tag:blogger.com,1999:blog-80013396836039157382024-02-07T01:28:47.962-08:00The Ultimate CuriosityBrainstorming is our aim. The Ultimate Curiosity is a site which deals with science and technology.juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comBlogger88125tag:blogger.com,1999:blog-8001339683603915738.post-33382895138463806722012-06-03T23:53:00.001-07:002012-06-03T23:55:33.089-07:00Protozoan Diseases of the Cardiovascular and Lymphatic Systems<div dir="ltr" style="text-align: left;" trbidi="on">
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<em>Trypanosoma cruzi</em> causes Chagas’ disease. The reservoir includes many wild animals. The vector is reduviid, the “kissing bug.”</div>
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Xenodiagnosis allows for the identification of trypanosomes in the intestinal tract of the reduviid bug, which confirms the diagnosis. </div>
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<strong style="text-align: -webkit-center;"><em>Trypanosoma cruzi </em></strong></div>
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Toxoplasmosis</h4>
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Toxoplasmosis is caused by the sporozoan <em>Toxoplasma gondii</em>.</div>
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<em>T. gondii </em>undergoes sexual reproduction in the intestinal tract of domestic cats (the reservoir), and oocysts are eliminated in cat feces.</div>
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In the host cell, sporozoites reproduce to form either tissue invading tachyzoites or bradyzoites.</div>
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Humans contract the infection by ingesting tachyzoites or tissue cysts in undercooked meat from an infected animal or contact with cat feces (transmission is gastrointestinal).</div>
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Congenital infections can occur. Signs and symptoms include severe brain damage or vision problems.</div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 14px; text-align: -webkit-auto;">Toxoplasmosis can be identified by serological tests, but interpretation of the results is uncertain. </span></div>
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Malaria</h4>
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The signs and symptoms of malaria are chills, fever, vomiting, and headache, which occur at intervals of 2-3 days.</div>
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Malaria is transmitted by <em>Anopheles</em> mosquitoes. The causative agent is any one of four species of <em>Plasmodium</em>.</div>
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Sporozoites reproduced in the liver and release merozoites into the blood stream, where they infect red blood cells and produce more merozoites.</div>
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Laboratory diagnosis is based on microscopic observation of merozoites in red blood cells.</div>
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New drugs are being developed as the protozoa develop resistance to drugs such as chloroquine.</div>
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<strong>Malaria in the United States</strong></div>
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<strong>Malaria</strong></div>
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Leishmaniasis</h4>
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<em>Leishmania</em> spp., which are transmitted by sandflies, cause leishmaniasis.</div>
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<em>Leishmania</em> <em>donovani</em> - visceral leishmaniasis: the protozoa reproduce in the liver, spleen and kidneys.</div>
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<em>Leishmania tropica</em> - cutaneous leishmaniasis (Oriental sore): affects skin</div>
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<em>Leishmania braziliensis</em> - mucocutaneous leishmaniasis: affects mucous membranes as well as skin</div>
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Antimony compounds are used for treatment.</div>
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<strong>Cutaneous Leishmaniasis</strong></div>
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Babesiosis</h4>
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Babesiosis is caused by the protozoan <em>Babesia microti</em> and transmitted to humans by ticks.</div>
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Helminthic Diseases of the Cardiovascular and Lymphatic Systems</h3>
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Schistosomiasis</h4>
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Species of the blood fluke <em>Schistosoma</em> cause schistosomiasis.</div>
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Eggs eliminated with feces hatch into larvae that infect the intermediate host, a snail. Free-swimming cercariae are released from the snail and penetrate the skin of a human.</div>
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The adult flukes live in the veins of the liver or urinary bladder in humans.</div>
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Granulomas are from the host’s defense against eggs that remain in the body.</div>
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Observation of eggs or flukes in feces, skin tests, or indirect serological tests may be used for diagnosis.</div>
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Chemotherapy (praziquantel or oxamniquine) is used to treat the disease; sanitation and snail eradication are used to prevent it.</div>
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<strong>Schistosomiasis</strong></div>
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<strong>Schistosome Granuloma</strong></div>
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Swimmer’s Itch</h4>
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Swimmer’s itch is a cutaneous allergic reaction to cercariae that penetrate the skin. The definitive hosts for this fluke are wildfowl.</div>
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</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-82663704119919478442012-05-18T19:58:00.001-07:002012-05-18T20:01:51.333-07:00ATP: The Perfect Energy Currency for the Cell<div dir="ltr" style="text-align: left;" trbidi="on">
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Abstract</h3>
<span style="color: #0000a0; font-family: 'Times New Roman';">The major energy currency molecule of the cell, ATP, is evaluated in the context of creationism. This complex molecule is critical for all life from the simplest to the most complex. It is only one of millions of enormously intricate nanomachines that needs to have been designed in order for life to exist on earth. This motor is an excellent example of irreducible complexity because it is necessary in its entirety in order for even the simplest form of life to survive.</span></td></tr>
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Introduction</h3>
<img align="LEFT" alt="I" border="0" height="51" hspace="1" src="http://www.trueorigin.org/images/i.gif" vspace="0" width="24" />In order to function, every machine requires specific parts such as screws, springs, cams, gears, and pulleys. Likewise, all biological machines must have many well-engineered parts to work. Examples include units called <i>organs</i> such as the liver, kidney, and heart. These complex life units are made from still smaller parts called <i>cells</i> which in turn are constructed from yet smaller machines known as<i>organelles</i>. Cell organelles include mitochondria, Golgi complexes, microtubules, and centrioles. Even below this level are other parts so small that they are formally classified as <i>macromolecules</i> (large molecules).<br />
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<tr><td><b>Fig. 1.</b> Views of ATP and related structures.</td></tr>
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<span style="font-family: 'Times New Roman';">A critically important macromolecule—arguably “second in importance only to DNA”—is <i>ATP</i>. ATP is a complex<i>nanomachine</i> that serves as the primary energy currency of the cell (Trefil, 1992, p.93). A nanomachine is a complex precision microscopic-sized machine that fits the standard definition of a machine. ATP is the “most widely distributed high-energy compound within the human body” (Ritter, 1996, p. 301). This ubiquitous molecule is “used to build complex molecules, contract muscles, generate electricity in nerves, and light fireflies. All fuel sources of Nature, all foodstuffs of living things, produce ATP, which in turn powers virtually every activity of the cell and organism. Imagine the metabolic confusion if this were not so: Each of the diverse foodstuffs would generate different energy currencies and each of the great variety of cellular functions would have to trade in its unique currency” (Kornberg, 1989, p. 62).</span><br />
<span style="font-family: 'Times New Roman';">ATP is an abbreviation for <i>adenosine triphosphate</i>, a complex molecule that contains the nucleoside <i>adenosine</i> and a tail consisting of three phosphates. (See Figure 1 for a simple structural formula and a space filled model of ATP.) As far as known, all organisms from the simplest bacteria to humans use ATP as their primary energy currency. The energy level it carries is just the right amount for most biological reactions. Nutrients contain energy in low-energy covalent bonds which are not very useful to do most of kinds of work in the cells.</span><br />
<span style="font-family: 'Times New Roman';">These low energy bonds must be translated to high energy bonds, and this is a role of ATP. A steady supply of ATP is so critical that a poison which attacks any of the proteins used in ATP production kills the organism in minutes. Certain cyanide compounds, for example, are poisonous because they bind to the copper atom in cytochrome oxidase. This binding blocks the electron transport system in the mitochondria where ATP manufacture occurs (Goodsell, 1996, p.74). </span><br />
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How ATP Transfers Energy</h3>
<span style="font-family: 'Times New Roman';">Energy is usually liberated from the ATP molecule to do work in the cell by a reaction that removes one of the phosphate-oxygen groups, leaving adenosine <i>di</i>phosphate (ADP). When the ATP converts to ADP, the ATP is said to be <i>spent</i>. Then the ADP is usually immediately recycled in the mitochondria where it is recharged and comes out again as ATP. In the words of Trefil (1992, p. 93) “hooking and unhooking that last phosphate [on ATP] is what keeps the whole world operating.”</span><br />
<span style="font-family: 'Times New Roman';">The enormous amount of activity that occurs inside each of the approximately one hundred trillion human cells is shown by the fact that at any instant each cell contains about <i>one billion </i>ATP molecules. This amount is sufficient for that cell’s needs for only a few minutes and must be rapidly recycled. Given a hundred trillion cells in the average male, about 10</span><span style="font-family: 'Times New Roman';"><sup>23</sup></span><span style="font-family: 'Times New Roman';"> or one sextillion ATP molecules normally exist in the body. For each ATP “the terminal phosphate is added and removed 3 times each minute” (Kornberg, 1989, p. 65).</span><br />
<span style="font-family: 'Times New Roman';">The total human body content of ATP is only about 50 grams, which must be constantly recycled every day. The ultimate source of energy for constructing ATP is food; ATP is simply the carrier and regulation-storage unit of energy. The average daily intake of 2,500 food calories translates into a turnover of a whopping 180 kg (400 lbs) of ATP (Kornberg, 1989, p. 65).</span><br />
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The Structure of ATP</h3>
<span style="font-family: 'Times New Roman';">ATP contains the purine base <i>adenine</i> and the sugar <i>ribose</i> which together form the nucleoside<i>adenosine</i>. The basic building blocks used to construct ATP are carbon, hydrogen, nitrogen, oxygen, and phosphorus which are assembled in a complex that contains the number of subatomic parts equivalent to over 500 hydrogen atoms. One phosphate ester bond and two phosphate anhydride bonds hold the three phosphates (PO</span><span style="font-family: 'Times New Roman';"><sub>4</sub></span><span style="font-family: 'Times New Roman';">) and the ribose together. The construction also contains a b-N glycoside bond holding the ribose and the adenine together.</span><br />
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<tr><td><b>Fig. 2.</b> The two-dimensional stick model of the adenosine phosphate family of molecules, showing the atom and bond arrangement.</td></tr>
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<span style="font-family: 'Times New Roman';">Phosphates are well-known high-energy molecules, meaning that comparatively high levels of energy are released when the phosphate groups are removed. Actually, the high energy content is not the result of simply the phosphate bond but the total interaction of all the atoms within the ATP molecule.</span><br />
<span style="font-family: 'Times New Roman';">Because the amount of energy released when the phosphate bond is broken is very close to that needed by the typical biological reaction, little energy is wasted. Generally, ATP is connected to another reaction—a process called <i>coupling</i>which means the two reactions occur at the same time and at the same place, usually utilizing the same enzyme complex. Release of phosphate from ATP is exothermic (a reaction that gives off heat) and the reaction it is connected to is endothermic (requires energy input in order to occur). The terminal phosphate group is then transferred by hydrolysis to another compound, a process called<i>phosphorylation</i>, producing ADP, phosphate (P</span><span style="font-family: 'Times New Roman';"><sub>i</sub></span><span style="font-family: 'Times New Roman';">) and energy.</span><br />
<span style="font-family: 'Times New Roman';">The self-regulation system of ATP has been described as follows:</span><br />
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<span style="font-family: 'Times New Roman';">The high-energy bonds of ATP are actually rather unstable bonds. Because they are unstable, the energy of ATP is readily released when ATP is hydrolyzed in cellular reactions. Note that ATP is an <i>energy-coupling agent</i> and <i>not</i> a fuel. It is not a storehouse of energy set aside for some future need. Rather it is produced by one set of reactions and is almost immediately consumed by another. ATP is formed as it is needed, primarily by oxidative processes in the mitochondria. Oxygen is not consumed unless ADP and a phosphate molecule are available, and these do not become available until ATP is hydrolyzed by some energy-consuming process. <i>Energy metabolism is therefore mostly self-regulating</i> (Hickman, Roberts, and Larson, 1997, p.43). [Italics mine]</span></blockquote>
<span style="font-family: 'Times New Roman';">ATP is not excessively unstable, but it is designed so that its hydrolysis is slow in the absence of a catalyst. This insures that its stored energy is “released only in the presence of the appropriate enzyme” (McMurry and Castellion, 1996, p. 601).</span><br />
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The Function of ATP</h3>
<span style="font-family: 'Times New Roman';">The ATP is used for many cell functions including <i>transport work</i> moving substances across cell membranes. It is also used for <i>mechanical work</i>, supplying the energy needed for muscle contraction. It supplies energy not only to heart muscle (for blood circulation) and skeletal muscle (such as for gross body movement), but also to the chromosomes and flagella to enable them to carry out their many functions. A major role of ATP is in <i>chemical work</i>, supplying the needed energy to synthesize the multi-thousands of types of macromolecules that the cell needs to exist.</span><br />
<span style="font-family: 'Times New Roman';">ATP is also used as an on-off switch both to control chemical reactions and to send messages. The shape of the protein chains that produce the building blocks and other structures used in life is mostly determined by weak chemical bonds that are easily broken and remade. These chains can shorten, lengthen, and change shape in response to the input or withdrawal of energy. The changes in the chains alter the shape of the protein and can also alter its function or cause it to become either active or inactive.</span><br />
<span style="font-family: 'Times New Roman';"> The ATP molecule can bond to one part of a protein molecule, causing another part of the same molecule to slide or move slightly which causes it to change its conformation, inactivating the molecule. Subsequent removal of ATP causes the protein to return to its original shape, and thus it is again functional. The cycle can be repeated until the molecule is recycled, effectively serving as an on and off switch (Hoagland and Dodson, 1995, p.104). Both adding a phosphorus (phosphorylation) and removing a phosphorus from a protein (dephosphorylation) can serve as either an on or an off switch.</span><br />
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How is ATP Produced?</h3>
<span style="font-family: 'Times New Roman';">ATP is manufactured as a result of several cell processes including fermentation, respiration and photosynthesis. Most commonly the cells use ADP as a precursor molecule and then add a phosphorus to it. In eukaryotes this can occur either in the soluble portion of the cytoplasm (cytosol) or in special energy-producing structures called mitochondria. Charging ADP to form ATP in the mitochondria is called <i>chemiosmotic phosphorylation</i>. This process occurs in specially constructed chambers located in the mitochondrion’s inner membranes.</span><br />
<table align="right" border="0" cellpadding="4" cellspacing="4" style="width: 292px;"><tbody>
<tr><td><img alt="" border="1" height="374" src="http://www.trueorigin.org/images/atp03.gif" width="288" /></td></tr>
<tr><td><b>Fig. 3.</b> An outline of the ATP-synthase macromolecule showing its subunits and nanomachine traits. ATP-synthase converts ADP into ATP, a process called charging. Shown behind ATP-synthase is the membrane in which the ATP-synthase is mounted. For the ATP that is charged in the mitochondria, ATP-synthase is located in the inner membrane.</td></tr>
</tbody></table>
<span style="font-family: 'Times New Roman';">The mitochondrion itself functions to produce an electrical chemical gradient—somewhat like a battery—by accumulating hydrogen ions in the space between the inner and outer membrane. This energy comes from the estimated 10,000 enzyme chains in the membranous sacks on the mitochondrial walls. Most of the food energy for most organisms is produced by the electron transport chain. Cellular oxidation in the Krebs cycle causes an electron build-up that is used to push H</span><span style="font-family: 'Times New Roman';"><sup>+</sup></span><span style="font-family: 'Times New Roman';"> ions outward across the inner mitochondrial membrane (Hickman et al., 1997, p. 71).</span><br />
<span style="font-family: 'Times New Roman';">As the charge builds up, it provides an electrical potential that releases its energy by causing a flow of hydrogen ions across the inner membrane into the inner chamber. The energy causes an enzyme to be attached to ADP which catalyzes the addition of a third phosphorus to form ATP. Plants can also produce ATP in this manner in their mitochondria but plants can also produce ATP by using the energy of sunlight in chloroplasts as discussed later. In the case of eukaryotic animals the energy comes from food which is converted to pyruvate and then to <i>acetyl coenzyme A</i> (acetyl CoA). Acetyl CoA then enters the Krebs cycle which releases energy that results in the conversion of ADP back into ATP.</span><br />
<span style="font-family: 'Times New Roman';">How does this potential difference serve to reattach the phosphates on ADP molecules? The more protons there are in an area, the more they repel each other. When the repulsion reaches a certain level, the hydrogens ions are forced out of a revolving-door-like structure mounted on the inner mitochondria membrane called <i>ATP synthase</i> complexes. This enzyme functions to reattach the phosphates to the ADP molecules, again forming ATP.</span><br />
<span style="font-family: 'Times New Roman';">The ATP synthase revolving door resembles a molecular water wheel that harnesses the flow of hydrogen ions in order to build ATP molecules. Each revolution of the wheel requires the energy of about nine hydrogen ions returning into the mitochondrial inner chamber (Goodsell, 1996, p.74). Located on the ATP synthase are three active sites, each of which converts ADP to ATP with every turn of the wheel. Under maximum conditions, the ATP synthase wheel turns at a rate of up to 200 revolutions per second, producing 600 ATPs during that second.</span><br />
<span style="font-family: 'Times New Roman';">ATP is used in conjunction with enzymes to cause certain molecules to bond together. The correct molecule first docks in the active site of the enzyme along with an ATP molecule. The enzyme then catalyzes the transfer of one of the ATP phosphates to the molecule, thereby transferring to that molecule the energy stored in the ATP molecule. Next a second molecule docks nearby at a <i>second</i> active site on the enzyme. The phosphate is then transferred to it, providing the energy needed to bond the two molecules now attached to the enzyme. Once they are bonded, the new molecule is released. This operation is similar to using a mechanical jig to properly position two pieces of metal which are then welded together. Once welded, they are released as a unit and the process then can begin again.</span><br />
<h3 style="color: #cc3366; font-family: Arial, Helvetica, sans-serif; font-size: 21px; text-align: center;">
A Double Energy Packet</h3>
<span style="font-family: 'Times New Roman';">Although ATP contains the amount of energy necessary for most reactions, at times more energy is required. The solution is for ATP to release <i>two</i> phosphates instead of one, producing an adenosine monophosphate (AMP) plus a chain of two phosphates called a <i>pyrophosphate</i>. How adenosine monophosphate is built up into ATP again illustrates the precision and the complexity of the cell energy system. The enzymes used in glycolysis, the citric acid cycle, and the electron transport system, are all so precise that they will replace only a <i>single</i> phosphate. They cannot add <i>two</i> new phosphates to an AMP molecule to form ATP.</span><br />
<span style="font-family: 'Times New Roman';">The solution is an intricate enzyme called <i>adenylate kinase</i> which transfers a <i>single</i> phosphate from an ATP to the AMP, producing <i>two</i> ADP molecules. The two ADP molecules can then enter the normal Krebs cycle designed to convert ADP into ATP. Adenylate kinase requires an atom of magnesium—and this is one of the reasons why sufficient dietary magnesium is important.</span><br />
<span style="font-family: 'Times New Roman';">Adenylate kinase is a highly organized but compact enzyme with its active site located deep within the molecule. The deep active site is required because the reactions it catalyzes are sensitive to water. If water molecules lodged between the ATP and the AMP, then the phosphate might break ATP into ADP and a free phosphate instead of transferring a phosphate from ATP to AMP to form ADP.</span><br />
<span style="font-family: 'Times New Roman';">To prevent this, adenylate kinase is designed so that the active site is at the <i>end</i> of a channel deep in the structure which closes around AMP and ATP, shielding the reaction from water. Many other enzymes that use ATP rely on this system to shelter their active site to prevent inappropriate reactions from occurring. This system ensures that the only waste that occurs is the normal wear, tear, repair, and replacement of the cell’s organelles.</span><br />
<span style="font-family: 'Times New Roman';">Pyrophosphates and pyrophosphoric acid, both inorganic forms of phosphorus, must also be broken down so they can be recycled. This phosphate breakdown is accomplished by the inorganic enzyme<i>pyrophosphatase</i> which splits the pyrophosphate to form two free phosphates that can be used to charge ATP (Goodsell, 1996, p.79). This system is so amazingly efficient that it produces virtually no waste, which is astounding considering its enormously detailed structure. Goodsell (1996, p. 79) adds that “our energy-producing machinery is designed for the production of ATP: quickly, efficiently, and in large quantity.” </span><br />
<span style="font-family: 'Times New Roman';">The main energy carrier the body uses is ATP, but other energized nucleotides are also utilized such as thymine, guanine, uracil, and cytosine for making RNA and DNA. The Krebs cycle charges only ADP, but the energy contained in ATP can be transferred to one of the other nucleosides by means of an enzyme called <i>nucleoside diphosphate kinase</i>. This enzyme transfers the phosphate from a nucleoside triphosphate, commonly ATP, to a nucleoside diphosphate such as guanosine diphosphate (GDP) to form guanosine triphosphate (GTP).</span><br />
<span style="font-family: 'Times New Roman';">The nucleoside diphosphate kinase works by one of its six active sites binding nucleoside triphosphate and releasing the phosphate which is bonded to a histidine. Then the nucleoside triphosphate, which is now a diphosphate, is released, and a different nucleoside diphosphate binds to the same site—and as a result the phosphate that is bonded to the enzyme is transferred, forming a new triphosphate. Scores of other enzymes exist in order for ATP to transfer its energy to the various places where it is needed. Each enzyme must be specifically designed to carry out its unique function, and most of these enzymes are critical for health and life.</span><br />
<span style="font-family: 'Times New Roman';">The body does contain some flexibility, and sometimes life is possible when one of these enzymes is defective—but the person is often handicapped. Also, back-up mechanisms sometimes exist so that the body can achieve the same goals through an alternative biochemical route. These few simple examples eloquently illustrate the concept of over-design built into the body. They also prove the enormous complexity of the body and its biochemistry.</span><br />
<h3 style="color: #cc3366; font-family: Arial, Helvetica, sans-serif; font-size: 21px; text-align: center;">
The Message of the Molecule</h3>
<span style="font-family: 'Times New Roman';">Without ATP, life as we understand it could not exist. It is a perfectly-designed, intricate molecule that serves a critical role in providing the proper size energy packet for scores of thousands of classes of reactions that occur in all forms of life. Even viruses rely on an ATP molecule identical to that used in humans. The ATP energy system is quick, highly efficient, produces a rapid turnover of ATP, and can rapidly respond to energy demand changes (Goodsell, 1996, p.79).</span><br />
<span style="font-family: 'Times New Roman';">Furthermore, the ATP molecule is so enormously intricate that we are just now beginning to understand how it works. Each ATP molecule is over 500 atomic mass units (500 AMUs). In manufacturing terms, the ATP molecule is a machine with a level of organization on the order of a research microscope or a standard television (Darnell, Lodish, and Baltimore, 1996).</span><br />
<span style="font-family: 'Times New Roman';">Among the questions evolutionists must answer include the following, “How did life exist before ATP?” “How could life survive without ATP since no form of life we know of today can do that?” and “How could ATP evolve and where are the many transitional forms required to evolve the complex ATP molecule?” No feasible candidates exist and none can exist because only a perfect ATP molecule can properly carry out its role in the cell.</span><br />
<span style="font-family: 'Times New Roman';">In addition, a potential ATP candidate molecule would not be selected for by evolution until it was functional and life could not exist without ATP or a similar molecule that would have the same function. ATP is an example of a molecule that displays <i>irreducible complexity</i> which cannot be simplified and still function (Behe, 1996). ATP could have been created only as a unit to function immediately in life and the same is true of the other intricate energy molecules used in life such as GTP.</span><br />
<span style="font-family: 'Times New Roman';">Although other energy molecules can be used for certain cell functions, none can even come close to satisfactorily replacing all the many functions of ATP. Over 100,000 other detailed molecules like ATP have also been designed to enable humans to live, and all the same problems related to their origin exist for them all. Many macromolecules that have greater detail than ATP exist, as do a few that are less highly organized, and in order for life to exist all of them must work together as a unit.</span><br />
<h3 style="color: #cc3366; font-family: Arial, Helvetica, sans-serif; font-size: 21px; text-align: center;">
The Contrast between Prokaryotic and<br />Eukaryotic ATP Production</h3>
<span style="font-family: 'Times New Roman';">An enormous gap exists between prokaryote (bacteria and cyanobacteria) cells and eukaryote (protists, plants and animals) type of cells:</span><br />
<blockquote>
<span style="font-family: 'Times New Roman';">...prokaryotes and eukaryotes are profoundly different from each other and clearly represent a marked dichotomy in the evolution of life. . . The organizational complexity of the eukaryotes is so much greater than that of the prokaryotes that it is difficult to visualize how a eukaryote could have arisen from any known prokaryote (Hickman et al., 1997, p. 39).</span></blockquote>
<span style="font-family: 'Times New Roman';">Some of the differences are that prokaryotes lack organelles, a cytoskeleton, and most of the other structures present in eukaryotic cells. Consequently, the functions of most organelles and other ultrastructure cell parts must be performed in bacteria by the cell membrane and its infoldings called mesosomes.</span><br />
<h3 style="color: #cc3366; font-family: Arial, Helvetica, sans-serif; font-size: 21px; text-align: center;">
The Four Major Methods of Producing ATP</h3>
<span style="font-family: 'Times New Roman';">A crucial difference between prokaryotes and eukaryotes is the means they use to produce ATP. All life produces ATP by three basic chemical methods only: oxidative phosphorylation, photophosphorylation, and substrate-level phosphorylation (Lim, 1998, p. 149). In prokaryotes ATP is produced both in the cell wall and in the cytosol by glycolysis. In eukaryotes most ATP is produced in chloroplasts (for plants), or in mitochondria (for both plants and animals). No means of producing ATP exists that is intermediate between these four basic methods and no transitional forms have ever been found that bridge the gap between these four different forms of ATP production. The machinery required to manufacture ATP is so intricate that viruses are not able to make their own ATP. They require cells to manufacture it and viruses have no source of energy apart from cells.</span><br />
<span style="font-family: 'Times New Roman';">In prokaryotes the cell membrane takes care of not only the cell’s energy-conversion needs, but also nutrient processing, synthesizing of structural macromolecules, and secretion of the many enzymes needed for life (Talaro and Talaro, 1993, p. 77). The cell membrane must for this reason be compared with the <i>entire</i> eukaryote cell ultrastructure which performs these many functions. No simple means of producing ATP is known and prokaryotes are not by any means simple. They contain over 5,000 different kinds of molecules and can use sunlight, organic compounds such as carbohydrates, and inorganic compounds as sources of energy to manufacture ATP.</span><br />
<span style="font-family: 'Times New Roman';">Another example of the cell membrane in prokaryotes assuming a function of the eukaryotic cell ultrastructure is as follows: Their DNA is physically attached to the bacterial cell membrane and DNA replication may be initiated by changes in the membrane. These membrane changes are in turn related to the bacterium’s growth. Further, the mesosome appears to guide the duplicated chromatin bodies into the two daughter cells during cell division (Talaro and Talaro, 1993).</span><br />
<span style="font-family: 'Times New Roman';">In eukaryotes the mitochondria produce most of the cell’s ATP (anaerobic glycolysis also produces some) and in plants the chloroplasts can also service this function. The mitochondria produce ATP in their internal membrane system called the cristae. Since bacteria lack mitochondria, as well as an internal membrane system, they must produce ATP in their cell membrane which they do by two basic steps. The bacterial cell membrane contains a unique structure designed to produce ATP and no comparable structure has been found in <i>any </i>eukaryotic cell (Jensen, Wright, and Robinson, 1997).</span><br />
<span style="font-family: 'Times New Roman';">In bacteria, the ATPase and the electron transport chain are located <i>inside</i> the cytoplasmic membrane between the hydrophobic tails of the phospholipid membrane inner and outer walls. Breakdown of sugar and other food causes the positively charged protons on the <i>outside</i> of the membrane to accumulate to a much higher concentration than they are on the membrane <i>inside</i>. This creates an excess positive charge on the outside of the membrane and a relatively negative charge on the inside.</span><br />
<span style="font-family: 'Times New Roman';">The result of this charge difference is a dissociation of H</span><span style="font-family: 'Times New Roman';"><sub>2</sub></span><span style="font-family: 'Times New Roman';">O molecules into H</span><span style="font-family: 'Times New Roman';"><sup>+</sup></span><span style="font-family: 'Times New Roman';"> and OH</span><span style="font-family: 'Times New Roman';"><sup>–</sup></span><span style="font-family: 'Times New Roman';"> ions. The H</span><span style="font-family: 'Times New Roman';"><sup>+</sup></span><span style="font-family: 'Times New Roman';"> ions that are produced are then transported outside of the cell and the OH</span><span style="font-family: 'Times New Roman';"><sup>–</sup></span><span style="font-family: 'Times New Roman';"> ions remain on the inside. This results in a potential energy gradient similar to that produced by charging a flashlight battery. The force the potential energy gradient produces is called a <i>proton motive force</i> that can accomplish a variety of cell tasks including converting ADP into ATP.</span><br />
<span style="font-family: 'Times New Roman';">In some bacteria such as <i>Halobacterium </i>this system is modified by use of <i>bacteriorhodopsin</i>, a protein similar to the sensory pigment rhodopsin used in the vertebrate retina (Lim, 1998, p. 166). Illumination causes the pigment to absorb light energy, temporarily changing rhodopsin from a <i>trans</i> to a <i>cis</i> form. The trans to cis conversion causes deprotonation and the transfer of protons across the plasma membrane to the periplasm.</span><br />
<span style="font-family: 'Times New Roman';">The proton gradient that results is used to drive ATP synthesis by use of the ATPase complex. This modification allows bacteria to live in low oxygen but rich light regions. This anaerobic ATP manufacturing system, which is unique to prokaryotes, uses a chemical compound other than oxygen as a terminal electron acceptor (Lim, 1998, p. 168). The location of the ATP producing system is only one of many major contrasts that exist between bacterial cell membranes and mitochondria.</span><br />
<h3 style="color: #cc3366; font-family: Arial, Helvetica, sans-serif; font-size: 21px; text-align: center;">
Chloroplasts</h3>
<span style="font-family: 'Times New Roman';">Chloroplasts are double membraned ATP-producing organelles found only in plants. Inside their outer membrane is a set of thin membranes organized into flattened sacs stacked up like coins called<i>thylakoids</i> (Greek <i>thylac</i> or sack, and <i>oid</i> meaning like). The disks contain chlorophyll pigments that absorb solar energy which is the ultimate source of energy for all the plant’s needs including manufacturing carbohydrates from carbon dioxide and water (Mader, 1996, p. 75). The chloroplasts first convert the solar energy into ATP stored energy, which is then used to manufacture storage carbohydrates which can be converted back into ATP when energy is needed.</span><br />
<span style="font-family: 'Times New Roman';"> The chloroplasts also possess an electron transport system for producing ATP. The electrons that enter the system are taken from water. During photosynthesis, carbon dioxide is reduced to a carbohydrate by energy obtained from ATP (Mader, 1996, p. 12). Photosynthesizing bacteria (cyanobacteria) use yet another system. Cyanobacteria do not manufacture chloroplasts but use chlorophyll bound to cytoplasmic thylakoids. Once again plausible transitional forms have never been found that can link this form of ATP production to the chloroplast photosynthesis system.</span><br />
<span style="font-family: 'Times New Roman';">The two most common evolutionary theories of the origin of the mitochondria-chloroplast ATP production system are 1) endosymbiosis of mitochondria and chloroplasts from the bacterial membrane system and 2) the gradual evolution of the prokaryote cell membrane system of ATP production into the mitochondria and chloroplast systems. Believers in endosymbiosis teach that mitochondria were once free-living bacteria, and that “early in evolution ancestral eukaryotic cells simply ate their future partners” (Vogel, 1998, p. 1633). Both the gradual conversion and endosymbiosis theory require many transitional forms, each new one which must provide the animal with a competitive advantage compared with the unaltered animals.</span><br />
<span style="font-family: 'Times New Roman';">The many contrasts between the prokaryotic and eukaryotic means of producing ATP, some of which were noted above, are strong evidence against the endosymbiosis theory. No intermediates to bridge these two systems has ever been found and arguments put forth in the theory’s support are all highly speculative. These and other problems have recently become more evident as a result of recent major challenges to the standard endosymbiosis theory. The standard theory has recently been under attack from several fronts, and some researchers are now arguing for a new theory:</span><br />
<blockquote>
<span style="font-family: 'Times New Roman';">Scientists pondering how the first complex cell came together say the new idea could solve some nagging problems with the prevailing theory... “[the new theory is]... elegantly argued,” says Michael Gray of Dalhouisie University in Halifax, Nova Scotia, but “there are an awful lot of things the hypothesis doesn’t account for.” In the standard picture of eukaryote evolution, the mitochondrion was a lucky accident. First, the ancestral cell—probably an archaebacterium, recent genetic analyses suggest—acquired the ability to engulf and digest complex molecules. It began preying on its microbial companions. At some point, however, this predatory cell didn’t fully digest its prey, and an even more successful cell resulted when an intended meal took up permanent residence and became the mitochondrion. For years, scientists had thought they had examples of the direct descendants of those primitive eukaryotes: certain protists that lack mitochondria. But recent analysis of the genes in those organisms suggests that they, too, once carried mitochondria but lost them later (<i>Science</i>, 12 September 1997, p. 1604). These findings hint that eukaryotes might somehow have acquired their mitochondria before they had evolved the ability to engulf and digest other cells (Vogel, 1998, p. 1633).</span></blockquote>
<h3 style="color: #cc3366; font-family: Arial, Helvetica, sans-serif; font-size: 21px; text-align: center;">
Summary</h3>
<span style="font-family: 'Times New Roman';">In this brief review we have examined only one cell macromolecule, ATP, and the intricate mechanisms which produce it. We have also looked at the detailed supporting mechanism which allows the ATP molecule to function. ATP is only one of hundreds of thousands of essential molecules, each one that has a story. As each of those stories is told, they will stand as a tribute to both the genius and the enormously complex design of the natural world. All the books in the largest library in the world may not be able to contain the information needed to understand and construct the estimated 100,000 complex macromolecule machines used in humans. Much progress has been made in understanding the structure and function of organic macromolecules and some of the simpler ones are now being manufactured by pharmaceutical firms.</span><br />
<span style="font-family: 'Times New Roman';">Now that scientists understand how some of these highly organized molecules function and why they are required for life, their origin must be explained. We know only four basic methods of producing ATP: in bacterial cell walls, in the cytoplasm by photosynthesis, in chloroplasts, and in mitochondria. No transitional forms exist to bridge these four methods by evolution. According to the concept of irreducible complexity, these ATP producing machines must have been manufactured as functioning units and they could not have evolved by Darwinism mechanisms. Anything less than an entire ATP molecule will not function and a manufacturing plant which is less than complete cannot produce a functioning ATP. Some believe that the field of biochemistry which has achieved this understanding has already falsified the Darwinian world view (Behe, 1996).</span><br />
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References</h3>
<blockquote>
<span style="font-family: 'Times New Roman';">Behe, Michael. 1996. <i>Darwin’s black box: The biochemical challenge to evolution</i>. The Free Press. New York.</span><br />
<span style="font-family: 'Times New Roman';">Darnell, James, Harvey Lodish, and David Baltimore. 1996. <i>Molecular cell biology</i>, 3rd edition. W.H. Freeman. New York.</span><br />
<span style="font-family: 'Times New Roman';">Goodsell, David S. 1996. <i>Our molecular nature</i>. Springer-Verlag. New York.</span><br />
<span style="font-family: 'Times New Roman';">Hickman, Cleveland P. 1997. <i>Integrated principles of zoology</i>, 10th edition. William C. Brown/McGraw Hill. New York.</span><br />
<span style="font-family: 'Times New Roman';">Hickman, Cleveland P., Larry Roberts, and Allan Larson. 1997. <i>The biology of animals</i>, 7th edition. William C. Brown/McGraw Hill. New York.</span><br />
<span style="font-family: 'Times New Roman';">Hoagland, Mahlon and Bert Dodson. 1995. <i>The way life works</i>. Random House. New York.</span><br />
<span style="font-family: 'Times New Roman';">Jensen, Marcus, Donald Wright, and Richard Robinson. 1997. <i>Microbiology for the health sciences</i>, 4th edition. Prentice-Hall. Upper Saddle River, NJ.</span><br />
<span style="font-family: 'Times New Roman';">Kornberg, Arthur. 1989. <i>For the love of enzymes</i>. Harvard University Press. Cambridge, MA.</span><br />
<span style="font-family: 'Times New Roman';">Lim, Daniel. 1998. <i>Microbiology</i>, 2nd edition. William C. Brown/McGraw Hill. New York.</span><br />
<span style="font-family: 'Times New Roman';">Mader, Sylvia. 1996. <i>Biology</i>, 6th edition. William C. Brown. Dubuque, IA.</span><br />
<span style="font-family: 'Times New Roman';">McMurry, John and Mary Castellion. 1996. <i>Fundamentals of general, organic, and biological chemistry</i>, 2nd edition. Prentice Hall. Upper Saddle River, NJ.</span><br />
<span style="font-family: 'Times New Roman';">Ritter, Peck. 1996. <i>Biochemistry, a foundation</i>. Brooks/Cole. Pacific Grove CA.</span><br />
<span style="font-family: 'Times New Roman';">Talaro, Kathleen and Arthur Talaro. 1993. <i>Foundations in microbiology</i>. William C. Brown. Dubuque, IA.</span><br />
<span style="font-family: 'Times New Roman';">Trefil, James. 1992. <i>1001 Things everyone should know about science</i>. Doubleday. New York.</span><br />
<span style="font-family: 'Times New Roman';">Vogel, Gretchen. 1998. Did the first complex cell eat hydrogen? <i>Science</i> 279: 1633-1634.</span></blockquote>
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</div>Anonymoushttp://www.blogger.com/profile/03487445523119762765noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-79032676174173066372012-05-18T19:48:00.000-07:002012-05-18T19:48:51.703-07:00The Aufbau Principle<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div style="text-align: -webkit-auto;">
<b>The electron configuration of an atom gives the distribution of electrons among atomic orbitals in the atom. Two general methods are used to show electron configurations. The subshell notation uses numbers to designate the principal shells and the letters <i>s, p, d, </i>and <i>f</i> to identify the subshells. A superscript following the letter indicates the number of electrons in the designated subshell. The ground state electron configuration for nitrogen would be 1<i>s<sup>2</sup></i>2<i>s<sup>2</sup></i>2<i>p<sup>3</sup></i>. A drawback to this method of showing the electron configuration is that it does not tell us how the three 2<i>p</i> electrons are distributed among the three 2<i>p</i> orbitals. We can show this by using an <i>orbital diagram </i>in which boxes are used to indicate orbitals within subshells and arrows to represent electrons in these orbitals. The direction of the arrows represent the directions of the electron spins. The orbital diagram for nitrogen is</b></div>
<table border="0"><tbody>
<tr><td width="7%"><center><b>1<i>s</i></b></center></td><td width="7%"><center><b>2<i>s</i></b></center></td><td width="4%"> </td><td width="4%"><center><b>2<i>p</i></b></center></td><td width="4%"> </td></tr>
<tr><td width="7%"><center><img border="0" height="40" src="https://chemistry.twu.edu/tutorial/BOX5.gif" width="40" /></center></td><td width="7%"><center><img border="0" height="40" src="https://chemistry.twu.edu/tutorial/BOX5.gif" width="40" /></center></td><td width="4%"><center><img border="0" height="40" src="https://chemistry.twu.edu/tutorial/BOX6.gif" width="40" /></center></td><td width="4%"><center><img border="0" height="40" src="https://chemistry.twu.edu/tutorial/BOX6.gif" width="40" /></center></td><td width="4%"><center><img border="0" height="40" src="https://chemistry.twu.edu/tutorial/BOX6.gif" width="40" /></center></td></tr>
</tbody></table>
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<b>The way we arrive at electron configurations such as the one for nitrogen above is to use a set of rules collectively called the aufbau principle. </b></div>
<ul style="text-align: -webkit-auto;">
<li><b>Electrons occupy orbitals of the lowest energy available</b></li>
<li><b>No two electrons in the same atom may have all four quantum numbers alike</b></li>
<li><b>When entering orbitals of the same energy, electrons initially occupy them singly ant with the same spin</b></li>
<li><b>Electrons fill orbitals in order of the quantum number sum (n + l). For equal (n + l) sums, fill levels in order of increasing n.</b></li>
</ul>
<div style="text-align: -webkit-auto;">
<b>A mnemonic diagram for the aufbau principle known as the diagonal rule is shown here</b></div>
<div style="text-align: -webkit-auto;">
<img border="0" height="164" src="https://chemistry.twu.edu/tutorial/MadelungsRule.gif" width="187" /></div>
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<b>The aufbau principle is really a thought process in which we think about building up an atom from the one that preceeds it in atomic number, by adding a proton and neutrons to the nucleus and one electron to the appropriate atomic orbital. </b></div>
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<b>There are some exceptions to the to the aufbau principle. The first is chromium (Z = 24), the aufbau principle predicts the an electron configuration of [Ar]3<i>d</i><sup>4</sup>4<i>s</i><sup>2</sup> but experimentally we find it to be [Ar]3<i>d</i><sup>5</sup>4<i>s</i><sup>1</sup>. The next exception found is that of copper (Z = 29), the predicted electron configuration is [Ar]3<i>d</i><sup>9</sup>4<i>s</i><sup>2</sup> but experimentally we find it to be [Ar]3<i>d</i><sup>10</sup>4<i>s</i><sup>1</sup>. The reason for these and other exceptions are not completely understood, but it seems that a half-filled 3<i>d</i> subshell in the case of chromium or a completely-filled 3<i>d</i> subshell in the case of copper lend a special stabilty to the observed electron configurations. There is no need to dwell on these exceptions, the point to remember is that the aufbau principle predicts the correct electron configuration most of the time and that the energy of the predicted electron configuration is very close to the ground state energy.</b></div>
</div>Anonymoushttp://www.blogger.com/profile/03487445523119762765noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-16604342617058326252012-05-17T00:14:00.000-07:002012-05-17T00:14:42.526-07:00Artificial respiration<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Artificial respiration</b> is the act of assisting or stimulating respiration, a metabolic process referring to the overall exchange of gases in the body by pulmonary ventilation, external respiration, and internal respiration. Assistance takes many forms, but generally entails providing air for a person who is not breathing or is not making sufficient respiratory effort on their own(although it must be used on a patient with a beating heart or as part of cardiopulmonary resuscitation to achieve the internal respiration).</div>
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Pulmonary anton ventilation (and hence external parts of respiration) is achieved through manual insufflation of the lungs either by the rescuer blowing into the patient's lungs, or by using a mechanical device to do so. This method of insufflation has been proved more effective than methods which involve mechanical manipulation of the patient's chest or arms, such as the Silvester method. It is also known as <b>Expired Air Resuscitation</b> (EAR), <b>Expired Air Ventilation</b> (EAV), <b>mouth-to-mouth resuscitation</b>, <b>rescue breathing</b> or colloquially the <b>kiss of life</b>.</div>
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Artificial respiration is a part of most protocols for performing cardiopulmonary resuscitation(CPR) making it an essential skill for first aid. In some situations, artificial respiration is also performed separately, for instance in near-drowning and opiate overdoses. The performance of artificial respiration in its own is now limited in most protocols to health professionals, whereas lay first aiders are advised to undertake full CPR in any case where the patient is not breathing sufficiently.</div>
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Mechanical ventilation involves the use of a mechanical ventilator to move air in and out of the lungs when an individual is unable to breathe on his or her own, for example during surgery withgeneral anesthesia or when an individual is in a coma.</div>
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<span class="mw-headline" id="Insufflations">Insufflations</span></h2>
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<span class="mw-headline"><b>Insufflation</b>, also known as 'rescue breaths' or 'ventilations', is the act of mechanically forcing air into a patient's respiratory system. This can be achieved via a number of methods, which will depend on the situation and equipment available. All methods require good airway management to perform, which ensures that the method is effective. These methods include:</span></div>
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<li style="margin-bottom: 0.1em;">Mouth to mouth - This involves the rescuer making a seal between their mouth and the patient's mouth and 'blowing', to pass air into the patient's body</li>
<li style="margin-bottom: 0.1em;">Mouth to nose - In some instances, the rescuer may need or wish to form a seal with the patient's nose. Typical reasons for this include maxillofacial injuries, performing the procedure in water or the remains of vomit in the mouth</li>
<li style="margin-bottom: 0.1em;">Mouth to mouth and nose - Used on infants (usually up to around 1 year old), as this forms the most effective seal</li>
<li style="margin-bottom: 0.1em;">Mouth to mask – Most organisations recommend the use of some sort of barrier between rescuer and patient to reduce cross infection risk. One popular type is the 'pocket mask'. This may be able to provide higher tidal volumes than a Bag Valve Mask.</li>
<li style="margin-bottom: 0.1em;">Bag valve mask (BVM) - This is a simple device manually operated by the rescuer, which involves squeezing a bag to expel air into the patient.</li>
<li style="margin-bottom: 0.1em;">Mechanical resuscitator - An electric unit designed to breathe for the patient.</li>
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A CPR pocket mask, with carrying case</div>
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Most training organisations recommend that in any of the methods involving mouth to patient, that a protective barrier is used, to minimise the possibility of cross infection (in either direction).</div>
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Barriers available include pocket masks and keyring-sized face shields. These barriers are an example of Personal Protective Equipment to guard the face against splashing, spraying or splattering of blood or other potentially infectious materials.</div>
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These barriers should provide a one-way filter valve which lets the air from the rescuer deliver to the patient while any substances from the patient (e.g. vomit, blood) cannot reach the rescuer. Many adjuncts are single use, though if they are multi use, after use of the adjunct, the mask must be cleaned and autoclaved and the filter replaced.</div>
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The CPR mask is the preferred method of ventilating a patient when only one rescuer is available. Many feature 18mm inlets to support supplemental oxygen, which increases the oxygen being delivered from the approximate 17% available in the expired air of the rescuer to around 40-50%.</div>
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Tracheal intubation is often used for short term mechanical ventilation. A tube is inserted through the nose (nasotracheal intubation) or mouth (orotracheal intubation) and advanced into the trachea. In most cases tubes with inflatable cuffs are used for protection against leakage and aspiration. Intubation with a cuffed tube is thought to provide the best protection against aspiration. Tracheal tubes inevitably cause pain and coughing. Therefore, unless a patient is unconscious or anesthetized for other reasons, sedative drugs are usually given to provide tolerance of the tube. Other disadvantages of tracheal intubation include damage to the mucosal lining of the nasopharynx or oropharynx and subglottic stenosis.</div>
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In an emergency a Cricothyrotomy can be used by health care professionals, where an airway is inserted through a surgical opening in the cricothyroid membrane. This is similar to atracheostomy but a cricothyrotomy is reserved for emergency access. This is usually only used when there is a complete blockage of the pharynx or there is massive maxillofacial injury, preventing other adjunts being used .</div>
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<span class="mw-headline" id="Efficiency_of_mouth_to_patient_insufflation">Efficiency of mouth to patient insufflation</span></h2>
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Normal atmospheric air contains approximately 21% oxygen when created in. After gaseous exchange has taken place in the lungs, with waste products (notably carbon dioxide) moved from the bloodstream to the lungs, the air being exhaled by humans normally contains around 17% oxygen. This means that the human body utilises only around 19% of the oxygen inhaled, leaving over 80% of the oxygen available in the exhalatory breath.</div>
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This means that there is more than enough residual oxygen to be used in the lungs of the patient, which then crosses the cell membrane to form oxyhemoglobin.</div>
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<span class="mw-headline">The efficiency of artificial respiration can be greatly increased by the simultaneous use of oxygen therapy. The amount of oxygen available to the patient in mouth to mouth is around 16%. If this is done through a pocket mask with an oxygen flow, this increases to 40% oxygen. If a Bag Valve Mask or mechanical respirator is used with an oxygen supply, this rises to 99% oxygen. The greater the oxygen concentration, the more efficient the gaseous exchange will be in the lungs.
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<br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-81689702288531631222012-05-16T12:34:00.000-07:002012-05-16T12:34:23.375-07:00Bone grafting<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Bone grafting</b> is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly.</div>
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Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Bone grafts may be autologous (bone harvested from the patient’s own body, often from the iliac crest), allograft (cadaveric bone usually obtained from a bone bank), or synthetic (often made ofhydroxyapatite or other naturally occurring and biocompatible substances) with similar mechanical properties to bone. Most bone grafts are expected to be reabsorbed and replaced as the natural bone heals over a few months’ time.</div>
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The principles involved in successful bone grafts include osteoconduction (guiding the reparative growth of the natural bone), osteoinduction (encouraging undifferentiated cells to become active osteoblasts), and osteogenesis (living bone cells in the graft material contribute to bone remodeling). Osteogenesis only occurs with autografts.</div>
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<span class="mw-headline" id="Biological_mechanism">Biological mechanism</span></h2>
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<table class="wikitable" style="background-color: #f9f9f9; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-collapse: collapse; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; color: black; font-size: 13px; margin-bottom: 1em; margin-left: 0px; margin-right: 1em; margin-top: 1em; text-align: center;"><caption style="font-weight: bold;">Properties of various types of bone graft sources.</caption><tbody>
<tr><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;"></th><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Osteoconductive</th><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Osteoinductive</th><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Osteogenic</th></tr>
<tr><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Alloplast</th><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">–</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">–</td></tr>
<tr><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Xenograft</th><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">–</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">–</td></tr>
<tr><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Allograft</th><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+/–</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">–</td></tr>
<tr><th style="background-color: #f2f2f2; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">Autograft</th><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+</td><td style="border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(170, 170, 170); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(170, 170, 170); border-right-style: solid; border-right-width: 1px; border-style: initial; border-top-color: rgb(170, 170, 170); border-top-style: solid; border-top-width: 1px; padding-bottom: 0.2em; padding-left: 0.2em; padding-right: 0.2em; padding-top: 0.2em;">+</td></tr>
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Bone grafting is possible because bone tissue, unlike most other tissues, has the ability to regenerate completely if provided the space into which to grow. As native bone grows, it will generally replace the graft material completely, resulting in a fully integrated region of new bone. The biologic mechanisms that provide a rationale for bone grafting are osteoconduction, osteoinduction and osteogenesis</div>
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<span class="mw-headline" id="Osteoconduction">Osteoconduction</span></h3>
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<span style="font-size: x-small;">Osteoconduction occurs when the bone graft material serves as a scaffold for new bone growth that is perpetuated by the native bone. Osteoblasts from the margin of the defect that is being grafted utilize the bone graft material as a framework upon which to spread and generate new bone. In the very least, a bone graft material should be osteoconductive.</span></div>
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<span class="mw-headline" id="Osteoinduction">Osteoinduction</span></h3>
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Osteoinduction involves the stimulation of osteoprogenitor cells to differentiate into osteoblasts that then begin new bone formation. The most widely studied type of osteoinductive cell mediators are <b>bone morphogenetic proteins</b> (BMPs). A bone graft material that is osteoconductive and osteoinductive will not only serve as a scaffold for currently existing osteoblasts but will also trigger the formation of new osteoblasts, theoretically promoting faster integration of the graft.</div>
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<span class="mw-headline" id="Osteopromotion"><br />Osteopromotion</span></h3>
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Osteopromotion involves the enhancement of osteoinduction without the possession of osteoinductive properties. For example,enamel matrix derivative has been shown to enhance the osteoinductive effect of demineralized freeze dried bone allograft(DFDBA), but will not stimulate <i>de novo</i> bone growth alone.</div>
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<span class="mw-headline" id="Osteogenesis"><br />Osteogenesis</span></h3>
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Osteogenesis occurs when vital osteoblasts originating from the bone graft material contribute to new bone growth along with bone growth generated via the other two mechanisms</div>
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<span class="mw-headline" id="Types_and_Tissue_Sources">Types and Tissue Sources</span></h2>
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<span class="mw-headline" id="Autograft">Autograft</span></h3>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-nHlNZ0XjEJ28NnlLYGaxlsSdAIl5xA7TPvTcFtn0guZ7iQAI1Dbw7_TiRozAonYQfFMPfsjIJI0lPHeVSFtkgjlGawzwVOoKe3VXvjyoOWmfEqdaI644ViF3nv7L1pRNtVWU53O7JcY/s1600/RightFemurV.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-nHlNZ0XjEJ28NnlLYGaxlsSdAIl5xA7TPvTcFtn0guZ7iQAI1Dbw7_TiRozAonYQfFMPfsjIJI0lPHeVSFtkgjlGawzwVOoKe3VXvjyoOWmfEqdaI644ViF3nv7L1pRNtVWU53O7JcY/s320/RightFemurV.JPG" width="320" /></a>Autologous (or autogenous) bone grafting involves utilizing bone obtained from the same individual receiving the graft. Bone can be harvested from non-essential bones, such as from the iliac crest, or more commonly in oral and maxillofacial surgery, from the mandibular symphysis (chin area) or anterior mandibular ramus (the coronoid process); this is particularly true for <i>block grafts</i>, in which a small block of bone is placed whole in the area being grafted. When a block graft will be performed, autogenous bone is the most preferred because there is less risk of the graft rejection because the graft originated from the patient's own body. As indicated in the chart above, such a graft would be osteoinductive and osteogenic, as well as osteoconductive. A negative aspect of autologous grafts is that an additional surgical site is required, in effect adding another potential location for post-operative pain and complications.</div>
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Autologous bone is typically harvested from intra-oral sources as the chin or extra-oral sources as the iliac crest, the fibula, the ribs, the mandible and even parts of the skull.</div>
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All bone requires a blood supply in the transplanted site. Depending on where the transplant site is and the size of the graft, an additional blood supply may be required. For these types of grafts, extraction of the part of the periosteum and accompanying blood vesels along with donor bone is required. This kind of graft is known as a vital bone graft.</div>
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An autograft may also be performed without a solid bony structure, for example using bone reamed from the anterior superior iliac spine. In this case there is an osteoinductive and osteogenic action, however there is no osteoconductive action, as there is no solid bony structure.</div>
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<span class="mw-headline" id="Allografts">Allografts</span></h3>
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Allograft bone, like autogenous bone, is derived from humans; the difference is that allograft is harvested from an individual other than the one receiving the graft. Allograft bone is taken from cadavers that have donated their bone so that it can be used for living people who are in need of it; it is typically sourced from a bone bank.</div>
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There are three types of bone allograft available:</div>
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<li style="margin-bottom: 0.1em;">Fresh or fresh-frozen bone</li>
<li style="margin-bottom: 0.1em;">Freeze-dried bone allograft (FDBA)</li>
<li style="margin-bottom: 0.1em;">Demineralized freeze-dried bone allograft (DFDBA)</li>
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<span class="mw-headline" id="Synthetic_variants">Synthetic variants</span></h3>
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<a href="http://en.wikipedia.org/wiki/Artificial_bone" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Artificial bone">Artificial bone</a> can be created from ceramics such as calcium phosphates (e.g. <a class="mw-redirect" href="http://en.wikipedia.org/wiki/Hydroxyapatite" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Hydroxyapatite">hydroxyapatite</a> and tricalcium phosphate), Bioglass and calcium sulphate; all of which are biologically active to different degrees depending on solubility in the physiological environment. These materials can be doped with growth factors, ions such as strontium or mixed with bone marrow aspirate to increase biological activity. Some authors believe this method is inferior to autogenous bone grafting however infection and rejection of the graft is much less of a risk, the mechanical properties such as Young's modulus are comparable to bone. The presence of elements such as strontium can result in higher bone mineral density and enhanced osteoblast proliferation in vivo</div>
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<span class="mw-headline" id="Xenografts">Xenografts</span></h3>
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<a class="mw-redirect" href="http://en.wikipedia.org/wiki/Xenograft" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Xenograft">Xenograft</a> bone substitute has its origin from a species other than human, such as <a href="http://en.wikipedia.org/wiki/Cattle" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Cattle">bovine</a>. Xenografts are usually only distributed as a calcified matrix. In January 2010 Italian scientists announced a breakthrough in the use of <a href="http://en.wikipedia.org/wiki/Wood" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Wood">wood</a> as a bone substitute, though this technique is not expected to be used for humans until at the earliest 2015.</div>
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<span class="mw-headline" id="Alloplastic_grafts"><br />Alloplastic grafts</span></h3>
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Alloplastic grafts may be made from hydroxylapatite, a naturally occurring mineral that is also the main mineral component of bone. They may be made from bioactive glass. Hydroxylapetite is a Synthetic Bone Graft, which is the most used now among other synthetic due to its osteoconduction, hardness and acceptability by bone. Some synthetic bone grafts are made of calcium carbonate, which start to decrease in usage because it is completely resorbable in short time which make the bone easy to break again. Finally used is the tricalcium phosphate which now used in combination with hydroxylapatite thus give both effect osteoconduction and resorbability.</div>
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<span class="mw-headline" id="Growth_Factors"><br />Growth Factors</span></h3>
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<a class="mw-redirect" href="http://en.wikipedia.org/wiki/Growth_Factor" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Growth Factor">Growth Factor</a> enhanced grafts are produced using recombinant DNA technology. They consist of either Human Growth Factors or Morphogens (Bone Morphogenic Proteins in conjunction with a carrier medium, such as collagen).</div>
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<br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-4272267781909944972012-05-16T12:12:00.004-07:002012-05-16T12:12:41.679-07:00Low HDL Cholesterol (Hypoalphalipoproteinemia)<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgY2-p4laneukuj_NADS0VUYvdBt2J8TxZtgB-cA8Tj1QeaThB2dwmtgwiiOjcSGvPkLtZOo1v9S6lTbi5jR029faIuYZKlZg-6mivnU3jnmtbsLffyv_A8tYCWRmaPuXRFxXEEyR9nsvlH/s1600/heart_2_b_crop.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgY2-p4laneukuj_NADS0VUYvdBt2J8TxZtgB-cA8Tj1QeaThB2dwmtgwiiOjcSGvPkLtZOo1v9S6lTbi5jR029faIuYZKlZg-6mivnU3jnmtbsLffyv_A8tYCWRmaPuXRFxXEEyR9nsvlH/s320/heart_2_b_crop.gif" width="195" /></a></div>
Low levels of high-density lipoprotein cholesterol (HDL), or hypoalphalipoproteinemia (HA), includes a variety of conditions, ranging from mild to severe, in which concentrations of alpha lipoproteins or high-density lipoprotein (HDL) are reduced. The etiology of HDL deficiencies ranges from secondary causes, such as smoking, to specific genetic mutations, such as Tangier disease and fish-eye disease.</div>
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HA has no clear-cut definition. An arbitrary cutoff is the 10th percentile of HDL cholesterol levels. A more practical definition derives from the theoretical cardioprotective role of HDL. The US National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) redefined the HDL cholesterol level that constitutes a formal coronary heart disease (CHD) risk factor. The level was raised from 35 mg/dL to 40 mg/dL for men and women. A prospective analysis by Mora et al investigated the link between cholesterol and cardiovascular events in women and found baseline HDL-C level was consistently and inversely associated with incident coronary and CVD events across a range of LDL-C values.</div>
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For the metabolic syndrome in which multiple mild abnormalities in lipids, waist size (abdominal circumference), blood pressure, and blood sugar increase the risk of CHD, the designated HDL cholesterol levels that contribute to the syndrome are sex-specific. For men, a high-risk HDL cholesterol level is still less than 40 mg/dL, but for women, the high-risk HDL cholesterol level is less than 50 mg/dL.</div>
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A low HDL cholesterol level is thought to accelerate the development ofatherosclerosis because of impaired reverse cholesterol transport and possibly because of the absence of other protective effects of HDL, such as decreased oxidation of other lipoproteins.</div>
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The common, mild forms of HA have no characteristic physical findings, but patients may have premature coronary heart or peripheral vascular disease, as well as a family history of low HDL cholesterol levels and premature CHD.</div>
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Therapy to raise the concentration of HDL cholesterol includes weight loss, smoking cessation, aerobic exercise, and pharmacologic management with niacin and fibrates.</div>
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This review addresses the pathogenesis and presenting features of, and the diagnostic tests, therapeutic interventions, and follow-up strategies for, low HDL cholesterol levels.</div>
</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-31171130791454120182012-05-16T12:12:00.002-07:002012-05-16T12:12:15.298-07:00ILOVEYOU ( virus)<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIWkwq6vpoNbS0YdJNTT5i1-rEDZufAfbWmp1Ns2FugkoPrLKQt-d4By-fMbYeQMROp1TrodaFa3rdyy24HCpWSuLEIuHfKKdiY-rFAYfKr86Czv_s_vNBAOvHIq2zKoLGxgKG5JlCoBVa/s1600/infected+with+a+virus+cover+art.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIWkwq6vpoNbS0YdJNTT5i1-rEDZufAfbWmp1Ns2FugkoPrLKQt-d4By-fMbYeQMROp1TrodaFa3rdyy24HCpWSuLEIuHfKKdiY-rFAYfKr86Czv_s_vNBAOvHIq2zKoLGxgKG5JlCoBVa/s320/infected+with+a+virus+cover+art.png" width="320" /></a></div>
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<b>ILOVEYOU</b>, sometimes referred to as <b>Love Letter</b>, was a <a href="http://en.wikipedia.org/wiki/Computer_worm" style="background-image: none; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Computer worm">computer worm</a> that attacked tens of millions of Windows personal computers on and after 5 May 2000 local time in the Philippines when it started spreading as an email message with the subject line "ILOVEYOU" and the attachment "LOVE-LETTER-FOR-YOU.txt.". The first file extension 'VBS' was most often hidden by default on Windows computers of the time, leading unwitting users to think it was a normal text file. Opening the attachment activated the Visual Basic script. The worm did damage on the local machine, overwriting image files, and sent a copy of itself to the first 50 addresses in theWindows Address Book used by Microsoft Outlook.</div>
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Four things led to the success of <b>ILOVEYOU</b>.</div>
<ul style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 19px; list-style-image: url(data:image/png; list-style-type: square; margin: 0.3em 0px 0px 1.6em; padding: 0px; text-align: -webkit-auto;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7V1YX161Frs6YR66S8kJNTFjEsZEhsNrOuCyE_33nSlmjR49UUf20vWuk1pFRB7aY4dXxrhon7-hoezIzph-ZYwSz0wm3-VigcwkPylRDvs3vmbV9YzLaghdA9z_Rq7iYeQRKsVQgMLUa/s1600/virus.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="214" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7V1YX161Frs6YR66S8kJNTFjEsZEhsNrOuCyE_33nSlmjR49UUf20vWuk1pFRB7aY4dXxrhon7-hoezIzph-ZYwSz0wm3-VigcwkPylRDvs3vmbV9YzLaghdA9z_Rq7iYeQRKsVQgMLUa/s320/virus.jpg" width="320" /></a>
<li style="margin-bottom: 0.1em;">It relied on the scripting engine system setting being enabled. The engine had not been known to have ever been used previously and Microsoft received scathing criticism for leaving such a powerful (and dangerous) tool enabled by default with no one aware of its existence.</li>
<li style="margin-bottom: 0.1em;">It took advantage of a Microsoft algorithm for hiding file extensions. Windows had begun hiding extensions by default; the algorithm parsed file names from right to left, stopping at the first 'period' ('dot'). The attachment (which had two file extensions) could thus display the inner file extension 'TXT' as the real extension; text files are considered to be innocuous as they are normally incapable of running executable code.</li>
<li style="margin-bottom: 0.1em;">It utilised social engineering to entice users to open the attachment (out of actual desire to connect or simple curiosity) to ensure continued propagation.</li>
<li style="margin-bottom: 0.1em;">It exploited systemic weaknesses in the design of Microsoft Outlook and Microsoft Windows which led to unused features easily running malicious code capable of achieving complete access to the operating system, secondary storage, and system and user data simply by unwitting users clicking on an icon.</li>
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<span class="mw-headline" id="Spread">Spread</span></h2>
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<span class="mw-headline"><span style="font-size: 13px;">Messages generated in the Philippines began to spread westwards through corporate email systems. Because the worm used mailing lists as its source of targets, the messages often appeared to come from acquaintances and were therefore often regarded as considered "safe" by their victims, providing further incentive to open them. Only a few users at each site had to access the attachment in order to generate millions more messages that crippled mail systems and overwrote millions of files on computers in each successive network</span>
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<span class="mw-headline">Impact</span></div>
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<span class="mw-headline"><span style="font-size: 13px;">The worm is believed to have originated near manil</span><span style="font-size: 20px;">a</span><span style="font-size: 13px;"> in the </span><span style="font-size: 20px;">Philippines</span><span style="font-size: 13px;"> on 5 May 2000 local time and to thereafter have spread westward across the world, moving first to Hong Kong, then to Europe, and finally the US as people reported to their offices that Friday morning.</span><span style="font-size: 13px;"> The outbreak was later estimated to have caused US $5.5 billion in damages worldwide.</span><span style="font-size: 13px;">Already ten days later 50 million infections had been reported.</span><span style="font-size: 13px;"> Most of the damage cited was the time and effort spent getting rid of the infection and recovering damaged files from backup. In order to protect themselves, </span><span style="font-size: 20px;">The Pentagon</span><span style="font-size: 13px;">, CIA</span><span style="font-size: 13px;">, the British Parliament, and most large corporations were forced to completely shut down their mail systems.</span>
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<span class="mw-headline" id="Architecture_of_the_Worm">Architecture of the Worm</span></span></h2>
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<span class="mw-headline">The <b>ILOVEYOU</b> script (the attachment) was written in Microsoft Visual Basic Scripting (VBS) which ran in Microsoft Outlook and was enabled by default. The script added Windows Registrydata for automatic startup on system boot.</span></div>
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<span class="mw-headline">The worm then searched connected drives and replaced files with extensions JPG, JPEG, VBS, VBE, JS, JSE, CSS, WSH, SCT, DOC, HTA, MP2, and MP3 with copies of itself, whilst appending the additional file extension VBS.</span></div>
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The worm propagated itself by sending out copies of the payload to the first 50 entries in theMicrosoft Outlook address book (Windows Address Book). It also downloaded the Barok trojan renamed for the occasion as "WIN-BUGSFIX.EXE"</div>
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<span class="mw-headline">On 5 May 2000 two young Filipino computer programmers named Reomel Ramores and Onel de Guzman became the target of a criminal investigation by the Philippines' National Bureau of Investigation (NBI) agents. The NBI received a complaint from Sky Internet, a local Internet service provider (ISP). The ISP claimed that they have received numerous calls from European computer users, complaining that malware in the form of an "ILOVEYOU" worm was sent to their computers through the said ISP.</span></div>
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<span class="mw-headline">After several days of surveillance and investigation spearheaded by Darwin Bawasanta, systems development manager of Sky Internet, the NBI was able to trace a frequently appearing telephone number which turned out to be that of Ramores' apartment in Manila. His residence was searched by the NBI and Ramores was consequently arrested and placed on inquest investigation before the Department of Justice (DOJ). Onel de Guzman was likewise arrested in absentia. At that point, the NBI were at a loss as to what felony or crime to charge them with. There were some agents who suggested they might be charged with violation of Republic Act 8484 or the Access Device Regulation Act, a law designed mainly to penalisecredit card fraud, the reason supposedly being that both used, if not stole, pre-paid Internet cards which enabled them to use several ISPs. Another school of thought within the NBI suggested Ramores and de Guzman could be charged with malicious mischief, a felony involving damage to property under the Philippines Revised Penal Code enacted in 1932. But the drawback with a charge of malicious mischief is that one of its elements, aside from damage to property, was intent to damage, and de Guzman and Igi Gando claimed during custodial investigation that de Guzman may have merely unwittingly released the worm.</span></div>
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To show intent, the NBI investigated AMA Computer College where de Guzman dropped out at the very end of his final year. They found that de Guzman was not only quite familiar with computer viruses but had in fact proposed to use one. For his undergraduate thesis, de Guzman proposed the implementation of a trojan to steal Internet login passwords. De Guzman proposed that users would finally be able to afford an Internet connection. The proposal was rejected by the College of Computer Studies board, prompting de Guzman to cancel his studies the day before graduation.</div>
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</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-8405576076231191642012-05-16T12:12:00.001-07:002012-05-16T12:12:02.634-07:00Rapid Weight Loss Side Effects<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="background-color: #f4f4f4; font-family: Verdana; font-size: 12px; line-height: 18px; text-align: -webkit-auto;">Weight loss is alright, but is losing weight too quickly going to harm your body? The answer is yes. To put it simply, the fast loss of weight will go unchecked by the body and it won't be able to control what it's losing and what it needs to gain. You just might end up putting your health at risk.</span>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrtjuoz_TKsTdZ6BT4IhMeJbierTeE6wwC5rucy0__HDroIvs7B6KlZzp6ArFm4ZA3Sb7ND_OhkpI9mucAHDshNjpY8LyargxAHlVH0XJMye7NsfGiN02FxPYopef3Ym-aKB8u1jhDqKMu/s1600/rapid-weight-loss.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrtjuoz_TKsTdZ6BT4IhMeJbierTeE6wwC5rucy0__HDroIvs7B6KlZzp6ArFm4ZA3Sb7ND_OhkpI9mucAHDshNjpY8LyargxAHlVH0XJMye7NsfGiN02FxPYopef3Ym-aKB8u1jhDqKMu/s1600/rapid-weight-loss.jpg" /></a><span style="background-color: white; font-family: Verdana; font-size: 12px; line-height: 18px; text-align: -webkit-auto;">Some people unfortunately fall to the fad that they can lose weight fast. While this may be possible theoretically, it is not the best thing to do. The problem is that people who try to go for rapid weight loss end up causing damage to their bodies because they may be tempted to excessively use diet pills, without being aware of the dangers of diet pills. Even those who go off food completely are not aware how much harm they may end up causing their bodies in the long run.</span>
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<b style="background-color: white; font-family: Verdana; font-size: 12px; line-height: 18px; text-align: -webkit-auto;">Problems With Losing Weight Too Fast</b><br />
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<li>While most side effects may be temporary, one of the most severe problems arising out of rapid weight loss is Gallstones. If you suddenly stop eating, there may be a shift in the balance of bile salts and cholesterol. This may turn out to be a lethal concoction for the body. The cholesterol will then form lumps, called gallstones. Gallstones lodge themselves in the bile ducts and can be extremely painful. In some situations, it may also result in inflammation in the liver, pancreas and bladder. Sudden reduction in eating also reduces contractions in the gallbladder which aids the process of gallstone creation.</li>
<li>Another problem is the loss of muscle mass. If the body does not get the necessary food to fuel its daily activities, it's going to turn to other sources for energy. And ironically, research suggests that it will not use up the fat reserve as the body is programmed to use fat reserves as the last resort. So, before eating up the fat reserve, your body will first consume the muscle mass.</li>
<li>Loss of muscle tissue will lead to loss of water content in the body. The muscle mass comes from protein, which has a significant amount of water. Muscles also store most of the water, so loss of muscle from the body will lead to loss of muscle mass.</li>
<li>One problem that will really get you in a tizzy is hair loss. Hair needs protein for its growth. In fact, hair itself is made of a protein known as keratin. Hence if you decide to go off food, your protein consumption will reduce and there will be no protein available for hair growth, as the body will try to optimize whatever protein it gets. So hair basically pulls out the short straw and is left as the last in the hierarchy functions that protein needs to perform.</li>
<li>Other side effects include shivering. This is temporary and occurs if you have resorted to weight loss surgery. Surgery dramatically cuts out all the fat from the body. Fat insulates the body and stops the loss of body heat. Once all the fat is lost, the body heat will be lost quickly, leading to shivering.</li>
<li>The most unsightly side effect is hanging skin. When you lose weight, the skin, stretched due the fat, takes some time to tighten itself around the body. In some cases, especially ones related to obese people, there have been instances where people have lost weight too quickly, but their skin still hangs lose because it wasn't given enough time to adapt and wrap itself around the body tightly enough again.</li>
<li>Some people consume weight loss pills without being aware of the dark side of excessive intake. Consuming diet pills may lead to various medical complications such as increasing your heart rate and causing palpitations.</li>
</ol>
<span style="background-color: white; font-family: Verdana; font-size: 12px; line-height: 18px; text-align: -webkit-auto;">While losing weight may be important from the point of view of fitness, you have to remember to do it step by step. Losing weight too fast can bring on the above problems</span>
</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-35477625756145612142012-05-16T00:03:00.001-07:002012-05-16T00:14:42.804-07:00Causes of Dark Spots<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="background-color: white; font-family: verdana; font-size: 12px; line-height: 18px;"><span style="color: #ea9999;">Dark spots on the skin, also called hyperpigmentation, are a common skin problem especially beginning in middle age. There are a variety of conditions and agents that can cause dark spots to develop.</span></span>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaOnoiUcOzN6Wp_VcTe-fqMgskMn6bE0aY12cLJnHuSDUe7SIhRE1EN-bPdaXyC4hbUS2eY3heC8_k3lRozkqLUJuY3A8AvCo6DvE5kQ7sU6bI88RaVUdiDwu4mD5GKQkYX0WE2l0Ou6EH/s1600/best-hyperpigmentation-creams.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="195" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaOnoiUcOzN6Wp_VcTe-fqMgskMn6bE0aY12cLJnHuSDUe7SIhRE1EN-bPdaXyC4hbUS2eY3heC8_k3lRozkqLUJuY3A8AvCo6DvE5kQ7sU6bI88RaVUdiDwu4mD5GKQkYX0WE2l0Ou6EH/s320/best-hyperpigmentation-creams.jpg" width="320" /></a></div>
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<h3 style="text-align: left;">
<b style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;">Skin Diseases that Cause Dark Spots</b></h3>
<b style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;"><br /></b><br />
<span style="background-color: white; font-family: verdana; font-size: 12px; line-height: 18px;"><span style="color: #cc0000;">One of the most under-recognized causes of dark spots is post-inflammatory hyperpigmentation. This is a dark spot that occurs after some type of trauma to the skin - especially infections like acne. This and other skin diseases are listed here</span></span><span style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;">:</span>
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<span style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;"> </span><br />
<span style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;"> </span><br />
<ul style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px; margin-bottom: 1.5em; margin-left: 0px; margin-right: 0px; margin-top: 1.5em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: relative; text-decoration: inherit; z-index: 0;">
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Melasma</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Riehl's melanosis</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Poikiloderma of Civatte</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Erythromelanosis follicularis</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Linea Fusca</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Post inflammatory hyperpigmentation </li>
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<h3>
<b style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;">Medications that Cause Dark Spots</b></h3>
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<h3 style="text-align: left;">
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<span style="color: #cc0000;">Certain medications sensitize the skin to the sun and other medications can cause dark spots without sun exposure. The most common offending medications are listed here</span><span style="color: #333333;">:</span></div>
<ul style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; font-weight: normal; line-height: 18px; margin-bottom: 1.5em; margin-left: 0px; margin-right: 0px; margin-top: 1.5em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: relative; text-decoration: inherit; z-index: 0;">
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Estrogens</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Tetracyclines</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Amiodarone</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Phenytoin</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Phenothiazines</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Sulfonamides </li>
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<b style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;">UV Light Causes Specific Types of Dark Spots </b></div>
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<b style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; line-height: 18px;"><br /></b></div>
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<div style="background-color: white; font-family: verdana; font-size: 12px; font-weight: normal; line-height: 18px; margin-bottom: 1.5em; margin-top: 1.5em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">
<span style="color: #ea9999;">UV light is a major cause of not only dark spots, but also other types of skin damage. The various types of dark spots caused by UV light are listed here</span><span style="color: #333333;">:</span></div>
<ul style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; font-weight: normal; line-height: 18px; margin-bottom: 1.5em; margin-left: 0px; margin-right: 0px; margin-top: 1.5em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: relative; text-decoration: inherit; z-index: 0;">
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Melasma</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Solar lentigines - freckles</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Ephelide </li>
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<b style="font-weight: normal;">Other Causes of Dark Spots</b><br />
These are other conditions or diseases that can cause dark spots<span style="font-weight: normal;">:</span></div>
<ul style="background-color: white; color: #333333; font-family: verdana; font-size: 12px; font-weight: normal; line-height: 18px; margin-bottom: 1.5em; margin-left: 0px; margin-right: 0px; margin-top: 1.5em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; position: relative; text-decoration: inherit; z-index: 0;">
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Pregnancy</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Liver disease</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Addison's disease</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Hemachromatosis</li>
<li style="font-family: inherit; font-style: inherit; list-style-type: disc; margin-bottom: 0px; margin-left: 18px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: inherit;">Pituitary tumors </li>
</ul>
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<span style="background-color: white; font-family: Georgia, serif; font-size: 22px; text-align: -webkit-auto;">Preventing and Treating Dark Spots on Your Skin</span>
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<span style="background-color: white; font-family: Georgia, serif; font-size: 22px; text-align: -webkit-auto;"><br /></span></div>
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Many women are dreaming to have beautiful and healthy skin and currently there are many beauty clinics that offer various treatments. People have two major contrasting skin colors, black and white. Skin as the outer layer of our body has many problems and most of people with brighter skin often complain about their reddish or purplish marks. In dermatology, those kinds of spots are called as macules. Macules are a condition where your skin turns red like freckles.</div>
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Macules can also happen to dark skin, except those same reddish spots will look a good deal darker, deep brown or completely black or dozens of shades in between, it is particularly true after they heal. Americans of African ancestry usually have more concern about these dark macules caused by acne rather than the acne itself. These dark spots are called PIP (postinflammatory pigmentation or postinflammatory hyperpigmentation).</div>
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<strong>How Dark Spots Are Formed?</strong></div>
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Here is a short explanation of how PIP is formed. It is limited to the skin area in which inflammation has developed previously. It is a kind of "footprints" or telltale signs of where the "first battle" took place. PIP can be caused by a cut, rash, burn, or the aftermath of a healed acne lesion.</div>
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These "footprints" can disappear eventually, but they usually outlast the original inflamed acne lesions, however sometimes it takes a few months or even several years to fade away completely.</div>
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PIP is divided into two types, which appear when skin inflammation happens:</div>
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<strong>1. Epidermal Hypermelanosis</strong></div>
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The highly-active melanocytes respond by transferring their melanin pigments (in small granules) to the nearby keratinocytes, which are one of the epidermal cells. The stimulation increases and melanin granules transfer causes epidermal hypermelanosis. As the result, the skin gets darker although the pigmentation isn’t too intense. In this condition, PIP responds quite well to many topical bleaching cream products, which help to make it disappears faster. This is because most of melanin pigments are in the top layer of the skin (epidermis) which allows better treatment.</div>
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<strong>2. Dermal Melanosis</strong></div>
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This type of PIP is quite difficult to treat and may never completely disappear. Unless the pigment is very deep, PIP will improve over time. It really needs a good deal of extra patience. The dermal melanosis happens when inflammation attacks the basal cell layer, which causes the release of melanin pigments and subsequently they are "dropped" deeper into the dermis, as the result, those pigments are trapped by scavenger white cells (macrophages).</div>
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It takes some time for dark spots to fade. PIP treatment is often a prolonged and difficult process that may require between six and twelve months to achieve good depigmentation results.</div>
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<strong>Prevention</strong></div>
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Because these dark spots could take time to disappear or often longer than expected, it’s important to perform actions to avoid their emergence. It can be stopped with early treatment. You need to be aware of things that can possibly give you greater risk of having PIP, such as:</div>
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a. Squeezing, picking or rubbing your acne</div>
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b. Using OTC toners, alcohol-based products and also prescribed acne products that may irritate and dry your skin and cause PIP</div>
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c. Excessive washing using harsh soaps</div>
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d. Scrubbing with buff puffs</div>
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e. Cosmetic products that might worsen your skin and acne problems</div>
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f. Shaving your beard may wreak havoc with your facial skin condition, as it increases the possibility of PIP development</div>
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<strong>Treatment</strong></div>
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The same medications that are used to treat acne for Caucasian skin can also used to treat people with different skin color. One way to treat acne and the dark spot is by OTC Medication.</div>
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<strong>Benzoyl Peroxide and Salicylic Acid</strong></div>
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Benzoyl peroxide and salicylic acid are parts of Over-the-counter (OTC) medications. They might be an excellent approach if your acne is mild and your body or skin is able to tolerate these products. But they can be quite irritating for some people due to the presence of benzoyl peroxide. If your skin is able to tolerate it and you see improvement with your acne, then stick with it. However, benzoyl peroxide and salicylic acid can be irritating and produce whitish scales on dark skin. These scales are often referred to as to look "ashy." The appearance of the scales is difficult for some people to tolerate. (Light skin or white skin gets ashy appearance too).</div>
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If benzoyl peroxide or salicylic acid is causing ‘ashy’ appearance and scales, apply a light non-oily moisturizer like Olay Active Hydrating Beauty Fluid or Cetaphil Moisturizing Cream. If you have dark spots, you can use a moisturizer that contains a sunscreen such as Purpose Moisturizer SPF 15. Alternatively, you may use a heavier, greasier moisturizer. If you have a sensitive skin, try to use the lower strength (like 2.5 percent water-based benzoyl peroxide).</div>
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Repeat treatment every two days, then increase to once a day, as you’re able to tolerate the product. Similarly, if your skin gets too ashy or is irritated from salicylic acid products that have a mild peeling activity, try using lower than the 1 percent concentration and try applying the medications on an alternate-day basis.</div>
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<strong>Over-the-Counter Bleaches</strong></div>
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxnasfS984OSVikrJ38UNwBOqLM54E7RoWnfDUKDeNlSTYBqbYFDYpCGZwArGEqYEEgf5AGaT7frBC9XSo4hEm10pprqq85mAeFWYa2x0UzR5Z-btHKthaDlcFkA5jnnXO5VgbHM4GsJqk/s1600/hyperpigmentation_img.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxnasfS984OSVikrJ38UNwBOqLM54E7RoWnfDUKDeNlSTYBqbYFDYpCGZwArGEqYEEgf5AGaT7frBC9XSo4hEm10pprqq85mAeFWYa2x0UzR5Z-btHKthaDlcFkA5jnnXO5VgbHM4GsJqk/s320/hyperpigmentation_img.jpg" width="297" /></a></div>
For PIP spots, look for over-the-counter preparations that contain 1 to 2 percent hydroquinone, a chemical that’s traditionally been the main component for the treatment of PIP. Esoterica, Porcelana, Black Opal and Ambi are companies that manufactured over-the-counter hydroquinone-containing creams and gels. These products are applied as thin layer on the affected areas once or twice a day. There are over-the-counter products that contain 10 percent of hydroquinone or higher that are available in many other countries, particularly within Africa and Asia, and some of them have found their way (illegally) into "health" stores in the United States — mostly in ethnic neighborhoods within big cities. These high concentrations actually bring the risk of a darkening reaction known as ochronosis.</div>
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<strong><span style="font-size: medium;">Home Remedies</span></strong></div>
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Unfortunately, typical kitchens have plenty of ingredients that can be used to treat dark spots. Before deciding to seek expensive treatment, you should know that there are safer and cheaper ways to eliminate dark spots.</div>
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<strong>Citrus Fruits</strong></div>
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Limes, lemons and oranges are packed with Vitamin C, a good natural bleaching agent. Among citrus fruits, lemon is considered to be the best remedy to eliminate dark spots. You can directly apply on the affected spot, using a dab of cotton or clean fingers. The citric acid will also help to bleach dark spots.</div>
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<strong>Honey and Milk</strong></div>
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Both are excellent remedies to treat facial dark spots. It is a good idea to choose sour milk as the lactic acid exhibits gentle peeling effects, which can lighten dark spots without irritating your skin. On the other hand, honey has a number of renewing properties.</div>
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<strong>Other Concoction</strong></div>
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Parsley juice can be mixed with red currant, orange and lemon juices, which can be applied along with moisturizing cream. This mixture may also work well with brown spots and freckles.</div>
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</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-85017762527548621022012-05-14T12:06:00.000-07:002012-05-14T12:06:54.277-07:00Pertussis (Whooping cough)<div dir="ltr" style="text-align: left;" trbidi="on">
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<span class="title" style="border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-family: inherit; font-size: 18px; font-style: inherit; font-weight: inherit; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; vertical-align: baseline;">Pertussis</span></h1>
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Whooping cough</div>
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Pertussis is a highly contagious bacterial disease that causes uncontrollable, violent coughing. The coughing can make it hard to breathe. A deep "whooping" sound is often heard when the patient tries to take a breath.</div>
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Pertussis, or whooping cough, is an upper respiratory infection caused by the <i>Bordetella pertussis</i> or<i>Bordetella parapertussis</i> bacteria. It is a serious disease that can cause permanent disability in infants, and even death.</div>
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When an infected person sneezes or coughs, tiny droplets containing the bacteria move through the air, and the disease is easily spread from person to person.</div>
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The infection usually lasts 6 weeks.</div>
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Whooping cough can affect people of any age. Before vaccines were widely available, the disease was most common in infants and young children. Now that most children are immunized before entering school, the higher percentage of cases is seen among adolescents and adults</div>
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<span class="title" style="border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-family: inherit; font-size: 16px; font-style: inherit; font-weight: inherit; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; vertical-align: baseline;"><span style="color: #e06666;">Symptoms</span></span></h2>
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Initial symptoms, similar to the common cold, usually develop about a week after exposure to the bacteria.</div>
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Severe episodes of coughing start about 10 to 12 days later. In children, the coughing often ends with a "whoop" noise. The sound is produced when the patient tries to take a breath. The whoop noise is rare in patients under 6 months of age and in adults.</div>
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Coughing spells may lead to vomiting or a short loss of consciousness. Pertussis should always be considered when vomiting occurs with coughing. In infants, choking spells are common.</div>
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Other pertussis symptoms include:</div>
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Runny nose</div>
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Slight fever (102 °F or lower)</div>
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Diarrhea</div>
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<span class="title" style="border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-family: inherit; font-size: 16px; font-style: inherit; font-weight: inherit; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; vertical-align: baseline;"><span style="color: #e06666;">Signs and tests</span></span></h2>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2htPX1WMA7nnQVrNdx-O717KoVMWrcogOrj4CdT5LGeeSTwutSot4h1DKNuYm5Zj7GL-IXKftbwF_Q2MCnqPNJsbMKw2N9eomlW5ENNytp8fkvk8m-w1OlZBoS6c8VUpPKyxt_vtuxWhn/s1600/images+(46).jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2htPX1WMA7nnQVrNdx-O717KoVMWrcogOrj4CdT5LGeeSTwutSot4h1DKNuYm5Zj7GL-IXKftbwF_Q2MCnqPNJsbMKw2N9eomlW5ENNytp8fkvk8m-w1OlZBoS6c8VUpPKyxt_vtuxWhn/s1600/images+(46).jpg" /></a>The initial diagnosis is usually based on the symptoms. However, when the symptoms are not obvious, pertussis may be difficult to diagnose. In very young infants, the symptoms may be caused by pneumonia instead.</div>
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To know for sure, the health care provider may take a sample of mucus from the nasal secretions and send it to a lab, which tests it for pertussis. While this can offer an accurate diagnosis, the test takes some time, and treatment is usually started before the results are ready.</div>
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Some patients may have a <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003642/" style="border-bottom-color: rgb(221, 221, 221); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; color: #642a8f; font-family: inherit; font-style: inherit; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none; vertical-align: baseline;">complete blood count</a> that shows large numbers of lymphocytes.</div>
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<span class="title" style="border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-family: inherit; font-size: 16px; font-style: inherit; font-weight: inherit; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; vertical-align: baseline;"><span style="color: #ea9999;">Treatment</span></span></h2>
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If started early enough, antibiotics such as <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000662/" style="border-bottom-color: rgb(221, 221, 221); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; color: #642a8f; font-family: inherit; font-style: inherit; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-decoration: none; vertical-align: baseline;">erythromycin</a> can make the symptoms go away more quickly. Unfortunately, most patients are diagnosed too late, when antibiotics aren't very effective. However, the medicines can help reduce the patient's ability to spread the disease to others.</div>
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Infants younger than 18 months need constant supervision because their breathing may temporarily stop during coughing spells. Infants with severe cases should be hospitalized.</div>
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An oxygen tent with high humidity may be used.</div>
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Fluids may be given through a vein if coughing spells are severe enough to prevent the person from drinking enough fluids.</div>
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Sedatives (medicines to make you sleepy) may be prescribed for young children.</div>
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Cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used.</div>
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</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-30292243165372907542012-05-14T11:34:00.000-07:002012-05-14T11:34:03.003-07:00The Big Bang Theory<div dir="ltr" style="text-align: left;" trbidi="on">
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<i><b>The Big Bang Theory</b></i> is an Americansitcom created by Chuck Lorre and Bill Prady, both of whom serve as executive producers on the show, along with Steven Molaro. All three also serve as head writers. It premiered on CBS on September 24, 2007.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUNFwNz5u5U5anGqXYDuMLVNYDh8io4Fjao8QMR3xdIZEaRYzGKoYawt7Xn6ogsa81E5hPSxufEJiCy4OR2TYUn4eDEh93EK6zWlWgJx0-7AdQcc2Y12VdF3INlhrRqc-wzD4YOlSSd75q/s1600/the_big_bang_theory_logo_by_NinjaPikachu-1.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUNFwNz5u5U5anGqXYDuMLVNYDh8io4Fjao8QMR3xdIZEaRYzGKoYawt7Xn6ogsa81E5hPSxufEJiCy4OR2TYUn4eDEh93EK6zWlWgJx0-7AdQcc2Y12VdF3INlhrRqc-wzD4YOlSSd75q/s320/the_big_bang_theory_logo_by_NinjaPikachu-1.png" width="240" /></a>The show is centered on five characters: roommates Leonard Hofstadter and Sheldon Cooper, two physicists who work at theCalifornia Institute of Technology (Caltech);Penny, a blonde waitress and aspiring actress who lives across the hall; and Leonard and Sheldon's equally geeky and socially awkward friends and co-workers aerospace engineerHoward Wolowitz and astrophysicist Rajesh Koothrappali. The geekiness and intellect of the four guys is contrasted for comic effect with Penny's social skills and common sense. Three other supporting characters have also been promoted to starring roles:Leslie Winkle, a physicist colleague at Caltech and, at different times, a lover of both Leonard and Howard who left the show after season 3; Bernadette Rostenkowski, Howard's fiancée, who is a microbiologist and former part-time waitress alongside Penny; and Amy Farrah Fowler, a neurobiologist who joins the group after being matched to Sheldon on a dating website.</div>
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The show is produced by Warner Bros. Television and Chuck Lorre Productions. In August 2009, the sitcom won the best comedy series TCA award and Jim Parsons(Sheldon) won the award for individual achievement in comedy. In 2010, the show won the People's Choice Award for Favorite Comedy, while Parsons won a PrimetimeEmmy Award for Outstanding Lead Actor in a Comedy Series. On January 16, 2011, Parsons was awarded a Golden Globe for Best Performance by an Actor in a Television Series – Comedy or Musical, an award that was presented by co-star Kaley Cuoco(Penny). On September 18, 2011, Parsons was again awarded an Emmy for Best Actor in a Comedy Series.</div>
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When the third season premiered on September 21, 2009, <i>The Big Bang Theory</i>ranked as CBS's highest-rated show of that evening in the adults 18–49 demographic (4.6/10), along with a then-series-high 12.83 million viewers. On May 19, 2010, it was announced that CBS would be moving the show to Thursdays at 8:00 ET for the 2010–2011 schedule. On January 12, 2011, CBS announced that the show had been renewed for an additional three years, extending it through the 2013–2014 season. The fifth seasonpremiered on September 22, 2011, in its usual time slot with two back-to-back episodes.The fifth season completed airing on May 10, 2012. The sixth season is expected to premiere in Fall 2012.</div>
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<span class="mw-headline" id="Production">Production</span></h2>
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The show's initial pilot, developed for the 2006–07 television season, was substantially different from its current form. The only characters from the initial pilot that were kept for the reshot pilot for the series were Leonard and Sheldon (portrayed by Johnny Galecki and Jim Parsons respectively and named for comedy great Sheldon Leonard. The cast was rounded off by two female leads: Canadian actress Amanda Walsh as Katie, "a street-hardened, tough-as-nails, woman with a vulnerable interior" who the boys meet after she breaks up with her boyfriend and invite to live in their apartment (Katie was effectively replaced by Penny in the second pilot); and Iris Bahr as Gilda, a scientist colleague and friend of the boys who was threatened by Katie's presence. The initial pilot used Thomas Dolby's hit "She Blinded Me With Science" as theme music.</div>
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The series was not picked up, but the creators were given an opportunity to retool the show and produce a second pilot. They brought in the remaining cast and retooled the show to its final format. The original unaired pilot has never been officially released, but it has circulated on the Internet. On the evolution of the show, Lorre said "We did the 'Big Bang Pilot' about two and a half years ago, and it sucked... but there were two remarkable things that worked perfectly, and that was Johnny and Jim. We rewrote the thing entirely, and then we were blessed with Kaley and Simon and Kunal." As to whether the world will ever see that original pilot, maybe on a DVD, Lorre said "Wow that would be something, we will see. Show your failures..."</div>
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The title card for the original 2006 pilot</div>
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The first and second pilots of <i>The Big Bang Theory</i> were directed by James Burrows, who did not continue with the show. The reworked second pilot led to a 13-episode order by CBS on May 14, 2007.Prior to its airing on CBS, the pilot episode was distributed on iTunes free of charge. The show premiered September 24, 2007, and was picked-up for a full 22-episode season on October 19, 2007.However, production was halted on November 6, 2007 due to the Writers Guild of America strike. The series returned on March 17, 2008 in an earlier time slot and ultimately only 17 episodes were produced. After the strike ended, the show was picked up for a second season airing in the 2008–2009 season, premiering in the same time slot on September 22, 2008. With increasing ratings, the show received a two-year renewal through the 2010–11 season. Since then, the show has been picked up for three more seasons.</div>
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David Saltzberg, a professor of physics and astronomy at the University of California, Los Angeles, checks scripts and provides dialogue, mathematics equations, and diagrams used as props. According to executive producer/co-creator Bill Prady, "We're working on giving Sheldon an actual problem that he's going to be working on throughout the [first] season so there's actual progress to the boards ... We worked hard to get all the science right."</div>
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Several of the actors in <i>The Big Bang Theory</i> worked together previously on <i>Roseanne</i>including Johnny Galecki, Sara Gilbert, and Laurie Metcalf (who plays Sheldon's mother, Mary Cooper). Additionally, Lorre was a writer on the series for several seasons.</div>
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<span class="mw-headline" id="Theme_song">Theme song</span></h3>
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Single cover for "Big Bang Theory Theme" by <a href="http://en.wikipedia.org/wiki/Barenaked_Ladies" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Barenaked Ladies">Barenaked Ladies</a> (2007)</div>
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The Canadian alternative rock band Barenaked Ladieswrote and recorded the show's theme song, which describes the history and formation of the universe and the Earth. Ed Robertson, lead singer and guitarist in the band, was asked by Lorre and Prady to write a theme song for the show. Having been asked to write songs for other films and shows only to have them rejected in favor of another artist's, Robertson agreed to write a theme only after learning that he was the sole writer that Lorre and Prady had asked. He drew inspiration from Simon Singh's book, <i>Big Bang</i>, which he had coincidentally just finished reading.</div>
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On October 9, 2007, a full-length (1 minute and 45 seconds) version of the song was released commercially. In a 2010 issue of <i>TV Guide</i>, the show's opening title sequence ranked No.6 on a list of television's top 10 credits sequences, as selected by readers.</div>
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<span class="mw-headline" id="Production_costs">Production costs</span></h3>
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For the first three seasons, Johnny Galecki, Kaley Cuoco and Jim Parsons, the three main stars of the show, received at most $60,000 per episode. The salary for the three went up to $200,000 per episode for the fourth season. According to their contracts, their pay will go up an additional $50,000 per episode in each of the following three seasons, culminating in $350,000 per episode in the seventh season.</div>
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<span class="mw-headline" id="Main_cast">Main cast</span></h2>
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List of The Big Bang Theory characters</div>
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<a class="image" href="http://en.wikipedia.org/wiki/File:The_Big_Bang_Theory_main_characters.png" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;"><img alt="" class="thumbimage" height="141" src="http://upload.wikimedia.org/wikipedia/en/thumb/e/e9/The_Big_Bang_Theory_main_characters.png/250px-The_Big_Bang_Theory_main_characters.png" style="background-color: white; border-bottom-color: rgb(204, 204, 204); border-bottom-style: solid; border-bottom-width: 1px; border-color: initial; border-image: initial; border-left-color: rgb(204, 204, 204); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(204, 204, 204); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(204, 204, 204); border-top-style: solid; border-top-width: 1px; border-width: initial; vertical-align: middle;" width="250" /></a><br />
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<a class="internal" href="http://en.wikipedia.org/wiki/File:The_Big_Bang_Theory_main_characters.png" style="background-attachment: initial !important; background-clip: initial !important; background-color: initial !important; background-image: none !important; background-origin: initial !important; background-position: initial initial !important; background-repeat: initial initial !important; border-bottom-style: none !important; border-color: initial !important; border-image: initial !important; border-left-style: none !important; border-right-style: none !important; border-top-style: none !important; border-width: initial !important; color: #0b0080; display: block; text-decoration: none;" title="Enlarge"><img alt="" height="11" src="http://bits.wikimedia.org/static-1.20wmf2/skins/common/images/magnify-clip.png" style="background-attachment: initial !important; background-clip: initial !important; background-color: initial !important; background-image: none !important; background-origin: initial !important; background-position: initial initial !important; background-repeat: initial initial !important; border-bottom-style: none !important; border-color: initial !important; border-image: initial !important; border-left-style: none !important; border-right-style: none !important; border-top-style: none !important; border-width: initial !important; display: block; vertical-align: middle;" width="15" /></a></div>
Cast of characters in <i>The Big Bang Theory</i>. From left: Howard Wolowitz, Leonard Hofstadter, Penny, Sheldon Cooper and Rajesh Koothrappali.</div>
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These actors have been credited in all episodes of the series:</div>
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<li style="margin-bottom: 0.1em;">Johnny Galecki as Leonard Hofstadter,Ph.D. – An experimental physicist with anIQ of 173, he received his Ph.D. when he was 24 years old. The <a class="extiw" href="http://en.wiktionary.org/wiki/straight_man" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #663366; text-decoration: none;" title="wikt:straight man">straight man</a> of the series, he shares an apartment with colleague and friend Sheldon Cooper. The writers immediately implied potential romance between him and neighborPenny, and their sexual tension is frequently explored.</li>
<li style="margin-bottom: 0.1em;">Jim Parsons as Sheldon Cooper, Ph.D., Sc.D. – Originally from East Texas, he was a child prodigy with an eidetic memory who began college at the age of 11 (after completing the fifth grade), started graduate studies at 14, and earned a Ph.D. at 16. A theoretical physicist focusing on quantum mechanics and string theory, he has a master's degree, a Ph.D. an Sc.D., and an IQ of 187. He exhibits a strict adherence to routine; a lack of understanding of irony and sarcasm; he is also uninterested in many of the romantic hijinks of his friends. Sheldon shares an apartment with Leonard Hofstadter, across the hall from Penny, and relies on both for advice in social situations. In the fourth season, he begins a relationship with Amy Farrah Fowler, who becomes his first girlfriend during the fifth season.</li>
<li style="margin-bottom: 0.1em;">Kaley Cuoco as Penny – From a small town outside of Omaha, Nebraska, a blonde who lives across the hall from Sheldon and Leonard. She is pursuing a career in acting, and has been on casting calls and auditions but has not been very successful thus far. To pay the bills, she is a waitress and occasional bartender at The Cheesecake Factory. To date, her last name has not been revealed. She dated Leonard at the end of the first season, and during the third and fifth seasons. By season four, Bernadette, Amy and Penny have formed their own group, who like to hang out in Penny's apartment or go out together.</li>
<li style="margin-bottom: 0.1em;">Simon Helberg as Howard Wolowitz, M.Eng. – He works as an aerospace engineer. He is Jewish, and lives with his mother. Unlike Sheldon, Leonard, and Raj, Howard lacks a Ph.D. He defends this by pointing out that he has a master's degree in engineering fromMIT and that the apparatus he designs are launched into space, unlike the purely abstract work of his friends. He provides outrageous pick-up lines and fancies himself a <a class="extiw" href="http://en.wiktionary.org/wiki/lady%27s_man" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #663366; text-decoration: none;" title="wiktionary:lady's man">ladies' man</a>with suitably unimpressed reactions from Penny; however, he has shown limited success with other women. He claims to be a polyglot. He dates and later marries Bernadette Rostenkowski. In the fifth season, he trained as an astronaut and blasted off into space in the season finale.</li>
<li style="margin-bottom: 0.1em;">Kunal Nayyar as Rajesh Koothrappali, Ph.D. – Originally from New Delhi, <a href="http://en.wikipedia.org/wiki/India" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="India">India</a>, and works as a particle astrophysicist at Caltech. His family is very well off. He communicates with his parents, Dr. and Mrs. V.M. Koothrappali, via webcam. He is very shy around women and is physically unable to talk to them unless he drinks alcohol (or thinks he has been drinking alcohol). However, he has often had better luck with women than his overly-confident best friend Howard. During the fourth season, his sister Priya (Aarti Mann) stays with him and became Leonard's girlfriend.</li>
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These actors were first credited as guest stars and later promoted to main cast. However, even after promotion, they are only credited in episodes in which they appear:</div>
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<li style="margin-bottom: 0.1em;">Sara Gilbert as Leslie Winkle, Ph.D. (recurring season 1, starring season 2, recurring season 3) – a physicist who works in the same lab as Leonard. In appearance she is essentially Leonard's female counterpart, equipped with the black framed glasses andsweat jackets. She is an enemy of Sheldon's, due to their conflicting scientific theories. Though they both consider each other to be intellectually inferior, Leslie is much wittier than Sheldon, regularly calling him "dumbass", and usually bests him in their repartee. Leslie has had casual sex with <a href="http://en.wikipedia.org/wiki/Leonard_Hofstadter" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Leonard Hofstadter">Leonard</a> and later <a href="http://en.wikipedia.org/wiki/Howard_Wolowitz" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Howard Wolowitz">Howard</a>; in the case of the former, it reunites Gilbert and Galecki together on-screen after the two played the on-screen couple of Darlene Connor and David Healy respectively during the run of <i>Roseanne</i>. Gilbert was promoted to a main cast member during the second season, but was demoted again because producers could not generate enough content for the character. Gilbert left the series after season 3 concluded to focus her efforts on <i>The Talk</i>, on which she serves as executive producer for CBS.</li>
<li style="margin-bottom: 0.1em;">Melissa Rauch as Bernadette Rostenkowski, Ph.D. (recurring 3x05–3x14, starring since 4x04) – a young woman who is initially a waitress and co-worker of Penny paying her way through graduate school microbiology studies, she defends her doctoral thesis and lands a high-paying science position at the end of season 4. Bernadette is introduced to Howard by Penny. At first she and Howard do not get along, as they appear to have nothing in common. When they find out that they both have overbearing mothers, they feel a connection. They became engaged near the end of season 4.</li>
<li style="margin-bottom: 0.1em;">Mayim Bialik as Amy Farrah Fowler, Ph.D. (guest 3x23 until 4x05, starring since 4x08) – a woman Raj and Howard met on an online dating site after secretly setting up an account using Sheldon's name and information. The site matches her to Sheldon, and the two share many similar traits though Amy is more interested in social and romantic interaction. Once she and Sheldon meet, she becomes, as Sheldon puts it, a girl who is his friend, but not his "girlfriend". In Season Five, Amy made Sheldon jealous by going on a date with comic book store owner, Stuart, causing Sheldon to solidify their relationship as boyfriend/girlfriend. Sheldon then insisted that Amy sign a 31-page "Relationship Agreement." She also believes she and Penny are best friends, a sentiment Penny doesn't seem to share but respectfully indulges. Her admiration for Penny has at times bordered on attraction. Amy Fowler has a Ph.D. in neurobiology, while Bialik herself has a doctorate in neuroscience; in the season 1 episode "The Bat Jar Conjecture", Raj suggests recruiting the real-life Bialik to their Physics Bowl team.</li>
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<br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-49035989105735233422012-05-14T11:31:00.000-07:002012-05-14T11:38:31.592-07:00Scaphoid Fracture of the Wrist<div dir="ltr" style="text-align: left;" trbidi="on">
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Introduction</h3>
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<b>Doctors commonly diagnose a sprained wrist after a patient falls on an outstretched hand. However, if pain and swelling don't go away, doctors become suspicious that the injury is actually more serious. A fall on an outstretched hand commonly breaks the scaphoid bone of the wrist. X-rays taken at the time of the injury may not clearly show the fracture. If the fracture is not recognized early, it may not heal properly. This can lead to problems later.</b></div>
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<b>This guide will help you understand</b></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhR7kwmsOCzu-KRThDgsgKQ-ApC-4zjIhb6oj9xjnG3Gbxka9sAmkHOBN6c5GoqZ_nmCyGcfhDCLNt9N4ESFcOTS6ud-q_nwg7Hchf_pB1W-Jmc5VYgN_mdWUVjHGrWBX4daHEIm7pTPrAB/s1600/wrist_anatomy_bones02.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhR7kwmsOCzu-KRThDgsgKQ-ApC-4zjIhb6oj9xjnG3Gbxka9sAmkHOBN6c5GoqZ_nmCyGcfhDCLNt9N4ESFcOTS6ud-q_nwg7Hchf_pB1W-Jmc5VYgN_mdWUVjHGrWBX4daHEIm7pTPrAB/s320/wrist_anatomy_bones02.jpg" width="320" /></a></div>
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<li style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">what causes fractures of the scaphoid bone</li>
<li style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">what nonunion of the scaphoid bone is</li>
<li style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">what you can do to treat each condition</li>
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Anatomy</h3>
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Where is the scaphoid bone of the wrist?</div>
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The anatomy of the wrist joint is extremely complex, probably the most complex of all the joints in the body. The joint is actually a collection of many joints and many bones. These joints and bones let us use our hands in many ways. The wrist must be extremely mobile to give our hands a full range of motion. At the same time, the wrist must provide the strength for heavy gripping.</div>
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The wrist is made up of eight separate small bones, called the <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">carpal bones</span>. The <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">scaphoid bone</span> is a carpal bone near the base of the thumb. The carpal bones connect the two bones of the forearm, the <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">radius</span> and the <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">ulna,</span> to the bones of the hand. The <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">metacarpal bones</span> are the long bones that lie underneath the palm. The metacarpals attach to the <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">phalanges</span>, which are the bones in the fingers and thumb.</div>
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One reason that the wrist is so complicated is because every small bone forms a joint with the bone next to it. This means that what we call the wrist joint is actually made up of many small joints. Ligaments connect all the small bones to each other, and to the radius, ulna, and metacarpal bones.</div>
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The scaphoid bone is a small carpal bone on the thumb side (<span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">radial side</span>) of the wrist. It is the most commonly fractured carpal bone. This is probably because it actually crosses two rows of carpal bones, forming a hinge. A fall on the outstretched hand puts heavy stress on the scaphoid bone. This stress can cause either a small crack through the middle of the bone or a complete separation of the bone into two pieces. A separation is called a<span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">displaced fracture</span>.</div>
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<center><img alt=" " id="wrist_anatomy_intro01" name="wrist_anatomy_intro01" src="http://www.eorthopod.com/images/ContentImages/wrist/wrist_anatomy/wrist_anatomy_intro01.jpg" /></center><br />
<h3>
Introduction</h3>
<blockquote>
<h4>
<i>The anatomy of the wrist joint is extremely complex, probably the most complex of all the joints in the body. The wrist is actually a collection of many bones and joints. These bones and joints let us use our hands in lots of different ways. The wrist must be extremely mobile to give our hands a full range of motion. At the same time, the wrist must provide the strength for heavy gripping.</i><i>This guide will help you understand</i><ul>
<li><i>what parts make up the wrist</i></li>
</ul>
<ul>
<li><i>how those parts work together</i></li>
</ul>
</h4>
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<h3>
Important Structures</h3>
<blockquote>
The important structures of the wrist can be divided into several categories. These include<br />
<ul>
<li>bones and joints</li>
<li>ligaments and tendons</li>
<li>muscles</li>
<li>nerves</li>
<li>blood vessels</li>
</ul>
<h3>
<b>Bones and Joints</b><b>There are 15 bones that form connections from the end of the forearm to the hand. The wrist itself contains eight small bones, called <i>carpal bones</i>. These bones are grouped in two rows across the wrist. The <i>proximal row</i> is where the wrist creases when you bend it. Beginning with the thumb-side of the wrist, the proximal row of carpal bones is made up of the<i>scaphoid</i>, <i>lunate</i>, and <i>triquetrum</i>. The second row of carpal bones, called the <i>distal row</i>, meets the proximal row a little further toward the fingers. The distal row is made up of the <i>trapezium</i>, <i>trapezoid</i>, <i>capitate</i>, <i>hamate</i>, and <i>pisiform</i> bones.</b><b>The proximal row of carpal bones connects the two bones of the forearm, the <i>radius</i> and the <i>ulna</i>, to the bones of the hand. The bones of the hand are called the <i>metacarpal bones</i>. These are the long bones that lie within the palm of the hand. The metacarpals attach to the <i>phalanges</i>, which are the bones in the fingers and thumb.</b></h3>
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<center><img alt=" " id="wrist_anatomy_bones04" name="wrist_anatomy_bones04" src="http://www.eorthopod.com/images/ContentImages/wrist/wrist_anatomy/wrist_anatomy_bones04.jpg" /></center><br />
<h3>
<span style="font-weight: normal;">One reason that the wrist is so complicated is because every small carpal bone forms a joint with the bone next to it. This means that what we call the wrist joint is actually made up of many small joints.<br /><i><a href="http://www.eorthopod.com/eorthopodV2/index.php?ID=bc6117f6c5f98a17135e5aac6c0cf6d7&fuseaction=topics.detail&area=10&TopicID=2f08cb47d2d0f85d66a33fad17b62d34" style="color: #003366;">Articular cartilage</a></i> is the material that covers the ends of the bones of any joint. Articular cartilage can be up to one-quarter of an inch thick in the large, weight-bearing joints. It is thinner in joints such as the wrist that don't support a lot of weight. Articular cartilage is white, shiny, and has a rubbery consistency. It is slippery, which allows the joint surfaces to slide against one another without causing any damage.<br />The function of articular cartilage is to absorb shock and provide an extremely smooth surface to make motion easier. We have articular cartilage essentially everywhere that two bony surfaces move against one another, or <i>articulate</i>. In the wrist, articular cartilage covers the sides of all the carpals and the ends of the bones that connect from the forearm to the fingers.<br />Ligaments and Tendons<br /><i>Ligaments</i> are soft tissue structures that connect bones to bones. The ligaments around a joint usually combine to form a<i>joint capsule</i>. A joint capsule is a watertight sac that surrounds a joint and contains lubricating fluid called <i>synovial fluid</i>. In the wrist, the eight carpal bones are surrounded and supported by a joint capsule.<br />Two important ligaments support the sides of the wrist. These are the <i>collateral ligaments</i>. There are two collateral ligaments that connect the forearm to the wrist, one on each side of the wrist.<br />As its name suggests, the <i>ulnar collateral ligament</i> (UCL) is on the ulnar side of the wrist. It crosses the ulnar edge (the side away from the thumb) of the wrist. It starts at the <i>ulnar styloid</i>, the small bump on the edge of the wrist (on the side away from the thumb) where the ulna meets the wrist joint. There are two parts to the cord-shaped UCL. One part connects to the pisiform (one of the small carpal bones) and to the <i>transverse carpal ligament</i>, a thick band of tissue that crosses in front of the wrist. The other goes to the triquetrum (a small carpal bone near the ulnar side of the wrist). The UCL adds support to a small disc of cartilage where the ulna meets the wrist. This structure is called the <i>triangular fibrocartilage complex</i> (TFCC) and is discussed in more detail below. The UCL stabilizes the TFCC and keeps the wrist from bending too far to the side (toward the thumb).<br />The <i>radial collateral ligament</i> (RCL) is on the thumb side of the wrist. It starts on the outer edge of the radius on a small bump called the <i>radial styloid</i>. It connects to the side of the scaphoid, the carpal bone below the thumb. The RCL prevents the wrist from bending too far to the side (away from the thumb).<br />Just as there are many bones that form the wrist, there are many ligaments that connect to and support these bones. Injury or problems that cause these ligaments to stretch or tear can eventually lead to arthritis in the wrist.<br />At the wrist, the end of the ulna bone of the forearm articulates with two carpal bones, the lunate and the triquetrum. A unique structure mentioned earlier, the triangular fibrocartilage complex (TFCC), sits between the ulna and these two carpal bones. The TFCC is a small cartilage pad that cushions this part of the wrist joint. It also improves the range of motion and gliding action within the wrist joint.<br />There are several important <a href="http://www.eorthopod.com/eorthopodV2/index.php?ID=bc6117f6c5f98a17135e5aac6c0cf6d7&fuseaction=topics.detail&area=10&TopicID=2f08cb47d2d0f85d66a33fad17b62d34" style="color: #003366;"><i>tendons</i></a> that cross the wrist. Tendons connect muscles to bone. The tendons that cross the wrist begin as muscles that start in the forearm. Those that cross the palm side of the wrist are the <i>flexor tendons</i>. They curl the fingers and thumb, and they bend the wrist. The flexor tendons run beneath the transverse carpal ligament (mentioned earlier). This structure lies on the palm side of the wrist. This band of tissue keeps the flexor tendons from <i>bowing</i> outward when you curl your fingers, thumb, or wrist. The tendons that travel over the back of the wrist, the <i>extensor tendons</i>, run through a series of tunnels, called <i>compartments</i>. These compartments are lined with a slick substance called <i>tenosynovium</i>, which prevents friction as the extensor tendons glide inside their compartment.<br />Muscles<br />The main muscles that are important at the wrist have been mentioned above in the discussion about tendons. These muscles generally start further up in the forearm. The tendons of these muscles cross the wrist. They control the actions of the fingers, thumb, and wrist.<br />Nerves<br />All of the nerves that travel to the hand cross the wrist. Three main nerves begin together at the shoulder: the <i>radial nerve</i>, the <i>median nerve</i>, and the <i>ulnar nerve</i>. These nerves carry signals from the brain to the muscles that move the arm, hand, fingers, and thumb. The nerves also carry signals back to the brain about sensations such as touch, pain, and temperature.</span></h3>
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<center><img alt=" " id="wrist_anatomy_nerves01" name="wrist_anatomy_nerves01" src="http://www.eorthopod.com/images/ContentImages/wrist/wrist_anatomy/wrist_anatomy_nerves01.jpg" /></center><br />
<h4>
<b>The <a href="http://www.eorthopod.com/eorthopodV2/index.php?ID=bc6117f6c5f98a17135e5aac6c0cf6d7&fuseaction=topics.detail&area=10&TopicID=2f08cb47d2d0f85d66a33fad17b62d34" style="color: #003366;">radial nerve</a> runs along the thumb-side edge of the forearm. It wraps around the end of the radius bone toward the back of the hand. It gives sensation to the back of the hand from the thumb to the third finger. It also goes to the back of the thumb and just beyond the main knuckle of the back surface of the ring and middle fingers.</b><b>The median nerve travels through a tunnel within the wrist called the <i>carpal tunnel</i>. The median nerve gives sensation to the palm sides of the thumb, index finger, long finger, and half of the ring finger. It also sends a nerve branch to control the<i>thenar muscles</i> of the thumb. The thenar muscles help move the thumb and let you touch the pad of the thumb to the tips each of each finger on the same hand, a motion called <i>opposition</i>.</b><b>The <a href="http://www.eorthopod.com/eorthopodV2/index.php?ID=bc6117f6c5f98a17135e5aac6c0cf6d7&fuseaction=topics.detail&area=10&TopicID=2f08cb47d2d0f85d66a33fad17b62d34" style="color: #003366;">ulnar nerve</a> travels through a separate tunnel, called <i>Guyon's canal</i>. This tunnel is formed by two carpal bones (the<i>pisiform</i> and <i>hamate</i>), and the ligament that connects them. After passing through the canal, the ulnar nerve branches out to supply feeling to the little finger and half the ring finger. Branches of this nerve also supply the small muscles in the palm and the muscle that pulls the thumb toward the palm.</b><b>The nerves that travel through the wrist are subject to problems. Constant bending and straightening of the wrist and fingers can lead to irritation or pressure on the nerves within their tunnels and cause problems such as pain, numbness, and weakness in the hand, fingers, and thumb.</b><b>Blood Vessels</b><b>Traveling along with the nerves are the large vessels that supply the hand with blood. The largest artery is the <i>radial artery</i>that travels across the front of the wrist, closest to the thumb. The radial artery is where the pulse is taken in the wrist. The<i>ulnar artery</i> runs next to the ulnar nerve through Guyon's canal (mentioned earlier). The ulnar and radial arteries arch together within the palm of the hand, supplying the front of the hand and fingers. Other arteries travel across the back of the wrist to supply the back of the hand and fingers.</b></h4>
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Causes</h3>
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<i>What causes a scaphoid fracture?</i></div>
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<i>A scaphoid fracture is almost always caused by a fall on the outstretched hand. We commonly try to break a fall by putting our hands out for protection. Landing on an outstretched hand makes hand and wrist injuries, including a fracture of the scaphoid bone, fairly common.</i></div>
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<i>When a scaphoid fracture is recognized on the first X-ray, treatment begins immediately. But patients often assume that the injury is just a sprain, and they wait for it to heal on its own. In some cases, the wrist gets better. In many cases the bone fails to heal. The scaphoid fracture then develops into what surgeons call a <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">nonunion</span>.</i></div>
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<i>A nonunion can occur in two ways. In a simple nonunion, the two pieces of bone fail to heal together. The second type of nonunion is much more serious. The lower half of the fractured bone loses its blood supply and actually dies. This condition is called <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">avascular necrosis</span> (<span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">Avascular</span> means no blood supply, and <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">necrosis</span> means dead.)</i></div>
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<i>The scaphoid bone is at risk for avascular necrosis. Only one small artery enters the bone, at the end that is closest to the thumb. If the fracture tears the artery, the blood supply is lost. Avascular necrosis becomes easy to see on X-rays several months after the injury.</i></div>
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<i>Symptoms</i></h3>
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<i>How will I know if I have a scaphoid fracture?</i></div>
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<i>The symptoms of a fresh fracture of the scaphoid bone usually include pain in the wrist and tenderness in the area just below the thumb. You may also see swelling around the wrist. The swelling occurs because blood from the fractured bone fills the wrist joint. Thin people will see a bulging of the <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">joint capsule</span>. The joint capsule is the watertight sac that encloses the joint.</i></div>
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<i>Symptoms of a nonunion of the scaphoid bone are more subtle. You may have pain when you use your wrist. However, the pain may be very minimal. It is fairly common for doctors to see a nonunion of the scaphoid bone on X-rays, but the patient can't remember an injury. These people probably suffered a wrist injury years ago that they thought was a simple sprain. Still, the most common symptom of a nonunion is a gradual increase in pain. Over several years the nonunion can lead to degenerative arthritis in the wrist joint.</i></div>
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<i>Diagnosis</i></h3>
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<i>What tests will my doctor run?</i></div>
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<i>Your doctor will first take a medical history. You will be asked questions about your pain and about any injuries to your wrist. Your doctor will also do a physical exam. The prodding and moving may hurt your wrist a bit. But it is important that your doctor know exactly where your pain is coming from.</i></div>
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<i>Doctors should assume that any patient who has fallen on an outstretched hand and has swelling or tenderness on the thumb side of the wrist has a scaphoid fracture. You should assume this until tests prove otherwise. X-rays taken immediately after the injury may not show a fracture. Still, most surgeons will put a cast on the wrist and get another X-ray in 10 days. This gives the edges of the fractured bone time to heal, and may prevent nonunion. By waiting 10 days, the fracture is easier to see on an X-ray.</i></div>
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<i>If it is still not clear whether or not you have a fracture, your doctor may order other imaging tests. You may have a <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">bone scan</span> done. A bone scan involves injecting tracers into your blood stream. The tracers then show up on special X-rays of your wrist. The tracers build up in areas of extra stress to bone tissue, such as a fracture.</i></div>
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<i>Your doctor may also order a <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; font-size: 16px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">magnetic resonance imaging</span> (MRI) scan. An MRI scan is a special imaging test that uses magnetic waves to create pictures of your body in slices. The MRI scan shows tendons as well as bones. It is painless and requires no needles or injections</i></div>
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<i>Treatment</i></h3>
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<i>Can a fracture or nonunion be healed?</i></div>
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<i>Nonsurgical Treatment</i></h3>
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<i>If the fracture is identified immediately and is in good alignment, you will probably wear acast for nine to 12 weeks. The cast will cover your forearm, wrist, and thumb. This is necessary to hold the scaphoid bone very still while it heals. Your doctor will take X-rays at least once a month to check the progress of the healing. Once your doctor is sure the fracture has healed, the cast will be removed. Even with this type of treatment, there is still a risk that the fracture may not heal well and will become a nonunion.</i></div>
<strong style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><i>Nonunion</i></strong><br />
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<i>A fracture that doesn't heal within several months is considered a nonunion. If the injury is fairly recent, your doctor might recommend more time in the cast. He or she might also prescribe an <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">electrical stimulator</span>. The electrical stimulator is a device that sends a small electrical current to your scaphoid bone. You wear it like a large bracelet for 10 to 12 hours a day. Electrical current has been shown to help the bones heal.</i></div>
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<i>Surgery</i></h3>
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<i>Some surgeons report good results doing surgery right away when a patient has had a recent, nondisplaced scaphoid fracture. Studies have shown that this method can help people get back to activity faster than wearing a cast for up to 12 weeks. The procedure involves inserting a screw through the scaphoid. The screw holds the scaphoid firmly until it heals.</i></div>
<strong style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><i>Scaphoid Debridement</i></strong><br />
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<i>In cases where a nonunion has occurred depite wearing a cast and using an electrical stimulator, surgery will likely be suggested. An incision is made in the wrist directly over the scaphoid bone. The surgeon finds the old fracture line on the scaphoid bone. All the scar tissue between the two halves of the bone must be removed (<span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">debrided</span>). This creates a fresh bone surface to allow healing to begin again. In some cases, damaged bone tissue from the scaphoid is also removed.</i></div>
<strong style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><i>Bone Graft Method</i></strong><br />
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<i>Your surgeon may use a <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">bone graft</span>. A bone graft involves taking bone tissue from another spot in your wrist and inserting it into the fracture. A bone graft can stimulate healing on the surface of the bones. The bone graft is usually taken through a second small incision just above the wrist. (It is sometimes taken from the pelvis, through an incision in the side of your hip.)</i></div>
<i><img alt=" " class="" height="auto" id="wrist_scaphoid_fracture_treatment03" smartload="3" src="http://www.eorthopod.com/images/ContentImages/wrist/wrist_scaphoid_fracture/wrist_scaphoid_fracture_treatment03.jpg" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; opacity: 1; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; visibility: visible; zoom: 1;" width="auto" /></i><br />
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<i>After the bone graft is placed between the parts of the scaphoid bone, some surgeons also insert a metal pin or screw across the bone. The goal is to hold the two pieces of bone tightly together, allowing them to fuse into one bone.</i></div>
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<i>When the surgery is complete, the incision is stitched closed. The arm is placed in a large bandage or a splint. You are then awakened and taken to the recovery room.</i></div>
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<i>Sometimes the bones still do not heal as planned. Surgeons call a fused bone that fails to heal a <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">pseudarthrosis</span>. If the nonunion continues to cause pain, you may need a second operation. Your surgeon will probably add more bone graft and check that the pins or screws are holding the bones together.</i></div>
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<i>Rehabilitation</i></h3>
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<i>What will my recovery be like?</i></div>
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<i>Nonsurgical Rehabilitation</i></h3>
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<i>If the bone is in good alignment, and there are no problems with the blood supply to the bone, you may be placed in a cast for nine to 12 weeks. Some doctors prefer to start with a long-arm cast. Others use a <span style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline-color: initial; outline-style: initial; outline-width: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;">thumb-spica cast</span> designed to keep the wrist and thumb from moving.</i></div>
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<i>The amount of time you need to wear the cast depends on what part is fractured and whether the bones heal well. When your doctor is certain the bones have healed, your cast will be removed. Your wrist will probably be stiff and weak from being in the cast. You may need physical or occupational therapy to help improve wrist range of motion and strength.</i></div>
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<i>After Surgery</i></h3>
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<i>Depending on the type of surgery you have, you may be placed in a splint for up to 12 weeks after surgery. Your surgeon will X-ray the wrist several times after surgery to make sure that the bones are healing properly. Once the two halves of the scaphoid bone have healed, you can safely begin a rehabilitation program.</i></div>
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<i>You may need physical or occupational therapy sessions for six to eight weeks after surgery. The first few treatments will focus on controlling the pain and swelling. You will work into doing exercises to help strengthen and stabilize the muscles around the wrist joint. Other exercises are used to improve fine motor control and dexterity of your hand. You'll be given tips on ways to do your activities while avoiding extra strain on the wrist joint.</i></div>
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</a></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-76694302428933796182012-05-14T11:10:00.000-07:002012-05-14T11:10:44.016-07:00ABO blood group system<div dir="ltr" style="text-align: left;" trbidi="on">
<h2 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ANTIGENS AND ANTIBODIES</span></h2>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Definition:</span></h3>
<dl style="background-color: #ffeaea; text-align: -webkit-auto;">
<dt><span style="font-family: Arial;">Blood group system</span></dt>
<dd><span style="font-family: Arial;">A series of antigens exhibiting similar serological and physiological characteristics, and inherited according to a specific pattern.</span></dd></dl>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Importance of the ABO system:</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="color: maroon; font-family: Arial;"><span style="background-color: #ffa6a6;"><b>Most important (clinically significant) Blood Group System for transfusion practice</b></span></span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<b><span style="color: maroon; font-family: Arial;">Why?</span></b></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">This is the only blood group system in which antibodies are consistently, predictably, and naturally present in the serum of people who lack the antigen. Therefore ABO compatibility between donor and recipient is crucial since these strong, naturally occurring A and B antibodies are IgM and can readily activate complement and cause agglutination. If ABO antibodies react with antigens in vivo, result is acute hemolysis and possibly death.</span></div>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Indications for ABO grouping:</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO grouping is required for all of the following individuals:</span></div>
<ul style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;"><b><span style="color: maroon;">Blood Donors-</span></b>since it can be life threatening to give the wrong ABO group to the patient.</span></li>
<li><span style="font-family: Arial;"><span style="color: maroon;"><b>Transfusion recipients</b>-</span>since we need to know the donor blood is ABO compatible.</span></li>
<li><b><span style="color: maroon; font-family: Arial;">T</span></b><span style="font-family: Arial;"><span style="color: maroon;"><b>ransplant Candidates and Donors</b>-</span>ABO antigens are found in other tissues as well. Therefore the transplant candidates and donors must be compatible.</span></li>
<li><span style="font-family: Arial;"><span style="color: maroon;"><b>Prenatal Patients</b>-</span>To determine whether the mothers may have babies who are suffering from ABO-HDN. It is also beneficial to know the ABO group should she start hemorrhaging.</span></li>
<li><span style="font-family: Arial;"><b><span style="color: maroon;">Newborns</span></b> (sometimes) If the baby is demonstrating symptoms of Hemolytic Disease of the Newborn, the ABO group needs to be determined along with Rh and others.</span></li>
<li><span style="font-family: Arial;"><b><span style="color: maroon;">Paternity testing</span></b> Since the inheritance of the ABO Blood Group System is very specific, this serves as one of the first methods to determine the likelihood that the accused father is the father or not.</span></li>
</ul>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Discovery of the ABO system:</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">In 1900 Karl Landsteiner reported a series of tests, which identified the ABO Blood Group System. In 1910 he won Nobel prize for medicine for this discovery. He mixed the serum and cells of all the researchers in his lab and found four different patterns of agglutination. From those studies he developed what we now know as <b><span style="color: maroon;">Landsteiner's rules for the ABO Blood Group:</span></b></span></div>
<ol style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">A person does not have antibody to his own antigens</span></li>
<li><span style="font-family: Arial;">Each person has antibody to the antigen he lacks (only in the ABO system)</span></li>
<li><span style="font-family: Arial;">Below are the four blood groups and the antigens and the expected, naturally-occurring antibodies present.</span></li>
</ol>
<table align="right" border="0" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber2" style="background-color: #ffeaea; border-collapse: collapse;"><tbody>
<tr><td align="center" width="31%"><b><span style="color: maroon; font-family: Arial;">BLOOD GROUP</span></b></td><td align="center" width="41%"><b><span style="color: maroon; font-family: Arial;">ANTIGEN</span></b></td><td align="center" width="28%"><b><span style="color: maroon; font-family: Arial;">ANTIBODY</span></b></td></tr>
<tr><td align="center" width="31%"><span style="font-family: Arial;">A</span></td><td align="center" width="41%"><span style="font-family: Arial;">A</span></td><td align="center" width="28%"><span style="font-family: Arial;">anti-B</span></td></tr>
<tr><td align="center" width="31%"><span style="font-family: Arial;">B</span></td><td align="center" width="41%"><span style="font-family: Arial;">B</span></td><td align="center" width="28%"><span style="font-family: Arial;">anti-A</span></td></tr>
<tr><td align="center" width="31%"><span style="font-family: Arial;">AB</span></td><td align="center" width="41%"><span style="font-family: Arial;">A and B</span></td><td align="center" width="28%"><span style="font-family: Arial;">neither</span></td></tr>
<tr><td align="center" width="31%"><span style="font-family: Arial;">O</span></td><td align="center" width="41%"><span style="font-family: Arial;">neither anti-A or anti-B</span></td><td align="center" width="28%"><span style="font-family: Arial;">anti-A,B</span></td></tr>
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<tr><td bgcolor="#800000" colspan="3" width="100%"><h3 align="center">
<span style="color: white; font-family: Arial;">Incidence (%) of ABO Blood Groups in the US Population</span></h3>
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<tr><td align="center" width="33%"><b><span style="color: maroon; font-family: Arial;">ABO Group</span></b></td><td align="center" width="33%"><b><span style="color: maroon; font-family: Arial;">Whites</span></b></td><td align="center" width="34%"><b><span style="color: maroon; font-family: Arial;">Blacks</span></b></td></tr>
<tr><td align="center" width="33%"><b><span style="font-family: Arial;">O</span></b></td><td align="center" width="33%"><b><span style="font-family: Arial;">45</span></b></td><td align="center" width="34%"><b><span style="font-family: Arial;">49</span></b></td></tr>
<tr><td align="center" width="33%"><b><span style="font-family: Arial;">A</span></b></td><td align="center" width="33%"><b><span style="font-family: Arial;">40</span></b></td><td align="center" width="34%"><b><span style="font-family: Arial;">27</span></b></td></tr>
<tr><td align="center" width="33%"><b><span style="font-family: Arial;">B</span></b></td><td align="center" width="33%"><b><span style="font-family: Arial;">11</span></b></td><td align="center" width="34%"><b><span style="font-family: Arial;">20</span></b></td></tr>
<tr><td align="center" width="33%"><b><span style="font-family: Arial;">AB</span></b></td><td align="center" width="33%"><b><span style="font-family: Arial;">4</span></b></td><td align="center" width="34%"><b><span style="font-family: Arial;">4</span></b></td></tr>
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<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO Typing</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO typing involves both antigen typing and antibody detection. The antigen typing is referred to as the forward typing and the antibody detection is the reverse typing</span></div>
<ul style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">The forward typing determines antigens on patient's or donor's cells<br /><b><span style="color: maroon;">a</span></b>. Cells are tested with the antisera reagents anti-A, anti-B, (and in the case of donor cells anti-A,B)<br /><b><span style="color: maroon;">b</span></b>. Reagents are either made from hyperimmunized human sources, or monoclonal antibodies. <br /><b><span style="color: maroon;">c</span>. </b>One advantages of the monoclonal antibodies are the antibody strength.<br /><span style="color: maroon;"><b>d</b></span>. Another advantage of monoclonals: human source reagents can transmit infectious disease (hepatitis).</span></li>
<li><span style="font-family: Arial;">Reverse typing determines antibodies in patient's or donor's serum or plasma<br /><span style="color: maroon;"><b>a. </b></span>Serum tested with reagent A<sub>1</sub> cells and B cells<br /><b><span style="color: maroon;">b.</span></b> Reverse grouping is also known as backtyping or serum confirmation</span></li>
</ul>
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<tr><td align="center" bgcolor="#800000" colspan="6" height="40" width="108%"><h3>
<span style="color: white; font-family: Arial;">Routine ABO Typing</span></h3>
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<tr><td align="center" bgcolor="#FFEAEA" colspan="2" height="38" width="32%"><h4>
<span style="color: maroon; font-family: Arial;">Reaction of Cells Tested With</span></h4>
</td><td align="center" bgcolor="#FFEAEA" height="38" width="17%"><b><span style="color: maroon; font-family: Arial;">Red Cell ABO Group</span></b></td><td align="center" bgcolor="#FFEAEA" colspan="2" height="38" width="37%"><h4>
<span style="color: maroon; font-family: Arial;">Reaction of Serum Tested Against</span></h4>
</td><td align="center" bgcolor="#FFEAEA" height="38" width="17%"><b><span style="color: maroon; font-family: Arial;">Reverse ABO Group</span></b></td></tr>
<tr><td align="center" height="27" width="16%"><span style="color: maroon; font-family: Arial;">Anti-A</span></td><td align="center" height="27" width="16%"><span style="color: maroon; font-family: Arial;">Anti-B</span></td><td align="center" height="27" width="17%"> </td><td align="center" height="27" width="17%"><span style="color: maroon; font-family: Arial;">A<sub>1 </sub>Cells</span></td><td align="center" height="27" width="17%"><span style="color: maroon; font-family: Arial;">B Cells</span></td><td align="center" height="27" width="17%"> </td></tr>
<tr><td align="center" height="19" width="16%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="16%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="17%"><span style="color: maroon;"><b>O</b></span></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="17%"><span style="color: maroon;"><b>O</b></span></td></tr>
<tr><td align="center" height="19" width="16%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="16%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="17%"><span style="color: maroon;"><b>A</b></span></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="17%"><span style="color: maroon;"><b>A</b></span></td></tr>
<tr><td align="center" height="19" width="16%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="16%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="17%"><b><span style="color: maroon; font-family: Arial;">B</span></b></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="17%"><b><span style="color: maroon; font-family: Arial;">B</span></b></td></tr>
<tr><td align="center" height="19" width="16%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="16%"><span style="font-family: Arial;">+</span></td><td align="center" height="19" width="17%"><b><span style="color: maroon; font-family: Arial;">AB</span></b></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="17%"><span style="font-family: Arial;">0</span></td><td align="center" height="19" width="17%"><b><span style="color: maroon; font-family: Arial;">AB</span></b></td></tr>
</tbody></table>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Discrepancies in ABO typing</span></h3>
<ol style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">Results of forward and reverse typing must agree before reporting out blood type as seen in the about table.</span></li>
<li><span style="font-family: Arial;">If forward and reverse do not agree, must identify cause of discrepancy.</span></li>
<li><span style="font-family: Arial;">If cannot resolve discrepancy, must report out blood type as UNKNOWN and give group O blood</span></li>
</ol>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Characteristics of ABO antigens:</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO antigens are glycolipid in nature, meaning they are oligosaccharides attached directly to lipids on red cell membrane. These antigens stick out from red cell membrane and there are many antigen sites per red blood cell (approximately 800,000)</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Besides their presence on red blood cells, soluble antigens can be present in plasma, saliva, and other secretions. These antigens are also expressed on tissues other than red cells. This last fact is important to consider in organ transplantation.</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO antigens are only moderately well developed at birth. Therefore ABO-HDN not as severe as other kinds of Hemolytic Disease of the Newborn. .</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
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<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Characteristics of ABO antibodies:</span></h3>
<ol style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">These are expected naturally occurring antibodies that occur without exposure to red cells containing the antigen. (There is some evidence that similar antigens found in certain bacteria, like <i>E.coli</i>, stimulate antibody production in individuals who lack the specific A and B antigens.)</span></li>
<li><span style="font-family: Arial;">Immunoglobulin M antibodies, predominantly</span></li>
<li><span style="font-family: Arial;">They react in saline and readily agglutinate. Due to the position of the antigen and the IgM antibodies it is not necessary to overcome the zeta potential.</span></li>
<li><span style="font-family: Arial;">Their optimum temperature is less than 30<sup>o</sup>C, but reactions do take place at body temperature</span></li>
<li><span style="font-family: Arial;">Not only are these antibodies expected and naturally occurring, they are also commonly present in high titer, 1/128 or 1/256.</span></li>
<li><span style="font-family: Arial;">They are absent at birth and start to appear around 3-6 months as result of stimulus by bacterial polysaccharides. (For this reason, newborn blood is only forward typed.)</span></li>
</ol>
<h2 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO INHERITANCE</span></h2>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Inheritance Terminology:</span></h3>
<dl style="background-color: #ffeaea; text-align: -webkit-auto;">
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">gene</span></b>:</span></dt>
<dd><span style="font-family: Arial;">determines specific inherited trait (ex. blood type)</span></dd>
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">chromosome</span></b>:</span></dt>
<dd><span style="font-family: Arial;">unit of inheritance. Carries genes. 23 pairs of chromosomes per person, carrying many genes. One chromosome inherited from mother, one from father</span></dd>
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">locus</span></b>:</span></dt>
<dd><span style="font-family: Arial;">site on chromosome where specific gene is located</span></dd>
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">allele</span></b>:</span></dt>
<dd><span style="font-family: Arial;">alternate choice of genes at a locus (ex. A or B; C or c, Lewis a or Lewis b)</span></dd>
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">homozygous</span></b>:</span></dt>
<dd><span style="font-family: Arial;">alleles are the same for any given trait on both chromosome (ex. A/A)</span></dd>
<dt><span style="font-family: Arial;"><span style="color: maroon;"><b>heterozygous</b></span>:</span></dt>
<dd><span style="font-family: Arial;">alleles for a given trait are different on each chromosome (ex. A/B or A/O)</span></dd>
<dt><span style="font-family: Arial;"><span style="color: maroon;"><b>phenotype</b></span>:</span></dt>
<dd><span style="font-family: Arial;">observed inherited trait (ex. group A or Rh positive)</span></dd>
<dt><span style="font-family: Arial;"><span style="color: maroon;"><b>genotype</b></span>:</span></dt>
<dd><span style="font-family: Arial;">actual genetic information for a trait carried on each chromosome (ex. O/O or A/O)</span></dd>
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">dominant</span></b>:</span></dt>
<dd><span style="font-family: Arial;">the expressed characteristic on one chromosome takes precedence over the characteristic determined on the other chromosome (ex. A/O types as A)</span></dd>
<dt><b><span style="color: maroon; font-family: Arial;">co-dominant:</span></b></dt>
<dd><span style="font-family: Arial;">the characteristics determined by the genes on both chromosomes are both expressed - neither is dominant over the other (ex. A/B types as AB)</span></dd>
<dt><span style="font-family: Arial;"><b><span style="color: maroon;">recessive</span></b>:</span></dt>
<dd><span style="font-family: Arial;">the characteristic determined by the allele will only be expressed if the same allele is on the other chromosome also (ex. can type as O only when genotype is O/O)</span></dd></dl>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO Genes</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The A and B genes found on chromosome #9. We inherit one gene (allele) from our father and one from our mother. The two co-dominant alleles are A or B. Anytime an individual inherits an A or B gene it will be expressed.</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The O gene signifies lack of A or B antigens. It is not expressed unless this gene is inherited from both parents (OO). Therefore the O gene is recessive. </span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Below is the example of two individuals who are A. One inherited only one A gene along with an O gene and is therefore heterozygous. The other inherited 2 A genes and is homozygous for A.</span></div>
<table border="0" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber1" style="background-color: #ffeaea; border-collapse: collapse;"><tbody>
<tr><td align="center" colspan="2" width="100%"><span style="font-family: Arial;"><img border="0" height="221" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/Chromosomes.gif" width="300" /></span></td></tr>
<tr><td width="50%"><div align="center">
<span style="font-family: Arial;">1 = A/A </span></div>
</td><td width="50%"><div align="center">
<span style="font-family: Arial;"> 2 = A/O</span></div>
</td></tr>
<tr><td align="center" width="50%"><span style="font-family: Arial;">1 = <span style="color: maroon;"><b>Homozygous A</b></span></span></td><td align="center" width="50%"><span style="font-family: Arial;">2 = <b><span style="color: maroon;">Heterozygous A</span></b></span></td></tr>
<tr><td align="center" width="50%"><b><span style="color: maroon; font-family: Arial;">Phenotype A</span></b></td><td align="center" width="50%"><b><span style="color: maroon; font-family: Arial;">Phenotype A</span></b></td></tr>
<tr><td align="center" width="50%"><b><span style="color: maroon; font-family: Arial;">Genotype A/A</span></b></td><td align="center" width="50%"><b><span style="color: maroon; font-family: Arial;">Genotype A/0</span></b></td></tr>
<tr><td align="center" width="50%"><span style="font-family: Arial;">Can Contribute Only an A Gene to Offspring</span></td><td align="center" width="50%"><span style="font-family: Arial;">Can Contribute A or O Gene to Offspring</span></td></tr>
</tbody></table>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Inheritance Patterns</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">We can't determine genotypes of A or B people unless family studies are done. Some basic rules of ABO inheritance are as follows:</span></div>
<ol style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">A/A parent can only pass along A gene</span></li>
<li><span style="font-family: Arial;">A/O parent can pass along either A or O gene</span></li>
<li><span style="font-family: Arial;">B/B parent can only pass along B gene</span></li>
<li><span style="font-family: Arial;">B/O parent can pass along either B or O gene</span></li>
<li><span style="font-family: Arial;">O/O parent can only pass along O gene</span></li>
<li><span style="font-family: Arial;">AB parent can pass along either A or B gene</span></li>
</ol>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">ABO phenotypes and genotypes</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">1. Group A phenotype = A/A or A/O genotype</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">2. Group B phenotype = B/B or B/O genotype</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">3. Group O phenotype = O/O genotype</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">4. Group AB phenotype = A/B genotype</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
</div>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Offspring possibilities</span></h3>
<h5 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Possibilities of an A/O mating with a B/O: <span style="color: purple;">(Children's genotypes in purple)</span></span></h5>
<table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber5" style="background-color: #ffeaea; border-collapse: collapse;"><tbody>
<tr><td align="center" rowspan="2" width="33%"><span style="color: red; font-family: Arial;"><b>Mother's Genes</b></span></td><td align="center" colspan="2" width="67%"><span style="color: blue; font-family: Arial;"><b>Father's Genes</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: blue; font-family: Arial;"><b>B</b></span></td><td align="center" width="34%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><b><span style="color: purple; font-family: Arial;">AB</span></b></td><td align="center" width="34%"><b><span style="color: purple; font-family: Arial;">AO</span></b></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>O</b></span></td><td align="center" width="33%"><b><span style="color: purple; font-family: Arial;">BO</span></b></td><td align="center" width="34%"><b><span style="color: purple; font-family: Arial;">OO</span></b></td></tr>
</tbody></table>
<h5 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Possibilities of AA mating with BB: <span style="color: purple;">(Children's genotypes in purple)</span></span></h5>
<div align="center" style="background-color: #ffeaea;">
<center><table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber6" style="border-collapse: collapse;"><tbody>
<tr><td align="center" rowspan="2" width="33%"><span style="color: red; font-family: Arial;"><b>Mother's Genes</b></span></td><td align="center" colspan="2" width="67%"><span style="color: blue; font-family: Arial;"><b>Father's Genes</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: blue; font-family: Arial;"><b>B</b></span></td><td align="center" width="34%"><span style="color: blue; font-family: Arial;"><b>B</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AB</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AB</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AB</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AB</b></span></td></tr>
</tbody></table>
</center></div>
<h5 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Possibilities of an A/A mating with a B/O: <span style="color: purple;">(Children's genotypes in purple)</span></span></h5>
<div align="center" style="background-color: #ffeaea;">
<center><table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber7" style="border-collapse: collapse;"><tbody>
<tr><td align="center" rowspan="2" width="33%"><div align="center">
<span style="color: red; font-family: Arial;"><b>Mother's Genes</b></span></div>
</td><td align="center" colspan="2" width="67%"><div align="center">
<span style="color: blue; font-family: Arial;"><b>Father's Genes</b></span></div>
</td></tr>
<tr><td align="center" width="33%"><span style="color: blue; font-family: Arial;"><b>B</b></span></td><td align="center" width="34%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AB</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AB</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td></tr>
</tbody></table>
</center></div>
<h5 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Possibilities of an A/A mating with an O/O:</span></h5>
<div align="center" style="background-color: #ffeaea;">
<center><table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber8" style="border-collapse: collapse;"><tbody>
<tr><td align="center" rowspan="2" width="33%"><span style="color: red; font-family: Arial;"><b>Mother's Genes</b></span></td><td align="center" colspan="2" width="67%"><span style="color: blue; font-family: Arial;"><b>Father's Genes</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td><td align="center" width="34%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td></tr>
</tbody></table>
</center></div>
<h5 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Possibilities of an A/O mating with an O/O:</span></h5>
<div align="center" style="background-color: #ffeaea;">
<center><table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber9" style="border-collapse: collapse;"><tbody>
<tr><td align="center" rowspan="2" width="33%"><div align="center">
<span style="color: red; font-family: Arial;"><b>Mother's Genes</b></span></div>
</td><td align="center" colspan="2" width="67%"><div align="center">
<span style="color: blue; font-family: Arial;"><b>Father's Genes</b></span></div>
</td></tr>
<tr><td align="center" width="33%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td><td align="center" width="34%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>O</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>OO</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>OO</b></span></td></tr>
</tbody></table>
</center></div>
<h5 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Possibilities of an A/B mating with a O/O:</span></h5>
<div align="center" style="background-color: #ffeaea;">
<center><table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber10" style="border-collapse: collapse;"><tbody>
<tr><td align="center" rowspan="2" width="33%"><div align="center">
<span style="color: red; font-family: Arial;"><b>Mother's Genes</b></span></div>
</td><td align="center" colspan="2" width="67%"><div align="center">
<span style="color: blue; font-family: Arial;"><b>Father's Genes</b></span></div>
</td></tr>
<tr><td align="center" width="33%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td><td align="center" width="34%"><span style="color: blue; font-family: Arial;"><b>O</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>A</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>AO</b></span></td></tr>
<tr><td align="center" width="33%"><span style="color: red; font-family: Arial;"><b>B</b></span></td><td align="center" width="33%"><span style="color: purple; font-family: Arial;"><b>BO</b></span></td><td align="center" width="34%"><span style="color: purple; font-family: Arial;"><b>BO</b></span></td></tr>
</tbody></table>
</center></div>
<h2 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">BIOCHEMISTRY OF THE ABO SYSTEM</span></h2>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The ABO antigens are terminal sugars found at the end of long sugar chains (oligosaccharides) that are attached to lipids on the red cell membrane. The A and B antigens are the last sugar added to the chain. The "O" antigen is the lack of A or B antigens but it does have the most amount of next to last terminal sugar that is called the H antigen.</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;"> <img border="0" height="231" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/Structure_of_red_cell_surface.gif" width="300" /></span></div>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Production of A, B, and H antigens</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The production of A, B and H antigens are controlled by the action of transferases. These transferases are enzymes that catalyze (or control) addition of specific sugars to the oligosaccharide chain. The H, A, or B genes each produce a different transferase, which adds a different specific sugar to the oligosaccharide chain.</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">To understand the process let's look at the sequence of events:</span></div>
<ol style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">Precursor chain of sugars is formed most frequently as either Type 1 or Type 2 depending on the linkage site between the N-acetylglucosamine (G1cNAc) and Galactose (Gal).<br /><img border="0" height="200" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/ABO_Precursor.gif" width="163" /></span></li>
<li><span style="font-family: Arial;">H gene causes L-fucose to be added to the terminal sugar of precursor chain, producing H antigen (shown in this diagram of a Type 2 H antigen saccharide chaine).<br /><img border="0" height="178" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/H_antigen.gif" width="366" /></span></li>
<li><span style="font-family: Arial;">Either <b><span style="color: maroon;">A gene</span></b> causes <b><span style="color: maroon;">N-acetyl-galactosamine </span></b>to be added to H substance, producing A antigen, (shown in this diagram) or<br /><img border="0" height="172" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/A_antigen.gif" width="365" /></span></li>
<li><span style="font-family: Arial;"><span style="color: maroon;"><b>B gene</b></span> causes <b><span style="color: maroon;">D-galactose</span></b> to be added to H substance, producing B antigen.<br /><img border="0" height="181" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/B_Antigen.gif" width="368" /><br /> </span></li>
<li><span style="font-family: Arial;">If both A and B genes present, some H-chains converted to A antigen, some converted to B antigen.</span></li>
<li><span style="font-family: Arial;">If H gene absent <span style="background-color: #ffa6a6;">(extremely rare)</span>, no H substance can be formed, and therefore no A or B antigen. Result is <span style="color: maroon;"><b>Bombay blood group</b>.</span></span></li>
</ol>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Bombay blood group:</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The Bombay blood group lacks H gene and therefore cannot make H antigen (H substance). Since the H substance is the precursor for the A and B antigens, these antigens also are not made. The cells type as O and the serum has anti-A, anti-B, and anti-H since the individual lacks all of these antigens. Anti-H agglutinates O cells. The only cells Bombay individuals do not agglutinate are from other Bombay blood people since they lack the H antigen,</span></div>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Subgroups of A and B</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The subgroups of A and B are caused by decreased amounts of antigen on the red blood cells. They are inherited conditions. </span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">The most common are subgroups of A. Approximately 80% of the A's and AB's have a normal expression of A<sub>1</sub>. Most of the other 20% are either A<sub>2 </sub>or A<sub>2</sub>B. This subgroup has fewer H chains converted to A antigen – result is more H chains on red cell, and fewer A antigens. </span><img border="0" height="188" src="http://faculty.matcmadison.edu/mljensen/BloodBank/lectures/Images/A2.gif" width="200" /><span style="font-family: Arial;">A small percentage of the individuals</span></div>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">There are other, weaker subgroups of A exist: A<sub>3</sub>; A<sub>int</sub>; A<sub>m</sub>, A<sub>x</sub>; A<sub>el</sub>. Each has a different pattern of reacting with anti-A, anti-A, and various antibody-like substances called lectins. </span></div>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Lectins</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Lectins are extracts of seeds of plants that react specifically with certain antigens. The two most common lectins used in Blood Bank are:</span></div>
<ul style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;"><i>Ulex europaeus</i>, or lectin H, which agglutinates cells that have H substance.</span></li>
<li><span style="font-family: Arial;"><i>Dolichos biflouros</i>, or lectin A<sub>1</sub>, which agglutinates cells with A<sub>1</sub>.</span></li>
</ul>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Lectin-H reacts strongest with O cells, which has a high concentration of H antigen, and weakest with A<sub>1</sub> cells, which have a low concentration of H.</span></div>
<table border="1" bordercolor="#111111" cellpadding="0" cellspacing="0" id="AutoNumber12" style="background-color: #ffeaea; border-collapse: collapse;"><tbody>
<tr><td bgcolor="#800000" width="12%"><b><span style="color: white; font-family: Arial;">Lectin</span></b></td><td bgcolor="#800000" width="12%"><b><span style="color: white; font-family: Arial;">O cells</span></b></td><td bgcolor="#800000" width="12%"><b><span style="color: white; font-family: Arial;">A<sub>2</sub> cells</span></b></td><td bgcolor="#800000" width="13%"><b><span style="color: white; font-family: Arial;">A<sub>2</sub>B cells</span></b></td><td bgcolor="#800000" width="13%"><b><span style="color: white; font-family: Arial;">B cells</span></b></td><td bgcolor="#800000" width="13%"><b><span style="color: white; font-family: Arial;">A<sub>1</sub> cells</span></b></td><td bgcolor="#800000" width="13%"><b><span style="color: white; font-family: Arial;">A<sub>1</sub>B cells</span></b></td><td bgcolor="#800000" width="13%"><b><span style="color: white; font-family: Arial;">Bombay cells</span></b></td></tr>
<tr><td width="12%"><span style="font-family: Arial;">lectin-H</span></td><td width="12%"><span style="font-family: Arial;">4+</span></td><td width="12%">3+</td><td width="13%"><span style="font-family: Arial;">2-3+</span></td><td width="13%"><span style="font-family: Arial;">2+</span></td><td width="13%"><span style="font-family: Arial;">weak to negative</span></td><td width="13%"><span style="font-family: Arial;">weak to negative</span></td><td width="13%"><span style="font-family: Arial;">negative</span></td></tr>
<tr><td width="12%"><span style="font-family: Arial;"><span style="background-color: #ffa6a6;">Lectin-A</span><sub><span style="background-color: #ffa6a6;">1</span></sub></span></td><td width="12%"><span style="font-family: Arial;">negative</span></td><td width="12%"><span style="font-family: Arial;">negative</span></td><td width="12%"><span style="font-family: Arial;">negative</span></td><td width="13%"><span style="font-family: Arial;">negative</span></td><td bgcolor="#FFA6A6" width="13%"><span style="font-family: Arial;">positive</span></td><td bgcolor="#FFA6A6" width="13%"><span style="font-family: Arial;">positive</span></td><td width="13%"><span style="font-family: Arial;">negative</span></td></tr>
</tbody></table>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<br /></div>
<h3 style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Differentiating Subgroups of A:</span></h3>
<div style="background-color: #ffeaea; text-align: -webkit-auto;">
<span style="font-family: Arial;">Use the following steps to help differentiate the subgroups of A:</span></div>
<ol style="background-color: #ffeaea; text-align: -webkit-auto;">
<li><span style="font-family: Arial;">Use lectin-A<sub>1</sub> to differentiate A<sub>1</sub> cells from all others - will agglutinate only A<sub>1 </sub>cells</span></li>
<li><span style="font-family: Arial;">Look for weaker or mixed field reactions</span></li>
<li><span style="font-family: Arial;">Look for anti-A<sub>1</sub> in serum (serum reacts with A<sub>1</sub> cells but not A<sub>2</sub> cells)</span></li>
<li><span style="font-family: Arial;">Look at strength of reactions with anti-A,B or with lectin-H</span></li>
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<tr><td bgcolor="#800000" height="23" width="162"><span style="color: white; font-family: Arial;"><b>GROUP</b></span></td><td align="center" bgcolor="#800000" height="23" width="76"><span style="color: white; font-family: Arial;"><b>A<sub>1</sub></b></span></td><td align="center" bgcolor="#800000" height="23" width="76"><span style="color: white; font-family: Arial;"><b>A<sub>2</sub></b></span></td><td align="center" bgcolor="#800000" height="23" width="76"><span style="color: white; font-family: Arial;"><b>A<sub>3</sub></b></span></td><td align="center" bgcolor="#800000" height="23" width="76"><span style="color: white; font-family: Arial;"><b>A<sub>x</sub></b></span></td></tr>
<tr><td height="18" width="162"><span style="font-family: Arial;">Reaction with anti-A</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">4+</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">4+</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">mf</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">0</span></td></tr>
<tr><td height="21" width="162"><span style="font-family: Arial;">Reaction with anti-A,B</span></td><td align="center" height="21" width="76"><span style="font-family: Arial;">4+</span></td><td align="center" height="21" width="76"><span style="font-family: Arial;">4+</span></td><td align="center" height="21" width="76"><span style="font-family: Arial;">mf</span></td><td align="center" height="21" width="76"><span style="font-family: Arial;">2+</span></td></tr>
<tr><td height="23" width="162"><span style="font-family: Arial;">Reaction with Lectin-A<sub>1</sub></span></td><td align="center" height="23" width="76"><span style="font-family: Arial;">4+</span></td><td align="center" height="23" width="76"><span style="font-family: Arial;">0</span></td><td align="center" height="23" width="76"><span style="font-family: Arial;">0</span></td><td align="center" height="23" width="76"><span style="font-family: Arial;">0</span></td></tr>
<tr><td height="18" width="162"><span style="font-family: Arial;">Reaction with Lectin-H</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">0-w</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">1-2+</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">2+</span></td><td align="center" height="18" width="76"><span style="font-family: Arial;">2-3+</span></td></tr>
<tr><td height="36" width="162"><span style="font-family: Arial;">Presence of anti-A<sub>1</sub></span></td><td align="center" height="36" width="76"><span style="font-family: Arial;">no</span></td><td align="center" height="36" width="76"><span style="font-family: Arial;">may</span></td><td align="center" height="36" width="76"><span style="font-family: Arial;">may</span></td><td align="center" height="36" width="76"><span style="font-family: Arial;">often in serum</span></td></tr>
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<span style="font-family: Arial;">Problems with A<sub>x</sub>:</span></h3>
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<span style="font-family: Arial;">Because A<sub>x</sub> cells initially type as O and serum usually has anti-A<sub>1</sub>, (along with anti-B), patient forwards and reverses as O. Unfortunately when A<sub>x</sub> is transfused into an O individual, the naturally occurring anti-A,B will react with the donor cells causing a transfusion reaction. Therefore: to prevent <span style="background-color: #ffa6a6;"> A<sub>x</sub> from being erroneously typed as O, confirm all group O donors with anti-A,B.</span></span></div>
</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-9550375779132647142012-05-14T11:04:00.002-07:002012-05-14T11:04:36.903-07:00Blood transfusion<div dir="ltr" style="text-align: left;" trbidi="on">
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<b>Blood transfusion</b> is the process of receivingblood products into one's circulationintravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells,plasma, clotting factors, and platelets.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhD7TcbZYQZtuUO1DbdHqN4a4-z7UkHOwSlPkguyo06dD1_NL7S5KDQoU62ikiWhUggsFP9b7GFULWazsa0ajnsC_sjz-C78vv3owx4qRs0gJWquzOtrB0nQKXsC2lAlhdlSfoZ-oMlR9x/s1600/bloodtransfusion_993201cl-8.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="179" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhD7TcbZYQZtuUO1DbdHqN4a4-z7UkHOwSlPkguyo06dD1_NL7S5KDQoU62ikiWhUggsFP9b7GFULWazsa0ajnsC_sjz-C78vv3owx4qRs0gJWquzOtrB0nQKXsC2lAlhdlSfoZ-oMlR9x/s320/bloodtransfusion_993201cl-8.jpg" width="320" /></a>They typically are only recommended when a persons hemoglobin fall below 70-80 mg/dL.One may consider transfusion for people with symptoms of cardiovascular disease such as chest pain or shortness of breath. Globally around 85 units of blood are transfused in a given year.</div>
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<span class="mw-headline" id="Pre-transfusion_procedures">Pre-transfusion procedures</span></h2>
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<span class="mw-headline">Before a blood transfusion is given, there are many steps taken to ensure quality of the blood products, compatibility, and safety to the recipient.
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<span class="mw-headline" id="Blood_donation"><span style="color: #e06666;">Blood donation</span></span></h3>
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<span class="mw-headline">Blood transfusions typically use two sources of blood: one's own (autologous transfusion), or someone else's (allogeneic transfusion). The latter is much more common than the former. Using another's blood must first start with donation of blood. Blood is most commonly donated as whole blood intravenously and collecting it with ananticoagulant. In developed countries, donations are usually anonymous to the recipient, but products in a blood bank are always individually traceable through the whole cycle of donation, testing, separation into components, storage, and administration to the recipient. This enables management and investigation of any suspected transfusion related disease transmission ortransfusion reaction. In developing countries the donor is sometimes specifically recruited by or for the recipient, typically a family member, and the donation occurs immediately before the transfusion
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<span class="mw-headline" id="Processing_and_testing_of_blood_products_after_donation">Processing and testing of blood products after donation</span></h3>
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Donated blood is usually subjected to processing after it is collected, to make it suitable for use in specific patient populations. Collected blood is then separated into blood components by centrifugation: red blood cells, plasma, platelets,albumin protein, clotting factor concentrates,cryoprecipitate, fibrinogen concentrate, andimmunoglobulins (antibodies). Red cells, plasma and platelets can also be donated individually via a more complex process called apheresis.</div>
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<li style="margin-bottom: 0.1em;">All donated blood are tested for infections. The current protocol tests donated blood for HIV-1,HIV-2, HTLV-1, HTLV-2, Hepatitis B, Hepatitis C, Syphilis (<i>T pallidum</i>), Chagas disease (<i>T cruzi</i>), and West Nile Virus. In addition, platelet products are also tested for bacterial infections due to its higher inclination for contamination due to storage at room temperature. Presence of Cytomegalovirus (CMV) is also tested because of risk to certain immunocompromised recipients if given, such as those with organ transplant or HIV. However, not all blood is tested for CMV because only a certain amount of CMV-negative blood needs to be available to supply patient needs. Other than positivity for CMV, any products tested positive for infections are not used.</li>
<li style="margin-bottom: 0.1em;">All donated blood are also tested for ABO and Rh groups, along with the presence of any red blood cell antibodies.</li>
<li style="margin-bottom: 0.1em;">Leukoreduction is the removal of white blood cells by filtration. Leukoreduced blood products are less likely to cause HLA alloimmunization (development of antibodies against specific blood types), febrile non-hemolytic transfusion reactions, cytomegalovirus infections, and platelet-transfuion refractoriness.</li>
<li style="margin-bottom: 0.1em;">Pathogen Reduction treatment that involves, for example, the addition of riboflavin with subsequent exposure to UV light has been shown to be effective in inactivating pathogens (viruses, bacteria, parasites and white blood cells) in blood products. By inactivating white blood cells in donated blood products, riboflavin and UV light treatment can also replace gamma-irradiation as a method to prevent graft-versus-host disease (TA-GVHD)</li>
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<span class="mw-headline" id="Compatibility_testing">Compatibility testing</span></h3>
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ABO blood group system</div>
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Rh blood group system</div>
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Before a recipient receives a transfusion, compatibility testing between donor and recipient blood must be done. The first step before a transfusion is given is to Type and Screen the recipient's blood. Typing of recipient's blood determines the ABO and Rh status. The sample is then Screened for any alloantibodies that may react with donor blood. It takes about 45 minutes to complete (depending on the method used). The blood bank technologist also checks for special requirements of the patient (e.g. need for washed, irradiated or CMV negative blood) and the history of the patient to see if they have a previously identified antibody.</div>
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A positive screen warrants an antibody panel/investigation to determine if it is clinically significant. An antibody panel consists of commercially prepared group O red cell suspensions from donors that have been phenotyped for commonly encountered and clinically significant alloantibodies. Donor cells may have homozygous (e.g. K+k-), heterozygous (K+k+) expression or no expression of various antigens (K-k+). The phenotypes of all the donor cells being tested are shown in a chart. The patient's serum is tested against the various donor cells using an enhancement method, e.g. Gel or LISS. Based on the reactions of the patient's serum against the donor cells, a pattern will emerge to confirm the presence of one or more antibodies. Not all antibodies are clinically significant (i.e. cause transfusion reactions, HDN, etc.). Once the patient has developed a clinically significant antibody it is vital that the patient receive antigen negative phenotyped red blood cells to prevent future transfusion reactions. A direct antiglobulin test (Coombs test) is also performed as part of the antibody investigation.</div>
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If there is no antibody present, an immediate spin crossmatch or computer assisted crossmatch is performed where the recipient serum and donor serum are incubated. In the immediate spin method, two drops of patient serum are tested against a drop of 3-5% suspension of donor cells in a test tube and spun in a serofuge. Agglutination or hemolysis (i.e., positive Coombs test) in the test tube is a positive reaction and the unit should not be transfused.</div>
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If an antibody is suspected, potential donor units must first be screened for the corresponding antigen by phenotyping them. Antigen negative units are then tested against the patient plasma using an antiglobulin/indirect crossmatch technique at 37 degrees Celsius to enhance reactivity and make the test easier to read.</div>
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In urgent cases where crossmatching cannot be completed, and the risk of dropping hemoglobin outweighs the risk transfusing uncrossmatched blood, O-negative blood is used, followed by crossmatch as soon as possible. O-negative is also used for children and women of childbearing age. It is preferable for the laboratory to obtain a pre-transfusion sample in these cases so a type and screen can be performed to determine the actual blood group of the patient and to check for alloantibodies.</div>
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<span class="mw-headline" id="Neonatal_transfusion">Neonatal transfusion</span></h3>
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To ensure the safety of blood transfusion to pediatric patients, hospitals are taking additional precaution to avoid infection and prefer to use specially tested pediatric blood units that are guaranteed negative for Cytomegalovirus. Most guidelines recommend the provision of CMV-negative blood components and not simply leukoreduced components for newborns or low birthweight infants in whom the immune system is not fully developed. These specific requirements place additional restrictions on blood donors who can donate for neonatal use. vnv Neonatal transfusions typically fall into one of two categories:</div>
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<li style="margin-bottom: 0.1em;">"Top-up" transfusions, to replace losses due to investigational losses and correction of anemia.</li>
<li style="margin-bottom: 0.1em;">Exchange (or partial exchange) transfusions are done for removal of bilirubin, removal of antibodies and replacement of red cells (e.g., for anemia secondary to thalassemias and other hemoglobinopathies).</li>
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<span class="mw-headline" id="Procedures">Procedures</span></h2>
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<span class="mw-headline" id="Massive_transfusion_protocol">Massive transfusion protocol</span></h3>
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<span class="mw-headline"><span style="font-family: sans-serif; font-size: 13px; font-weight: normal; text-align: -webkit-auto;">A massive transfusion protocol is typically defined as when it is anticipated that more than ten units of packed red blood cells will be needed.</span><span style="font-family: sans-serif; font-size: 13px; font-weight: normal; text-align: -webkit-auto;">Typically higher ratios of fresh frozen plasma</span></span> <span style="background-color: white;"></span></div>
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<span class="mw-headline"><span style="font-family: sans-serif; font-size: 13px; font-weight: normal; text-align: -webkit-auto;">and platlets </span><span style="font-family: sans-serif; font-size: 13px; font-weight: normal; text-align: -webkit-auto;">are given relative to pakes red blood cells.</span></span></div>
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<span class="mw-headline" id="Adverse_effects">Adverse effects</span></h2>
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<span style="font-size: 13px;">Transfusions of blood products are associated with several complications, many of which can be grouped as immunological or infectious. There is also increasing focus (and controversy) on complications arising directly or indirectly from potential quality degradation during storage.</span><span style="font-size: 13px;">Overall, adverse events from transfusions in the US account for about $17Billion - and in effect add more to the cost of each transfusion than acquisition and procedure costs combined.</span><span style="font-size: 13px;">While some complication risks depend on patient status or specific transfusion quantity involved, a baseline risk of complications simply increases in direct proportion to the frequency and volume of transfusion.</span>
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<span class="mw-headline" id="Immunologic">Immunologic</span></h3>
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<li style="margin-bottom: 0.1em;"><i>Acute hemolytic reactions</i> occur with transfusion of red blood cells, and occurs in about 0.016 percent of transfusions, with about 0.003 percent being fatal. This is due to destruction of donor erythrocytes by preformed recipient antibodies. Most often this occurs due to clerical errors or improper typing and crossmatching. Symptoms include fever, chills, chest pain, back pain, hemorrhage, increased heart rate, shortness of breath, and rapid drop in blood pressure. When suspected, transfusion should be stopped immediately, and blood sent for tests to evaluate for presence of hemolysis. Treatment is supportive. Kidney injury may occur due to the effects of the hemolytic reaction (pigment nephropathy).</li>
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<li style="margin-bottom: 0.1em;"><i>Delayed hemolytic reactions</i> occur more frequently (about 0.025 percent of transfusions) and are due to the same mechanism as in acute hemolytic reactions. However, the consequences are generally mild and a great proportion of patients may not have symptoms. However, evidence of hemolysis and falling hemoglobin levels may still occur. Treatment is generally not needed, but due to the presence of recipient antibodies, future compatibility may be affected.</li>
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<li style="margin-bottom: 0.1em;"><i>Febrile nonhemolytic reactions</i> are due to recipient antibodies to donor white blood cells, and occurs in about 7% of transfusions. This may occur after exposure from previous transfusions. Fever is generally short lived and is treated with antipyretics, and transfusions may be finished as long as an acute hemolytic reaction is excluded. This is a reason for the now-widespread use of leukoreduction - the filtration of donor white cells from red cell product units.</li>
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<li style="margin-bottom: 0.1em;"><i>Allergic reactions</i> may occur when the recipient has preformed antibodies to certain chemicals in the donor blood, and does not require prior exposure to transfusions. Symptoms include urticaria, pruritus, and may proceed to anaphylactic shock. Treatment is the same as for any other type 1 hypersensitivity reactions. A small population (0.13%) of patients are deficient in the immunoglobin IgA, and upon exposure to IgA-containing blood, may develop an anaphylactic reaction.</li>
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<li style="margin-bottom: 0.1em;"><i>Posttransfusion purpura</i> is a rare complication that occurs after transfusion containing platelets that express a surface protein HPA-1a. Recipients who lack this protein develop sensitization to this protein from prior transfusions, and develop thrombocytopenia about 7–10 days after subsequent transfusions. Treatment is with intravenous immunoglobulin, and recipients should only receive future transfusions with washed cells or HPA-1a negative cells.</li>
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<li style="margin-bottom: 0.1em;">Transfusion-associated acute lung injury (TRALI) is an increasingly recognized adverse event associated with blood transfusion. TRALI is a syndrome of acute respiratory distress, often associated with fever, non-cardiogenic pulmonary edema, and hypotension, which may occur as often as 1 in 2000 transfusions. Symptoms can range from mild to life-threatening, but most patients recover fully within 96 hours, and the mortality rate from this condition is less than 10%. Although the cause of TRALI is not clear, it has been consistently associated with anti-HLA antibodies. Because these types of antibodies are commonly formed during pregnancy, several transfusion organisations have decided to use only plasma from men for transfusion. TRALI is typically associated with plasma components rather than packed red blood cells (RBCs), though there is some residual plasma in RBC units.</li>
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<span class="mw-headline" id="Infectious">Infectious</span></h3>
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<li style="margin-bottom: 0.1em;">Rarely, blood products are contaminated with bacteria. This can result in life-threatening infection, also known as transfusion-transmitted bacterial infection. The risk of severe bacterial infection is estimated, as of 2002, at about 1 in 50,000 platelet transfusions, and 1 in 500,000 red blood cell transfusions. It is important to note that blood product contamination, while rare, is still more common than actual infection. The reason platelets are more often contaminated than other blood products is that they are stored at room temperature for short periods of time. Contamination is also more common with longer duration of storage, especially when exceeding 5 days. Sources of contaminants include the donor's blood, donor's skin, phlebotomist's skin, and from containers. Contaminating organisms vary greatly, and include skin flora, gut flora, or environmental organisms. There are many strategies in place at blood donation centers and laboratories to reduce the risk of contamination. A definite diagnosis of transfusion-transmitted bacterial infection includes the identification of a positive culture in the recipient (without an alternative diagnosis) as well as the identification of the same organism in the donor blood.</li>
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<li style="margin-bottom: 0.1em;">Since the advent of HIV testing of donor blood in the 1980s the transmission of HIV during transfusion has dropped dramatically. Prior testing of donor blood only included testing for antibodies to HIV. However, due to latent infection (the "window period" in which an individual is infectious, but has not had time to develop antibodies), many cases of HIV seropositive blood were missed. The development of a nucleic acid test for the HIV-1 RNA has dramatically lowered the rate of donor blood seropositivity to about 1 in 3 million units. As transmittance of HIV does not necessarily mean HIV infection, the latter could still occur, at an even lower rate.</li>
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<li style="margin-bottom: 0.1em;">The transmission of hepatitis C via transfusion currently stands at a rate of about 1 in 2 million units. As with HIV, this low rate has been attributed to the ability to screen for both antibodies as well as viral RNA nucleic acid testing in donor blood.</li>
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<li style="margin-bottom: 0.1em;">Other rare transmissible infections include hepatitis B, syphilis, Chagas disease, cytomegalovirus infections (in immunocompromised recipients), HTLV, and Babesia.</li>
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</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-71029660031860588312012-05-13T09:26:00.000-07:002012-05-16T23:24:02.355-07:00CBSE Class 10 Results 2012<div dir="ltr" style="text-align: left;" trbidi="on">
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Hi friends I am Abhijeet Bhattacharya student of Class 10th from Kendriya Vidyalaya, Manendragarh. I am too waiting for results of Class X. As announced by CBSE (Central Board Of Secondary Education) the results should be announced in the last week of May. But some are saying that results will announced in 16 May and some are saying 28 May.<br />
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All websites which are related to results are saying different dates.<br />
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<span style="font-size: large;">So, friends please comment and tell us the date of results.</span></div>Anonymoushttp://www.blogger.com/profile/03487445523119762765noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-36607023775797051072012-04-19T01:26:00.000-07:002012-04-22T03:52:24.098-07:00Circulatory system<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">The <b>circulatory system</b> is an organ system that passes nutrients (such as<a class="mw-redirect" href="http://en.wikipedia.org/wiki/Amino_acids" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Amino acids">amino acids</a>, <a class="mw-redirect" href="http://en.wikipedia.org/wiki/Electrolytes" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Electrolytes">electrolytes</a> and <a href="http://en.wikipedia.org/wiki/Lymph" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Lymph">lymph</a>), gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases, stabilize body temperature and <a href="http://en.wikipedia.org/wiki/PH" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="PH">pH</a>, and to maintain homeostasis.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">This system may be seen strictly as a blood distribution network, but some consider the circulatory system as composed of the <b>cardiovascular system</b>, which distributes blood, and the <b><a href="http://en.wikipedia.org/wiki/Lymphatic_system" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Lymphatic system">lymphatic system</a></b>, which returns excessfiltered blood plasma from the interstitial fluid (between cells) as lymph. While humans, as well as other vertebrates, have a closed cardiovascular system (meaning that the blood never leaves the network of arteries, veins andcapillaries), some invertebrate groups have an open cardiovascular system. The most primitive animal phyla lack circulatory systems. The lymphatic system, on the other hand, is an open system providing an accessory route for excess interstitial fluid to get returned to the blood.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dxKsF4O7kNZ26A0yE26ks2bHhb5IASMUMnez3u2sis6hB7_l0T3xdrTBG9mdjWc2gV8jqXCek0ClrNiYfOS3g' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><br />Two types of fluids move through the circulatory system: blood and lymph. Lymph is essentially recycled blood plasma after it has been filtered from the blood cellsand returned to the lymphatic system. The blood, heart, and blood vessels form the cardiovascular (from Latin words meaning 'heart'-'vessel') system. The lymph, lymph nodes, and lymph vessels form the lymphatic system. The cardiovascular system and the lymphatic system collectively make up the circulatory system.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"></div><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Human_cardiovascular_system">Human cardiovascular system</span></h2><br /><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpdmzE7hEmo2uZk6r89q3K6ldTMmqR6bB7Di5Y1-hKWwgDs2mJnnyGH56fzNv-LldaZ5VxGVlWLJBsECncjc1hyphenhyphenBqfy4L_1S6UmXr66w7iaPHs77b_rE5nnRlXK-650lK4OT1LutUasc4/s1600/circulatory+system.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="234" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpdmzE7hEmo2uZk6r89q3K6ldTMmqR6bB7Di5Y1-hKWwgDs2mJnnyGH56fzNv-LldaZ5VxGVlWLJBsECncjc1hyphenhyphenBqfy4L_1S6UmXr66w7iaPHs77b_rE5nnRlXK-650lK4OT1LutUasc4/s320/circulatory+system.jpg" width="320" /></a></div>The main components of the human cardiovascular system are the heart, blood, andblood vessels. It includes: the pulmonary circulation, a "loop" through the lungswhere blood is oxygenated; and the systemic circulation, a "loop" through the rest of the body to provide oxygenated blood. An average adult contains five to six quarts (roughly 4.7 to 5.7 liters) of blood, which consists of plasma, red blood cells, white blood cells, and platelets. Also, the digestive system works with the circulatory system to provide the nutrients the system needs to keep the heart pumping</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Pulmonary_circulation">Pulmonary circulation</span></h3><br /><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The pulmonary circulatory system is the portion of the cardiovascular system in whichoxygen-depleted blood is pumped away from the heart, via the pulmonary artery, to the lungs and returned, oxygenated, to the heart via the pulmonary vein.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Oxygen deprived blood from the vena cava, enters the right atrium of the heart and flows through the tricuspid valve (right atrioventricular valve) into the right ventricle, from which it is then pumped through the pulmonary semilunar valve into the pulmonary artery to the lungs. Gas exchange occurs in the lungs, whereby CO<sub style="line-height: 1em;">2</sub> is released from the blood, and oxygen is absorbed. The pulmonary vein returns the now oxygen-rich blood to the heart.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><a name='more'></a><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Systemic_circulation">Systemic circulation</span></h3><br /><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGNo9VNGS96Qdy5vntxyYnorScvPyLCkneY6zB5hRXm_n50X9NcQMFrsPQMvH01zIQVtfUi2aKLT7co1KHh8kTI6kQrsP2cXPEbOOROMIeZsleMMQKB7AlWqq7rkM_ByBc4ZsUs65QWmQ/s1600/image034.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="239" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGNo9VNGS96Qdy5vntxyYnorScvPyLCkneY6zB5hRXm_n50X9NcQMFrsPQMvH01zIQVtfUi2aKLT7co1KHh8kTI6kQrsP2cXPEbOOROMIeZsleMMQKB7AlWqq7rkM_ByBc4ZsUs65QWmQ/s320/image034.jpg" width="320" /></a>Systemic circulation is the portion of the cardiovascular system which transports oxygenated blood away from the heart, to the rest of the body, and returns oxygen-depleted blood back to the heart. Systemic circulation is, distance-wise, much longer than pulmonary circulation, transporting blood to every part of the body.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Coronary_circulation">Coronary circulation</span></h3><br /><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The coronary circulatory system provides a blood supply to the heart. As it provides oxygenated blood to the heart, it is by definition a part of the systemic circulatory system</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Heart">Heart</span></h3><div class="rellink relarticle mainarticle" style="font-style: italic; margin-bottom: 0.5em; padding-left: 1.6em;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8CRPS2FCtB1uE5-QfYRC_YYDf5y51TgmmQXgSeUAx767PFkawYBazLVpMRLB1CDh5NPOtHbzuvZQ2Bts48t8BvadCV-1eAt0K660dhUT2O_pVFjqxvTV24RyuMo9kgzL17Tc2gIli5E0/s1600/iiiiooooooooo.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8CRPS2FCtB1uE5-QfYRC_YYDf5y51TgmmQXgSeUAx767PFkawYBazLVpMRLB1CDh5NPOtHbzuvZQ2Bts48t8BvadCV-1eAt0K660dhUT2O_pVFjqxvTV24RyuMo9kgzL17Tc2gIli5E0/s1600/iiiiooooooooo.png" /></a></div> Human heart</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The heart pumps oxygenated blood to the body and deoxygenated blood to the lungs. In the human heart there is one atrium and oneventricle for each circulation, and with both a systemic and a pulmonary circulation there are four chambers in total: left atrium, left ventricle,right atrium and right ventricle. The right atrium is the upper chamber of the right side of the heart. The blood that is returned to the right atrium is deoxygenated (poor in oxygen) and passed into the right ventricle to be pumped through the pulmonary artery to the lungs for re-oxygenation and removal of carbon dioxide. The left atrium receives newly oxygenated blood from the lungs as well as the pulmonary vein which is passed into the strong left ventricle to be pumped through the aorta to the different organs of the body.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Closed_cardiovascular_system">Closed cardiovascular system</span></h3><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The cardiovascular systems of humans are closed, meaning that the blood never leaves the network of blood vessels. In contrast, oxygen and nutrients diffuse across the blood vessel layers and enters interstitial fluid, which carries oxygen and nutrients to the target cells, and carbon dioxide and wastes in the opposite direction. The other component of the circulatory system, the lymphatic system, is not closed.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Oxygen_transportation">Oxygen transportation</span></h3><div class="rellink relarticle mainarticle" style="font-style: italic; margin-bottom: 0.5em; padding-left: 1.6em;">Main article: Blood#Oxygen transport</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">About 98.5% of the oxygen in a sample of arterial blood in a healthy human breathing air at sea-level pressure is chemically combined with haemoglobin molecules. About 1.5% is physically dissolved in the other blood liquids and not connected to haemoglobin. The haemoglobin molecule is the primary transporter of oxygen in mammals and many other species.</div><br /><br /><br /><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Development">Development</span></h3><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The development of the circulatory system initially occurs by the process ofvasculogenesis. The human arterial and venous systems develop from different embryonic areas. While the arterial system develops mainly from the aortic arches, the venous system arises from three bilateral veins during weeks 4 - 8 of human development.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h4 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 16px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Arterial_development">Arterial development</span></h4><div class="rellink relarticle mainarticle" style="font-style: italic; margin-bottom: 0.5em; padding-left: 1.6em;"> Aortic arches</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The human arterial system originate from the aortic arches and from the dorsal aortaestarting from week 4 of human development. Aortic arch 1 almost completely regresses except to form the maxillary arteries. Aortic arch 2 also completely regresses except to form the stapedial arteries. The definitive formation of the arterial system arise from aortic arches 3, 4 and 6. While aortic arch 5 completely regreses.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The dorsal aortae are initially bilateral and then fuse to form the definitive dorsal aorta. Approximately 30 posterolateral branches arise off the aorta and will form theintercostal arteries, upper and lower extremity arteries, lumbar arteries and the lateral sacral arteries. The lateral branches of the aorta form the definitive renal, suprarrenaland gonadal arteries. Finally, the ventral branches of the aorta consist of the vitelline arteries and umbilical arteries. The vitelline arteries form the celiac, superior andinferior mesenteric arteries of the gastrointestinal tract. After birth, the umbilical arteries will form the internal iliac arteries.</div><h4 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 16px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Venous_development">Venous development</span></h4><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMJxsyJduWWwkixU8iNuaKWu03CyZX_WZaGnNhC7tGnMUigdMlYwW1OKtSkD_aQqiW04tHHm4e-86YpaVV7Ez_gv2rStXEVtraLAxj2UguSbVHBfmmjr1gee5ZX7x5-kB_LbQththoMQw/s1600/Arteria-lusoria_MRA_MIP.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="298" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMJxsyJduWWwkixU8iNuaKWu03CyZX_WZaGnNhC7tGnMUigdMlYwW1OKtSkD_aQqiW04tHHm4e-86YpaVV7Ez_gv2rStXEVtraLAxj2UguSbVHBfmmjr1gee5ZX7x5-kB_LbQththoMQw/s320/Arteria-lusoria_MRA_MIP.gif" width="320" /></a></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">The human venous system develops mainly from the vitelline veins, the umbilical veinsand the cardinal veins, all of which empty into the sinus venosus.</div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Measurement_techniques">Measurement techniques</span></h3><ul style="list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><li style="margin-bottom: 0.1em;">Electrocardiogram—for cardiac electrophysiology</li><li style="margin-bottom: 0.1em;">Sphygmomanometer and stethoscope—for blood pressure</li><li style="margin-bottom: 0.1em;">Pulse meter—for cardiac function (heart rate, rhythm, dropped beats)</li><li style="margin-bottom: 0.1em;">Pulse—commonly used to determine the heart rate in absence of certain cardiac pathologies</li><li style="margin-bottom: 0.1em;">Heart rate variability -- used to measure variations of time intervals between heart beats</li><li style="margin-bottom: 0.1em;">Nail bed blanching test—test for perfusion</li><li style="margin-bottom: 0.1em;">Vessel cannula or catheter pressure measurement—pulmonary wedge pressure or in older animal experiments.</li></ul><br /><br /><br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-67367556191279240202012-04-17T03:38:00.000-07:002012-04-22T03:52:24.157-07:00Evolution Of Eye<div dir="ltr" style="text-align: left;" trbidi="on"><br /><br /><div class="thumb tright"><div class="thumbinner" style="width: 332px;"><a class="image" href="http://en.wikipedia.org/wiki/File:Diagram_of_eye_evolution.svg"><img alt="" class="thumbimage" height="461" src="http://upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Diagram_of_eye_evolution.svg/330px-Diagram_of_eye_evolution.svg.png" width="330" /></a><br /><div class="thumbcaption"><div class="magnify"><a class="internal" href="http://en.wikipedia.org/wiki/File:Diagram_of_eye_evolution.svg" title="Enlarge"><img alt="" height="11" src="http://bits.wikimedia.org/skins-1.19/common/images/magnify-clip.png" width="15" /></a></div>Evolution of the eye</div></div></div>Photoreception is phylogenetically very old, with various theories of phylogenesis.<sup class="reference" id="cite_ref-Autrum1979_9-0"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-Autrum1979-9"></a></sup> The common origin (monophyly) of all animal eyes is now widely accepted as fact. This is based upon the shared anatomical and genetic features of all eyes; that is, all modern eyes, varied as they are, have their origins in a proto-eye believed to have evolved some 540 million years ago,<sup class="reference" id="cite_ref-10"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-10"></a></sup><sup> </sup>and the PAX6 gene is considered a key factor in this. The majority of the advancements in early eyes are believed to have taken only a few million years to develop, since the first predator to gain true imaging would have touched off an "arms race".<sup class="reference" id="cite_ref-13"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-13"></a></sup> Prey animals and competing predators alike would be at a distinct disadvantage without such capabilities and would be less likely to survive and reproduce. Hence multiple eye types and subtypes developed in parallel.<br />Eyes in various animals show adaptation to their requirements. For example, birds of prey have much greater visual acuity than humans, and some can see ultraviolet light. The different forms of eye in, for example, vertebrates and molluscs are often cited as examples of parallel evolution, despite their distant common ancestry.<br /><a name='more'></a><br />The very earliest "eyes", called eyespots, were simple patches of photoreceptor protein in unicellular animals. In multicellular beings, multicellular eyespots evolved, physically similar to the receptor patches for taste and smell. These eyespots could only sense ambient brightness: they could distinguish light and dark, but not the direction of the light source.<sup class="reference" id="cite_ref-Land1992_0-2"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-Land1992-0"></a></sup><br />Through gradual change, as the eyespot depressed into a shallow "cup" shape, the ability to slightly discriminate directional brightness was achieved by using the angle at which the light hit certain cells to identify the source. The pit deepened over time, the opening diminished in size, and the number of photoreceptor cells increased, forming an effective pinhole camera that was capable of dimly distinguishing shapes.<sup class="reference" id="cite_ref-ee_14-0"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-ee-14"></a></sup><br />The thin overgrowth of transparent cells over the eye's aperture, originally formed to prevent damage to the eyespot, allowed the segregated contents of the eye chamber to specialise into a transparent humour that optimised colour filtering, blocked harmful radiation, improved the eye's refractive index, and allowed functionality outside of water. The transparent protective cells eventually split into two layers, with circulatory fluid in between that allowed wider viewing angles and greater imaging resolution, and the thickness of the transparent layer gradually increased, in most species with the transparent crystallin protein.<sup class="reference" id="cite_ref-lenses_come_from_15-0"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-lenses_come_from-15"></a></sup><br />The gap between tissue layers naturally formed a bioconvex shape, an optimally ideal structure for a normal refractive index. Independently, a transparent layer and a nontransparent layer split forward from the lens: the cornea and iris. Separation of the forward layer again formed a humour, the aqueous humour. This increased refractive power and again eased circulatory problems. Formation of a nontransparent ring allowed more blood vessels, more circulation, and larger eye sizes.<sup class="reference" id="cite_ref-lenses_come_from_15-1"><a href="http://en.wikipedia.org/wiki/Eye#cite_note-lenses_come_from-15"></a></sup></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-27175562814950599672012-04-17T01:15:00.000-07:002012-04-22T03:52:24.089-07:00Sinus tachycardia<div dir="ltr" style="text-align: left;" trbidi="on"><b style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">Sinus tachycardia</b><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"> (also colloquially known as </span><b style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">sinus tach</b><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"> or </span><b style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">sinus tachy</b><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">) is a heart rhythm with elevated rate of impulses originating from the </span>sinoatrial node<span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">, defined as a rate greater than 100 beats/min in an average adult. The normal heart rate in the average adult ranges from 60–100 beats/min. Note that the normal heart rate varies with age, with infants having normal heart rate of 110–150 bpm to the elderly, who have slower normals. </span><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbJvcXovCLx-nm5gNXcbVZImIVn9-U66xzIMzoLDRx3pEqH9M_RLNWrN7X3Fio1CDC5FDqBjw7D35u58TtuyybaxNZSvrjhfhGE1WUbiEYwutP_D3-uGVkpaRaI4cOU3EhS5lUDq_afps/s1600/picture27.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="110" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbJvcXovCLx-nm5gNXcbVZImIVn9-U66xzIMzoLDRx3pEqH9M_RLNWrN7X3Fio1CDC5FDqBjw7D35u58TtuyybaxNZSvrjhfhGE1WUbiEYwutP_D3-uGVkpaRaI4cOU3EhS5lUDq_afps/s320/picture27.jpg" width="320" /></a><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"><br /></span><br /><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"><br /></span><br /><br /><h2 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-family: sans-serif; font-size: 20px; font-weight: normal; line-height: 20px; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="Etiology">Etiology</span></h2><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Sinus tachycardia is usually a response to normal physiological situations, such as exercise and an increased sympathetic tone with increased catecholamine release—stress, fright, flight, anger. Other causes include:</div><ul style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: -webkit-auto;"><li style="margin-bottom: 0.1em;">Fever</li><li style="margin-bottom: 0.1em;">Anxiety</li><li style="margin-bottom: 0.1em;">Dehydration</li><li style="margin-bottom: 0.1em;">Malignant hyperthermia</li><li style="margin-bottom: 0.1em;">Hypovolemia with hypotension and shock</li><li style="margin-bottom: 0.1em;">Anemia</li><li style="margin-bottom: 0.1em;">Heart failure</li><li style="margin-bottom: 0.1em;">Hyperthyroidism</li><li style="margin-bottom: 0.1em;">Mercury poisoning</li><li style="margin-bottom: 0.1em;">Kawasaki disease</li><li style="margin-bottom: 0.1em;">Pheochromocytoma</li><li style="margin-bottom: 0.1em;">Sepsis</li><li style="margin-bottom: 0.1em;">Pulmonary embolism</li><li style="margin-bottom: 0.1em;">Acute coronary ischemia and myocardial infarction</li><li style="margin-bottom: 0.1em;">Chronic pulmonary disease</li><li style="margin-bottom: 0.1em;">Hypoxia</li><li style="margin-bottom: 0.1em;">Intake of stimulants such as caffeine, nicotine, cocaine, or amphetamines</li><li style="margin-bottom: 0.1em;">Hyperdynamic circulation</li><li style="margin-bottom: 0.1em;">Electric shock</li><li style="margin-bottom: 0.1em;">Drug withdrawal</li></ul><h2 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-family: sans-serif; font-size: 20px; font-weight: normal; line-height: 20px; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="Symptoms"><br /></span></h2><h2 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-family: sans-serif; font-size: 20px; font-weight: normal; line-height: 20px; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline">Symptoms </span></h2><div><span class="mw-headline"><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">Tachycardia is often asymptomatic. If the heart rate is too high, </span>cardiac output<span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"> may fall due to the markedly reduced ventricular filling time. Rapid rates, though they may be compensating for </span>ischemia<span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"> elsewhere, increase myocardial oxygen demand and reduce coronary blood flow, thus precipitating an ischemic heart or valvular disease</span><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">. Sinus tachycardia accompanying a </span>myocardial infarction<span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"> may be indicative of </span>cardiogenic shock<span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;">. </span></span></div><div><span class="mw-headline"><span style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; text-align: -webkit-auto;"><br /></span></span></div><div><span class="mw-headline"><h2 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-family: sans-serif; font-size: 20px; font-weight: normal; line-height: 20px; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="ECG_characteristics">ECG characteristics</span></h2><ul style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: -webkit-auto;"><li style="margin-bottom: 0.1em;"><i>Rate</i>: Greater than or equal to 100.</li><li style="margin-bottom: 0.1em;"><i>Rhythm</i>: Regular.</li><li style="margin-bottom: 0.1em;"><i>P waves</i>: Upright, consistent, and normal in morphology (if no atrial disease)</li><li style="margin-bottom: 0.1em;"><i>P–R interval</i>: Between 0.12–0.20 seconds and shortens with increasing heart rate</li><li style="margin-bottom: 0.1em;"><i>QRS complex</i>: Less than 0.12 seconds, consistent, and normal in morphology.</li></ul></span></div><div><span class="mw-headline"><br /></span></div><div><span class="mw-headline"><br /><br /><a name='more'></a><h2 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-family: sans-serif; font-size: 20px; font-weight: normal; line-height: 20px; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="Diagnosis_and_differentials">Diagnosis and differentials</span></h2><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Usually apparent on the EKG, but if heart rate is above 140 bpm the P wave may be difficult to distinguish from the previous T wave and one may confuse it with a paroxysmal supraventricular tachycardia or <a href="http://en.wikipedia.org/wiki/Atrial_flutter" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Atrial flutter">atrial flutter</a> with a 2:1 block. Ways to distinguish the three are:</div><ul style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; text-align: -webkit-auto;"><li style="margin-bottom: 0.1em;">Vagal maneuvers (such as carotid sinus massage or Valsalva's maneuver) to slow the rate and identification of P waves</li><li style="margin-bottom: 0.1em;">administer AV blockers (e.g., adenosine, verapamil) to identify atrial flutter with 2:1 block</li></ul><h3 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-family: sans-serif; font-size: 17px; line-height: 20px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="Inappropriate_sinus_tachycardia_.28IST.29"><br />Inappropriate sinus tachycardia (IST)</span></h3><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Also known as chronic nonparoxysmal sinus tachycardia, patients have elevated resting heart rate and/or exaggerated heart rate in response to exercise. These patients have no apparent heart disease or other causes of sinus tachycardia. IST is thought to be due to abnormal autonomic control..</div><div class="rellink relarticle mainarticle" style="background-color: white; font-family: sans-serif; font-size: 13px; font-style: italic; line-height: 20px; margin-bottom: 0.5em; padding-left: 1.6em; text-align: -webkit-auto;"> Inappropriate sinus tachycardia</div><h3 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-family: sans-serif; font-size: 17px; line-height: 20px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="Postural_orthostatic_tachycardia_syndrome_.28POTS.29"><br />Postural orthostatic tachycardia syndrome (POTS)</span></h3><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Usually in women with no heart problems, this syndrome is characterized by normal resting heart rate but exaggerated postural sinus tachycardia with or without orthostatic hypotension.</div><div class="rellink relarticle mainarticle" style="background-color: white; font-family: sans-serif; font-size: 13px; font-style: italic; line-height: 20px; margin-bottom: 0.5em; padding-left: 1.6em; text-align: -webkit-auto;"> Postural orthostatic tachycardia syndrome</div><h2 style="background-attachment: initial; background-clip: initial; background-color: white; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-family: sans-serif; font-size: 20px; font-weight: normal; line-height: 20px; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; text-align: -webkit-auto; width: auto;"><span class="mw-headline" id="Treatment"><br />Treatment</span></h2><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Not required for physiologic sinus tachycardia. Underlying causes are treated if present.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><i><b>Acute myocardial infarction</b></i>. Sinus tachycardia can present in more than a third of the patients with AMI but this usually decreases over time. Patients with sustained sinus tachycardia reflects a larger infarct that are more anterior with prominent left ventricular dysfunction, associated with high mortality and morbidity. Tachycardia in the presence of AMI can reduce coronary blood flow and increase myocardial oxygen demand, aggravating the situation. Beta blockers can be used to slow the rate, but most patients are usually already treated with beta blockers as a routine regimen for AMI.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Practically, many studies showed that there is no need for any treatment.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><i><b>IST and POTS</b></i>. Beta blockers are useful if the cause is sympathetic overactivity. If the cause is due to decreased vagal activity, it is usually hard to treat and one may consider radiofrequency catheter ablation.</div></span></div></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-20847863667736138172012-04-16T08:08:00.000-07:002012-04-22T03:52:24.077-07:00Ezetimibe<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><b>Ezetimibe </b> is a drug that lowers cholesterol. It acts by decreasing cholesterol absorption in the intestine. It may be used alone (marketed as Zetia or Ezetrol), when other cholesterol-lowering medications are not tolerated, or together with statins (e.g., ezetimibe/simvastatin, marketed as Vytorin and Inegy) when statins alone do not control cholesterol.</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoADx0FMBCkHohJ8WWi986LDd8fb5BO0W41b25zbLKw9yyOeTg8R0I8s9VJxTwTXmVP33cEwG6jQlPqWi_PGg0PtgMNolQ1ngjSFx6QmMRqby3UQ4u8nhhIjATtE_lUyWAaTixzpwD6Cc/s1600/512px-Ezetimibe.svg.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="155" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoADx0FMBCkHohJ8WWi986LDd8fb5BO0W41b25zbLKw9yyOeTg8R0I8s9VJxTwTXmVP33cEwG6jQlPqWi_PGg0PtgMNolQ1ngjSFx6QmMRqby3UQ4u8nhhIjATtE_lUyWAaTixzpwD6Cc/s320/512px-Ezetimibe.svg.png" width="320" /></a></div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">Even though ezetimibe decreases cholesterol levels, the results of two major, high-quality clinical trials (in 2008 and 2009) showed that it did not improve clinically significant outcomes, such as major coronary events, and actually made some outcomes, such as artery wall thickness, <i>worse</i>. Indeed, a panel of experts concluded in 2008 that it should "only be used as a last resort". In one of those studies, a head-to-head trial in 2009, a much less expensive medication (extended-release niacin) was found to be superior. Ezetimibe actually increased the thickness of artery walls (a measurement of atherosclerosis) and caused more major cardiovascular events. A more positive view of the benefits of Ezetimibe is offered by Britain's NICE statement which however was published in 2007 and may not have been updated to reflect the results of the above mentioned trials </div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><br /></div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"></div><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Pharmacology">Pharmacology</span></h2><div><span class="mw-headline"><br /></span></div><div><span class="mw-headline">Ezetimibe localises at the brush border of the small intestine, where it inhibits the absorption of cholesterol from the intestine. Specifically, it appears to bind to a critical mediator of cholesterol absorption, the Niemann-Pick C1-Like 1 (NPC1L1) protein on the gastrointestinal tract epithelial cells as well as in hepatocytes. In addition to this direct effect, decreased cholesterol absorption leads to an upregulation of LDL-receptors on the surface of cells and an increased LDL-cholesterol uptake into cells, thus decreasing levels of LDL in the blood plasmawhich contribute to atherosclerosis and cardiovascular events</span></div><br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-17879312155518049632012-04-16T08:00:00.000-07:002012-04-22T03:52:24.070-07:00Hypertriglyceridemia<div dir="ltr" style="text-align: left;" trbidi="on"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEge4ZYI534VFHGsKac2a1RHjPxR7jgO3kBzSd6QrcJ0KRFGiMTqcs5IqoN-_71T7BMxtjpAzwwx7v9wKdo0KinQK2asxI8Y-n06TQk4C4ML2MtC3Es_FvaRzdQXySbyk3va04SnyygEF64/s1600/erc573460.fig1.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="291" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEge4ZYI534VFHGsKac2a1RHjPxR7jgO3kBzSd6QrcJ0KRFGiMTqcs5IqoN-_71T7BMxtjpAzwwx7v9wKdo0KinQK2asxI8Y-n06TQk4C4ML2MtC3Es_FvaRzdQXySbyk3va04SnyygEF64/s320/erc573460.fig1.gif" width="320" /></a><br /><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">In medicine, <b>hypertriglyceridemia</b> denotes high (<i>hyper-</i>) blood levels (<i>-emia</i>) oftriglycerides, the most abundant fatty molecule in most organisms. It has been associated with atherosclerosis, even in the absence of hypercholesterolemia (highcholesterol levels). It can also lead to pancreatitis in excessive concentrations (i.e. when the triglyceride concentration is greater, and often very much greater, than 1000 mg/dl or 12 mmol/l). Very high triglyceride levels may also interfere with blood tests; hyponatremia may be reported spuriously (<i>pseudohyponatremia</i>).</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;">A related term is "hyperglyceridemia" which refers to a high level of all glycerides, including monoglycerides, diglycerides and triglycerides.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><br /></div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"></div><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Signs_and_symptoms">Signs and symptoms </span></h2><div><span class="mw-headline">Modestly elevated triglyceride levels do not lead to any physical symptoms. Higher levels are associated with lipemia retinalis(white appearance of the retina), eruptive xanthomas (small lumps in the skin, sometimes itchy).</span></div><div><span class="mw-headline"><br /></span></div><div><span class="mw-headline"><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Causes">Causes</span></h2><ul style="list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><li style="margin-bottom: 0.1em;">High carbohydrate diet</li><li style="margin-bottom: 0.1em;">Idiopathic (constitutional)</li><li style="margin-bottom: 0.1em;">Obesity</li><li style="margin-bottom: 0.1em;">Diabetes mellitus and insulin resistance - it is one of the defined components of metabolic syndrome (along with central obesity, hypertension, and hyperglycemia)</li><li style="margin-bottom: 0.1em;">Excess alcohol intake</li><li style="margin-bottom: 0.1em;">renal failure, Nephrotic syndrome</li><li style="margin-bottom: 0.1em;">Genetic predisposition; some forms of familial hyperlipidemia such as familial combined hyperlipidemia i.e. Type II hyperlipidemia</li><li style="margin-bottom: 0.1em;">Lipoprotein lipase deficiency - Deficiency of this water soluble enzyme, that hydrolyzes triglycerides in lipoproteins, leads to elevated levels of triglycerides in the blood.</li><li style="margin-bottom: 0.1em;">Lysosomal acid lipase deficiency or Cholesteryl ester storage disease</li><li style="margin-bottom: 0.1em;">Certain medications e.g. isotretinoin, estrogen, hydrochlorothiazide diuretics, beta blockers, protease inhibitors</li><li style="margin-bottom: 0.1em;">Hypothyroidism (underactive thyroid)</li><li style="margin-bottom: 0.1em;">Systemic Lupus Erythematosus</li><li style="margin-bottom: 0.1em;">Glycogen storage disease type 1. </li></ul><div><br /></div><div><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Relationship_of_Hypertriglyceridemia_to_Atherosclerosis">Relationship of Hypertriglyceridemia to Atherosclerosis</span></h2></div><div><span class="mw-headline"><a name='more'></a><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Since triglycerides are not a component of the atherosclerotic plaque, it is not intuitively obvious whether hypertriglyceridemia promotes atherosclerosis. Numerous studies (summarized in references ) have examined the relationship between hypertriglyceridemia and atherosclerosis with a definitive answer still not apparent. In large part, the conflicting results reflect whether various other relevant risk factors for atherosclerosis were examined and taken into account. Specifically, the following are all risk factors for atherosclerosis and all are also associated with (not necessarily in a causal way) hypertriglyceridemia:</div><ul style="list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><li style="margin-bottom: 0.1em;">obesity</li><li style="margin-bottom: 0.1em;">diabetes and insulin resistance</li><li style="margin-bottom: 0.1em;">metabolic syndrome</li><li style="margin-bottom: 0.1em;">presence of other dyslipidemias associated themselves both with high triglycerides and atherosclerosis (e.g. mixed hyperlipidemia, low HDL (hypoalphalipoproteinemia), Familial dysbetalipoproteinemia (type III hyperlipoproteinemia), etc.)</li><li style="margin-bottom: 0.1em;">high levels of small, dense LDL</li><li style="margin-bottom: 0.1em;">high levels of apolipoprotein B (apoB)</li></ul><div style="margin-bottom: 0.5em; margin-top: 0.4em;">In other words, any study purporting to demonstrate an association of hypertriglyceridemia and atheroslerosis must not only have controlled for the classic atherosclerosis risk factors but also for the more recently recognized risk factors such as insulin resistance, levels of small, dense LDL, and apoB levels. The relationship among hypertriglyceridemia, atherosclerosis, and apoB is particularly instructive. Specifically, those forms of hypertriglyceridemia associated with high levels of apoB, but not those associated with low levels of apoB, are associated with atherosclerosis </div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Treatment">Treatment</span></h2><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet, as well as with niacin, fibrates and statins(three classes of drugs). Increased fish oil intake may substantially lower an individual's triglycerides.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Clinical practice guidelines by the National Cholesterol Education Program (NCEP) suggest that pharmacotherapy should be considered for a triglycerides level over 200 mg/dL. The guidelines state "the sum of LDL + VLDL cholesterol (termed non-HDL cholesterol [total cholesterol - HDL cholesterol]) as a secondary target of therapy in persons with high triglycerides (200 mg/dL). The goal for non-HDL cholesterol in persons with high serum triglycerides can be set at 30 mg/dL higher than that for LDL cholesterol on the premise that a VLDL cholesterol level 30 mg/dL is normal."</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Non–HDL cholesterol contains the highly atherogenic, small, dense lipoproteins that are associated with a high incidence of cardiovascular disease (CVD). Studies subsequent to the NCEP report have shown that the non–HDL cholesterol level predicts CVD in people who have diabetes. It may be superior to LDL cholesterol in this regard, and should be used as the primary lipid target in persons with diabetes</div></span></div></span></div><div><span class="mw-headline"><br /></span></div><div><span class="mw-headline"><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Primary_prevention">Primary prevention</span></h3><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Omega-3 fatty acid supplementation in the form of fish oil has been found to be effective in decreasing levels of triglycerides and all cardiovascular events by 19% to 45%.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Gemfibrozil twice daily in asymptomatic men ages 40–55 without heart disease was also found to be effective at reducing cardiac endpoints at 5 years (4.14% to 2.73%). This means that 71 people must take the treatment for five years to prevent one cardiac event (number needed to treat of 71).</div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Secondary_prevention"><br />Secondary prevention</span></h3><div style="margin-bottom: 0.5em; margin-top: 0.4em;">A randomized controlled trial of men with known heart disease and HDL cholesterol of 40 mg/dl or less, 600 mg of gemfibrozil twice daily reduced cardiac endpoints (non-fatal myocardial infarction or death from coronary causes) at 5 years from 21.7% to 17.3%. This means that 23 patients must be treated for five years to prevent one cardiac event (number needed to treat is 23).</div></span></div><div><span class="mw-headline"><br /></span></div><br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-46979336276821563562012-04-14T00:04:00.000-07:002012-04-22T03:52:24.107-07:00Hideki Yukawa and the Pion<div dir="ltr" style="text-align: left;" trbidi="on"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizuhEtEgtwEMUHbRqhgeSSXbYrlLNueBEE7WDQVmU3iKWxVZNI-Keu1SghUZ3pXiVOAlQBAUBbRC9MI0EPIQO8HkUe0ApEngViQFfU7EubCIFj3ImnHvvmsQ0aIAxyzI-K-YX9OihQUj0Q/s1600/200px-Yukawa.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizuhEtEgtwEMUHbRqhgeSSXbYrlLNueBEE7WDQVmU3iKWxVZNI-Keu1SghUZ3pXiVOAlQBAUBbRC9MI0EPIQO8HkUe0ApEngViQFfU7EubCIFj3ImnHvvmsQ0aIAxyzI-K-YX9OihQUj0Q/s1600/200px-Yukawa.jpg" /></a>Once quantum electrodyamics had produced the picture of the electromagnetic force as a process of exchanging photons, the question of whether or not the other forces were also exchange forces was a natural one. In 1935, Hideki Yukawa reasoned that the electromagnetic force was infinite in range because the exchange particle was massless. He proposed that the short range strong force came about from the exchange of a massive particle which he called a meson. By observing that the effective range of the nuclear force was on the order of a fermi, a mass for the exchange particle could be predicted using the uncertainty principle. The predicted particle mass was about 100 MeV. It did not receive immediate attention since no one knew of a particle which fit that description. <br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEinuNUUKrHL3vBd_O209FT-ZKRLWUJcfLtEX_myYQy_86-_02f7hNH3Yr1rV6F5wk4m0zRNq_wqcakxT1q5XnKitCcgv9SXBjsdw1xhWzD4W4-ndrC5DkH-zXFrIbGdpcE1i-Il9bDNFYuC/s1600/Hideki-Yukawa.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="254" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEinuNUUKrHL3vBd_O209FT-ZKRLWUJcfLtEX_myYQy_86-_02f7hNH3Yr1rV6F5wk4m0zRNq_wqcakxT1q5XnKitCcgv9SXBjsdw1xhWzD4W4-ndrC5DkH-zXFrIbGdpcE1i-Il9bDNFYuC/s320/Hideki-Yukawa.jpg" width="320" /></a></div>In 1937 a particle of mass close to Yukawa's prediction was discovered in cosmic rays by Anderson & Neddermeyer and by Street & Stevenson in independent experiments. This particle, the muon, turned out not to interact by the strong interaction. Hans Bethe and Robert Marshak predicted that the muon could be a decay product of the particle sought. In 1947, Lattes, Muirhead, Occhialini and Powell conducted a high altitude experiment, flying photographic emulsions at 3000 meters. These emulsions revealed the <a href="http://abbrainstorm.blogspot.in/2012/04/pion.html" target="_blank">pion</a>, which met all the requirements of the Yukawa particle. <br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGROWAAYWFAYuAy665svSFmjU3o9w35gpm_hoz3MQBirgI46zWaPUvLD-5CZTyQG1KMRN43BGgD3pIm4oK5K42Lu6HJIAcrtpzxt4IhnjqovcUTHdbxvYfwbsYNFVYp6iQmhNsQ356AKgj/s1600/hideki_may3.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGROWAAYWFAYuAy665svSFmjU3o9w35gpm_hoz3MQBirgI46zWaPUvLD-5CZTyQG1KMRN43BGgD3pIm4oK5K42Lu6HJIAcrtpzxt4IhnjqovcUTHdbxvYfwbsYNFVYp6iQmhNsQ356AKgj/s320/hideki_may3.jpg" width="320" /></a><br /><br />We now know that the pion is a <a href="http://abbrainstorm.blogspot.in/2012/04/mesons.html" target="_blank">meson</a>, a composite particle, and the current view is that the strong interaction is an interaction between quarks, but the Yukawa theory stimulated a major advance in the understanding of the strong interaction.<br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsejAgJxj2dj-iHVOmlH5OcZSFFDTdOETDoJ8KoO3tPWT5JkkDW9RBDEaBnsrS0NVbCfQ2hVWu_5gckjk27faI2xUa80qjsdA0yoBqgY5nK5huPcsHSY0BgrD7ASdC8byWGxYlpcdpicVD/s1600/Johns+Hopkins+Einstein.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="260" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsejAgJxj2dj-iHVOmlH5OcZSFFDTdOETDoJ8KoO3tPWT5JkkDW9RBDEaBnsrS0NVbCfQ2hVWu_5gckjk27faI2xUa80qjsdA0yoBqgY5nK5huPcsHSY0BgrD7ASdC8byWGxYlpcdpicVD/s400/Johns+Hopkins+Einstein.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><span style="font-family: arial; font-weight: bold;">Einstein talks with Hideki Yukawa, 1949 Nobel Laureate in Physics and John A. Wheeler, a Hopkins alum</span></td><td class="tr-caption" style="text-align: center;"><span style="font-family: arial; font-weight: bold;"></span></td><td class="tr-caption" style="text-align: center;"><span style="font-family: arial; font-weight: bold;"></span></td></tr></tbody></table></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-65061092374350153262012-04-13T23:53:00.000-07:002012-04-22T03:52:24.119-07:00Baryons<div dir="ltr" style="text-align: left;" trbidi="on"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgq32qX1Cm26-hfp4hrsXUnnQDwdPiO3rqkH7J5tRNEZ1NWvoJnWhOpaVDzA5dD7WmVGfaXD7Hy9pcnOOomBekZHMLun4f2v1ssX5yQ1Oernl5N0BlOhEaiqMdaSPz816QwNuHoc5X2XScy/s1600/Baryons_32.gif" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="296" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgq32qX1Cm26-hfp4hrsXUnnQDwdPiO3rqkH7J5tRNEZ1NWvoJnWhOpaVDzA5dD7WmVGfaXD7Hy9pcnOOomBekZHMLun4f2v1ssX5yQ1Oernl5N0BlOhEaiqMdaSPz816QwNuHoc5X2XScy/s400/Baryons_32.gif" width="400" /></a> Baryons are massive particles which are made up of three <a href="http://abbrainstorm.blogspot.in/search/label/Quark" target="_blank"> quarks</a> in the standard model. This class of particles includes the proton and neutron. Other baryons are the lambda, sigma, xi, and omega particles. Baryons are distinct from <a href="http://abbrainstorm.blogspot.in/2012/04/mesons.html">mesons</a> in that mesons are composed of only two quarks. Baryons and mesons are included in the overall class known as hadrons, the particles which interact by the strong force. Baryons are fermions, while the mesons are bosons. Besides charge and spin (1/2 for the baryons), two other quantum numbers are assigned to these particles: baryon number (B=1) and strangeness (S), which in the chart can be seen to be equal to -1 times the number of strange quarks included. <br /> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoFv5LsOUBipWacgDiWYEaxFicql3-lpmJwYb3Hsgn403-AQWx6K5NgzmO-_U9rLVT53fu8ISd5rov_g2XN_zyqfsf37YBTLRq0nO-rRkeEzaKhnfLdNmf3DJQTfAwKShry0mrhQw9vNJR/s1600/Baryon.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="187" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoFv5LsOUBipWacgDiWYEaxFicql3-lpmJwYb3Hsgn403-AQWx6K5NgzmO-_U9rLVT53fu8ISd5rov_g2XN_zyqfsf37YBTLRq0nO-rRkeEzaKhnfLdNmf3DJQTfAwKShry0mrhQw9vNJR/s200/Baryon.gif" width="200" /></a>The conservation of baryon number is an important rule for interactions and decays of baryons. No known interactions violate conservation of baryon number.<br />Recent experimental evidence shows the existence of five-quark combinations which are being called pentaquarks. The pentaquark would be included in the classification of baryons, albeit an "exotic" one. The pentaquark is composed of four quarks and an antiquark, like a combination of an ordinary baryon plus a meson.<br /><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigFyUlmJr2bvNrY08bERS7m6EVmrh3GXoBWrjBQ7ZYtJzZx_sFHMqEDCiwkNpVC4vswL7PdwtVkltQZWS_Gt1DSzjssmdcZFwfUViiO2jZbaqS55tgSpLCEbGESlWAYxVdt5SoqY4WnFoS/s1600/baryons.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigFyUlmJr2bvNrY08bERS7m6EVmrh3GXoBWrjBQ7ZYtJzZx_sFHMqEDCiwkNpVC4vswL7PdwtVkltQZWS_Gt1DSzjssmdcZFwfUViiO2jZbaqS55tgSpLCEbGESlWAYxVdt5SoqY4WnFoS/s320/baryons.jpg" width="320" /></a></div></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-10616861739348238582012-04-13T23:44:00.000-07:002012-04-22T03:52:24.061-07:00pion<div dir="ltr" style="text-align: left;" trbidi="on"><table border="1" cellpadding="2" cellspacing="2"><tbody><tr><td>Particle</td><td>Symbol</td><td>Anti-<br />particle</td><td>Makeup</td><td><center>Rest mass<br />MeV/c<sup>2</sup></center></td><td>S</td><td>C</td><td>B</td><td>Lifetime</td><td><center>Decay Modes</center></td></tr><tr><td><center>Pion</center></td><td><center><span>π<sup>+</sup></span></center></td><td><center><span>π<sup>-</sup></span></center></td><td><center>u<u>d</u></center></td><td><center>139.6</center></td><td><center>0</center></td><td><center>0</center></td><td>0</td><td><center>2.60<br />x10<sup>-8</sup></center></td><td><center>μ<sup>+</sup>ν<sub>μ</sub></center></td></tr><tr><td><center>Pion</center></td><td><center><span>π<sup>0</sup></span></center></td><td><center>Self</center></td><td><center><img src="http://hyperphysics.phy-astr.gsu.edu/hbase/particles/imgpar/pio.gif" /></center></td><td><center>135.0</center></td><td><center>0</center></td><td><center>0</center></td><td>0</td><td><center>0.83<br />x10<sup>-16</sup></center></td><td><center>2γ</center></td></tr></tbody></table>The neutral pion decays to an electron, positron, and gamma ray by the electromagnetic interaction on a time scale of about 10<sup>-16</sup> seconds. The positive and negative pions have longer lifetimes of about 2.6 x 10<sup>-8</sup> s. <br /><center><img src="http://hyperphysics.phy-astr.gsu.edu/hbase/particles/imgpar/pion1.gif" /></center>The negative pion decays into a muon and a muon antineutrino as illustrated below. This decay is puzzling upon first examination because the decay into an electron plus an electron antineutrino yields much more energy. Usually the pathway with the greatest energy yield is the preferred pathway. This suggests that some symmetry is acting to inhibit the electron decay pathway. <br /><center><img src="http://hyperphysics.phy-astr.gsu.edu/hbase/forces/imgfor/feynw6.gif" /></center>The symmetry which suppresses the electron pathway is that of angular momentum, as described by Griffiths. Since the negative pion has spin zero, the electron and antineutrino must be emitted with opposite spins to preserve net zero spin. But the antineutrino is always right-handed, so this implies that the electron must be emitted with spin in the direction of its linear momentum (i.e., also right-handed). But if the electron were massless, it would (like the neutrino) only exist as a left-handed particle, and the electron pathway would be completely prohibited. So the suppression of the electron pathway is attributed to the fact that the electron's small mass greatly favors the left-handed symmetry, thus inhibiting the decay. Weak interaction theory predicts that the fraction of muons decaying into electrons should be 1.28 x 10<sup>-4</sup> and the measured branching ratio is 1.23 +/- 0.02 x 10<sup>-4</sup>. <br />The pion, being the lightest meson, can be used to predict the maximum range of the strong interaction. The strong interaction properties of the three pions are identical. The connection between pions and the strong force was proposed by Hideki Yukawa. Yukawa worked out a potential for the force and predicted its mass based on the uncertainty principle from measurements of the apparent range of the strong force in nuclei. <br />Being composed of an up and an antidown <a href="http://abbrainstorm.blogspot.in/search/label/Quark" target="_blank">quark</a>, the positive pion would be expected to have a mass about 2/3 that of a proton, yet it's mass is only about 1/6 of that of the proton! This is an example of how hadron masses depend upon the dynamics inside the particle, and not just upon the <a href="http://abbrainstorm.blogspot.in/search/label/Quark" target="_blank">quarks</a> contained.<br /><table><tbody><tr><td>The pion is a <a href="http://abbrainstorm.blogspot.in/2012/04/mesons.html">meson</a>. The π<sup>+</sup> isconsidered to be made up of anup and an anti-down <a href="http://abbrainstorm.blogspot.in/search/label/Quark">quark</a>. The neutral pion is considered to be a combination<center> <img src="http://hyperphysics.phy-astr.gsu.edu/hbase/particles/imgpar/pio.gif" /></center></td><td><img src="http://hyperphysics.phy-astr.gsu.edu/hbase/particles/imgpar/pion2.gif" /></td></tr></tbody></table>Pions interact with nuclei and transform a neutron to a proton or vice versa:<br /><center><img src="http://hyperphysics.phy-astr.gsu.edu/hbase/particles/imgpar/pionr.gif" /></center>The pions π<sup>+</sup> and π<sup>-</sup> have spin zero and negative intrinsic parity (Rohlf Sec 17-2).</div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-62894183871712467292012-04-13T23:40:00.000-07:002012-04-22T03:52:24.116-07:00Mesons<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF2dc6bmqIIdKpujqiTHNOX8iwObbqj9YcH402b76rt-XMb-wXWZKl5DwHO3RZLHAnYXNPt39UjvqlrBn6eoisCgjRFFACFyt7YQBNGXMRwahwpd8xitjlEiX8GeC-61fOXvyblMH5-Mse/s1600/200px-Meson_nonet_-_spin_0.svg.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="288" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF2dc6bmqIIdKpujqiTHNOX8iwObbqj9YcH402b76rt-XMb-wXWZKl5DwHO3RZLHAnYXNPt39UjvqlrBn6eoisCgjRFFACFyt7YQBNGXMRwahwpd8xitjlEiX8GeC-61fOXvyblMH5-Mse/s400/200px-Meson_nonet_-_spin_0.svg.png" width="400" /></a></div><br /><span>Mesons are intermediate mass particles which are made up of a quark-antiquark pair. Three quark combinations are called baryons. Mesons are bosons, while the baryons are fermions. Recent experimental evidence shows the existence of five-quark combinations which are being called pentaquarks.</span></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.comtag:blogger.com,1999:blog-8001339683603915738.post-60398029780925109912012-04-13T23:14:00.000-07:002012-04-22T03:52:24.112-07:00Microcephaly<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><b>Microcephaly</b> is a neurodevelopmental disorder in which the circumference of the head is more than two standard deviations smaller than average for the person's age and sex. Microcephaly may be congenital or it may develop in the first few years of life. The disorder may stem from a wide variety of conditions that cause abnormal growth of the brain, or from syndromes associated with chromosomal abnormalities. Two copies of a loss-of-function mutation in one of the<i>microcephalin</i> genes causes primary microcephaly.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEgjUCRIGNS_TrOoHhLes5fOaaAaB2NHHNaz8cuBIB2HOxCJ-hG8vwSZ8Xlbjw9CdWwtUXpOOy3Z-ZFgsMViUl3UnQdOtWbuMlVgGABG0QxiYyD7lsCIKxyUj5BdmN28JNGc4vLBDA0FU/s1600/microcephaly.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="237" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEgjUCRIGNS_TrOoHhLes5fOaaAaB2NHHNaz8cuBIB2HOxCJ-hG8vwSZ8Xlbjw9CdWwtUXpOOy3Z-ZFgsMViUl3UnQdOtWbuMlVgGABG0QxiYyD7lsCIKxyUj5BdmN28JNGc4vLBDA0FU/s320/microcephaly.jpg" width="320" /></a>In general, life expectancy for individuals with microcephaly is reduced and the prognosis for normal brain function is poor. The prognosis varies depending on the presence of associated abnormalities.</div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><br /></div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"><br /></div><div style="background-color: white; font-family: sans-serif; font-size: 13px; line-height: 20px; margin-bottom: 0.5em; margin-top: 0.4em; text-align: -webkit-auto;"></div><h2 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: rgb(170, 170, 170); border-bottom-style: solid; border-bottom-width: 1px; font-size: 20px; font-weight: normal; margin-bottom: 0.6em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Causes">Causes </span></h2><div><span class="mw-headline"><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Microcephaly is a type of cephalic disorder.</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;">A genetic factor may play a role in causing some cases of microcephaly. Relations have been found between autism, duplications of chromosomes and macrocephaly on one side. On the other side a relation has been found between schizophrenia, deletions of chromosomes and microcephaly</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Microencephaly">Microencephaly</span></h3><div style="margin-bottom: 0.5em; margin-top: 0.4em;">"Microcephaly" means "small head". "Microencephaly" means "small brain". Because the size of the head is mostly determined by the size of the brain, microencephaly is implied when discussing microcephaly</div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"><br /></div><div style="margin-bottom: 0.5em; margin-top: 0.4em;"></div><h3 style="background-attachment: initial; background-clip: initial; background-image: none; background-origin: initial; border-bottom-color: initial; border-bottom-style: none; border-bottom-width: initial; font-size: 17px; margin-bottom: 0.3em; margin-left: 0px; margin-right: 0px; margin-top: 0px; overflow-x: hidden; overflow-y: hidden; padding-bottom: 0.17em; padding-top: 0.5em; width: auto;"><span class="mw-headline" id="Other">Other</span></h3><div style="margin-bottom: 0.5em; margin-top: 0.4em;">Microcephaly can also be associated with other conditions that are only indirectly associated with the nervous system:</div><ul style="list-style-image: url(data:image/png; list-style-type: square; margin-bottom: 0px; margin-left: 1.6em; margin-right: 0px; margin-top: 0.3em; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;"><li style="margin-bottom: 0.1em;">alcoholism (which can result in the fetal alcohol syndrome disability)</li><li style="margin-bottom: 0.1em;">diabetes</li><li style="margin-bottom: 0.1em;">varicella zoster virus (Chickenpox)</li><li style="margin-bottom: 0.1em;">rubella (German measles)</li><li style="margin-bottom: 0.1em;">CMV (human cytomegaovirus)</li><li style="margin-bottom: 0.1em;">radiation</li></ul><div style="margin-bottom: 0.5em; margin-top: 0.4em;">After the dropping of atomic bombs on Hiroshima and Nagasaki, several women close to ground zero who had been pregnant at the time gave birth to children with microcephaly. A total of seven of the in utero children at Hiroshima were affected.Microcephaly prevalence was 7 out of a group of 11 pregnant women who held the distinction of surviving the blast at an distance of ≈1 km from ground zero. Due to their proximity to the bomb, the pregnant women's <a href="http://en.wikipedia.org/wiki/In_utero" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="In utero">in utero</a> children received a biologically significant radiation dosage that was relatively high due to the massive <a href="http://en.wikipedia.org/wiki/Neutron" style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: none; background-origin: initial; background-position: initial initial; background-repeat: initial initial; color: #0b0080; text-decoration: none;" title="Neutron">neutron</a> output of the lower explosive-yielding Little Boy.Microcephaly is the only proven malformation, or congenital abnormality, found in the children of Hiroshima and Nagasaki</div><br /></span></div><br /></div>juilitehttp://www.blogger.com/profile/15270031688971561330noreply@blogger.com