By George Gladir
Archie's Double Digest #153 - September 2004
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Extra info for Archie's Double Digest 153 (September 2004)
Augmented by heparin. Protein C: Circulating protein activated by the thrombin-thrombomodulin complex on the (intact) endothelial surface. With protein S, it cleaves Factors Va and VIIIa to halt the coagulation cascade. Protein S: Cofactor for activity of protein C. Heparin and low molecular e-Aminocaproic acid blocks activation of plasminogen to plasmin. Aprotinin is a serine ■ protease that also inhibits plasmin and has antiinﬂammatory effects. Consider SU RG ICAL PRI NC I PLES after cardiac bypass surgery for postoperative bleeding or for tPA overdose.
The Cori cycle is an additional pathway for producing glucose in the starvation state. These reactions use lactate (byproduct of anaerobic respiration) as a substrate. Lactate is transported to the liver; at a net cost of 4 ATP, it is used to create glucose (with pyruvate as an intermediate). The glucose is then transported back to peripheral tissues for use. nitrogen (g) + 4 g] SURGICAL NUTRITION Nutritional assessment includes physical exam or laboratory evaluation. Must evaluate relative weight for height, body fat, temporal bulk, extremity strength, and presence of ascites.
Though this ketogenesis occurs in the liver, the liver itself cannot use ketone bodies as an energy source for its metabolic pathways. Nitrogen balance is calculated by subtracting nitrogen output from nitrogen intake. Output consists of urinary nitrogen (urea component is measured; 3 g/d nonurea nitrogen estimated) and fecal nitrogen (estimated at 1 g/d). 25 g protein = 1 g nitrogen). Gluconeogenesis provides an exhaustible source of glucose in the starvation state. The substrates for gluconeogenesis are proteolysis-derived amino acids (except leucine and lysine) and the glycerol carbon backbone generated by lipolysis.
Archie's Double Digest 153 (September 2004) by George Gladir