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In all cases the poly- saccharide section may have linear or branched chain structures discount 60mg xenical mastercard, which often contain the derivatives of both monosaccharides and aminosugars (Figure 1 order xenical 60 mg mastercard. They occur as integral parts of the structures of specific tissues: the mureins xenical 60mg generic, for example, (Figure 1. For example, heparin inhibits the clotting of blood whilst starch and glycogen (Figure 1. Adapted from G Thomas Medicinal Chemistry, an Introduction, 2000, John Wiley and Sons, Ltd. Both structures are based on chains of a-glucose residues joined by a-(1,4) glycosidic links in a similar manner to that found in amylose. In glycogen, these chains are branched every eight to 10 glucose residues, the branches being attached by a-(1,6) glycosidic links similar to those found in the amylopectins. This section discusses a selection of the classes of compound that are classified as lipids. However, not all classes of compound obtained by extraction with nonpolar solvents are classified as lipids. They occur as isolated molecules and are more commonly found as residues in other lipid structures. The fatty acids and residues that are commonly found are normally referred to by trivial names (Table 1. They usually have ‘straight chain structures’ with even numbers of between 14 and 22 carbon atoms inclu- sive. In the latter case both cis and trans isomers are known but the cis isomers are more common. A few residues have structures that have side chains and/or other functional groups. Complex mixtures of acylglycerols are the major components of naturally occuring fats and oils. Their liquidity is attributed to their acid residues having a high proportion of C ¼ C bonds. Triacylglycerols are the predominant energy store in animals and are mainly located in adipose tissue. Metabolism of fats is responsible for supplying a significant part of the energy requirements of many cells. Metabolic oxidation of these fatty acids liberates energy in a form that can be utilized by the cell. The first uses glycerol as a stem name, the fatty acid residuesbeingindicatedbytheiracylprefixestogetherwithanappropriatelocant. Thesecondsystem uses glyceryl followed by the names of the acid residues arranged in the order they appear in the molecule. However, the ending -ic of the acid is replaced by the suffix -o except for the last residue, which is given the ending -ate. Six membered saturated rings usually have a chair conformation whilst the five mem- bered saturated rings have an envelope configuration. For steroids with satur- ated A and B rings with chair conformations the substituents at the A/B ring junction can be trans or cis but those of the B/C and C/D ring junction are usually trans (Figure 1. Bonds that lie in the plane or project above the plane of the rings are known as b-bonds (solid lines) whilst bonds that are directed below the plane of the rings are designated as a-bonds (dotted lines). The traditional number system used for steroids is also extended to include their side chains. Cholesterol, for example, is an important component of mammalian cell membranes (Appendix 3), whilst ergosterol (Figure 1. The structures of terpenes may also contain functional groups, such as alcohols, ethers, esters and ketones. Myrcene (oil of bay) α-Pinene Isoprene Two isoprene units Two isoprene units Figure 1. To apply the rule one ignores the double bonds (see myrcene) and in some cases it is also necessary to distort the isoprene structure (see a-pinene) Most terpenes are known by their historic trivial names, although systematic names may be used for simple compounds. Terpenes are also classified according to the number of carbon atoms in their structures (Table 1. They are extracted from plants and animals and have been used as perfumes, medicines and spices for thousands of years (Figure 1. They may be initially classified as phosphatidyl compounds, plasmalogens, ether phospholipids and sphingomyelins depending on the nature of the R1 group attached to the phosphate residue (Table 1. Common names are given in brackets R2 Classification Glycerol Phosphatidyl glycerol Choline Phosphatidyl choline Inositol Phosphatidyl inositol (lecithins) Serine Phosphatidyl serine Ethanolamine Phosphatidyl ethanolamine (a-cephalins) The a-phosphatidyl lipids are further subdivided according to the nature of their R2 residues (Table 1. The R2 groups of plasmalogens and ether phos- pholipids are similar to the R2 groups of the phosphatidyl lipids, whilst the sphingomyelins have a choline residue. They are subdivided according to the nature of the carbohy- drate residue (Table 1. Sulphatides are the main sulpholipids in the brain, where they account for approximately 15% of the white matter. Gangliosides are particularly abundant in the cells of the central nervous system. These bases are indicated by the appropriate letter in the structures of Nucleic acids. Nucleotides can exist as individual molecules with one or more phosphate or polyphosphate groups attached to the sugar residue. The purine and pyrimidine rings are numbered in the conventional manner (Figure 1. Numbers are not included in the name if the phosphate unit is at position 5’ (Figure 1. The positions of phosphates attached at any other position are indicated by the appropriate locants. The abbreviations used to represent the structures of nucleotides based on deoxyribose are prefixed by d- 1. These pairs of bases, which are referred to as complementary base pairs, form the internal structure of the helix.

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Is losing language the the laws which make these bodies xenical 60 mg amex, into which He reverse of learning it? People who have lost some has put our minds discount 120 mg xenical visa, healthy or unhealthy organs or most of their language because of brain damage of those minds purchase xenical 60mg on-line, are all but unlearnt. Using language involves these laws—the laws of life—are in a certain mea- many kinds of knowledge and skill; some can be sure understood, but not even mothers think it badly damaged while others remain in fair condi- worth their while to study them—to study how to tion. People with aphasia have different combina- give their children healthy existences. They call it 104 nonlocal mind medical or physiological knowledge, fit only for can be used today in healing illness and disease in doctors. And nothing diseased material, such as tuberculinum from tis- but observation and experience will teach us the sue infected with Mycobacterium tuberculosis. It is often thought that medicine is the nursing, holistic Professional nursing with a curative process. It is no such thing; medicine is deliberate focus on treating the entire individual— the surgery of functions, as surgery proper is that physical, emotional, and spiritual. Nonlocal happenings, Dossey writes excessive sugar, irradiation, genetic engineering, on page 9, are unmediated by a sensory experience fish from polluted waters, toxins in the food chain, or other intermediate signal or stimulus, and nonlo- and repetition, as opposed to variety, in the daily cal events are unmitigated: that is, their magnitude foods, has a significant ill effect on our health. Nonlocal medicine, Dossey says, tional therapy are acidophilus culture complexes; involves a totally free mind in which to explore all activated charcoal; aloe vera; amaranth; amazake; possibilities for healing. This is the infinite piece of your drinks; essene bread; essential fatty acids; flax seed consciousness. But as we shall see, ‘non- guar gum; gum guggul; gymnema sylvestre; kashi; local’ or ‘infinite’ describes a natural part of who kefir; kuzu; lecithin; millet; miso; mochi; molasses; we are. Its expressions include sharing of thoughts mushrooms; Nutrasweet; oats and oat bran; octa- and feelings at a distance, gaining information and cosanol; oils (natural vegetable); omega 3-oils; wisdom through dreams and visions, knowing the pasta; psyllium husks; pycnogenol; quercetin; future, radical breakthroughs in creativity and dis- quinoa; rice; rice syrup; royal jelly; sea vegetables; covery, and many more. And this part of your mind soy milk and cheese; spirulina; spelt and kamut; nutritional therapy 105 sprouts; sucanat; tahini; teas (black and green); them—advocate certain types of foods and food tempeh; tofu; tortillas; triticale; turbinado sugar; regimens believed to promote and restore health, umeboshi plums; vinegars; wheat germ and wheat such as low-salt diet. O obeah The science of traditional medicine and • Ajowan: herbaceous, spicy; Trachyspermum herbs according to African bush medicine. Essential oils are Myrtaceae); used in potpourris and flavoring of absorbed by the skin and are not meant to be taken beverages, sweets, and other foods; warming, orally unless under the supervision of a trusted cheering, sense-enhancing; avoid use in sun; aromatherapist or other practitioner. Plants produce essential oils in the form labdanum, ylang ylang, patchouli, orris; may of globules in or on the surface of the plant tissues irritate skin as a way to ensure their environmental safety. The oils may attract beneficial insects and ward off • Almond: sweet; Prunus amygdalus, P. Some healers believe the oil is the essence also known as Hibiscus abelmoschus (family, Mal- of the plant and therefore its vital force, or energy, vaceae); sweet, floral, musky aroma that inten- which can be used therapeutically. There is evidence of distil- balancing, calming; emollient aphrodisiac; lation devices used more than 5,000 years; ancient blends well with neroli, olibanum, rose, sandal- Egyptians, for example, used essential oils for wood, other floral oils many purposes, such as mummification and cos- metics. Ancient Babylonians, Chinese, Asian Indi- • Amyris: woodsy; Amyris balsamifera, Schimmelia ans, Greeks, and Romans documented their use of oleifera (family, Rutaceae); for stress relief, mus- essential oils, which may be blended for intensified cle relaxation, and a meditation aid; also known effects. Synthetic oils are not considered for use by as sandalwood amyris; from wood, West Indies; healers because they lack the energy of a living production method: steam distillation; blends organism. Among the many oils are the following: well with lavandin, citronella, cedarwood 107 108 oils, essential • Angelica root: earthy, musky; Angelica archangel- counteract fatigue and stress; blends well with ica, A. John’s wort: Hypericum perforatum (family, used also as antiseptic, hair tonic, before- and Guttiferae); antidepressant, calming, stress- after-sports rub; helps fight water retention, reducing, mood-elevating; reduced aches, pains, 118 oils, herbal and menstrual discomfort; do not use before • Vetivert: woodsy; Vetivera zizanoides, Andropogon going out in the Sun muricatus (family, Poaceae [Gramineae]); also • Styrax (liquidambar Levant storax, or Storax): known as vetiver; relaxing, grounding, sensual, Balsam styracis, Liquidambar orientalis, (family, earthy, smoky; helps reduce blood pressure; Steracaceae); believed to help remove cellulite from roots, Haiti; production method: steam dis- and break down lymphatic deposits, reduce tillation; blends with lavender, sandalwood, and inflammation, and enhance mood jasmine • Tangerine: citrus; Citrus reticulata (family, • Violet leaves: herbaceous; Viola odorata; calming Rutaceae); sweet, tangy; used as astringent for (family, Violaceae); used as soothing agent, skin oily skin, and in drinks and desserts; not for use conditioner; from leaves, France and Egypt; pro- in the Sun duction method: solvent extraction; blends well with clary sage, basil • Tarragon: citrus; Artemisia dracunculus (family, Asteraceae [Compositae]); energizing; said to • Wintergreen: minty; Gaultheria procumbens (fam- relieve aches, pains, and menstrual discomfort ily, Ericaceae); cleansing; harmful or fatal if and improve mental alertness; also used as taken internally; may irritate skin; not for use astringent; from fruit peels, United States; pro- during pregnancy duction method: expression; blends well with • Yarrow: Achillea millefolium (family, Asteraceae basil, bergamot, chamomile, clary sage, [Compositae]); sedative properties; used for olibanum, geranium, grapefruit, lavender, chest infections, digestive problems, nervous lemon, lime, neroli, orange, rose exhaustion, menstrual problems, rheumatism, • Tea tree: camphoraceous; Melaleuca alternifolia, acne, scarring, burns, cuts M. Kaufman is the author of Happiness Is orthomolecular medicine The practice of pre- A Choice (New York: Fawcett Columbine, 1991), venting and treating disease by providing the body and other books. He and his wife, Samahria (Suzi with optimal amounts of substances that are nat- Lyte) Kaufman, operate the Institute in Sheffield, ural to it. In nine reports, Pauling pro- organ remedies In Chinese traditional medicine, vided a rational basis for the use of optimal, even homeopathy, and Ayurvedic medicine, herbal if large, doses of nutrients. His theory explained remedies corresponding to the body’s organs and how evolution was shaped by the loss of the their disease or dysfunction and to the whole indi- chemical machinery required to make essential vidual’s status. His first paper appeared in 1970, his last may be prescribed for disorders of the spleen and one in 1992. The optimum amounts of this vitamin, many of the idea that “the herbs are organs” is derived from the world’s major diseases would vanish. The National writings of the Swiss alchemist and physician Academy of Sciences refused to accept Dr. Orthomolecular medicine maintains that genetic factors are pivotal to both the structure of the body and its biochemicals. In the presence or event of a biochemi- Physical, Emotional, and Sexual Wellness (Pittsburgh, cal anomaly, diseases including atherosclerosis, Pa. Correcting the amount of Ornish, Dean American physician; assistant clin- vitamins, amino acids, trace elements, or fatty acids ical professor of medicine and attending physician in order to correct the biochemical abnormality is a at the School of Medicine, University of California, major goal of orthomolecular therapy. San Francisco; and attending physician at the Cali- Hoffer also wrote in The Journal of Orthomolecular fornia Pacific Medical Center in San Francisco. A graduate of Baylor College of Medicine, Schizophrenia Association, we published the first he was a clinical fellow in medicine at Harvard issue of a journal called the Journal of Schizophrenia. Medical School and an intern and medical resident We had to create our own journals because it was at Massachusetts General Hospital. Ornish is the impossible to obtain entry into the official journals author of books including Dr. Before 1967 I had not for Reversing Heart Disease (New York: Ballantine found it difficult to publish reports in these jour- Books, 1990). One complete system of health care, based on broad of the assistant editors of the American Psychiatric principles that offer a way of thinking and acting in Association Journal announced that he would never relation to questions of health and disease. He had been the chairman of the task force mote healthy functioning by correcting mechanical which had out of hand condemned any of this imbalances within and between the structures— work. This new journal was to become the forum muscles, bones, ligaments, organs, and fascia (thin available to practitioners of the new psychiatry layers of tissue under the skin)—of the body. Even today the The name osteopathy, derived from the Greek Medical Index will not abstract our journals using osteon (bone) and pathos (to suffer), that is, “disease the excuse that they do not have enough money. Still, who viewed the muscu- protect the establishment from ideas that run loskeletal system as the vital mechanism of the counter to their own. In 1972 the title integrity of the whole body is seen as one of the was changed to the Journal of Orthomolecular Psychi- most important factors in health and disease. Linus Pauling in 1968 had proposed the physiology and clinical methods of investigation. Excerpted from the book Discovering that psychiatrists remained singularly disinterested Osteopathy (Berkeley, Calif.

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So-called temperate bacteriophages lysogenize the host cells buy 60mg xenical free shipping, whereby their genomes are integrated into the host cell chro- mosomes as the so-called prophage xenical 120 mg lowest price. The phage genes are inactive in this stage buy cheap xenical 60mg on line, although the prophage is duplicated synchronously with host cell pro- liferation. The transition from prophage status to the lytic cycle is termed spontaneous or artificial induction. Some genomes of temperate phages may carry genes which have the capacity to change the phenotype of the host cell. Integration of such a prophage into the chromosome is known as lysogenic conversion. Morphology Similarly to the viruses that infect animals, bacteriophages vary widely in ap- pearance. Right: phage shell Tail (contractile) after injection of the 3 Tail fibers genome with phage head empty and tail sheath con- a Base plate with tail pins tracted. The proteins form the head, tail, and other morphological elements, the function of which is to protect the phage genome. This element bears the genetic information, the structural genes for the structural proteins as well as for other proteins (enzymes) re- quired to produce new phage particles. Attachment to cell surface involving specific interactions be- tween a phage protein at the end of the tail and a bacterial receptor. Lysis occurs by a phage-encoded murein hydrolase, which gains access to the murein through membrane channels 3 formed by the phage-en- coded protein holin. Enzymatic penetration of the wall by the tail tube tip and injection of the nucleic acid through the tail tube. Beginning with synthesis of early proteins (zero to two minutes after injection), e. Then follows transcription of the late genes that code for the structural proteins of the head and tail. The new phage particles are assembled in a maturation process toward the end of the reproduction cycle. This step usually follows the lysis of the host cell with the help of murein hydrolase coded bya phage gene that destroys the cell wall (Fig. Depending on the phage species and milieu conditions, a phage reproduction cycle takes from 20 to 60 minutes. This is called the latency period, and can be considered as analogous to the generation time of bacteria. Depending on the phage species, an infected cell releases from 20 to several hundred new phages, which number defines the burst size. In view of this fact, one might wonder how any bacteria have survived in nature at all. It is important not to forget that cell population density is a major factor determining the probability of finding a host cell in the first place and that such densities are relatively small in nature. Another aspect is that only a small proportion of phages reproduce solely by means of these lytic or vegetative processes. Following injection of the phage genome, it is integrated into the chromosome by means of region-spe- cific recombination employing an integrase. Cells carrying a prophage are called lysogenic because they contain the genetic information for lysis. It prevents immediate host cell lysis, but also ensures that the phage genome replicates concurrently with host cell reproduction. Lysogenic conversion is when the phage genome lysogenizing a cell bears a gene (or several genes) that codes for bacterial rather than viral processes. Genes localized on phage genomes include the gene for diphtheria toxin, the gene for the pyrogenic toxins of group A streptococci and the cholera toxin gene. Ad- ministration of suitable phage mixtures in therapy and prevention of gastrointestinal infections. Recognition of the bacterial strain responsible for an epidemic, making it possible to follow up the chain of infection and identify the infection sources. The Principles of Antibiotic Therapy 187 The Principles of Antibiotic Therapy & Specific antibacterial therapy refers to treatment of infections with anti- infective agents directed against the infecting pathogen. The most important group of anti-infective agents are the antibiotics, which are products of fungi and bacteria (Streptomycetes). Anti-infective agents are categorized as having a broad, narrow, or medium spectrum of action. The efficacy, or effectiveness, of a substance refers to its bactericidal or bacteriostatic effect. Under the influence of sulfonamides and trimethoprim, bacteria do not synthesize sufficient amounts of tetrahydrofolic acid. Due to their genetic variability, bacteria may devel- op resistance to specific anti-infective agents. The most important resistance mechanisms are: inactivating enzymes, resistant target molecules, reduced influx, increased efflux. Resistant strains (problematic bacteria) occur fre- quently among hospital flora, mainly Enterobacteriaceae, pseudomonads, staphylococci, and enterococci. The disk test is a semiquantitative test used to classify the test bacteria as resistant or susceptible. In combination therapies it must be remembered that the interactions of two or more antibiotics can give rise to an antagonistic effect. Surgical chemoprophylaxis must be administered as a short-term anti- microbial treatment only. One feature of these pharmaceuticals is “selective toxicity,” that is, they act upon bacteria at very low concentration levels without causing damage to the macroorganism. These natural substances are produced by fungi or bacteria (usually Streptomycetes). The term “anti- biotic” is often used in medical contexts to refer to all antibacterial pharma- ceuticals, not just to antibiotics in this narrower sense. The most important groups (cephalosporins, penicillins, 4-quinolones, macrolides, tetracyclines) are in bold print. Pseudomonas; labile against Gram-positive and Gram-negative penicillinases temocillin (6-a-methoxy No effect against Pseudomonas; highly stable in the ticarcillin) presence of betalactamases Acylureidopenicillins azlocillin, mezlocillin, Effective against Enterobacteriaceae and piperacillin, apalcillin Pseudomonas; despite lability against beta- lactamases active against many enzyme-producing strains due to good penetration and high levels of sensitivity of the target molecules Penems Penicillins with a double bond in the second ring system A carbapenem (C atom instead of sulfur in second N-formimidoyl thienamycin ring); very broad spectrum and high level of (imipenem = activity against Gram-positive and Gram-negative N-F-thienamycin + bacteria, including anaerobes; frequently effective cilastatin) against Enterobacteriaceae and Pseudomonas with resistance to the cephalosporins of Group 3b; inactivated by renal enzymes; is therefore administered in combination with the enzyme inhibitor cilastatin Kayser, Medical Microbiology © 2005 Thieme All rights reserved. Sulfones dapsone diaminodiphenylsulfone; for therapy of leprosy Tetracyclines doxycycline tetracycline, Broad spectrum including all bacteria, chlamydias, oxytetracycline, and rickettsias; resistance frequent; dental deposits rolitetracycline, minocycline in small children Kayser, Medical Microbiology © 2005 Thieme All rights reserved.