Preface

Chapter 7 **Dynamic Properties of Skeletal Muscle Contraction in Rats with**

Chapter 8 **Immunopathology of Kidney Transplantation 143**

Chapter 9 **The Way from Renal Calcifications and Urinary Crystals to**

Chapter 10 **An Overview on Prostate Pathophysiology: New Insights into**

**Prostate Cancer Clinical Diagnosis 183**

Chapter 11 **Polycystic Ovary Syndrome, Pathophysiology, and Reproductive Health Implications 203**

Tetyana Volodymyrivna Beregova, Dmytro Nozdrenko, Sergii Berehovyi, Natali Nikitina, Tetyana Falalyeyeva and Liudmyla

Zesergio Melo, Juan A. Ruiz-Pacheco, Claudia A. Mendoza-Cerpa

**Kidney Stones: An Important Aspect in the Pathogenesis of**

Gustavo Ferreira Simoes, Paula Sakuramoto, Caroline Brito dos Santos, Nilva Karla Cervigne Furlan and Taize Machado Augusto

**Diabetes 119**

**VI** Contents

Ivanivna Ostapchenko

and Raquel Echavarria

Johannes M. Baumann

Bassim Alsadi

**Section 5 Genitourinary Pathophysiology 181**

**Calcium Nephrolithiasis 161**

**Section 4 Renal Pathophysiology 141**

The term "*pathophysiology"* comes from the Ancient Greek πάθος (*pathos*) and φυσιολογία (*phusiologia*). Pathophysiology is the convergence of pathology (the discipline of observed changes in a diseased state) with physiology (the mechanisms of systems operation). It rep‐ resents the functional changes that occur because of injury or disease.

This volume provides state-of-the-art up-to-date literature reviews on pathophysiological processes in a number of disease states. The book is organised methodically in a head-to-toe systems approach, comprising five sections:

a. Neuropathophysiology

This section includes chapters concerning the central nervous system. Chapter 1 explores the psychiatric associations in patients with body dysmorphic disorder (BDD), which is increasing in prevalence globally. The authors discuss the psy‐ chopathology and associated pathologies in BDD. Chapter 2 examines the nasal cycle rhythm alterations, in which asymmetrical airflow forms one nasal passage to the other. This cycle is regulated by the hypothalamus by coordinating the au‐ tonomic and sympathetic nerves in the nasal mucosa. Observed changes in nasal airflow duration, pattern and rhythm correspond to various disease states. Chap‐ ter 3 is a translational biology chapter detailing the changes in striatal network connectivity in Parkinson's disease via a dyskinetic rodent model. The striatum of the basal ganglia receives the major dopaminergic innervation. Using network analysis, the authors have quantified the pathological changes on a functional his‐ tological scale associated with Parkinson's disease.

b. Endocrine pathophysiology

In Chapter 4, the authors explore the transport protein transthyretin (prealbu‐ min), which binds thyroid hormones and retinol. Transthyretin can be measured in the blood as an indicator of protein calorie malnutrition and as a prognostica‐ tor in critically ill patients. The authors discuss various clinical applications of this disease state biomarker. In Chapter 5, the authors investigate the intricate re‐ lationship between diabetes, dietary state and gut microbiota. Diabetes is a global health concern. Only now are we learning of the role of gut microbiota composi‐ tion and its role in health and disease. The authors summarise recent advances in the microbiome-diet-diabetes interactions with a view to establishing novel thera‐ peutic approaches in patients with diabetes.

c. Endocrine Structural pathophysiology

The structural pathophysiology section starts with Chapter 6 in which the clinical sequelae of hypophosphatasia are discussed. This inherited bone disease results from a deficiency of bone alkaline phosphatase. Some 300 mutations in the *ALPL* gene that encodes alkaline phosphatase result in differential clinical manifesta‐ tions. Chapter 7 investigates the dynamic properties of skeletal muscle contrac‐ tion in a rat model with diabetes. The investigators studied the tibia muscle activation in rats with induced diabetes (streptozotocin) compared to a control group of nondiabetic rats. The findings reported help to understand the patholo‐ gy of diabetic polyneuropathy.

d. Renal pathophysiology

The penultimate section investigates renal pathophysiology. The immunopathol‐ ogy of kidney transplantation is discussed in Chapter 8. Allograft rejection rates in transplantation surgery remain high and occur because of cellular and humoral responses to specific antigens. These are discussed as potential adaptive respons‐ es by therapeutic intervention to reduce allograft rejection. Chapter 9 examines renal calcification in the pathogenesis of calcium nephrolithiasis, detailing stone composition and the role of calcium oxalate.

e. Genitourinary pathophysiology

In the final section on "Genitourinary Pathophysiology", an overview of prostate pathophysiology is given in Chapter 10, detailing the epidemiology of prostate cancer, clinical diagnosis and the role of biomarkers such as prostate-specific anti‐ gen (PSA) with emphasis on treatment modalities for patients with prostate can‐ cer. The final chapter investigates the pathophysiology and reproductive health implications of polycystic ovary syndrome, which is clinically heterogeneous re‐ flecting many potential aetiologies. The chapter reviews the endocrine involve‐ ment and links to obesity, insulin resistance and diabetes, demonstrating the complexity of the syndrome beyond that of a purely reproductive disorder.

This short volume on pathophysiology is intended for general medical and biomedical stu‐ dents at both undergraduate and postgraduate levels. In addition, it is a useful short update of recent advances in research and translational biology to those working in academia or as healthcare scientists.

> **David C. Gaze** University of Westminster London, United Kingdom

**Section 1**

**Neuropathophysiology**

**Neuropathophysiology**

c. Endocrine Structural pathophysiology

gy of diabetic polyneuropathy.

e. Genitourinary pathophysiology

healthcare scientists.

composition and the role of calcium oxalate.

d. Renal pathophysiology

VIII Preface

The structural pathophysiology section starts with Chapter 6 in which the clinical sequelae of hypophosphatasia are discussed. This inherited bone disease results from a deficiency of bone alkaline phosphatase. Some 300 mutations in the *ALPL* gene that encodes alkaline phosphatase result in differential clinical manifesta‐ tions. Chapter 7 investigates the dynamic properties of skeletal muscle contrac‐ tion in a rat model with diabetes. The investigators studied the tibia muscle activation in rats with induced diabetes (streptozotocin) compared to a control group of nondiabetic rats. The findings reported help to understand the patholo‐

The penultimate section investigates renal pathophysiology. The immunopathol‐ ogy of kidney transplantation is discussed in Chapter 8. Allograft rejection rates in transplantation surgery remain high and occur because of cellular and humoral responses to specific antigens. These are discussed as potential adaptive respons‐ es by therapeutic intervention to reduce allograft rejection. Chapter 9 examines renal calcification in the pathogenesis of calcium nephrolithiasis, detailing stone

In the final section on "Genitourinary Pathophysiology", an overview of prostate pathophysiology is given in Chapter 10, detailing the epidemiology of prostate cancer, clinical diagnosis and the role of biomarkers such as prostate-specific anti‐ gen (PSA) with emphasis on treatment modalities for patients with prostate can‐ cer. The final chapter investigates the pathophysiology and reproductive health implications of polycystic ovary syndrome, which is clinically heterogeneous re‐ flecting many potential aetiologies. The chapter reviews the endocrine involve‐ ment and links to obesity, insulin resistance and diabetes, demonstrating the complexity of the syndrome beyond that of a purely reproductive disorder.

This short volume on pathophysiology is intended for general medical and biomedical stu‐ dents at both undergraduate and postgraduate levels. In addition, it is a useful short update of recent advances in research and translational biology to those working in academia or as

**David C. Gaze**

University of Westminster London, United Kingdom

**Chapter 1**

**Provisional chapter**

**Body Dysmorphic Disorder: Characteristics,**

**Body Dysmorphic Disorder: Characteristics,** 

**Psychopathology, Clinical Associations, and** 

**Factors**

Patricia Tatiana Soler,

**Abstract**

Patricia Tatiana Soler,

**Influencing Factors**

Cristina Michiko Harada Ferreira, Jefferson da Silva Novaes and Helder Miguel Fernandes

Cristina Michiko Harada Ferreira, Jefferson da Silva Novaes and Helder Miguel Fernandes

http://dx.doi.org/10.5772/intechopen.76446

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

future research that may benefit society and these patients.

obsessive–compulsive disorder, behavior

**Psychopathology, Clinical Associations, and Influencing**

Body dysmorphic disorder (BDD) is defined by a recurring and persistent concern characterized by psychic suffering caused by a possible physical imperfection in appearance. It is a severe psychiatric condition, duly confirmed by neuroanatomical findings, very peculiar repetitive behaviors, and specific personalities. The prevalence of BDD is increasing around the world and differs between countries, because of cultural differences and different health-care systems. This increase is worrying because BDD is a pathology that presents comorbidity like severe depression, suicidal ideation, and functional and social impairment. However, BDD is an unrecognized and often not diagnosed in our society. Many patients are ashamed of their complaints and do not usually seek psychiatric help with ease, and unfortunately, they seek help in cosmetic and surgical treatments to improve their appearance, and these professionals are not yet prepared to assist in the diagnosis of this disorder. Therefore, this chapter presents not only the psychopathology of BDD but also its associations with other pathologies and their main factors of influence. Finally, we present a clinical experience with a detailed description of a clinical case. The aim is to contribute to the diagnosis and treatment of this pathology and also to

**Keywords:** body dysmorphic disorder, appearance disorders, social anxiety disorder,

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.76446

#### **Body Dysmorphic Disorder: Characteristics, Psychopathology, Clinical Associations, and Influencing Factors Body Dysmorphic Disorder: Characteristics, Psychopathology, Clinical Associations, and Influencing Factors**

DOI: 10.5772/intechopen.76446

Patricia Tatiana Soler, Cristina Michiko Harada Ferreira, Jefferson da Silva Novaes and Helder Miguel Fernandes Patricia Tatiana Soler, Cristina Michiko Harada Ferreira, Jefferson da Silva Novaes and Helder Miguel Fernandes

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.76446

#### **Abstract**

Body dysmorphic disorder (BDD) is defined by a recurring and persistent concern characterized by psychic suffering caused by a possible physical imperfection in appearance. It is a severe psychiatric condition, duly confirmed by neuroanatomical findings, very peculiar repetitive behaviors, and specific personalities. The prevalence of BDD is increasing around the world and differs between countries, because of cultural differences and different health-care systems. This increase is worrying because BDD is a pathology that presents comorbidity like severe depression, suicidal ideation, and functional and social impairment. However, BDD is an unrecognized and often not diagnosed in our society. Many patients are ashamed of their complaints and do not usually seek psychiatric help with ease, and unfortunately, they seek help in cosmetic and surgical treatments to improve their appearance, and these professionals are not yet prepared to assist in the diagnosis of this disorder. Therefore, this chapter presents not only the psychopathology of BDD but also its associations with other pathologies and their main factors of influence. Finally, we present a clinical experience with a detailed description of a clinical case. The aim is to contribute to the diagnosis and treatment of this pathology and also to future research that may benefit society and these patients.

**Keywords:** body dysmorphic disorder, appearance disorders, social anxiety disorder, obsessive–compulsive disorder, behavior

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
