Maze (pul adenocarcinoma)

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Joungho Han

Micorscopic image of pulmonary adenocarcinoma

Adenocarcinoma, papillary and acinar pattern

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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram. Learning objectives: 1. Define an electrocardiogram (ECG) and electrocardiography 2. Describe how dipoles generated by the heart produce the waveforms of the ECG 3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II) 4. Differentiate between intervals and segments 5. Enlist some common indications for obtaining an ECG Study Resources: 1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition 3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition 4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/ 5. ECG in Medical Practice by ABM Abdullah, 4th edition 6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics

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Title: Sense of Smell Presenter: Dr. Faiza, Assistant Professor of Physiology Qualifications: MBBS (Best Graduate, AIMC Lahore) FCPS Physiology ICMT, CHPE, DHPE (STMU) MPH (GC University, Faisalabad) MBA (Virtual University of Pakistan) Learning Objectives: Describe the primary categories of smells and the concept of odor blindness. Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction. Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain. Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential. Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes. Key Topics: Olfactory Genes: 3% of the human genome accounts for olfactory genes. 400 genes for odorant receptors. Olfactory Membrane: Located in the superior part of the nasal cavity. Medially: Folds downward along the superior septum. Laterally: Folds over the superior turbinate and upper surface of the middle turbinate. Total surface area: 5-10 square centimeters. Olfactory Mucosa: Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell. Sustentacular Cells: Produce mucus and maintain ionic and molecular environment. Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months. Bowman’s Gland: Secretes mucus. Stimulation of Olfactory Cells: Odorant dissolves in mucus and attaches to receptors on olfactory cilia. Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve. Quality of a Good Odorant: Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble. Facilitated by odorant-binding proteins in mucus. Membrane Potential and Action Potential: Resting membrane potential: -55mV. Action potential frequency in the olfactory nerve increases with odorant strength. Adaptation Towards the Sense of Smell: Rapid adaptation within the first second, with further slow adaptation. Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system. Primary Sensations of Smell: Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid. Odor Detection Threshold: Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm). Some toxic substances are odorless at lethal concentrations. Characteristics of Smell: Odor blindness for single substances due to lack of appropriate receptor protein. Behavioral and emotional influences of smell. Transmission of Olfactory Signals: From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition. Primitive, less old, and new olfactory systems with different path

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i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource. This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and Associate Division Director for Ambulatory Operations The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma. STATEMENT OF NEED Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL. Target Audience Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL). Learning Objectives 1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL 2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults 3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection

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Title: Sense of Taste Presenter: Dr. Faiza, Assistant Professor of Physiology Qualifications: MBBS (Best Graduate, AIMC Lahore) FCPS Physiology ICMT, CHPE, DHPE (STMU) MPH (GC University, Faisalabad) MBA (Virtual University of Pakistan) Learning Objectives: Describe the structure and function of taste buds. Describe the relationship between the taste threshold and taste index of common substances. Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation. Recognize different abnormalities of taste perception and their causes. Key Topics: Significance of Taste Sensation: Differentiation between pleasant and harmful food Influence on behavior Selection of food based on metabolic needs Receptors of Taste: Taste buds on the tongue Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper) Primary and Secondary Taste Sensations: Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami Chemical basis and signal transduction mechanisms for each taste Taste Threshold and Index: Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine) Taste index relationship: Inversely proportional to taste threshold Taste Blindness: Inability to taste certain substances, particularly thiourea compounds Example: Phenylthiocarbamide Structure and Function of Taste Buds: Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers Location of Taste Buds: Found in papillae of the tongue (Fungiform, Circumvallate, Foliate) Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus Mechanism of Taste Stimulation: Interaction of taste substances with receptors on microvilli Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes Taste Sensitivity and Adaptation: Decrease in sensitivity with age Rapid adaptation of taste sensation Role of Saliva in Taste: Dissolution of tastants to reach receptors Washing away the stimulus Taste Preferences and Aversions: Mechanisms behind taste preference and aversion Influence of receptors and neural pathways Impact of Sensory Nerve Damage: Degeneration of taste buds if the sensory nerve fiber is cut Abnormalities of Taste Detection: Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia) Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels Neurotransmitters and Taste Threshold: Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity Supertasters: 25% of the population with heightened sensitivity to taste, especially bitterness Increased number of fungiform papillae

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