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Alpha Synuclein protein is and Sertoli cells of the testis buy 25mg viagra super active, endometrium and ovarian phosphorylated mainly on serine residues purchase viagra super active on line amex. Calretinin is also a sensitive and specifc indicator of normal and reactive meso- thelial cells in effusion cytology order discount viagra super active on-line. It is demonstrable by immunohistochem- A blood group antigen that is sialylated or in mucin-con- istry in normal intestinal epithelium nuclei. Many mucinous car- the recurrence of pancreatic cancer following surgery and cinomas of the ovary also stain positive for this antibody as to distinguish between neoplastic and benign conditions of do carcinomas of the upper gastrointestinal tract. It interacts with both normal adult and fetal pression in neoplasia portends a poor prognosis and is found liver tissue yielding a granular cytoplasmic staining pattern. Monocytes, macrophages, and dermal dendritic Melan A) is a melanocyte differentiation antigen. This antibody is very useful in (90% +), dermatofbrosarcoma protuberans (25% +), and establishing the diagnosis of metastatic melanomas. This antibody may be used to aid in the iden- tifcation of cells of melanocytic lineage. Unexpected antigen expression or loss of expression may occur, especially in neoplasms. Clinical interpretation must be complemented by morphological studies and evaluation of proper controls. Anti-p53 primary antibody (clone Bp53-11) is a mouse monoclonal antibody directed against both the mutant and wild-type of the p53 nuclear phosphoprotein. Very rare nor- mal cells express p53, but alterations in the p53 suppressor gene result in an overproduction of this protein in malignan- cies. This reagent may be used to aid in the identifcation of abnormally proliferating cells in neoplastic cell populations. The antibody is intended for qualitative staining in sections of formalin-fxed, paraffn-embedded tissue on a Ventana auto- mated slide staining device. The p53 antibody specifcally binds to nuclear antigen(s) associated cystadenocarcinoma, gonadoblastoma, nephroblastoma, and with the normal downregulation of cell division. Adenocarcinomas of expression of p53 in actively dividing cells is an indication of the lung are only rarely positive with this stain. It is noma is a mouse monoclonal antibody that identifes a 200kD demonstrated by immunoperoxidase staining. It is highly expressed on a variety of may also be reactive with parathyroid adenoma, rare breast adenocarcinomas of different origin such as breast, ovary, colon, carcinoma cases. Staining with this antibody is not positive and lung, whereas its expression in normal tissue is very limited. Anti-tyrosinase mouse monoclonal the germinal centers, but only faintly with B lymphocytes of antibody used in immunoperoxidase techniques identifes the mantle zone. In the case of breast cancer, c-erb-B2 expression has been shown to be associated with poor prognosis. Almost all cases of Paget’s disease and approximately 70% of cases of in situ ductal carcinoma are positive. Immunoper- oxidase staining identifes this marker in most breast tumors and a few tumors of the ovary and lung. The detection of various types of intermediate fla- fed bone matrix and the release of calcium into the blood. More than 50% of metastatic breast nal fuid of patients with opsoclonus without myoclonus that tumors and some salivary gland and skin appendage tumors occurs in conjunction with gait ataxia in women with breast stain positively for lactalbumin. The condition may remit, manifest exacerbations immunoperoxidase staining, that is found in glandular epi- and remissions, and occasionally respond to steroids or other thelium and adenocarcinomas but not in stratifed squamous immune interventions. Selected mesotheliomas express this c-erb-B2 murine monoclonal antibody is specifc for antigen as well. The pharyngeal, or branchial, arches are the mammalian equivalent of the gill arches in fish. In humans, there are five pairs of branchial arches that develop in a cranio-caudal sequence (equivalent to gill arches 1, 2, 3, 4, 6). The fifth branchial arch never forms in humans, or forms as a short-lived rudiment and promptly regresses. Each arch contains a central cartilaginous element, striated muscle, cranial nerve and aortic arch artery, surrounded by ectoderm on the outside and lined by endoderm. The arches are separated externally by ectodermally lined branchial clefts and internally by endodermally lined branchial pouches. Branchial cleft derivatives arise from the ectoderm whereas branchial pouches are derived from endoderm. The first arch gives rise to the muscles of mastication the second arch gives rise to the muscles of facial expression the third and fourth arches give rise to the muscles of vocalisation and deglutition the sixth arch gives rise to the intrinsic muscles of the larynx What are the clinical implications? Certain key features concerning the branchial arches are worth remembering because of their clinical significance: the superior parathyroid glands develop from the fourth branchial pouch; the inferior parathyroids, along with the thymus, are third pouch derivatives. Consequently, the inferior parathyroids may migrate with the thymus down into the mediastinum, hence its liability to end up in unusual positions. The anterior two-thirds of the tongue mucosa is a first arch derivative, whereas the posterior one-third is derived from the third and fourth arches. For this reason, the motor and sensory (special taste and somatic touch) nerve fibres of the tongue are carried by separate sets of cranial nerves. The thyroid gland arises from between the first and second arch as a diverticulum (thyroglossal duct) which grows downwards leaving the foramen caecum at its origin. Incomplete thyroid descent may give rise to a lingual thyroid, a thyroglossal duct cyst or a pyramidal thyroid lobe. Apart from the first branchial cleft (which forms the external ear), the other clefts are normally obliterated by overgrowth of the second pharyngeal arch, enclosing the remaining clefts in a transient, ectoderm-lined, lateral cervical sinus. There are four muscles of mastication: Temporalis Masseter Medial pterygoid Lateral pterygoid They are all first branchial arch derivatives and are therefore all innervated by the same nerve (mandibular division of trigeminal, or Vc). Note: the buccinator muscle is regarded as a muscle of facial expression and is, therefore, a second branchial arch derivative innervated by the facial, or seventh, cranial nerve. This is one of many situations in which a good knowledge of embryology and especially, the branchial arches may help to predict the anatomy. During embryonic and fetal life, the testes and the ovaries both descend from their original position at the 10th thoracic level. This explains the long course taken by the gonadal arteries and the site of referred pain from the gonads to the umbilicus (T10 dermatome). Descent is genetically, hormonally and anatomically regulated and depends on a ligamentous cord known as the gubernaculum. Furthermore, descent of the testis through the inguinal canal into the scrotum depends on an evagination of peritoneum known as the processus vaginalis. Gonadal descent is a complicated process and there are many ways in which it can go wrong. Most commonly, an undescended, or maldescended, testis may occur (cryptorchidism).

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Fetal tolerance is due to four mechanisms: the transplantation of tissues from the identical twin buy discount viagra super active line. During the formation of placenta cheap viagra super active 50 mg on line, trophoblast cells that separate Isograft is also not rejected 25 mg viagra super active visa. Allograft: This is the transplantation of organs between therefore, loose their immunogenicity. Therefore, antibodies against individuals of the same species, but with different fetal tissue do not develop. Allograft This attachment causes apoptosis of T cells that are supposed to is rejected. Xenograft: This is a transplant from or between dif- causes suppression of T and B cells that react against fetal graft. High level of progesterone during pregnancy is believed to between animal and man. This is a purine antimetabolite that debilitating diseases like renal failure, liver failure, etc. However, the individual on aza- Commonly transplanted organs are skin, kidney, bone and thioprine is susceptible to severe infection because of liver. Glucocorticoid therapy: Glucocorticoids have strong planted organ, which is a foreign tissue to him: immunosuppressive activity. Antilymphocyte globulins: These are monoclonal anti- the year 1990 was awarded to American transplant bodies produced against T lymphocytes. Antibiotics: Antibiotics usually used for the prevention transplantation in the treatment of human disease. Cyclosporine is a fungal extract and tacrolimus is an antibiotic of fungal origin. Monoclonal antibodies: They prevent activation and Immunotherapy is the treatment that aims at induction proliferation of T cells. This is Monoclonal Antibodies especially helpful for the treatment of different malig- nant diseases. There are different types of immunothera- Monoclonal antibodies are antibodies prepared from pies: cellular immunotherapy, cytokine therapy, antibody a single clone of B or plasma cells. They are obtained by fusing a Cellular Immunotherapy B cell with a tumor cell that produces antibodies in large Cells that have anti-tumor activity are injected into the quantity. These activated cells are called as lympokine-activated in a patient suffering from multiple myeloma. The fused cells (hybridoma cells) are separated and Different cytokines (see below) can be used in the treat- every single cell is allowed to form a clone of cells. The single clone of hybridoma cells produce specific Interferons are especially used for the treatment of viral antibody consisting of heavy or light chains of spleen infections or malignancies. Antibody Therapy Uses of Monoclonal Antibody Monoclonal antibodies are extensively used for the treat- Monoclonal antibodies are used in a wide variety clinical ment of malignancies or for preventing transplant rejection. Diagnosis of allergic diseases, hepatitis, sexually trans- Adjuvant is a compound, which is introduced with an anti- mitted diseases, etc. There are two system and the discovery of the principle for production of monoclonal types of allergies: the local allergy and the systemic antibodies”. Examples are swelling of the These reactions are mediated by macrophages that are lips, eczema, hives, urticaria, etc. This causes proliferation of T cells, some of which functions), is called systemic allergy or anaphylaxis. The appropriate example is the skin test for tuber- results in shock, called anaphylactic shock. Scientist contributed Autoimmune Diseases the Nobel Prize for the year 1913 for Physiology or Medicine was awarded to the Staff of Professors Normally, the immune system does not react against self of the Caroline Institute, Charles Richet, Professor proteins. However, in some conditions, immune system of Physiology in the Medical Faculty, Paris, for his fails to neglect self antigens and triggers immune reaction work on anaphylaxis. This may be due to the persistence of T cells or B cells (1850–1935) that are active against self antigens. Especially, failure of the process that removes antibodies against self Hypersensitivity Reactions antigens leads to formation of autoantibodies (Clinical There are four types of hypersensitivity reactions: Box 19. For example, in myasthenia gravis, and slow-releasing substance A from mast cells and antibodies are formed against nicotinic cholinergic basophils. It is an acute medical emer- Antibodies may cross-react: Sometimes autoantibodies may cross­ gency, which requires prompt medical support. Another example is Goodpasture syndrome, in which antibodies formed against alveolar Incompatible blood transfusions, hemolytic diseases of basement membrane cross react against glomerular basement newborn and autoimmune hemolytic anemias are exam- membrane, resulting in pulmonary hemorrhage and glomerulonephritis. They are secreted from activated lymphocytes, cells (pre-T cells) in thymus fail to develop into mature macrophages, endothelial cells, glial cells, etc. Therefore, severe deficiency occurs in the develop- Interleukins ment of both humoral and cellular immunity. They are produced by macrophages, activated T cells, ciency of humoral system of immunity ensues. Thus, both cellular and leucocytes, lymphopoiesis, erythropoiesis, thrombo- humoral immunities fail to develop. Though it increases capillary permeability, it on the surface of helper cells and decreases number of produces hypertension. T cell (T8 cell or cytotoxic T cell) is for cellular immunity, which is mainly targeted against intracellular pathogens like viruses, parasites and fungi, cancer cells, tumor cells, and transplanted tissues. B cell is for humoral immunity mediated by antibodies, which is mainly targeted against extracellular pathogens like bacteria. Type 1 helper cell induces cellular immunity and type 2 helper cell induces humoral immunity. In examinations, ‘Mechanism of cellular immunity’, ‘Mechanism of humoral immunity’, ‘Mechanism of defense by phagocytic and inflammatory cells’ and ‘Development of T and B lymphocytes’ usually come as Long Questions. In addition, classification of immunity, types of antibodies and their functions, and all immunological disorders, may be asked. Describe the structure (cytoskeletal systems and granules) of platelet and correlate the structure with platelet functions. Appreciate the properties of platelet, especially platelet adhesion, aggregation and release reaction. Explain the role of platelet in hemostasis, with special reference to the role in temporary hemostatic plug formation. Hemostasis is the mechanism by which loss of blood from vascular system is prevented by a complex interac- Steps of Hemostasis tion of vessel wall, platelets and plasma proteins. This hap- Hemostasis occurs in three stages: vasoconstriction, tem- pens broadly in two stages: primary and secondary. This is also called temporary Vasoconstriction hemostasis, as platelet plug alone cannot stop bleeding for a longer duration.