Solution Manual Chemical Reaction Enginnering by Octave Levenspiel

By Octave Levenspiel

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Immunologic injury 6. Tissue death. Inflammatory changes occur in viable tissue adjacent to necrotic areas. II. Acute Inflammation A. Adhesion molecules 1. General considerations a. Adhesion molecules play an important role in acute inflammation. b. They are divided into three families: selectins, immunoglobulin (Ig)-family adhesion proteins, and integrins. 2. Selectins a. These molecules are induced by the cytokines interleukin-1 (IL-1) and tumor ­necrosis factor (TNF). L-selectins are expressed on neutrophils and bind to endothelial mucin-like molecules such as GlyCam-1.

C5a is chemotactic, mediates the release of histamine from platelet-dense granules, induces the expression of leukocyte adhesion molecules, and activates the lipoxygenase pathway of arachidonic acid metabolism. (2) C3b is an opsonin. (3) C5b-9, the membrane attack complex, is a lytic agent for bacteria and other cells. Nitric oxide (formerly known as endothelium-derived relaxing factor) (1) This is produced by endothelial cells. (2) It stimulates relaxation of smooth muscle, thus playing a role in controlling vascular tone.

Methylene tetrahydrofolate reductase mutation (MTHFR C677T) (1) This results in a moderate increase in serum homocysteine, which is associated with both arterial and venous thrombosis. The increased homocysteine can be reduced by dietary supplementation with folic acid and vitamins B6 (pyridoxine) and B12 (cobalamin). (2) This is also associated with an increased risk of neural tube defects and possibly a number of diverse neoplasms. e. Increased levels of factor VIII, factor IX, factor XI, or fibrinogen are also associated with increased venous thrombosis.

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