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The ops gradually and eventually causes severe intellectual im- lack of dopamine results in overactivity of the basal nuclei purchase 5 mg haldol with visa, pairment with mood changes and confusion discount 1.5 mg haldol with visa. Memory areas of the brain that control voluntary movement. The loss, especially for recent events, is a common early symp- average age of onset is 55 years. Dangers associated with Alzheimer disease are in- known as parkinsonism, may result from encephalitis or jury, infection, malnutrition, and inhalation of food or flu- other brain diseases, exposure to certain toxins, or re- ids into the lungs. Changes in the brain occur many years peated head injury, as may occur in boxing. These The main therapy for Parkinson disease is administra- changes include the development of amyloid, an abnormal tion of L-dopa, a substance that is capable of entering the protein, and a tangling of neuron fibers that prevents com- brain and converting to dopamine (see Box 10-1). In some tests, herbal extracts of Ginkgo biloba, the cells that can do the missing cells’ job and implanting a de- hormone estrogen, vitamin E, antiinflammatory drugs, vice that electrically stimulates the brain to control symp- and calcium channel blockers (drugs used primarily to toms of Parkinson disease. Drugs also can control some of its physical and behavioral effects. Stress reduction is an ◗ Cranial Nerves important part of patient care. Multi-infarct dementia (de-MEN-she-ah) represents There are 12 pairs of cranial nerves (in this discussion, the accumulation of brain damage resulting from chronic when a cranial nerve is identified, a pair is meant). They ischemia (is-KE-me-ah) (lack of blood supply), such as are numbered, usually in Roman numerals, according to would be caused by a series of small strokes. There is a their connection with the brain, beginning anteriorly and stepwise deterioration of function. Except for the first infarct dementia are troubled by progressive loss of mem- two pairs, all the cranial nerves arise from the brain stem. Many people older The first 9 pairs and the 12th pair supply structures in the than 80 years of age have some evidence of this disorder. THE NERVOUS SYSTEM: THE BRAIN AND CRANIAL NERVES 217 Box 10-3 Hot Topics Psychoactive Drugs: Adjusting Neurotransmitters to Alter MoodPsychoactive Drugs: Adjusting Neurotransmitters to Alter Mood rozac (fluoxetine) and related compounds are among the eralized anxiety disorder. Zyban (bupropion) inhibits reup- Pnewest chemicals used to alter mood.
The fatty acids of the chylomicron triacylglycerols are stored mainly as triacylglycerols in adipose cells quality haldol 10 mg. They are subsequently oxi- Amino acids dized for energy or used in biosynthetic pathways cheap haldol 5mg amex, such as synthesis of membrane lipids. Protein Synthesis of synthesis nitrogen-containing compounds Oxidation Energy Fats THE WAITING ROOM Storage Oxidation TAG Energy Ivan Applebod returned to his doctor for a second visit. His initial efforts to lose weight had failed dismally. In fact, he now weighed 270 Synthesis lb, an increase of 6 lb since his first visit 2 months ago (see Chapter 1). Membrane lipids He reported that the recent death of his 45-year-old brother of a heart attack had Fig. Because 22 CHAPTER 2 / THE FED OR ABSORPTIVE STATE 23 Mr. Applebod’s brother had a history of hypercholesterolemia and because Mr. The body can make fatty acids Applebod’s serum total cholesterol had been significantly elevated (296 mg/dL) from a caloric excess of carbohy- at his first visit, his blood lipid profile was determined, his blood glucose level drate and protein. These fatty acids, together with the fatty acids of chy- was measured, and a number of other blood tests were ordered. Thus, Ivan Applebod’s increased adi- systolic and 98 mm Hg diastolic or 162/98 mm Hg (normal 140/90 mm Hg or pose tissue is coming from his intake of all less). His waist circumference was 48 inches (healthy values for men, less than fuels in excess of his caloric need. DIGESTION AND ABSORPTION After a meal is consumed, foods are digested (broken down into simpler compo- nents) by a series of enzymes in the mouth, stomach, and small intestine. The prod- ucts of digestion eventually are absorbed into the blood. The period during which digestion and absorption occur constitutes the fed state (Fig.
Oxidation of Ketone Bodies as Fuels acetoacetate CoA transferase Succinate Acetoacetate and -hydroxybutyrate can be oxidized as fuels in most tissues discount 1.5mg haldol with mastercard, including skeletal muscle generic 1.5mg haldol overnight delivery, brain, certain cells of the kidney, and cells of the intes- O O tinal mucosa. Cells transport both acetoacetate and -hydroxybutyrate from the cir- CH C CH C 3 2 culating blood into the cytosol, and into the mitochondrial matrix. Here -hydrox- SCoA ybutyrate is oxidized back to acetoacetate by -hydroxybutyrate dehydrogenase. Subsequent steps convert acetoacetate to acetyl CoA (Fig. CoASH In mitochondria, acetoacetate is activated to acetoacetyl CoA by succinyl thiolase CoA:acetoacetate CoA transferase. As the name suggests, CoA is transferred from succinyl CoA, a TCA cycle intermediate, to acetoacetate. Although the liver pro- duces ketone bodies, it does not use them, because this thiotransferase enzyme is O O CH3 + CH3 not present in sufficient quantity. SCoA SCoA Acetoacetyl CoA is cleaved to two molecules of acetyl CoA by acetoacetyl CoA thiolase, the same enzyme involved in -oxidation. The principal fate of this acetyl 2 Acetyl CoA CoA is oxidation in the TCA cycle. The energy of activation is calculated at one high-energy phos- from succinyl CoA. Acetoacetyl CoA is phate bond, because succinyl CoA is normally converted to succinate in the TCA cycle, cleaved to two acetyl CoA, which enter the with generation of one molecule of GTP (the energy equivalent of ATP). Oxidation of -hydroxybu- tyrate generates one additional NADH. Therefore the net energy yield from one mole- cule of -hydroxybutyrate is approximately 21. Ketogenic diets, which are high-fat diets with a 3:1 ratio of lipid to car- C. Alternate Pathways of Ketone Body Metabolism bohydrate, are being used to Although fatty acid oxidation is usually the major source of ketone bodies, they also reduce the frequency of epileptic seizures in can be generated from the catabolism of certain amino acids: leucine, isoleucine, children.