipoxygenase is responsible for production of leukotrienes and lipoxins. Gastric Ulers are caused by long term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. COX-1 and COX-2 inhibitors are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Platelet-activating factor (PAF) is another phospholipid-derived mediator with a broad spectrum of inflammatory effects. PAF is acetyl glycerol ether phosphocholine. Cytokines are polypeptide products of many cell types that function as mediators of inflammation. TNF and IL-1 are produced by activated macrophages, as well as mast cells, and endothelial cells.The principal role of these cytokines in inflammation is in endothelial activation. systemic acute-phase reaction is what happens when TNF and IL-1 get into the blood stream and create a systemic response. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The complement system consists of plasma proteins that play an important role in host defense (immunity) and inflammation. Membrane attack complex (MAC), lectin pathway, C3 convertase, and C5 convertase are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Chronic inflammation is inflammation of extended duration (weeks to months to years) in which active inflammation, tissue injury, and healing occur simultaneously. Macrophages is the primary cell involved in the chronic inflammation pathway. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The concepts of Hematopoiesis, Lymphocytes, Plasma Cells, Eosinophils, and Mast Cells are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Anyone who has suffered through a severe bout of a viral illness (such as influenza) has experienced the systemic effects of inflammation, collectively called the acute-phase reaction, or the systemic inflammatory response syndrome. C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA) protein, pyrogens, IL-1, TNF, erythrocyte sedimentation rate (ESR), Leukocytosis, and “shift to the left” concepts are explained and explored. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Critical to the survival of an organism is the ability to repair the damage caused by toxic insults and inflammation. This video is an overview of the process of tissue repair. Fibrosis causes a lack of function. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
To understand physiologic cell proliferation (as in repair) and pathologic proliferation (as in cancer), it is important to learn about the cell cycle and its regulation. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The ability of tissues to repair themselves is influenced by their capacity to regenerate the missing tissue and their ability that is inherent for them to divide and undergo mitosis. In most continuously dividing tissues the mature cells are terminally differentiated and short-lived. As mature cells die the tissue is replenished by the differentiation of cells generated from stem cells. Thus, in these tissues there is a homeostatic equilibrium between the replication and differentiation of stem cells and the death of the mature, fully differentiated cells. Regenerative medicine is the “process of replacing or regenerating human cells, tissues or organs to restore or establish normal function”. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Cell proliferation can be triggered by many chemical mediators, such as growth factors, hormones, and cytokines. Expansion of cell populations usually involves an increase in cell size (growth), cell division (mitosis), and protection from apoptotic death (survival). Protooncogenes are also discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Concepts of paracrine, autocrine, and endocrine are discussed. This video presents an overview of signal transduction originating from three types of receptors: receptors with tyrosine kinase activity, G-protein-coupled receptors, and receptors without intrinsic enzymatic activity. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What is the extracellular matrix? Why is the extracellular matrix comprise of 25% of our bodies? The ECM is a dynamic, constantly remodeling macromolecular complex synthesized primarily by fibroblasts, which assembles into a network that surrounds cells.The ECM sequesters water, provides turgor to soft tissues, is a reserve for minerals, and gives rigidity to bone. ECM occurs in two basic forms: interstitial matrix and basement membrane. Collagen, Elastin, Proteoglycans, Hyaluronan, glycosaminoglycans, Fibronectin, laminin, and Integrins are discussed in the next 2 videos. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video continues the discussion on the Extracellular Matrix (ECM) and what it does. Elastin, Proteoglycans, Hyaluronan, Integrins, glycosaminoglycans (GAG), Laminin, Fibronectin, cell adhesion molecules (CAMs), immunoglobulins, cadherins, selectins, and integrins are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
If tissue injury is severe or chronic, and results in damage to parenchymal cells and epithelia as well as the stromal framework, or if nondividing cells are injured, repair cannot be accomplished by regeneration alone. Under these conditions, repair occurs by replacement of the nonregenerated cells with connective tissue, or by a combination of regeneration of some cells and scar formation. Repair by connective tissue deposition consists of a four step process: Formation of new blood vessels (angiogenesis) Migration and proliferation of fibroblasts Deposition of ECM (scar formation) Maturation and reorganization of the fibrous tissue (remodeling) Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Angiogenesis is a critical process in healing at sites of injury, in the development of collateral circulations at sites of ischemia, and in allowing tumors to increase in size beyond the constraints of their original blood supply. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Several factors induce angiogenesis, but the most important are vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (FGF-2). Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video describes the healing of skin wounds (cutaneous wound healing). Primary union, or healing by first intention, and secondary union or healing by second intention are explained in this video. Wound strength is also discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Localized increases in intravascular pressure can result from impaired venous return. Generalized increases in venous pressure causes fluid back up and consequently causes fluid to leak out into the surrounding tissues, this is edema. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video explains one purpose of lymphatics, which is to drain the fluid escaped from the capillary that was not reabsorbed by the venous side of the capillary.Impaired lymphatic drainage and consequent lymphedema is usually localized; it can result from inflammatory or neoplastic obstruction. The parasitic infection filariasis can cause extensive inguinal lymphatic and lymph node fibrosis which causes the lower extremity to swell and is called elephantiasis. In breast carcinoma infiltration and obstruction of superficial lymphatics can also cause edema of the overlying skin, the so-called peau d’orange (orange peel) appearance. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Osmosis is the net movement of solvent molecules through a partially permeable membrane into a region of higher solute concentration, in order to equalize the solute concentrations on the two sides.Albumin is the serum protein most responsible for maintaining intravascular colloid osmotic pressure; reduced osmotic pressure occurs when albumin is inadequately synthesized or is lost from the circulation. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Edema is most easily recognized on a gross appearance. Any organ or tissue in the body may have edema. It is most commonly encountered in subcutaneous tissues, lungs, and brain. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The terms hyperemia and congestion both suggest a local increased volume of blood in a particular tissue outside of the blood vessel. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Hemorrhage is extravasation of blood from vessels into the ECM or extravascular space. The concepts of petechiae, purpura, and ecchymoses are explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
How does the body prevent bleeding to go uncontrolled? This question is answered by the process of Hemostasis. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
After an injury, a brief period of arteriolar vasoconstriction occurs mostly as a result of reflex neurogenic mechanisms and is augmented by the local secretion of factors such as endothelin. Endothelial injury also exposes highly thrombogenic subendothelial extracellular matrix, allowing platelets to adhere and be activated. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
After vascular injury, platelets encounter ECM constituents (of which collagen is the most important) and additional proteins (vWF being critical) that are normally not exposed when the endothelial layer is intact. Upon contact with these proteins, platelets undergo three reactions: (1) adhesion and shape change, (2) secretion (release reaction), and (3) aggregation. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The coagulation cascade is essentially an amplifying series of enzymatic conversions; each step in the process proteolytically cleaves an inactive proenzyme into an activated enzyme, eventually culminating in thrombin formation; thrombin is the most important enzyme regulating the coagulation process. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The clinical pathology lab assesses the two pathways using two standard assays: prothrombin time (PT) and partial thromboplastin time (PTT). The concept of International normalized ratio (INR) is also discussed with the concept of prothrombin time (PT). Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
There are three primary influences on thrombus formation (called Virchow’s triad): (1) endothelial injury, (2) stasis or turbulence of blood flow, and (3) blood hypercoagulability. Platelet adhesion molecules, tissue factor, plasminogen activator inhibitors, thrombomodulin, PGI2, and t-PA are also explained. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Turbulence contributes thrombosis by causing endothelial injury or dysfunction, as well as by forming countercurrents and local pockets of stasis. Stasis is a major contributor to the development of venous thrombi. Normal blood flow is laminar, which mean blood flows in sheets. Platelets flow centrally in the vessel lumen, separated from the endothelium by a slower moving clear zone of plasma. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Hypercoagulability is loosely defined as any alteration of the coagulation pathways that predisposes to thrombosis, and it can be divided into primary (genetic) and secondary (acquired) disorders. Mutation in factor V gene (factor V Leiden), Mutation in prothrombin gene, and Protein C functions are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Heparin-induced thrombocytopenia (HIT) syndrome and antiphospholipid antibody syndrome (previously called the lupus anticoagulant syndrome) conditions are discussed. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Thrombi can develop anywhere in the cardiovascular system. Lines of Zahn represent pale platelet and fibrin layers alternating with darker erythrocyte-rich layers. Thrombi occurring in heart chambers or in the aortic lumen are designated mural thrombi. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What is an embolism? There are several types of embolism, and in the next few videos, I will discuss the main types. An embolus is a detached intravascular solid, liquid, or gaseous mass that is carried by the blood to a site distant from its point of origin. Virtually 99% of all emboli represent some part of a dislodged thrombus, hence the term thromboembolism. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
What is bronchial artery collateral circulation, Anastomosis, Cor Pulmonale, and SIEA? This video discusses the basic concepts of Brachial artery collateral circulation, Anastomosis, Cor Pulmonale, and SIEA. The Respiratory tree includes: trachea main bronchus lobar bronchus segmental bronchus conducting bronchiole terminal bronchiole respiratory bronchiole alveolar duct alveolar sac alveolus Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Systemic thromboembolism refers to emboli in the arterial circulation. Most (80%) arise from intracardiac mural thrombi, two-thirds of which are associated with left ventricular wall infarcts and another quarter with dilated left atria (e.g., secondary to mitral valve disease). Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Microscopic fat globules can be found in the circulation after fractures of long bones (which contain fatty marrow) or after soft-tissue trauma. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Gas bubbles within the circulation can obstruct vascular flow (and cause distal ischemic injury) almost as readily as thrombotic masses can. Air may enter the circulation during obstetric procedures or as a consequence of chest wall injury. Generally, more than 100 mL of air are required to produce a clinical effect; bubbles can coalesce to form frothy masses sufficiently large to occlude major vessels. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Regardless of the underlying pathology, shock gives rise to systemic hypoperfusion; it can be caused either by reduced cardiac output or by reduced effective circulating blood volume. The end results are hypotension, impaired tissue perfusion, and cellular hypoxia. Cardiogenic shock results from failure of the cardiac pump. Hypovolemic shock results from loss of blood or plasma volume. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
The pathogenesis of septic shock is explored in this video. Endotoxins are bacterial wall lipopolysaccharides (LPS) consisting of a toxic fatty acid (lipid A) core common to all gram-negative bacteria, and a complex polysaccharide coat (including O antigen) unique for each species. Analogous molecules in the walls of gram-positive bacteria and fungi can also elicit septic shock. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Immunity refers to protection against infections, and the immune system is the collection of cells and molecules that are responsible for defending us against the countless pathogenic microbes in our environment. Diseases of immunity range from those caused by “too little” to those caused by “too much or inappropriate” immune activity. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Innate immunity (also called natural, or native, immunity) is mediated by cells and proteins that are always present and ready to fight microbes and are called into action immediately in response to an infection. The major components of innate immunity are epithelial barriers of the skin, gastrointestinal tract, and respiratory tract, which prevent microbe entry (and have to be breached for a microbe to establish infection); phagocytic leukocytes (neutrophils and macrophages); a specialized cell type called the natural killer (NK) cell; and several circulating plasma proteins, the most important of which are the proteins of the complement system. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Natural killer (NK) cells are lymphocytes that arise from the common lymphoid progenitor that gives rise to T and B lymphocytes. NK cells use a limited set of activating receptors to recognize molecules expressed on stressed or infected cells or cells with DNA damage, and then kill these cells. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
There are two types of adaptive immune responses: humoral immunity, mediated by soluble antibody proteins that are produced by B lymphocytes (also called B cells), and cell-mediated immunity, mediated by T lymphocytes (also called T cells). Antibodies provide protection against extracellular microbes in the blood, mucosal secretions, and tissues. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Thymus-derived, or T, lymphocytes are the effector cells of cellular immunity and provide important stimuli for antibody responses to protein antigens. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video discusses t-cell function. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
This video discusses the polymorphic nature of the Major histocompatibility complex. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177
Humoral immunity explained. B cells or B lymphocytes are the cell type that is responsible for humoral immunity pathway. Kumar, Vinay, Abul K. Abbas, and Jon C. Aster. Robbins basic pathology e-book. Elsevier Health Sciences, 2017. Kumar, Vinay, et al. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences, 2014. https://www.amazon.com/Robbins-Cotran-Pathologic-Disease-Pathology/dp/1455726133 https://www.amazon.com/Robbins-Basic-Pathology/dp/0323353177