Download Pediatric Gastrointestinal and Liver Disease by Robert Wyllie MD, Jeffrey S. Hyams MD, Marsha Kay MD PDF
By Robert Wyllie MD, Jeffrey S. Hyams MD, Marsha Kay MD
Consult the major textual content within the box that delivers the knowledge you must diagnose and deal with pediatric gastrointestinal and liver ailments successfully. In one handy and finished quantity, Drs. Robert Wyllie, Jeffrey S. Hyams, and Marsha Kay offer all of the most recent information at the best new treatments, new medicinal drugs, and new innovations in the forte. moreover, the new two-color layout throughout is helping you discover what you wish quick and easily.
- Full-color endoscopy images
- Definitive assistance from renowned overseas contributors who proportion their wisdom and services during this advanced box
- Detailed diagrams
- More than four hundred board review-style questions, solutions, and rationales
to aid enhance your visible acceptance
that correctly illustrate complicated thoughts and supply at-a-glance attractiveness of sickness procedures
on hand within the e-book incorporated along with your buy
- New treatments for hepatitis B and C, new medications for the remedy of inflammatory bowel affliction,
- The most modern info on diagnosing and treating abnormalities of protein, fats, and carbohydrate metabolism
- New chapters on pancreatic transplantation and liver pathology
- The newest surgical ideas for young ones with gastrointestinal conditions
and an extended dialogue of the most up-to-date endoscopic and motility innovations available for pediatric sufferers
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Extra resources for Pediatric Gastrointestinal and Liver Disease
Sample text
Substrate specificity. 49 A brush border Na+, H+ exchange pump, along with Na+, K+ ATPase in the basolateral membrane, maintains this confined acidic milieu (Figure 2-7). 50 Both substrates of these carriers are absorbed normally in disease states if presented in the form of small peptides. 52 This is handled by transport proteins different from those in the brush border membrane. In addition to exporting amino acids into the portal circulation, these amino acid transport proteins take up amino acids into the entero cyte for use during fasting periods.
BRUSH BORDER DIGESTION Since only monosaccharides can be absorbed across the enterocyte membrane, bigger molecules such as disac charides and the products of luminal starch breakdown need further processing. This is achieved by the hydro lases of the brush border (see Figure 2-1). Maltase (glucoamylase) breaks the α1,4 links in oligo saccharides that are 5 to 9 glucose molecules long. ISO MALTASE (also called α-dextrinase) breaks α1,6 bonds, acting as a debranching enzyme. 9 Sucrase breaks sucrose into glucose and fructose.
Elastase Figure 2-6. Overview of digestion and absorption of protein. 39-41 Because almost all protein that enters the portal vein is in the form of amino acids, further digestion of any oligopep tides (which have 2 to 6 amino acids) must take place either at the brush border level or within the enterocyte cytoplasm. An oligopeptide’s length determines the rate and the site (brush border versus intracellular) of its assimilation. The brush border peptidases are active at neutral pH and include an array of aminopeptidases, carboxypeptidases, endopeptidases, and dipeptidases.