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No matter minished pulse pressure; the diastolic pressure increases discount lasuna 60 caps without prescription, what initial volume is present, the same change in volume while the systolic pressure decreases around an unchanged causes the same change in pressure. An increase in stroke volume with aortic compliance decreases as aortic volume is increased, as no change in cardiac output likewise causes no change in shown in Figure 15. The increased stroke volume, how- aortic volume at a low initial volume causes a relatively small ever, produces a rise in pulse pressure; systolic pressure in- change in pressure, but the same change in volume at a high creases and diastolic pressure decreases. The Another way to think about these events is depicted in large arteries behave in an analogous manner. The first two pressure waves have a diastolic pressure of 80 mm Hg, systolic pressure of 120 mm Hg, and mean arterial pressure of 93 mm Hg. After the second beat, the heart rate is slowed to A B 60 beats/min, but stroke volume is increased sufficiently to maintain the same cardiac output. The longer time interval between beats allows the diastolic pressure to fall to a new P2 (lower) value of 70 mm Hg. The next systole, however, produces an increase in pulse pressure because of the ejec- P2 tion of a greater stroke volume, so systolic pressure rises to 130 mm Hg. The pressure then falls to the new (lower) di- P astolic pressure, and the cycle is repeated. Mean arterial 1 P1 pressure does not change because cardiac output and SVR are constant. The increased pulse pressure is distributed V1 V2 V V2 evenly around the same mean arterial pressure. The change in volume ( V1) causes the change astolic pressure increases. The same change in volume ( V2) at a higher initial volume causes a change in pressure ( P2) equal to P1. The Effect of Changes in Cardiac Output Balanced by change in volume ( V1) causes the change in pressure ( P1). Mean arte- same change in volume ( V2) at a higher initial volume causes a rial pressure may remain constant despite a change in car- much larger change in pressure ( P2).
For substances lacking tyro- sine residues lasuna 60 caps without prescription, such as steroids, labeling may be accom- 20 14 plished by incorporating radioactive carbon ( C) or hy- 3 drogen ( H). In either case, the use of the radioactive hormone permits detection and quantification of very small 0 0 1 2 3 4 5 6 amounts of the substance. Unlabeled hormone (arbitrary units) Fixed amounts of Ab and of H* are added to all tubes (Fig. Varying by the dashed lines, the hormone content in known concentrations of unlabeled hormone (the stan- unknown samples can be deduced from the standard curve. The amount of each hormone that is bound to antibody is a proportion of that present in solu- One major limitation of RIAs is that they measure im- tion. In a sample containing a high concentration of hor- munoreactivity, rather than biological activity. The pres- mone, less radioactive hormone will be able to bind to the ence of an immunologically related but different hormone antibody, and less antibody will be able to bind to the ra- or of heterogeneous forms of the same hormone can com- dioactive hormone. In each case, the amount of radioactiv- plicate the interpretation of the results. The re- POMC, the precursor of ACTH, is often present in high sponse produced by the standards is used to generate a concentrations in the plasma of patients with bronchogenic standard curve (Fig. Antibodies for ACTH may cross-react with known samples are then compared to the standard curve to POMC. The results of a RIA for ACTH in which such an determine the amount of hormone present in the unknowns antibody is used may suggest high concentrations of (see dashed lines in Fig. Because POMC has less than 5% of the biological potency of ACTH, there may be little clinical evidence of significantly A elevated ACTH. If appropriate measures are taken, how- ever, such possible pitfalls can be overcome in most cases, and reliable results from the RIA can be obtained. One important modification of the RIA is the radiore- Antibody Radioactive Hormone-antibody ceptor assay, which uses specific hormone receptors rather (Ab) hormone complex than antibodies as the hormone-binding reagent.