It started as a joke. Happenstance maybe. Saizo, my chief security officer dropped his pair in my office. God knows how or why. Maybe they were meant as a signal for Yukimura and I was the mistaken recipient. The thought came much later in my mind. I unconsciously slipped the handcuffs in my pocket at the time.
And now she found them as I embraced her.
I tried to laugh it off. Telling her how I came across them. I turned around to look at her after hanging up my coat, the hand cuffs still dangling from her fingers. She had a speculative gleam in her eyes. Oho, was my kitten ready? She had come to me untouched and unsullied, and I exercised as much restraint as was possible by a man of as impatient a temperament as I. But if she was ready I would gladly introduce her to the world of bondage.
I chuckled inwardly. We did not need a paltry pair of steal cuffs. Diamond encrusted gold as befitted my Queen. If she so desired. I kept watching her closely. Gauging her body language and responses. Judging her instinctively.
Was she ready?
I put my hands on her shoulder and she turned around. I raised an eyebrow and she smiled. “I suppose you are no stranger to recreational restraining?” she asked sweetly.
I laughed out loud. “I adore your elegant turn of phrase, love. Would you like to be introduced to the world of recreational restraining?”
She blushed immediately, becoming shy and turning away. Just as I was enjoying the look of innocent embarrassment on her face she turned around and gave me a defiant look and said, “Maybe.”
Oho, the kitten was growing up.
I moved forward to grasp her chin in my hand when I caught sight of a troubled look in her eyes. “What is it, love?”
She turned away and said in a small voice. “I would not like to appear lacking in expertise in any area of interest to you.”
Oh, how clinical! What a very clinically expressed adorable sentiment. I found myself falling for my little scientist all over again. Battling with my incurable disease. She was working so hard to find a cure for me, and at the same time, keeping me alive with her bone marrow cells since she was a perfect match for me. In more ways than one. My little scientist. I had refused her help in the form of her blood cells, but she had forced my hand and made me agree. No less than a feat since no one, and I repeat no one, made Takeda Shingen do anything I did not desire.
No one but her. I am a fool when it comes to her and in my folly I am afraid I rather worship her. She bit her lips, uncertainty and nervousness colouring her face, a look not befitting of my beloved. I smoothed the frown away from her brow.
“You are not lacking in any department of my interest. You are all my areas of interest,” I said, my words meant as a caress as my hands touched all of her her adoringly.
I picked her up easily, took us to the bedroom and proceeded to show her my very much invested interest in all her departments. We kissed breathlessly and she smiled, but I did not stop to ask her what made her do so. I loved kissing her smiling lips, loved knowing that I put that smile there. I could identify the types of her smiles just by the quirk of her lips next to mine.
And that’s when I knew a second too late of mischief afoot. I was so drowned in the happiness her smile brought me I failed to recognise the mischievous quirk of her lips followed by a click and the feeling of restraints on my wrists. How in heavens did those wrist cuffs get here? I growled and moved to dislodge her from my lap but she bit my lips. I growled again and she sucked them to placate me. I pretended to be unmoved.
“Open them,” I said as soon as she released my lip. My voice level, calm, distant, a trifle frosty.
Lesser men and women have cowered before that glacial look of mine. Lesser men, I snorted inwardly. She sat back on her hunches hands on my shoulders and looked at me speculatively, mischievously, cocking her head to the side she slightly shook her head, biting her plump lower lip.
“Open them right now.” I put every bit of intimidation I could muster. Well as much intimidation a naked man with a beautiful woman on his lap sitting directly on a raging hard with hands cuffed to the bed board could muster.
I have never been ashamed of my body or any bodily functions. I do not believe in using the body to attain pleasure as sin. Sin meant guilt. And I find no guilt in pleasure.When it comes to her it is pleasure mixed with boundless joy. Complete and utter bliss. Why would I mar these moments of benediction with feelings of sin or guilt? It is a concept completely alien to me.
My mind returned to the question at hand: the inelegant rough steal handcuffs retraining my wrists. I looked at my kitten again and said remove them, but she only threw her head back and laughed teasingly. She looked like a child drunk on mischief enjoying herself tremendously. Who was I to rob her of any joy? I could not keep the sternness in my voice and she knew she had me as she laughed again, her eyes alight with a mixture of pure joy, mischief and affection.
Caught you. I caught the tiger, I read her heart say.
Yes you did, my heart answered.
She must have noticed the shift in expression. This was the first time I found myself in such a position. I had never allowed any one to restrain me before. I don’t enjoy it. Sex was about giving. A man’s duty was to give and fulfil his partner and himself. I was at the giving end. In that I found pleasure.
Until I found her.
For the first time with her I was at the receiving end of physical and emotional intimacy, love, care, joy and laughter. I felt indulged by her. I felt unworthy of her indulgence. This innocent sprite of a girl, a feisty flower child, would fare much better with a man less battered than I. Yet she won me over and I couldn’t let her go. I looked at her trying to assess if she was enjoying this apparent dominance over me. In my mind this was what restraining meant. Taking away the power of pleasure in your hands; leaving the restrainee at the others’ mercy. Instead what I found in her face was pure joy, love and happiness. Not an ounce of pride at being able to control me.
I was stumped. I was baffled.
Once again she made me realize my limitations as a man. My narrow horizon when it came to intimacy. This was not about control. This was never about control. At least not the way I thought. She leaned in, the curtain of her thick hair falling on my face. I inhaled the intoxicating fragrance of her. Her hand ran slowly over every inch of my body. I could see her eyes focused intensely on me, cataloguing my responses, mapping me like a cartographer taking note of the goose bumps and hair raised on its end.
“I like the hair on your forearms,” she remarked offhandedly, and bent down to press a chaste kiss there. It was so like her. So so like her.
I am used to being praised for different parts of my anatomy. But never the hair on my forearms. I huffed out a laugh. Her eyes followed her hands as her fingers moved across my chest to my neck. She dipped her head to nuzzle into my neck and lick at the outer shell of my ear, nipping at my neck. I hummed approvingly. She brought her cheek next to mine and slowly nuzzled again. The silken feel of her skin against my roughened stubbled face was such an exquisite contrast. In my heightened state of sensual awareness I shuddered, groaning as an answering moan came from her.
“My patience is limited kitten,” I purred.
She looked at me more seriously. “Tell me what you want me to do to you?” she asked, her voice exquisitely tender and I stared at her open mouthed and shocked. She kissed my neck and whispered in my ear, “Let me pleasure you, darling.”
The last vestiges of sanity ripped from me. The cuffs rattled as I tried to free my hands. But then I stopped completely. This was never about control or dominance. It was just her innocent desire to pleasure me, slow me down, since I was a man with little patience and finesse. I let my instinct govern me.
“Do whatever you want,” I replied in a quiet noncommittal voice. She quirked an eyebrow. Was she losing confidence? Oh no, that was not allowed. She was my queen. Such an expression did not befit her. I smiled up at her. “Do what pleases you. Let’s see how it pleases me”.
A previously absent predatory gleam entered her eyes. She proceeded to spoil me with her touch, her fingers and her lips.
I loved it.
The simple act of being touched by the one I love was an exquisitely erotic act to me. No fancy toys, no props. Just touch. I could feel her love, her affection, mingled with her arousal and it aroused me to no end. This act of giving and receiving of touch.We kissed over and over again, sharing the very air we breathe, our sweat mingled as our hearts beat in tandem. She brought her head up and I growled.
“Enough fun, little one, I have let you amuse yourself.” She was not the shy kitten or the smiling girl intent upon slowing me down anymore. I understood now why she did it. She wished to slow me down so that I would take my time enjoying each other’s touch. As loath as I was to admit it, I loved this lesson in restraint. But I was at my ropes end and getting feral by the moment.
I had always let instinct govern me. Never had I allowed myself to slow down and smell the roses in the garden. I laughed inwardly at this out of place analogy. She looked so different; the air around her shifted and she appeared at once regal and proud. A primal confidence cloaked her, the feral look in my eyes reflected in hers.
“Release me,” I roared.
“No,” she said. To drive her point home she ground on my hardness.
Lesser men would have backed down in front of this new avatar of her.
I was entranced by her beauty. We were slow dancing in a burning room. Fire filled my lungs. We were both gasping for breath as we attacked eachothers lips, feral growls and moans punctuated our fevered embrace.
“Unlock them,” I snapped.
“No,” she answered in equally feral tones. She threaded her fingers through my hair and tugged it none too gently.
At last she has taken control. My kitten had grown and claimed her throne. I marvelled at her transition . In the recesses of my mind I mused that I would not mind it if she would restrain me further, pull my hair and ride me to oblivion then and there. I would welcome her dominance. Of course, she would have to repay in kind later.
“Release me right now!!” I commanded.She tugged at my hair again “ What did you say to me?” She said matching glare for glare.I changed tactics and smiled at her tenderly. “Open them, my love”. No one was more surprised at my gentle tone. It was a soft voice she drew from me, laced with the warmth of my tenderness and laughter. I wanted to throw her off and see what she would do now, how this would play out how would this shift the balance of power resting precariously between us. A dark part of my brain ironically questioned my manly ego at still being fixated on power when this was about so much else.
Old habits died hard.
She would have to put me through my paces again and again before I learned of joy without power. She quirked her head and looked at me, undeterred by this unexpected curveball and then smiled, trailing her hand from my thighs up to my neck. My muscles clenched reflexively and thrummed with tension under her touch.
“If you want them undone, break them,” she said evenly. I look at her, startled. Her eyes were wild with my feral gleam reflecting in them. Her lips were swollen, face flushed, eyes heavy lidded with a heady mixture of love and lust, her hair a glorious main framing her delicate elfine features. She brought her face close to mine and whispered, “If you want them gone break them. Break those chains and take me. All of me. Take me apart.”
Once again the tables turned on me spectacularly. I growled and saw nothing but red. My mind was on fire. The paltry cuffs broke and lay on the mattress unheeded by either of us. In a moment I flipped her and took her without mercy or restraint. But she did not hold anything back either. We bit, scratched, screamed, and came together again and again. It was a beautiful wild, glorious mess and it drove us both to the edge of sanity.
Later, much later, as we lay wrapped up in each other’s arms, languid, sated happy, she looked up at me, chin on my chest.
“What are you cooking up now?” I flicked her forehead. “I knew you were always trouble.”
She laughed, shaking her head. She tossed her head,her glorious mane of sun kissed hair cascading down her back. She was a bewitching vision to behold. Since when had laughter become a regular part of my intimate life? I marvelled at the new things she introduced to me.
I joined in her laughter and leaned in to kiss her kiss swollen cherry lips.
A simple guide to CRISPR, one of the biggest science stories of 2016
If you haven’t heard of CRISPR yet, the short explanation goes like this: In the past four years, scientists have figured out how to exploit a quirk in the immune systems of bacteria to edit genes in other organisms — plant genes, mouse genes, even human genes. With CRISPR, they can now make these edits quickly and cheaply, in days rather than weeks or months. In 2016 alone, researchers have shown CRISPR can do some truly astounding things, like create mushrooms that don’t brown easily or edit bone marrow cells in mice to treat sickle-cell anemia. Read more
Hello! I’m Hanna and right now I really need your help. Please reblog this pst if you can.
Some of You may now I’ve been diagnosed with anemia in early 2000′s when I was in my early teens. I have been dealing with it since then. For first years I pretty much ignored it . I used to go from time to time to get blood transfusions but that was all.
Now it all changed this year. Sometime in January when I was at work I started to bleeding from my nose. I couldn’t stop it. Then I felt dizzy and blacked out. After hospitalization, blood transfusion and test I’ve been told to go home. I got next apointment with the doctor on and next tests. After some tests later doctor told me to take a bone marrow biopsy. After results I got diagnosed with Aplastic Anemia: is a blood disorder in which the body’s bone marrow doesn’t make enough new blood cells. Bone marrow is a sponge-like tissue inside the bones. It makes stem cells that develop into red blood cells, white blood cells, and platelets .Red blood cells carry oxygen to all parts of your body. They also carry carbon dioxide (a waste product) to your lungs to be exhaled. White blood cells help your body fight infections. Platelets are blood cell fragments that stick together to seal small cuts or breaks on blood vessel walls and stop bleeding.It’s normal for blood cells to die. The lifespan of red blood cells is about 120 days. White blood cells live less than a day. Platelets live about 6 days. As a result, your bone marrow must constantly make new blood cells.If your bone marrow can’t make enough new blood cells, many health problems can occur. These problems include irregular heartbeats called arrhythmias ), an enlarged heart, heart failure, infections, and bleeding. Severe aplastic anemia can even cause death.
The best cure for me would be a bone marrow transplant. Right now I can’t afford it. So far I managed to save money is around 1500 euro and there is no way I can pay for trasplantation,treatment and home expenses since.
I am trying to save money for a hospital treatment, but since I live alone and work so it is impossible for me to save enough money that fast. I don’t like asking for help, but right now I don’t have much of a choice. The money raised would all go for medical bills and living expenses . I would really appreciate any amount would help! Thank you everyone!
The dark soft languages are being silenced: Mothertongue Mothertongue Mothertongue falling one by one back into the moon. Language of marshes, language of the roots of rushes tangled together in the ooze, marrow cells twinning themselves inside the warm core of the bone: pathways of hidden light in the body fade and wink out.
The sibilants and gutturals, the cave language, the half-light forming at the back of the throat, the mouths damp velvet moulding the lost syllable for “I” that did not mean separate, all are becoming sounds no longer heard because no longer spoken, and everything that could once be said in them has ceased to exist.
Margaret Atwood, from “Marsh Languages,” Morning in the Burned House (Houghton Mifflin, 1995)
The dark soft languages are being silenced: Mothertongue Mothertongue Mothertongue falling one by one back into the moon.
Languages of marshes, language of the roots of rushes tangled together in the ooze, marrow cells twinning themselves inside the warm core of the bone: pathways of hidden light in the body fade and wink out.
The sibilants and gutturals, the cave languages, the half-light forming at the back of the throat, the mouth’s damp velvet moulding the lost syllable for ‘I’ that did not mean separate, all are becoming sounds no longer heard because no longer spoken, and everything that could once be said in them has ceased to exist.
The languages of the dying suns are themselves dying, but even the word for this has been forgotten. The mouth against skin, vivid and fading, can no longer speak both cherishing and farewell. It is now only a mouth, only skin. There is no more longing.
Translation was never possible. Instead there was always only conquest, the influx of the language of hard nouns, the language of metal, the language of either/or, the one language that has eaten all others.
What hasn’t happened: completely unpacking our apartment, our cats getting along, SLEEP, feeling like I have a handle on our new routine/life, my tax refund, getting out of work at a reasonable hour, my sister going home from the hospital.
What has: Many trips out to Long Island. They tested me and I’m a complete DNA match for my sister. They’ve done 3 rounds of aggressive chemo. Her hair is gone, she’s nauseous, and skinny, and in pain. But they think they killed all the leukemia cells. Her bone marrow was biopsied again today, and we will know more within a day or two. It looks like my sister’s bone marrow stem cell transplant will be sometime between the end of May and June. I’ve freaked myself all the way out by reading accounts of donor experiences, and I will be happy to get it all over with and for my sister to be well again.
And then, when this is all over, I am taking myself on a huge vacation. One of my dearest friends moved to France last year before settling in London a handful of months ago. I’m going to visit her and rent a fancy flat and see what it’s like to live among Londoners for a few days.
Do I know anyone who’s flown on Norwegian Air? It seems like the international version of Spirit airlines, i.e. choosing your seat or bringing any luggage beyond a small personal item costs extra. There are roundtrip flights from NYC to London for less than $700, though, so it might be a good option, especially since they flights I looked at are overnight and I wouldn’t be awake to experience any bells and whistles. I have to research is some more to see if it makes more sense to fly a different airline that costs more upfront but allows, you know, luggage.
Hey rosy I'm a bit confused about the whole nightblood thing. Is Clarke now a nightblood, like "permanently' and if she is, why didn't she become one from the moment she received Ontari's blood transfusion ?
Ontari’s blood just ran through Clarke’s system. Blood does not reproduce more blood. Red blood cells are created WITHIN bone marrow. Bone marrow is how you get new blood. The transfusion was not permanent.
When she received the bone marrow injection, apparently, the cells which CREATE the nightblood cells were introduced into her body. I do not think this is the way a bone marrow transplant actually works, but this is kind of a science fantasy and it does not fit real world rules. It does fit the rules they have created within their world, so I let it slide. They would probably have to do it in a much more painful and slow process with a bone marrow transplant. But like I said, science fantasy and there’s some handwaving so they can tell their story, which is about speculation, wonder, horror, humanity, morality and transformation, rather than about actual science.
It does seem as if the nightblood marrow injection took and she is now permanently a nightblood, as in her body is creating new nightblood the way the original recipients of Becca’s serum did.
Alright tumblr, I’ll be honest - I wasn’t expecting the number of notes or replies about skeleton blood, but I’ve gotten a whole lot of responses… and I appreciate all of them, serious or otherwise. I think it’s only fair I respond to your ideas! This is long, so look under the cut for the idea that it’s bone marrow, magic, the sword, or Todd Howard’s fault … if you dare!
The color of a crystal is one of the easier ways of identifying the right crystal for specific healing, personal empowerment, or protection purposes. If a color is “hot” like red – associated with life blood and fire – its action will be dynamic, fast, and go straight to the root of a problem. In contrast, a green crystal represents gradual growth and nature, linked to a slow but continuing increase in any area of life. The shade of a crystal can also offer clues: a sparkling transparent clear quartz crystal, reflecting sunlight, has different energies and vibrations than a cloudier shimmering white selenite that resembles moonlight.
The power of a crystal can be enhanced by placing it near a burning candle of a similar color. It could be beneficial to build up a collection of crystals in different shades and intensities of brightness in the same color, such as soothing transparent purple amethyst and brighter opaque sugilite that is still gentle but faster acting. Feel free to try using “antidote” colors as well; for example, draw on the power of a blue crystal if someone is very angry or a situation is too fast moving.
The following are “traditional” color association for crystals and their uses. These correspondences should be used as suggestions or ideas, and are by no means concrete or absolute; personal associations within magic are generally more powerful, though these correspondences are a good base to gain inspiration or work from.
Disclaimer: This information should not be used as a substitute for medical treatment or advice, or as a means of diagnosis. If you have - or suspect you may have - a medical condition, please consult a healthcare professional immediately. The home remedies included here should not be used to diagnose, treat, prevent, or cure any illness.
* Some of the “healing powers” sections mention specific body parts and ailments that may be triggering for some parties, so please be wary reading through.
What do geneticists think will be possible when the the new gene-splicing CRISPR is fully operational on patients?
For those of us unfamiliar, CRISPR is a revolutionary new genetic splicing technology. Gene splicing refers to modifications to a gene transcript that can result in different proteins being made from a single gene. Interestingly, CRISPR’s inception began when dairy scientists discovered that bacteria used to create yogurt (by transforming lactose into lactic acid) had incorporated snippets of benign viruses into its genome. To their surprise, the incorporated DNA would create toxic agents to thwart infective viruses. In 2007, dairy scientists realized that they could effectively fortify bacteria by adding spacer DNA, which does not code for any protein sequence, from a virus. Then, five years later, as Time Magazine writer Alice Park skilfully describes, professors Jennifer Doudna and Emanuelle Charpentier noticed “up to 40% of bacteria developed a particular genetic pattern in their genomes. What they found were sequences of genes immediately followed by the same sequence in reverse, known as palindromic sequences. Further, bits of random DNA bases cropped up after each such pairing and right before the next one. After the dairy bacteria transcribed its spacer DNA and palindromic sequence into RNA, it self-spliced those segments into shorter fragments, with an enzyme called CAS9”. As you may be wondering, CRISPR stands for “clustered regularly interspaced short palindromic repeats”.
It is important for us to emphasize the versatility of this method. In the 2007 article, Doudna and Charpentier go into depth regarding the many benefits of the new genetic technology. These include the potential to “systematically analyze gene functions in mammalian cells, study genomic rearrangements and the progression of cancers or other diseases, and potentially correct genetic mutations responsible for inherited disorders”. As you might imagine, this opens up possibilities that were previously science fiction. Currently, painful blood transfusions are commonplace in the treatment of many diseases such as sickle cell anemia. Sickle cell affects red blood cells, which are made by stem cells in bone marrow. Soon, Massachusetts Institute of Technology synthetic biologist Feng Zhang envisions that this will soon no longer be necessary. She predicts that after doctors extract some of the marrow, scientists will splice out the defective fragment of DNA using CRISPR from the removed stem cells, then bathe the cells in a solution containing the non-sickle-cell sequence. As the DNA repairs itself naturally, it picks up the correct sequence and incorporates it into the stem cell genomes. After this one-time procedure, the stem cells would give rise to more red blood cells with the healthy gene. Eventually, the blood system would be repopulated with normal cells.
The treatment of HIV using CRISPR would be very similar. In this potential treatment, “patients would provide a sample of blood stem cells from their bone marrow, which would be treated with CRISPR to remove the CCR5 gene, and these cells would be transplanted back to the patient. Since the bone marrow stem cells populate the entire blood and immune system, the patient would eventually have blood cells that were protected, or “immunized,” against HIV”.
Despite this extraordinary potential, no biological technology comes without serious ethical concerns. As Jennifer Douda says herself, CRISPR “really requires us to careful thought to how we employ such a tool: What are we trying to do with it, what are the appropriate applications, how can we use it safely?”
Check out her book The Stem Cell Hope for learning about the future of stem cell technology.
Sources: Park, Alice. “A New Gene-Splicing Technique.” 100 New Scientific Discoveries: Fascinating, Unbelievable and Mind-expanding Stories. New York, NY: TIME, 2014. 92-95. Print.
Park, Alice. “It May Be Possible To Prevent HIV Even Without a Vaccine.” Time. Time, 6 Nov. 2014. Web.
Doudna, Jennifer A., and Charpentier, Emmanuelle (2014). The new frontier of genome engineering with CRISPR-Cas9. Science, 346(6213), 1258096–1258096. doi:10.1126/science.1258096
Answered by: Teodora S., Expert Leader and Expert John M.
serum sickness is a type 3 HSR characterized by deposition of circulation complement fixing immune complexes and resulting vasculitis. Associated findings include fever, urticaria, arthralgias, glomerulonephritis, lymphadenopathy and a low serum c3 level 5-10 days after intravascular exposure to antigen. type 3 HSR typically activate complement at local site where immune complexes containing IgG and or IgM complement fixing antibodies have been deposited. This often results in hypocomplementemia including decreased C3 level
liver dz-a/w AFP
carcinoembryonic antigen (CEA) a/w colorectal cancer
CA125 -ovarian cancer. Both CEA and ca125 are fr monitoring purposes
PSA prostate specific antigen is most useful in establishing extent of prostate cancer and evaluating response to prostate cancer tx.
Iced water think cold – cold think cold agglutinins – cold agglutinin associated with infection with mycoplasma pneumonia
another cold agglutinin is EBV
free air in peritoneal cavity= bowel perforation
pancreatic calcification= chronic pancreatitis
heavily calcified vessels = atherosclerosis and vascular dz
distended bladder= urinary retention
air in billiary tract a/w gallstone ileus
fluoxetine a/w anorgasmia and decreased libido and increase latency to orgasm. They can however be used to tx premature ejaculation
phenelzine= MAO-I used in tx of depression monoamine oxidase is a mitochondrial enzyme that deaminates primary and secondary aromatic amines
tricyclic antidepressants can cause orthostatic hypotension example imipramine
paroxysmal breathlessness and wheezing in young patient unrelated to ingestion of aspirin, pulmonary infection inhaled irritant stress and or exercise should raise a strong suspicion for extrinsic allergic asthma. The granule containing cells in sputum are most likely eosinophils and the crystalloid bodies are most likely Charcot Leyden crystals (contain eosinophil membrane protein)
chronic eosinophilic bronchitis in asthmatics involves bronchial wall infiltration by numerous activated eosinophils largely in response to IL5 released by TH2 cells
digestion and absorption of nutrients primarily occurs in small intestine. SI cells produce enzymes responsible for nutrient absorption. Proteins in ingested food exist primarily as polypeptides and require hydrolysis to dipeptides tripeptides and amino acid for absorption. Hydrolysis of these polypeptides is accomplished by proteolytic enzymes such as pepsin and trypsin
these enzymes are secreted inactive proenzymes trypsinogen and pepsinogen from stomach and pancreas
trypsin activates other proteolytics enzymes including chymotrypsin carboxypeptidase and elastase. Activation of trypsinogen to trypsin is achieved by enteropeptidase (or enterokinase)an enzyme produced in duodenum
enteropeptidase deficiency results in defective conversion of trypsinogen to active trypsin
lipase secreted from exocrine pancreas is the most important enzyme of digestion of triglycerides. Chronc pancreatitis is a painful condition that causes lipase deficiency. This leads to poor fat absorption and steatorrhea
secretin is a peptide hormone secreted by S cells of duodenum un response to low duodenal pH. Secretins timulates secretion of bicarbonate from the pancreas and gall bladder and reduces acid secretion in the stomach by reducing production of gastrin. Neutralizing the acidic pH of food entering the duodenum from the stomachis necessary for proper function of pancreatic enzymes (amylase, lipase)
trisomy 18 (47XX: Edwards syndrome
face: micrognathia, microstomia, eye defects (microphthalmis, cataracts) low set ears and malformed ears prominent occiput
CNS: microcephaly, neural tube defects (meningocele, anencephaly), holoprosencephaly, arnold chiri malformation, severe MR delayed psychomotor development
musculoskeletal: clenched hands with overlapping fingers (index finger overrides the middle fingerand fifth finger overrides the fourth finger) rocker bottom feet short sternum and hypertonia
cardiac: VSD, PDA
distinguishing features: clenched hands and or overlapping finger
GI: Meckel diverticulum, malrotation
ultrasound: intrauterine growth restriction and polyhydramnios especially ina fetus with abnormal hand arrangement
unlike patients with Edward’s syndrome neonates with Patau syndrome (trisomy 13) have cleft lip and palate, polydactyly and omphalocele. Patau syndrome is not a/w low set ears and overlapping fingers but do present with rocker bottom feet also
47XXX karyotype is clinically silent however, some affected women have slightly decreased IQ scores. Female newborns with this karyotype are phenotypically normal with no obvious dysmorphism
47XXY Kleinfelter’s syndrome: may be a/w mild mental retardation or normal intelligence. The typical patient is tall mall adult with gynecomastia small testes and infertility. Male newborns with this karyotype are phenotypically normal with no obvious dysmorphism. The clinical findings do not become apparent until adulthood.
Sudden onset of abdominal or flank pain hematuria and left sided varicocele together suggests renal vein thrombosis a well known complication of nephrotic syndrome. Nephrotic syndrome is a hypercoagulable state d/t increased loss of anticoagulant factors especially anti thrombinIII (responsible for the thrombotic and thromboembolic complications of nephrotic syndrome)
venous drainage from left testes travels throught the left testicular vein into the left renal vein and from there the IVC. In contrast to the right testicular vein which empties directly into the IVC. This difference in venous drinage gives diagnostic significance to left sided varicocele in that it often indicates an occlusion of the left renal vein by a malignant tumour or thrombus
malaise low grade fever followed by a facial rash. Feels better now but still has the rash- red flushed cheeks with – clinical presentation of erythema infectiosum aka fifth dz. As the facial rash fades an erythematous rash in reticular lace like pattern often appears on trunk and extremities. The rash of erythema infectiosum is thought to result at lest partly from local immune complex deposition once serum levels of virus specific IgM and IgG have attained high enough levels.
Erythema infectiosum= non enveloped DNA virus called parvo B19. The blood group P antigen globoside is a parvovirus B19 is highly tropic for erythrocyte precursors particularly erythrocytes and erythroid progenitor cells
Parvo B19 replicates predominantly in the bone marrow
anthracyclines daunorubicin doxorubicin epirubicin and idarubicin are chemotherapeutic agents a/w severe cardiotoxicity because of their unique ability to generate free radicals.. Dilated cardiomyopathy is dose dependent and may present months after discontinuation of the drug . Swelling of sarcoplasmic reticulum is the morphologic sign of early stage doxorubicin associated cardiomyopathy. Followed by loss of cardiomyocytes and its symptoms are those of biventricular CHF including dyspnea on exertion orthopnea and peripheral edema
dexrazoxane prevents Doxorubicin associated cardiomyopathy because dex is a iron chelating agent that decreases formation of free radicals by anthracyclines.
LSD can also cause aggressive behaviour but it is more typically characterized by affective liability thought disruption )delusion) and visual hallucination whereas PCP produces more psychomotor agitation including clonic jerking of extremities
angel dust can be put on marijuana and smoked LD is ingested orally
secobarbital is a street barbiturate a CNS depressant which leads to drowsy drunken state of consciousness without the violent behaviour
heroin (opioid) produces CNS psychomotor depression and respiratory depression miosis and bradycardia are common
dry tap with no splenomegaly or lymphadenopathy – think aplastic anemia which causes pancytopenia
aplastic anemia= hypo cellular bone marrow with fat cells and fibrotic stroma
hyper cellular marrow with increased blasts found in myeloproliferative d/o and certain leukemias
most common side effect of streptokinase= hemorrhage . Streptokinase is a thrombolytic agent that acts by converting plasminogen to plasmin which subsequently degrades fibrin. It is a foreign protein derived from streptococci and induce HSR.
Dissection of ascending aorta manifests as tearing chest pain that radiates to the inter-scapular area commonly occurs in hypertension marfans and ehlers danlos
hyperactive jaw jerk reflex when lightly tapped= chvostek’s sign- Hypocalcemic – facial m contraction elicited by tapping facial nerve just anterior to ear. The most common cause of outpatient hypocalcemia is primary hypoparathyroidism which is often d/t prior loss of parathyroid tissue during thyroidectomy
scotoma is visual defect that occurs d/t pathologic processes that involve parts of retina or optic nerve resulting in discrete area of altered vision surrounded by zones of normal vision. Lesions of macula cause central scotomas.. examples would include MS, diabetic retinopathy and retinitis pigmentosa
verapamil is a calcium channel blocker that slows SA and AV node phase 0 depolarization (in nodal cells, the phase of depolarization is mediated by calcium influx)
phase 0 depolarization of cardiac conduction system occurs during diastole thus verapamil slows diastolic depolarization
The problem: More than 3,200 people are on the waiting list for a heart transplant in the United States. Some won’t survive the wait. Last year, 340 died before a new heart was found.
The solution: Take a pig heart, soak it in an ingredient commonly found in shampoo and wash away the cells until you’re left with a protein scaffold that is to a heart what two-by-four framing is to a house.
Then inject that ghost heart, as it’s called, with hundreds of millions of blood or bone-marrow stem cells from a person who needs a heart transplant, place it in a bioreactor – a box with artificial lungs and tubes that pump oxygen and blood into it – and wait as the ghost heart begins to mature into a new, beating human heart.
It’s most likely years off, but it’s a pretty sure bet it will happen.
Researchers believe the human hearts, just like the animal ones, won’t be rejected because they’ll be custom-made using the recipient’s stem cells. That means future transplant patients won’t have to take anti-rejection medication and won’t have to put up with the side effects that accompany those drugs: an increased risk of high blood pressure, diabetes and kidney failure. They won’t have to undergo dozens of heart biopsies. And they won’t have to worry about the pain, time and expense of a second transplant.
At some point in our lives we all meet someone who changes our lives. I happened to meet mine on December 24, 2009. Michael Bradlee Christian (or Mikey) was born on the way to the hospital at 70 mph. To go along with his high speed birth, he’s wanted to be a race car driver since he knew what that was. For someone of such small stature, he’s impacted the lives of everyone around him and even those thousands of miles away.
When you first look at him you would never guess that he is in bone marrow failure. When Mikey was 3 years old, he had a nosebleed at preschool. My dad went to pick him up expecting the nosebleed to stop. It didn’t. He was rushed to the ER where my dad sat with him and waited for hours. It wasn’t until Mikey went unconscious that they finally paid attention to him. His nose bled for 10 hours. He was in the Pediatric Intensive Care Unit for about 6 days. A very renowned hematologist-oncologist came in to take a look at him. He ordered a blood count to check his platelets. Platelets are the blood cells in our body that help your blood clot. Normal counts are around 150-400. Mikey’s were 4. The doctor took all of this into account along with his small stature, his speech impediment, the birth marks on his body and suspected he had Fanconi Anemia. FA is a rare, inherited blood disorder that leads to bone marrow failure. Although FA is a blood disorder, it also can affect many of your body’s organs, tissues, and systems. Children who inherit FA are at higher risk of being born with birth defects. FA also increases the risk of some cancers and other serious health problems. Mikey’s main issue is that his bone marrow is failing, but he also has a speech impediment. He also has a special helmet that he needs to wear anytime he is active to prevent head trauma. Treatment options for Mikey are slim to none. He receives blood transfusions as needed (usually once a month). But his doctor recently started him on a type of steroid that produces blood cells. With this steroid it has stopped his nosebleeds so far. The bad part of the steroid is that it only works for so long before it stops.
The main cure for Mikey’s FA is a bone marrow transplant. So far we have not found a match. This is where you guys come in. It is absolutely free to sign up to be a bone marrow donor at bethematch.org. It does have restrictions such as you have to be 18 and you do have to answer a few health related questions. Donating bone marrow is super easy. You will be put under anesthesia. While the donation varies slightly from hospital to hospital, generally, the doctors use special, hollow needles to withdraw liquid marrow (where blood-forming cells are made) from both sides of the back of the pelvic bone. The incisions are less than one-fourth inch long and do not require stitches. Most donors walk out the same day.
Just please if you see this, sign up for him. If you are unable to sign up please reblog this. I want everyone to see what a wonderful boy he is. My brother is my best friend. His laugh is something you’ll never forget. Through all of these treatments, all of these procedures, he ALWAYS keeps a smile on his face. He never lets it get him down. He’s the strongest person I have ever met. Anyone else might get down in the dumps and feel depressed but he’s a special one. Every nurse or doctor he’s come in contact with has had their hearts captured by him with his great spirit. I sincerely hope that one day all of you get to see, in person, what type of person he is. But until then please, I am begging you to sign up to be a marrow donor or spread this wherever you can. If you end up not being a match for him, you could very well be a match for someone else and save a life.
All T-cell effector functions involve the interaction of an armed effector T cell with a target cell displaying specific antigen. The effector proteins released by these T cells are focused on the appropriate target cell by mechanisms that are activated by recognition of antigen on the target cell. The focusing mechanism is common to all types of effector T cells, whereas their effector actions depend on the array of membrane and secreted proteins they express or release upon receptor ligation. The different types of effector T cell are specialized to deal with different types of pathogen, and the effector molecules they are programmed to produce cause distinct and appropriate effects on the target cell.
Matures in Bone marrow. B cells form plasma cells and memory cells when exposed to antigen. plasma cells will secrete the antibody and memory cells stick around in case the same antigen attacks in the future
Matures in the Thymus. Consists of cytotoxic T cells that recognize antigen on infected cells, and signal for apoptosis and helper T cells that recognize antigen on antigen-presenting cells, and signal for activation of B cells, more T cells, and macrophages.
Etoposide is used as treatment for cancer in chemotherapy for cancers such as testicular cancer, lung cancer, Ewing’s sarcoma and Kaposi’s sarcoma. The drug usually given with a combination of other treatment drugs and can be used prior to a bone marrow or blood cell transplant. Its chemical can be found in the American Mayapple plant.