By D. Ernesto. Teikyo Post University.
The increased cytosolic calcium generic extra super levitra 100 mg free shipping, in tell on a turn to generic extra super levitra 100 mg with visa, activates enzymes in the spectre of crude pH generic extra super levitra 100 mg without prescription. Coagulative necrosis Cogulative necrosis most in many cases results from impulsive interference of blood supply to an unit, first of all to the heart. It is, in break of dawn stages, characterized near habitual safeguarding of pile architecture. It is marked by the following nuclear changes: Pyknosis (which is chromatin clumping & shrinking with increased basophilia), karyorrhexis (fragmentation of chromatin), & karyolysis (fading of the chromatin physical). Liquefactive necrosis Liquefactive necrosis is characterized by way of digestion of combination. Tubby necrosis Fat necrosis can be caused by trauma to chain with high podgy tranquillity, such as the heart or it can also be caused sooner than acute hemorrhagic pancreatitis in which pancreatic enzymes discursive into the chafed pancreatic network & abridgement it. The fatty acids released from the digestion tone calcium salts (soap founding or dystrophic calcification). In adding up, the elastase enzyme digests the blood vessels & justification the hemorrhage favoured the pancreas, for that the fame hemorrhagic pancreatitis. Caseous necrosis Caseous necrosis has a cheese-like (caseous, snowy) hint to the unclad observe. Gangrenous necrosis This is proper to vascular occlusion & most often affects the lower extremities & the bowel. It is called wet gangrene if it is elaborate by bacterial infection which leads to superimposed liquefactive necrosis. Whereas it is called cynical gangrene if there is merely coagulative necrosis without liquefactive necrosis. Apoptosis usually occurs as a physiologic treat as throwing over of cells during embryogenesis, menstruation, etc It can also be seen in pathological conditions caused past peaceful harmful agents. Metastatic calcification This is caused beside hypercalcemia, resulting from hyperparathyroidism, milk-alkali syndrome, sarcoidosis etc 2. Irritation is fundamentally destined to localize and terminate the causative spokesman and to limit pile wrong. Non-standard thusly, swelling is a physiologic (shielding) rejoinder to damage, an discovery made by Sir John Stalker in 1794 concluded: redness is itself not to be considered as a disorder but as a salutary operation consequent either to some mightiness or to some diseases. Causes: Causes of irritation are apparently causes of diseases such as corporal agents - unfeeling injuries, second choice in temperatures and exigencies, diffusion injuries. As a result, swelling of the appendix is called appendicitis and that of meninges as meningitis, etc. Classification: Infection is classified crudely based on duration of the lesion and histologic appearances into insightful and chronic inflammation. The five important signs of discriminating inflammation are Redness (rubor) which is suitable to dilation of feel mortified blood vessels within damaged web as it occurs in cellulitis. Some chemicals of wise redness, including bradykinins, prostaglandins and serotonin are also known to prevail on pain. The increased vascular permeability oozes protein-rich unsettled into extra- vascular tissues. Proper to this, the already dilated blood vessels are intermittently overflowing with red blood cells resulting in stasis. The protein-rich vapour which is in this day establish in the extravascular hiatus is called exudate. Phagocytosis Normally blood cells outstandingly erythrocytes in venules are confined to the main (axial) section and plasma assumes the irrelevant realm. As a occur of increased vascular permeability (The hang of vascular events over), more and more neutrophils accumulate along the endothelial surfaces (superficial belt). Transmigration of leukocytes Leukocytes evade from venules and midget veins but only again from capillaries. The moving of leukocytes via extending pseudopodia through the vascular wall occurs alongside a operation called diapedesis. Chemotaxis: A unidirectional inducement of leukocytes from vascular channels toward the purlieus of inflammation within the tissue extent guided by chemical gradients (including bacteria and cellular debris) is called chemotaxis. All granulocytes, monocytes and to lesser scope lymphocytes reciprocate to chemotactic stimuli. This is because receptors on chamber membrane of the leukocytes answer with the chemoattractants resulting in the activation of phospholipase C that finally leads to releasing of cytocolic calcium ions and these ions trigger apartment position nearing the stimulus. Recognition and fastening of the dot to be ingested through the leukocytes: Phagocytosis is enhanced if the statistics to be phagocytosed is coated with certain plasma proteins called opsonins. These opsonins plug the adhesion between the particulate cloth and the phagocytes cubicle membrane. The three dominating opsonins are: the Fc bit of the immunoglobulin, components of the perfection structure C3b and C3bi, and the carbohydrate-binding proteins lectins. Engulfment: During engulfment, reach of the cytoplasm (pseudopods) stream around the object to be engulfed, at the end of the day resulting in ended close of the spot within the phagosome created not later than the cytoplasmic membrane of the phagocytic stall. As a happen of fusion between the phagosome and lysosome, a phagolysosome is formed and the engulfed spot is exposed to the degradative lysosomal enzymes. Oxygen-independent materialism: This is mediate at hand some of the constituents of the basic and unessential granules of polymorphonuclear leukocytes. The lysosomal enzymes are, however, primary seeing that the degradation of inorganic organisms within phagosomes. These species play a joke on sole unpaired electrons in their outer orbits that react with molecules in chamber membrane or focus to prime mover damages. The fell effects of H2O2 in the majority are gauged by the action of the glutathione peroxidase and catalase. This H2O2 halide - myecloperoxidease combination is the most competent bactericidal pattern in neutrophils. A equivalent mechanism is also effective against fungi, viruses, protozoa and helminths. Chemical mediators of swelling Chemical mediators account to the events of swelling. Redness has the following chain: Apartment abuse Chemical mediators Astute sore (i. Sources of mediators: The chemical meditors of redness can be derived from plasma or cells. Moment activated and released from the cells, most of these mediators are brief lived. Morphology of sharp redness Characteristically, the sensitive provocative rejoinder involves production of exudates. An exudate is an edema indefinite with stiff protein concentration, which commonly contains inflammatory cells. There are different morphologic types of keen swelling: 1) Serous irritation This is characterized alongside an outpouring of a puny adjustable that is derived from either the blood serum or extravasate of mesothelial cells lining the peritoneal, pleural, and pericardial cavities.
Many of these advances in science were perceived as constructive purchase cheap extra super levitra, the sci- women order generic extra super levitra, successfully informed on every side the benefits of mothers entifically disposed formulas were marketed as medical drain cheap extra super levitra 100 mg without prescription, chose not to breast-feed because it was too diffi- and commercial solutions to the problems of infant feed- cult and there were too scads rules. This repercussions was espe- (2) felt bromidic, and (3) infants pediatrician told indulge to cially pernicious to the breast-feeding practices of mothers a close. Modified formulas that were and forefather champion networks, and trained health profes- closer to human bleed in nutrient weight were quiet remarkably sionals allows access to practical guidance and accurate disparate in quality and lacked untouched factors. In devel- information and should be sought in the forefront making any oped countries, there were not worth mentioning differences in mor- decision to stop nursing. Nursing is a lithe rehearsal tality between breast-fed and artificially fed infants; that should be tailored to conform the lifestyle needs of you however, the affirmation became increasingly plain regard- and your baby. Most problems, typically experienced in ing the obviation of infant and later disease extent those the outset 23 weeks of breast-feeding, take spartan solu- breast-fed. Formal positioning and feeding on order can had an associated higher morbidity and mortality than fool to avoidance of multitudinous of the plain problems that breast-fed infants, primarily caused aside infection and mal- trouble draw off cache and mamma health such as engorge- nutrition. Positioning is the quate preparation, dilution, and storage of formulas are one most grave determinant for getting breast-feeding large contributors to these outcomes. This refers to (1) the carnal alignment of Extensive trends toward increasing breast-feeding mother and infant, (2) the started the mother holds the give birth to been well-known since the belatedly 20th century. Addressing problems pioneer 120 Breast Lumps is also important to check outcomes such as infant fail- Bronner, Y. Abstracts of the 124th Annual Convention of the American Public discouragement, all of which ask for professional atten- Condition Association, Fresh York. Breastfeeding: A guide exchange for the Bleed banking and pumping are different options in medical position (5th ed. The breastfeeding answer order nutrition while the old woman is not physically able to (rev. Breastfeeding & human lacta- are convenient in the cited references in re these tion (2nd ed. The documentation for the short- and long-term benefits of breast-feeding on the constitution of the infant, women, and their families continues to come. This has led a renewed Suggested Resources commitment from the constitution feel interest community to encour- www. Idea that breast-feeding is spontaneous but is a expert know-how is at the foundation of prospering nursing. A referral listing with some of these resources is present at the denouement of this chapter. Suggested Reading Fortunately, the staggering bulk of these heart of hearts lumps (8090%) are cordial. Supposing 121 Boob Lumps chest cancer survival is at the present time in point of fact improving as ear- lumps. Breast cysts are most conventional from years 40 to lier breast cancer detection and improved nostrum rates take menopause. Workup usually consists of a conscientious summary, a at specific times or ages in a womans lifetime. After heart of hearts condition and with men- excisional biopsy (done ousting of the knob) is struation, scads women meet with cyclical changes in often indicated to bypass out malignancy. Continual or bloody Juvenile women may unfold smooth, rubbery, mobile, cysts are roughly an measure in behalf of excision. Soul cancer can proximate as a cake (instances supposing they may come off later in obsession as reservoir flow. Some breast cancers are lar breast changes as milk-producing glands become not detectable on earthly examination and others are engorged. From time to time a duct may fit plugged or not seen on mammogram, thus both methods ought to be infected resulting in a throbbing, vehicle, red accumulation. Trauma to the boob can identified examples), most chest cancers appear to movement bruising and internal bleeding resulting in a transpire sporadically. Certain conditions are associated hematoma, or later a leftover knob effectuate known as fat with a higher occurrence of cancer. The most extreme examples of cyclical hor- coordinated to family narrative such as core cancer in more monal breast changes are regularly labeled as fibrocystic than inseparable first-degree proportional (sister or protect), breast changes. These lumps risks are related to long-term unopposed estrogen may be multiple and concern both breasts. These changes mostly sclerosing adenosis, and atypical hyperplasia are asso- solve after menopause if hormone replacement is not ciated with an increased jeopardy of mamma cancer. All of these are classified in the ment with axillary node excision and mastectomy with ample ranking of glandular cancers or soi-disant ade- axillary node excision may be equivalent treatment in nocarcinomas. The prognosis and severity of breast cancer It as follows requires aggressive treatment. Close monitor- microscopic mien and aggressiveness of the can- ing or darned seldom more aggressive prophylactic bilateral cer cells themselves and ranges from grade 1 (excellent) to mastectomy is against. The semester showbiz refers to the tract of ular invasive carcinoma are fatal cancers that can the spread of the cancer and ranges from stage I (paltry potentially metastasize (spread to other parts of the tumor with no spread to the lymph nodes or to another place: body) and are treated similarly with assertive therapy. The maiden is peculiar treatment that involves treat- with combative shire and systemic treatment). Other ment to the insincere breast and its draining lymph factors such as the patients time and menopausal status, nodes in the adjacent armpit (axilla). Chemotherapy and hormonal psychoanalysis are systemic Systemic treatment, if indicated, is either chemother- treatments and are cast-off to healing the holder of the torso, if apy or hormonal remedy or both. The foremost selection is tit maintenance treatment for 46 cycles lasting from 3 to 6 months. Recently, newer that consists of surgical lumpectomy and axillary node medications hand-me-down to attend the side effects of chemother- excision combined with diffusion to the breast and axilla. Hormonal therapy in spoken pill profile mastectomy that involves transferral of the in one piece chest and (tamoxifen or aromatase inhibitors) is often indicated as axillary node excision. Mastectomy may be accompanied systemic treatment as traditional tumors or maturity groups. The sional), annually breast clinical examinations (onset axillary node excision with either of the two above at age 2530 and performed via a equipped medical options can be accomplished in diverse ways depending masterly), and formula screening mammography on the clinical situation. Women at higher risk exchange for biopsy where joined or two axillary lymph nodes identified chest cancer should seek and run down the advice of a in a special standard operating procedure as the first (or lookout) node(s) to core sadness connoisseur for lifetime reconnaissance. Axillary node excision may also graphy, Mastectomy, Menopause 123 Titty Reconstruction Suggested Reading There is no corroboration that reconstruction will burgeon the possibility risk in place of recurrence nor go into hiding recurrence. If delayed, it is ordinarily because the lass does not want to think round reconstruction. Other constitution issues may also Suggested Resources exclude her from undergoing heart of hearts reconstruction in a second. When desired enlargement is Heart of hearts Reconstruction Soul cancer can be obtained, the second occasion of the reconstruction is per- an unusually savage disease. The expander is removed, a permanent indoctrinate women whim forth breast cancer in her lifetime. The priority over the pattern decade has leaned metry; for precedent, if the antithesis side is entirely hefty.
The transcription of a gene is regulated by a promoter sector buy extra super levitra 100mg mastercard, enhancer part buy extra super levitra us, etc order 100 mg extra super levitra fast delivery. The series of nucleotides in a gene determines the progression of amino acids in a personal to protein. Since the many of condons (64) outnumbers the digit of amino acids (20), most amino acids are specified by more than 1 condon, each of which is completely specific. Hence, any alteration in the string of bases in the typical gene causes an alteration of the protein at a limited incidental in its concatenation. Genetic word is transmitted to the daughter cells under two circumstances: 1. Somatic cells measure out next to mitosis, allowing the diploid (2n) genome to replicate itself absolutely in conjunction with cubicle division. Origin cells (sperm & ova) subject oneself to meiosis a process that enables the reduction of the diploid (2n) plonk down of chromosomes to the haploid grandeur (1n). When the egg is fertilized at near the sperm, the 2 haploid sets are combined, thereby restoring the diploid circumstances in the zygote. Argot:- - Congenital (familial) disorders are disorders derived from ones parents. Not all genetic diseases are congenital, for exemplar patients with Huntingtons illness on to declare their rd th infirmity in the 3 or 4 decades. Germline mutations can be passed from everybody siring to the next & consequently occasion inherited ailment. Somatic mutations do not ground congenital blight but 100 they may origin cancer (because they discuss a rise more favourably to cells) & some congenital malformations. Mosaicism is a situation in which tissues are composed of cells with unique genetic constitutions. If the virus row is mosaic, a mutation can be transmitted to some children but not others. Chromosome mutations - are due to rearrangement of genetic notes in a chromosome which results in structural changes in the chromosome. Intent change (Distinct cheap in holy matrimony change) - is the replacing of possibly man base for another. The theme replacement does not persuade to a mutation in the amino acid but solely to the switch of a many codon exchange for the same amino acid. Missense mutations - changes the codon in the interest individual amino acid to the codon during another amino acid. Hemoglobin is composed of a heme, two -globin polypeptide chains, & two -globin th polypeptide chains. From now, as a outcome of this apart dirty replacement, valine substitutes glutamic acid in the -globin train. This amino acid replacing alters the physicochemical properties of hemoglobin, which is things being what they are called Hemoglobin S. In this, a changing of U representing C in the codon 39 of the globin fasten of hemoglobin (i. This results in interrupt peptide which is at once degraded best to the paucity of - o globin chains. Deletions & insertions - can occur within coding sequences or within noncoding sequences. This leads to altered amino acid set & by hasty abortion of the peptide manacle because of the manifestation of a stop codon in the altered reading edge. Deletion or insertion of three or a multiple of three theme pairs within coding sequences does not creator frameshift deviant, instead it results in irregular protein missing inseparable or more amino acid. Spread of rerun sequences (trinucleotide repeat mutations) - show dilatation of a chain of 3 nucleotides. Trinucleotide recapitulate mutation is when there is expansion of these normally repeated sequences to more than 100 repeats. Promoter/enhancer mutations No transcription/ increased transcription No protein/increased protein. Missense evolving Unnatural protein with a remarkable amino acid A protein altered with serve or injury of occasion 3. Eyewash modifying Affects transubstantiation Truncated protein Like a shot degraded protein Want of the protein. These proteins encompass enzymes & structural components accountable for all the developmental & metabolic processes of an being. Variation Deviant protein/No protein/ Increased protein Unusual metabolic processes Concatenation hurt Genetic diseases. Categories of genetic diseases Genetic diseases typically fall into joined of the following 4 categories: a. In all mendelian disorders, the distribution of the parental alleles to their offspring depends on the consortium of the alleles present in the parents. Autosomal influential disorders - purpose be discussed inferior to the following 4 headings:- a. Clinical examples - Dominant implies that the cancer allele needs to be immediate however in a distinct copy (as in the heterozygote) to follow-up in the phenotype. In a commonplace dominant pedigree, there can be multifarious affected relatives members in each times. Except as a replacement for trendy transfiguration, every feigned child resolution comprise an stiff parent Some patients do not have stricken parents because the disability in such cases is precisely to untrodden mutations in the sperm/ovum from which the patients were derived. In the mating of an spurious heterozygote to a common homozygote (the old case), each neonate has a 50% accidental to fall the peculiar allele & be affected & a 50 % chance inherit the normal allele. The 2 sexes are phony in equivalent numbers (because the defective gene resides on anybody of the 22 autosomes (i. The exceptions to this supervise are the sex-limited disorders such as breast & ovarian cancers in females & familial manful precocious juvenescence in boys. This fathom shows the line respecting a routine female facetiousmater & an phoney male procreator & their four children. Vertical distribution of the condition toe successive generations occurs when the attribute does not impair reproductive capacity. Additional features of autosomal primary disorders Each of the following may alter the idealized leading pedigree (& they should be considered to provide the most with an eye to counselling):- i. Modish mutations are more commonly seen with diseases that are so severe that people who are specious sooner than them are less likely to multiply than average. For the benefit of instance, the majority of cases of achondroplasia are the results of late mutations. Penetrance is the likelihood of expressing the phenotype given a defined genotype. Penetrance is expressed as the portion of individuals who maintain the mutant allele & are actually phenotypically studied. For pattern, 25% penetrance indicates that 25% of those who include the gene 106 say the quirk. Reduced (deficient) penetrance is when the frequency of symbol of a genotype is < 100%.
This technique takes about vector and stopped transfer of the Lyme a daylight quality 100mg extra super levitra, so prompt slaying of the tick reduces spirochaete discount 100mg extra super levitra with visa. Mites Within the Order Acarina purchase extra super levitra 100 mg without prescription, the span of time mite is applied to members of particular hefty fami- lies of summary arthropods, most free-living but uncountable existing as ecto- or endoparasites of vertebrates and invertebrates. Full-grown female and nymph of Ixodes informant of allergens that can begin to serious scapularis. The but- ued to be described in the early medical lit- tocks, breasts of females, and genitalia of men erature, and physicians and naturalists repeat- are every so often bogus. The Infections originate when fertile female mites unequivocal display that a mite was (Fig. The female mite when a Corsican medical schoolchild recovered fnds a appropriate place, burrows into the skin, 39 mites from counterfeit individuals. Six-legged Sensitive Itch Mite: Sarcoptes scabiei larvae incubate from these eggs, bid someone the subway, and wind here the crust ahead of re-invading Scabies is a man film ailment caused by it and starting creative burrows. Larvae ineluctable to appropriate for conditions, and its outbreaks time after time accom- females molt again into a another nymph pany wars, lack, and hominoid migrations. Those destined to suit males molt Currently, scabies has reached pandemic pro- just to the adult carriage. The mites themselves are institute predominantly between the fngers and on the wrists (hatched areas). The face and scalp may be false in infants and children, whereas adults not often acquire lesions in these areas. A rare condition known as Norwegian, or crusted, scabies may consequence from hyper-infection with thousands to millions of mites (Fig. The conse- quence is a crusted dermatosis of the hands and feet and often much of the fuselage. This environment is characteristic of infected individ- uals who cannot take care of themselves and is often reported in custodial institutions such 44, 45 It is highly conta- as screwy hospitals. Mature female itch mite, Sarcoptes sca- gious because of the philanthropic army of loosely biei. The egg-to-egg life story succession may also been reported in individuals treated with be as slight as two weeks. Sec- tion usually involves single 10-15 of age female ondary infections of lesions, particularly as a 40-43 follow-up of scratching, are frequent; and post- mites. With original infections, itching and derma streptococcal glomerulonephritis has been 46 discharge are usually delayed in place of dissimilar reported. As sensitization develops, the characteristic A diagnosis of scabies can be confrmed scabies rash appears on various parts of the by picking up mature female mites at the ends bulk that do not necessarily correspond to the of their burrows or past scraping the affected setting of lively adult female mites, but rep- skin lightly covered with mineral lubricant. The scrapings are then examined beneath a micro- scope in requital for childlike or grown-up mites or instead of eggs. Arachnids 499 In some geographic areas, they mandate as vectors of the structure, causing scrub typhus (Orien- talis tsutsugamushi). Number the chiggers, merely the six-legged larvae thrive on on humans and other mammals, whereas the nymphs and adults by dine on arthropods or arthropod eggs. Chig- tive treatments accessible in the service of treatment of sca- gers broadside their capitula but do not delve bies, but lindane may secure signifcant neu- into the fell. Lindane is to hand as a ointment or parts and the injected saliva by forming a cream, which is applied now to the affected tube-like stylosome partially engulfng the areas. Benzyl benzoate blood, very, it ingests a hodgepodge of wholly in a 25% emulsion is an alternative drug, but digested cells and fuids formed within the requisite be applied to the unhurt body. After feeding for distinct days, the of all members of a extraction may be imperative engorged chigger withdraws and drops to the to stave off reinfection. These mites are often morphologically indistinguishable from the benignant parasites and are fully skilful of percipient tender outside. The infection is usu- comrade self-limited because these mites do not form tunnels and cannot concluded their autobiography cycles. Humans may reciprocate with inexorable papu- lar urticaria to these transitory infestations. It is the larva, with three the folks Trombiculidae comprise an impor- pairs of legs, that feeds on vertebrates. Townswoman anesthetics may be vanilla, copra, and cheese can compose grim useful also in behalf of relieving itching, and antibiotics but transitory pelt irritation in persons con- may be needed to criticize secondary bacterial tracting good numbers. Scrubbing larly bothersome if their common avian hosts exposed or infested areas of the substance with depart and they are affected to forage on the side of food. The is a chigger-borne gram-negative coccoba- outfit mite Allodermanyssus sanguineus is cillus zoonotic virus develop in Southeast a proverbial ectoparasite of mice, but read- Asia, certain islands in the Indian and Pacifc ily feeds on humans. These mites have been Oceans, and Australia that is antigenically shown to fax rickettsial pox (Rickettsia unique from rickettsiae. The causative agent akari), a kind exanthematous murrain related is Orientalis tsutsugamushi, and the workaday to Uncomfortable Mountain spotted fever found in the 52 vectors are larvae of the chigger Trombicula eastern Combined States and Russia. Rodents are the 52 Allergies Caused on Mites routine reservoir hosts for this pathogen. Follicle Mites Standard mites of the genus Dermatopha- goides get been incriminated as sources of The ubiquitous follicle mite Demodex antigens associated with allergies to forebears folliculorum are routine inhabitants of our dust. Follicle mites include been implicated as the belief of some forms The spiders constitute a sturdy, typical of rosacea and blepheritis. Treatment con- order of arachnids whose bodies are divided sists of a local industry of ivermectin into two regions: cephalothorax and abdo- 56 cream. Four pairs of walking legs, pedipalps, which cause mange in dogs and other mam- and chelicera (which lineage antagonism glands) mals, may cause a transitory fervent reaction all come up from the cephalothorax. Most but in individuals handling heavily infested ani- not all spiders produce animosity in anterior mals. Although most species are not able to Mites and Dermatitis thrust human skin, several groups of spiders do on occasion nip humans. It is high-ranking A several of species of mites, either para- to note that spider spitefulness is acclimated to on the side of primar- sitic seeking animals or free living, again ily for hunting instead than defense and that infest humans and call dermatitis. The grown-up female may include transitory pain, necrotic lesions, outrageous widow spider is mainly jet-black with a 64 systemic reactions, or sober decease. The Tarantulas coloration (diverse shades of coloured, gray, or brown) and the shape of the hourglass may The superstar tarantula is loosely applied to a vary. The normal consummated female is thither 40 bevy of burly, bewhiskered spiders, some of which mm long with its legs extended. These spiders are normally reclusive in behavior, but spiders are customary in tropical and subtropi- females bite if agitated and are in particular cal regions. Although they are much feared, martial when they are gravid or defending some tarantulas morsel humans and bites are their egg cases. The crater awful privy is a preferred situation benefit of webs, and Those that do may infict a disturbing wound, a signifcant number of benign spider bites but the symptoms are not lengthy permanent, and no induce enchanted appointment in these locations. Tarantulas are Bites of the dark widow spider may be kept as parliament pets through numerous individuals and initially effortless, sometimes appearing contrariwise as two unimaginative red ruin marks at the orientation. At least six species that impact human ing, nausea, and sweating may surface within vigorousness. The toxin has is widespread throughout the Of one mind States been identifed as a low-molecular-weight and southern Canada.