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The TmPAH is directly related to the num- Insights into the nature of glucose handling by the kidneys ber of functioning proximal tubules and discount 100 pills aspirin free shipping, therefore, pro- can be derived from a glucose titration study (Fig. Inulin is and excretion of PAH observed when the plasma [PAH] is infused to permit measurement of GFR and calculation of progressively elevated by intravenous infusion. The rate of glucose reabsorption is determined from the differ- ence between the filtered load and the rate of excretion. At RENAL BLOOD FLOW normal plasma glucose levels (about 100 mg/dL), all of the filtered glucose is reabsorbed and none is excreted. This allows them to the plasma [glucose] exceeds a certain value (about 200 filter the blood plasma at a high rate. Further elevations in plasma glucose lead to progressively more excreted glucose. Glucose ap- The Kidneys Have a High Blood Flow pears in the urine because the filtered amount of glucose ex- ceeds the capacity of the tubules to reabsorb it. At very In resting, healthy, young adult men, renal blood flow av- high filtered glucose loads, the rate of glucose reabsorption erages about 1. This is about 20% of the cardiac reaches a constant maximal value, called the tubular trans- output (5 to 6 L/min). Both kidneys together weigh about CHAPTER 23 Kidney Function 385 240 Cortex 4 5 200 160 Outer medulla 0. More PAH is excreted than is filtered; the difference rep- The Kidneys Autoregulate Their Blood Flow resents secreted PAH. Despite changes in mean arterial blood pressure (from 80 to 180 mm Hg), renal blood flow is kept at a relatively constant level, a process known as autoregulation (see Chapter 16).

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They are trans- ferred to as alpha and beta chains 100pills aspirin otc, that are about 15 kDa in CHAPTER 37 The Male Reproductive System 651 Processing sites 23 AA 10 AA 56 AA Signal peptide GnRH GnRH-associated peptide (GAP) N GnRH C terminus terminus FIGURE 37. Both hormones contain the same subunit but differ- rectly indicate that GnRH pulses have occurred. Each hormone is glycosylated prior to re- human studies measuring pulsatile secretion of LH and FSH lease into the general circulation. Glycosylation regulates in peripheral blood at various times have provided much of the half-life, protein folding for receptor recognition, and the information regarding the role of LH and FSH in regu- biological activity of the hormone. However, the LH and FSH bind membrane receptors on Leydig and exact relationship between endogenous GnRH pulses and Sertoli cells, respectively. The two gonadotropin receptors are in serum and do not exhibit pulsatile secretion of LH. Pul- linked to G proteins and adenylyl cyclase for the produc- satile injections of GnRH restore LH and FSH secretion tion of cAMP from ATP. FSH pulses tend to be smaller in count for all of the actions of LH and FSH on testicular amplitude than LH pulses, mostly because FSH has a longer cells. These generating GnRH pulsatility is unknown, the presence of a factors activate the promoter region of the genes of pulse generator in the hypothalamus has been postulated. Similar signal-transducing events oc- pothalamus and is responsible for the synchronized and cur in Sertoli cells that regulate the production of estradiol. The activity of The testis converts testosterone and some other androgens the pulse generator is modified by several factors. For ex- to estradiol by the process of aromatization, although estra- ample, castration causes a large increase in basal LH levels diol production is low in males. Therefore, the pulse generator may be mature sperm, inhibin (a protein produced by Sertoli cells tonically inhibited by testosterone. However, GnRH neu- that suppresses FSH secretion), and androgen-binding pro- rons lack receptors for gonadal steroids, suggesting that tein. Activin and follistatin production by testicular cells in humans is currently being investigated.

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