s*******1
发帖数: 428 | 1 My guess is :D
The question is asking for the causes of this patient's current symptoms.
For my understanding, the current symptoms are 1. epigastric pain; 2. foul-
smelling stool.
So, 1. Epigastric pain is caused by chronic pancreatitis.
2. Foul-smelling stool is caused by lack of pancreatic enzyme.
Fecal elastase from wiki:
Chymotrypsin-like elastase family member 3B also known as elastase-3B,
protease E, or fecal elastase is an enzyme that in humans is encoded by the
CELA3B gene.[1][2]... 阅读全帖 |
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M********s
发帖数: 104 | 2 以前网上淘到的一个,
College of _____
Department of __________
XXX ____ Avenue, 7th Floor
(city), (State) (zip) (推荐人地址)
August 12, 2007
U.S. Citizenship & Immigration Services
Nebraska Service Center
850 “S” Street Lincoln, NE 68508
Re: Dr. ____ ___ (your full name)
Dear Sir/Madam,
I strongly support the National Interest Waiver application for ______ ___,
M.D, Ph.D.. Dr. ___ is an extraordinary young scientist who is making
significant contributions to our understanding of ... 阅读全帖 |
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V*****G
发帖数: 337 | 3 Nice to see the lab.
Majority consistent to GI loss (malnutrition/malabsorption)
Edema is due to hypoalbumin and low protein. Originally lower extremity edema was thought to be due to systemic involvement. But when I saw "4+ pitting edema up to low back" on PE on day 2, I knew it could be due to low protein level. I appreciate the good PE you did. :)
Hypokalemia is most likely due to GI loss too.
Other lab abnormalities suggested:
Group 1: Low VitD, low phosphate, low calcium = Vit D deficienc... 阅读全帖 |
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e*****i
发帖数: 993 | 4 好感谢！！！看来遇到行家了！！！
我还有一些问题想请教：
1）emphysema和chronic bronchitis的病因是不是不一样呢？我感觉emphysema源于
endogenous antiprotease的缺乏,导致elastin被elastase分解,进而导致alveoli的弹
性被破坏；而chronic bronchitis是由于支气管壁发炎，出现mucus所导致咳嗽。不知
道我的理解对不对？
2）都说吸烟是导致COPD的主要原因，因为吸烟可以导致：1> oxidants/antioxidants
imbalance;2>apoptosis;3>chronic inflammation;4>protease/antiprotease
imbalance.请问这四者是相互关联,互为因果的吗?一个chronic bronchitis患者很有可
能患emphysema吗?
我是外行,如果问题很幼稚,请见谅.
再次感谢!!!!
it'
from |
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z*******6
发帖数: 679 | 5 这只是我粗浅的感慨而已...
不知道你了解NET吗？简单说一下，就是neutrophil（也有其他细胞被报道）在收到各
种刺激，细菌病毒，ROS什么的，就会经过一些列酶解的过程释放自己的DNA和histone
到体外，然后形成一个很大的trap，这里同时有high concentration的各种杀菌酶，比
如neutrophil elastase，MPO等等，然后可以将细菌真菌trap同时杀死... 在这个过程
中，出了那些酶类，其实histone fragments本身就具有很强的杀菌能力，号称把
histone fragments（不是whole histone）加到简单的saline之类的buffer里面，细菌
就会被杀死...
这些就是让我感叹neutrophil像最前线的战士一样，尽自己最大的努力阻止外界各种
microbe，最后死的时候还会爆发一下小宇宙，发出histone fragments和NET这种厉害
的武器...
PS 昨天那个review看的真的很不淡定，感叹host和microbe互相竞争同时促进进化...
各种细菌也进化出对付NET的方法，比如说有的就可以... 阅读全帖 |
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a*********f
发帖数: 101 | 6 病人的表现是ecthyma gangreosum,这是应该是由 elastase LasA and LasB 导致的，
不是exotoxin A。但目答案是 Diphtheria toxin.
PS:哪位知道如何从图片中直接提取文字？截屏，改格式，再传图片挺麻烦的。如果能
直接提取文字，粘贴过来，就方便多了。 |
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a*********f
发帖数: 101 | 7 绿脓对白喉是没错，都抑制elongation factor 2。
但是绿脓还有elastase，导致ecthyma gangrenosum.
Cat的观点是对的，不过我感觉这道题有点玩文字游戏。
关于从图像中提取文字：
1.直接用adobe acrobat打开图片，然后用ocr。
2.免费网站 http://www.free-ocr.com/，直接上传图片就行了。 |
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x****n
发帖数: 893 | 8 2. A 56-year-old man with alcoholism comes to the physician because of a 2-
month history of increasingly severe stomach pain and increased volumes
offoul-smelling
stool; he also has had a 9-kg (20..Jb) weight loss during this period. He
has a history of multiple visits to the emergency department because of
severe abdominal pain.
He has consumed one bottle of red wine daily for 5 years. His temperature is
37"C (98.6"F). Physical examination shows epigastric tendemess. His fasting
serum
glucose ... 阅读全帖 |
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g*******n
发帖数: 91 | 9 Could be C. Foul-smelling stool means fat malabsorption. In this case,it
might be more related to pancreatic lipase inactivation and bile acid
precipiation, rather than proteases, like elastase. In alcoholic chronic
pancreatitis suggested by pancreatic calcifications, lipase is often
inactivated by very low intraduodenal pH. Bile acid is also precipitated due
to very low intraduodenal pH (often less than 4). |
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e*****i
发帖数: 993 | 10 我最近发现了COPD和Rheumatoid arthritis都和elastin有关(COPD-elastase,RA-MMP-
12)；
而elastin也存在于intervertebral disc，我在想，COPD,RA和Slipped Disc是不是也
有关系呢？比如说都是antiprotease的缺乏？
有没有研究med chem的前辈知道呢？谢谢！ |
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