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Hypovolemic shock - caused by a drop in blood volume that causes blood pressure (and blood flow) to drop 3 menstruation 9 years old purchase 0.03/0.15mg alesse otc. Neurogenic shock - caused by nerve condition that relaxes (dilates) blood vessels and thus reduces blood flow 4. Anaphylactic shock - caused by a severe allergic reaction characterized by blood vessel dilation 5. There is a difference in thickness in these layers because arteries carry blood under higher pressure. Arteries and veins carry blood in opposite directions: arteries away from the heart and veins toward the heart. If you are asked to learn the names and locations of specific blood vessels, make flash cards, use online resources, and use the figures in this chapter as learning tools. The hepatic portal system makes more sense if you see it as a homeostatic mechanism. The liver helps keep the blood leaving the digestive system from having too high a concentration of various nutrients, such as glucose. Fetal circulation will make sense to you if you consider the environment in which the fetus is living. A liquid always moves from a higher pressure to a lower pressure, so pressure would be highest leaving the heart and lowest in the vena cava. It helps to organize them by whether they are arterial disorders or venous disorders. In your study group, review the structure of the blood vessels and try to relate it to its function. Discuss hepatic portal circulation and fetal circulation in terms of their advantages or efficiencies. Go over the factors influencing blood pressure and the location of places where a pulse can be taken. Refer to the Language of Science and Language of Medicine terms and review the questions and the outline summary at the end of the chapter and discuss possible test questions. Explain what would occur if the foramen ovale failed to close at the time of birth. Explain how the formation of varicose veins is an example of a positive feedback mechanism. How is it different from normal circulation, and what advantages are gained from this type of circulation? When nutrients from a meal are being absorbed, the blood in the portal vein contains a higher than normal concentration of glucose. Why does the blood, after it leaves the liver, usually have a somewhat normal blood glucose concentration? Explain the differences between normal postnatal circulation and fetal circulation. Based on the environment of the fetus, explain how these differences make fetal circulation more efficient. The are microscopic blood vessels where substances are exchanged between the blood and the tissues. A (an) is a section of an artery that has become abnormally widened because of a weakening of the arterial wall. Systemic circulation involves moving blood throughout the body; circulation involves moving blood to the lungs and back. In a condition called, the number of blood cells increases beyond the normal and thus increases blood viscosity. The two structures in the fetus that allow most of the blood to bypass the lungs are the and the. The strength of the heart contraction and blood volume are two factors that influence blood pressure.

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From puberty on pregnancy non stress test cheap 0.18mg alesse with mastercard, the seminiferous tubules continuously form spermatozoa, or sperm. Although the number of sperm produced each day diminish with increasing age, most men continue to produce significant numbers throughout life. The testes prepare for sperm production before puberty by increasing the numbers of sperm precursor (stem) cells called spermatogonia. Before puberty, spermatogonia increase in number by the process of mitotic cell division, which was described in Chapter 3. Several seminiferous tubules surrounded by septa containing interstitial cells are shown. A, Cross section of seminiferous tubule shows layers of cells undergoing the process of spermatogenesis. B, Diagram of spermatogenesis, including the role of meiosis in producing daughter sperm cells with half the number of nuclear chromosomes found in typical body cells. The hypothalamus is a small but functionally important structure located near the base of the brain. A gonadotropin is a hormone that has a stimulating effect on the gonads - the testes and ovaries. You may want to review these roles of the hypothalamus and pituitary gland in Chapter 10 (p. One of these cells remains as a spermatogonium and the other forms another type of cell called a primary spermatocyte. These primary spermatocytes then undergo another type of cell division characterized by meiosis, which ultimately results in sperm formation. Unlike the two daughter cells that result from mitosis, the four spermatids each have only half the genetic material in its nucleus and half of the nuclear chromosomes (23) of other body cells. And each sperm cell has a tail and moves independently somewhat like a microscopic animal. All of the characteristics that a baby will inherit from its father at fertilization are contained in the nuclear chromosomes found in each sperm head. B, Illustration shows the components of a mature sperm cell and an enlargement of a sperm head and midpiece. The forceful ejection of fluid containing sperm, or ejaculation, into the female vagina during sexual intercourse is only one step in the long journey that these sex cells must make before they can meet and fertilize an ovum. To accomplish their task, these tiny packages of genetic information are equipped with tails for motility and enzymes to penetrate the outer membrane of the ovum when contact occurs with it. Note the sperm head containing the nucleus with its genetic material from the father. The sperm head is covered by the acrosome - a caplike structure containing enzymes that enable the sperm to break down the covering of the ovum and permit entry if contact occurs. In addition to the head with its covering acrosome, each sperm has a midpiece and an elongated tail. In addition to spermatogenesis, the other function of the testes is to secrete the male hormone testosterone. This function is carried on by the interstitial cells of the testes, not by their seminiferous tubules. Testosterone promotes and maintains the development of the male accessory organs (prostate gland, seminal vesicles, and so on). Testosterone has a stimulating effect on protein anabolism - it is an anabolic steroid hormone. Testosterone thus is responsible for the greater muscular development and strength of the male. The other two components included in the listing of accessory organs of reproduction in the male - the supportive sex glands and external genitals - are discussed separately here. When they exit from these tubules within the testis, they enter and then pass, in sequence, through the epididymis, vas (ductus) deferens, ejaculatory duct, and the urethra on their journey out of the body. Epididymis Each epididymis consists of a single and very tightly coiled tube about 6 m (20 feet) in length. Sperm mature and develop their ability to move, or swim, as they pass through the epididymis.

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The nonpolar (hydrophobic) hydrocarbon tails of the soap are lipophilic (fat loving) and attract and dissolve noncharged hydrophobic substances menstruation 6 weeks after birth discount alesse 0.03/0.15 mg with visa. Conjugated fatty acids attached to glycerol are the common components of fat or triglycerides (a). Triglycerides found in nature commonly have dissimilar hydrocarbon chain lengths in each molecule, but most typically range from 16 to 20 carbon atoms. Since both plants and animals synthesize fats with acetyl CoA, which conveys 2 carbon atoms at a time to the synthesis, most of these naturally occurring triglycerides have an even number of carbons in the fatty acids. Reaction of a fat with a strong base will break down the triglyceride structure into glycerol (b) and salts of the three fatty acids (c). Note that the R groups (R1, R2, and R3) of the fat designate the different chain lengths included in a single triglyceride (a and c). Note that the chemical structure of the soaps yielded from the reaction can contain up to three different chemical structures, R(1­3) (c). The schematic representation of soap features the hydrophilic head group, made up of the charged end of the molecule and the hydrophobic hydrocarbon tail (c). This schematic depicts the typical structure of a saturated fatty acid (without double bonds). Micelles and Liposomes 53 with hydrophobic tails extending into the air above the water and the hydrophilic heads extending into the water. The blue circle represents the polar heads, while the yellow zigzag lines represent the hydrocarbon tails (simplified to show saturated fatty acids). Dashed lines and ellipses indicate the preferred steric occupancy volumes around the amphiphiles that help determine the preferred spherical micellar shape for single-chain species. Dotted ellipses around the polar head groups represent the spherical circumference of hydration shells associated with the hydrophilic end. Head group spacing (d) is determined by the nature of the charged group and its hydration shell and helps determine the preferred number of amphiphiles per micelle. These steric differences allow decreased energy requirement for reduced head group spacing (d) with double-chain amphiphiles as opposed to single-chain molecules. Head group spacing is maximized on a spherical shape, while it is reduced toward a minimum in a bilayer structure (Katsaras and Gutberlet 2010). The alkyl group length of the single-chain amphiphile monomers determines the micelle radius. Therefore, varying the length of the hydrophobic chain most commonly alters micelle size (and radius). Attempts to enlarge the micelle by adding more monomers destabilize the optimal structure by either forcing the charged head groups closer together (decreasing the surface charge dispersion) or expanding the micelle beyond the micelle radius, thereby undermining the central hydrophobic domain through the introduction of water. Elliptical and cylindrical structures are possible but require special conditions and additional energy; however, they permit incorporation of additional monomers into the structure. Ultimately, such environmental factors may drive single-chain amphiphiles toward the forming bilayers, which allow relatively unlimited incorporation of monomers into their structure. Phospholipid micelles can be utilized to carry other amphiphilic molecules or, based on the micelle radius, significant amounts of hydrophobic substances within their inner lipophilic region (Kabanov et al. Currently, amphiphilic block copolymers are commonly used to produce clinical nanomicelles to deliver therapeutics (Jones and Leroux 1999). Polymer micelle categories include hydrophobically assembled or polyion-complex structures (Gaucher et al. Tailoring the micelle structure with copolymers enables variable drug delivery kinetics and particle longevity (Moghimi and Hunter 2001; Torchilin 2001), while maintaining the basic micellar size and architecture. The nature of the hydrophobic core-forming copolymer blocks provides the basis for the delivery kinetics of these nanomicelles (Attwood et al. Polyion-complex micelles use charged copolymer blocks to bind and deliver therapeutic charged proteins or nucleic acids (Oishi et al. The classic spherical lipid micelle typically contains the hydrophilic head groups on the surface and the hydrophobic tails within the center. Certain amphiphilic substances (drugs or other compounds) can also incorporate into the substance of the micelle (blue/orange rectangle). The length of the fatty acid chains and the presence or absence of double bonds within the liposome bilayer lipids affect membrane fluidity, as does the combination of different phospholipids within the membrane structure (Chapman 1975; Chapman and Benga 1984). Cholesterol moieties strengthen and stabilize the bilayer membrane (Kates and Manson 1984) and reduce cation leakage in physiologic systems (Haines 2001). Increasing the molar cholesterol content of liposomal drug carriers typically reduces the release kinetics of the therapeutic from the nanocarrier (Panwar et al.

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This chapter begins with classification and discussion of the important body membranes pregnancy exhaustion purchase alesse 0.18 mg without prescription. Ideally, you should study the skin and its appendages before proceeding to the more traditional organ systems in the chapters that follow to improve your understanding of how structure is related to function. Membranes cover and protect the body surface, line body cavities, and cover the inner surfaces of the hollow organs such as the digestive, reproductive, and respira tory passageways. Some membranes anchor organs to each other or to bones, and others cover the internal organs. In certain areas of the body, membranes secrete lubricating fluids that reduce friction during organ movements such as the beating of the heart or lung ex pansion and contraction. Epithelial membranes, composed of epithelial this sue and an underlying layer of fibrous connective tissue 2. Connective tissue membranes, composed exclu sively of various types of connective tissue; no epi thelial cells are present in this type of membrane ties. The serous membrane layer that lines the walls of a body cavity, much like wallpaper covers the walls of a room, is called the parietal layer. The other type of se rous membrane layer instead folds inward to cover the surface of organs found within a body cavity and is called the visceral layer. In the thoracic cavity the serous membranes are called pleura, and in the abdominal cavity, they are called peritoneum. In both cases the parietal layer forms the lining of the body cavity, and the vis ceral layer covers the organs found in that cavity. Serous membranes secrete a thin, watery fluid that helps reduce friction and serves as a lubricant when organs rub against one another and against the walls of the cavities that contain them. Pleurisy is a very pain Epithelial Membranes There are three types of epithelial tissue membranes in the body: 1. Mucous membranes Cutaneous Membrane the cutaneous membrane, or skin, is the primary organ of the integumentary system. It is one of the most im portant and certainly one of the largest and most visible organs of the body. It fulfills the re quirements necessary for an epithelial tissue membrane in that it has a superficial layer of epithelial cells and an underlying layer of supportive connective tissue. Serous Membranes Serous membranes are found only on surfaces within closed cavities. Like all epithelial membranes, a serous membrane is composed of two distinct layers of tissue. The connective tissue layer forms a very thin, gluelike basement membrane that holds and sup ports the epithelial cells. The serous membrane that lines body cavities and covers the surfaces of organs in those cavities is in real ity a single, continuous sheet of tissue covering two different surfaces. A, Epithelial membranes, including cutaneous membrane (skin), serous membranes (parietal and visceral pleura and peritoneum), and mucous membranes. Pain is caused by ir ritation and friction as the lungs rub against the walls of the chest cavity. In severe cases the inflamed surfaces of the pleura fuse, and permanent damage may de velop. The term peritonitis is used to describe inflam mation of the serous membranes in the abdominal cavity. Peritonitis is sometimes a serious complication of an infected appendix that has ruptured. Connective Tissue Membranes Unlike cutaneous, serous, and mucous membranes, connective tissue membranes do not contain epithelial components. These membranes are smooth and slick and secrete a thick and colorless lubricating fluid called synovial fluid. The membrane itself, with its synovial fluid, helps re duce friction between the opposing surfaces of bones in movable joints.

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Ideally women's health center pembroke pines buy 0.18mg alesse fast delivery, within an hour of arrival at a hospital, a neurologist could diagnose stroke and deliver therapy. The advantage here of a theranostic agent would be that, as the diagnosis is being established, treatment is already being started, and there is no further loss of time to initiate therapy. The sooner therapy can be administered to the patient, the better is the prognosis. If the nanoparticle encounters fibrin, fibrin will interact with its molecular structure and lead to the degradation of the part of the nanoparticle that in turn frees an antithrombotic agent. The release of an antithrombotic agent can hence specifically target a fibrin clot at its location (a). This would allow a much higher concentration of antithrombotic agent to be delivered because it will only have a local effect. Because this theranostic nanoparticle may have many components, it is possible to engineer multiple therapeutics within a single particle. For instance, a clotting agent could be part of the same agent, allowing safe administration of the same theranostic agent irrespective of the stroke being ischemic or hemorrhagic. An anti-inflammatory agent could also be part of the same agent not only to affect the cause of stroke, but also to prevent the spread of the ischemic cascade. Selective release of anti-inflammatory agents in response to , for instance, the expression of P-selectin could reduce endothelial inflammation (b). This inflammation induces an immune response that will allow macrophages to infiltrate the area of stroke and potentially worsen outcome. In lieu of these factors (or in conjunction with these), contrast agents could be released to indicate whether the patient had suffered an ischemic stroke or a hemorrhagic stroke or whether, for instance, neuroprotective agents are released within the area of infarction. Improving Treatment of Stroke through Nanotechnology 293 the evolution of ever-smarter theranostics is promising. Multilayered nanoparticles could contain multiple potential diagnostic and therapeutic agents (Haglund et al. Although there have been no reported studies on the use of theranostic agents in stroke, preliminary studies on brain tumors are starting to generate important parameters that will define appropriate physiochemical characteristics for these agents. For instance, systemically administered theranostic agents should be sized between 7 and 10 nm so that they would accumulate specifically within the tumor tissue rather than within the vasculature (Sarin 2010). Nevertheless, although this knowledge will be essential to designing environment-responsive agents, very little is known about how these agents interact with molecules within diseased tissues. In stroke, activating a specific diagnostic moiety that is responsive to the presence of fibrin, for example, could lead to the release of an antithrombotic agent. This would control the administration of therapy to only conditions where fibrin clots are present, but keep the theranostic agent inactive in all other conditions, such as intracranial bleeding. Because multiple elements can be bound within one particle, it would also be possible to release anti-inflammatory agents in the same location if inflammatory molecules are present, besides dissolving the clot with an antithrombotic agent. Therefore, theranostic agents potentially afford the opportunity to engineer decision trees (algorithms) based on physiological and pathological markers typically used in patient management. Novel approaches that bundle diagnosis and therapeutics into a theranostic agent are likely to have a major impact on stroke management, but, currently, little research effort is dedicated to this approach. However, even delayed therapeutic applications, such as cell therapy, will benefit from developments in nanotechnology. Imaging magnetic particles offers novel views of developing methods to monitor cells and drug delivery. Multifunctional biomaterials are key to providing greater control over therapeutic interventions, but they will require integration with the complex in vivo biology of stroke. The concerted effort of bioengineers and neuroscientists, as well as neurologists, neurosurgeons, and neuroimagers, is required to usher in this new era of treatment for stroke. Endovascular microcoil gene delivery using immobilized anti-adenovirus antibody for vector tethering. Long-term cross-species brain transplantation of a polymerencapsulated dopamine-secreting cell line. Poly(ethylene glycol) hydrogels formed by thiol-ene photopolymerization for enzyme-responsive protein delivery. Surface functionalization of single superparamagnetic iron oxide nanoparticles for targeted magnetic resonance imaging. Protective effect of post-ischaemic viral delivery of heat shock proteins in vivo. Quantitative evaluation of blood­brain barrier permeability following middle cerebral artery occlusion in rats.

References

• Dempsey, A.R., S.S. Johnson, and C.L. Westhoff, Prediction oral contraceptive continuation using the transtheoretical model of health behavior change. Perspect. Sex Reprod. Health, 2011.
• Berge J, Tourdias T, Moreau JF, et al. Perianeurysmal brain inflammation after flow-diversion treatment. AJNR Am J Neuroradiol 2011;32(10):1930-4.
• Brown KA, Maloney JD, Smith CH, et al: Carotid sinus reflex in patients undergoing coronary angiography: relationship of degree and location of coronary artery disease to response to carotid sinus massage. Circulation 62:697-703, 1980.
• Higuchi TT, Granberg CF, Fox JA, et al: Augmentation cystoplasty and risk of neoplasia: fact, fiction and controversy, J Urol 184(6):2492n2496, 2010.
• Ripley RT, Gajdos C, Reppert AE, et al. Sequential radiofrequency ablation and surgical debulking for unresectable colorectal carcinoma: thermo- surgical ablation. J Surg Oncol 2013;107(2):144-147.