Lung Ultrasound to Quantitatively Evaluate Extravascular ...
Surgery Trauma Burns Sepsis Radiation Chemicals Toxins Stressful Forces Extravascular Tissue...
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Transcript of Surgery Trauma Burns Sepsis Radiation Chemicals Toxins Stressful Forces Extravascular Tissue...
SurgeryTraumaBurnsSepsisRadiationChemicalsToxins
Stressful ForcesExtravascularTissue Disruption
TISSUE REPAIR COMPONENT
Tissue Factor Pathway InhibitorATIIIProtein C
MetabolismAngiogenesisChemokinesCytokinesProstaglandins
Malignancy
Apoptosis
BoneMuscle
PneumoniaInfluenza
AsthmaARDSMSOF
EclampsiaARF
PusScabsCasts
Exudates
Abscesses
SOLUBLEFIBRIN
TISSUEREPAIR
PlateletsInflammationChemotaxisMitosis
FIBRONIGENFactor X
ImmuneProteins
TemperatureCatabolismFeverImmune CellsEndotheliumOsteoblastsMyoblastsFibroblasts
Collagen
Factor XIII
VitronectinFibronectin
COAGULATION
SYSTOLICTURBULENTRESISTANCE
HyperviscosityHypercoagulableFlow ResistanceIncreased SWRCardiac WorkHypertensionDecreased COAtherosclerosis
Tissue IschemiaHypoxemiaOrgan QuiescenceIncreased SWROrgan StressHypertensionDecreased COIncreased HR
Tissue PerfusionHyperoxemiaOrgan ActivityDecreased SVROrgan PreservationHypotensionIncreased CODecreased HR
CAPILLARYHEMOSTASIS
CAPILLARYFLOW
SYSTOLICLAMINARFLOW
Optimal ViscosityNormocoagulableFlow FacilitationDecreased SVRCardiac RestHypertensionIncreased COHealth & Longevity
Cerebral Cortex
FibrinSplit Products
Insoluble Fibrin
TAFI
THROMBIN TISSUE FACTORThrombin ActivationFactor VII
Krebs
Cycle
Ca+
Factor VIIIC
ThrombinAcceleration
VON WILLIBRAND FACTOR
PAI
TPA
The Stress Repair Mechanism (SRM)
ThrombinAmplificationFactor IX
VASCULARENDOTHELIUM
EpinephrineNorepinephrineCortisol
HPA Axis
NitricOxide
Analgesia
Visual, OlfactoryAuditory, Tactile
Pain
CAPILLARY GATE COMPONENTStressful StimuliIntravascularNeurons Pathways
ATP
Nociception
Internuncial
Spinal Cord
Hypothalamus
Peripheral Nerves
PeripheralReceptors
Sensory Stressors
SPINAL PATHWAY
EmotionalMechanisms
Anesthesia
SYMPATHETIC
PARASYMPATHETIC
Insulin
COGNITIVE PATHWAY
FibrosisScar
Adhesion
The Universal Theory of Medicine of Hans Selye
Dr. Hans Selye 1907-1982
Fundamentals of Stress Theory
1. DNA + Stress Mechanism + embryological development?2. Capillary Gate Theory ?3. Clot formation?4. Unified Tissue Repair Theory?5. Coagulation Cascade6. Mechanisms can now be described for all these old theories!!7. It is the function of science to discover the existence of a general reign of
order in nature and to find the causes governing this order.
Factor VIII: The Odd Couple
Von Willebrand’s Factor
Vascular Endothelium
Inert
Fluctuates with Nervous activity
Gigantic molecule
Factor VIIIC
liver
Labile enzyme
Generates Insoluble Fibrin
Gigantic molecule
Capillary Gate Theory
Tissue Repair Theory
Coagulation Cascade
Stress Repair Mechanism
Autonomic Nervous System
Vascular Endothelium
Insoluble Fibrin
The Coagulation Cascade
Autonomic Nervous System
SurgeryTraumaBurnsSepsisRadiationChemicalsToxins
Stressful ForcesExtravascularTissue Disruption
TISSUE REPAIR COMPONENT
Tissue Factor Pathway InhibitorATIIIProtein C
MetabolismAngiogenesisChemokinesCytokinesProstaglandins
Malignancy
Apoptosis
BoneMuscle
PneumoniaInfluenza
AsthmaARDSMSOF
EclampsiaARF
PusScabsCasts
Exudates
Abscesses
SOLUBLEFIBRIN
TISSUEREPAIR
PlateletsInflammationChemotaxisMitosis
FIBRINOGENFactor X
ImmuneProteins
TemperatureCatabolismFeverImmune CellsEndotheliumOsteoblastsMyoblastsFibroblasts
Collagen
Factor XIII
VitronectinFibronectin
COAGULATION
SYSTOLICTURBULENTRESISTANCE
HyperviscosityHypercoagulableFlow ResistanceIncreased SWRCardiac WorkHypertensionDecreased COAtherosclerosis
Tissue IschemiaHypoxemiaOrgan QuiescenceIncreased SWROrgan StressHypertensionDecreased COIncreased HR
Tissue PerfusionHyperoxemiaOrgan ActivityDecreased SVROrgan PreservationHypotensionIncreased CODecreased HR
CAPILLARYHEMOSTASIS
CAPILLARYFLOW
SYSTOLICLAMINARFLOW
Optimal ViscosityNormocoagulableFlow FacilitationDecreased SVRCardiac RestHypertensionIncreased COHealth & Longevity
Cerebral Cortex
FibrinSplit Products
Insoluble Fibrin
TAFI
THROMBIN TISSUE FACTORThrombin ActivationFactor VII
Krebs
Cycle
Ca+
Factor VIIIC
ThrombinAcceleration
VON WILLIBRAND FACTOR
PAI
TPA
The Stress Repair Mechanism (SRM)
ThrombinAmplificationFactor IX
VASCULARENDOTHELIUM
EpinephrineNorepinephrineCortisol
HPA Axis
NitricOxide
Analgesia
Visual, OlfactoryAuditory, Tactile
Pain
CAPILLARY GATE COMPONENTStressful StimuliIntravascularNeurons Pathways
ATP
Nociception
Internuncial
Spinal Cord
Hypothalamus
Peripheral Nerves
PeripheralReceptors
Sensory Stressors
SPINAL PATHWAY
EmotionalMechanisms
Anesthesia
SYMPATHETIC
PARASYMPATHETIC
Insulin
COGNITIVE PATHWAY
FibrosisScar
Adhesion
The Universal Theory of Medicine of Hans Selye
The End
Dr. Johannes Rhodin 1922-2004
Oswald Avery 1877-1955
Francis Crick 1916-2004James Watson 1928-?
The Vascular Endothelium
TF
TF VWF
SNS
PNSNO
TF
Thrombin: The Universal Enzyme of Energy Transformation
1. Transforms ATP into cell and enzyme effects2. Requires Ca+3. Parathyroid glands regulate Ca+ to optimize thrombin activity4. Energizes all tissue repair activities5. Converts fibrinogen into soluble and insoluble fibrin6. Clot formation, inflammation, mitosis, metabolism, angiogenesis & all other
aspects of tissue repair7. Chemokines, cytokines, prostaglandins for cell communications that
coordinate the stages of tissue repair8. Thrombin elevations cause malignancy9. Thrombin declines trigger apoptosis10.Vascular Endothelium regulates thrombin in healthy tissues11.Red clot governs thrombin levels in healing tissues
Soluble Fibrin: The Universal Protein of Tissue Repair
Insoluble Fibrin: The Universal Polymer of Hemostasis
SurgeryTraumaBurnsSepsisRadiationChemicalsToxins
Stressful ForcesExtravascularTissue Disruption
TISSUE REPAIR COMPONENT
Tissue Factor Pathway InhibitorATIIIProtein C
MetabolismAngiogenesisChemokinesCytokinesProstaglandins
Malignancy
Apoptosis
BoneMuscle
PneumoniaInfluenza
AsthmaARDSMSOF
EclampsiaARF
PusScabsCasts
Exudates
Abscesses
SOLUBLEFIBRIN
TISSUEREPAIR
PlateletsInflammationChemotaxisMitosis
FIBRONIGENFactor X
ImmuneProteins
TemperatureCatabolismFeverImmune CellsEndotheliumOsteoblastsMyoblastsFibroblasts
Collagen
Factor XIII
VitronectinFibronectin
COAGULATION
SYSTOLICTURBULENTRESISTANCE
HyperviscosityHypercoagulableFlow ResistanceIncreased SWRCardiac WorkHypertensionDecreased COAtherosclerosis
Tissue IschemiaHypoxemiaOrgan QuiescenceIncreased SWROrgan StressHypertensionDecreased COIncreased HR
Tissue PerfusionHyperoxemiaOrgan ActivityDecreased SVROrgan PreservationHypotensionIncreased CODecreased HR
CAPILLARYHEMOSTASIS
CAPILLARYFLOW
SYSTOLICLAMINARFLOW
Optimal ViscosityNormocoagulableFlow FacilitationDecreased SVRCardiac RestHypertensionIncreased COHealth & Longevity
Cerebral Cortex
FibrinSplit Products
Insoluble Fibrin
TAFI
THROMBIN TISSUE FACTORThrombin ActivationFactor VII
Krebs
Cycle
Ca+
Factor VIIIC
ThrombinAcceleration
VON WILLIBRAND FACTOR
PAI
TPA
The Stress Repair Mechanism (SRM)
ThrombinAmplificationFactor IX
VASCULARENDOTHELIUM
EpinephrineNorepinephrineCortisol
HPA Axis
NitricOxide
Analgesia
Visual, OlfactoryAuditory, Tactile
Pain
CAPILLARY GATE COMPONENTStressful StimuliIntravascularNeurons Pathways
ATP
Nociception
Internuncial
Spinal Cord
Hypothalamus
Peripheral Nerves
PeripheralReceptors
Sensory Stressors
SPINAL PATHWAY
EmotionalMechanisms
Anesthesia
SYMPATHETIC
PARASYMPATHETIC
Insulin
COGNITIVE PATHWAY
FibrosisScar
Adhesion
The Universal Theory of Medicine of Hans Selye
Charles Atlas or 90lb Weakling?
Blood Acceleration & Turbulence
Systolic Acceleration
Diastolic Deceleration
Diastolic Turbulence
Pipe Flow TurbulenceLateral ForcesFast Faster Fastest