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Prolonged exposure to high alti- (h zoloft 100mg overnight delivery, in km): tudes increases the hematocrit levels, al- PB (at h) = PB (at sea level)! PAO2 is an important measure of oxygen above 7000m, where PIO2 is almost as high as supply. Mod- about 4000m above sea level during normal ern long-distance planes fly slightly below this ventilation (! As a result, larger possible without pressurized chambers or volumes of CO2 are exhaled, and the PACO2 and pressurized suits like those used in space PaCO2decrease(seebelow). Otherwise, the body fluids would begin alveolar gas equation, to boil at altitudes of 20km or so (! O2 deficiency ventilation stopsthePAO2frombecomingcriticaluptoalti- Hyperoxia occurs when PIO2 is above normal tudes of about 7000m (altitude gain,! The degree of O2 tox- times the resting rate) during strenuous physi- icity depends on the PIO2 level (critical: ca. Seizures and unconscious- signals from O2 chemosensors to increase the ness occur at PIO2 levels above 220kPa respiratory drive. This helps return the pH of the levels much greater than 40kPa (300mmHg) blood toward normal, and the O2 deficiency- for long periods of time (e. Large devia- + – added H or OH ions per unit volume that tions from the norm can have detrimental ef- change the pH by one unit. The buffer capacity fects on metabolism, membrane permeability, therefore corresponds to the slope of the titra- and electrolyte distribution. The farther the VariouspHbuffersareresponsibleformain- pH is from the pKa of a buffer system, the taining the body at a constant pH (! The Oneimportantbufferforbloodandotherbody buffer capacity of the blood is about fluids is the bicarbonate/carbon dioxide –1 –1 – 75mmol·L ·(∆pH) at pH 7. It is therefore classified as an open vinegar) or by metabolism, or removal from buffer system (! A drop in [CO ]2 2 The relatively acidic oxyhemoglobin anion – + leads to a rise in pH and vice versa (! A: [CO ]2 (Oxy-Hb ) combines with fewer H ions than – is the denominator in the equation).

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It would be convenient if a clinician could combine cheap zoloft 100mg line, interface, convert, and extract disparate medical information such as those listed above from peripheral devices like photo cameras, video conferencing session, content management systems, PACS, and regular office documents into a Web-based composite document. Thereafter, it would be convenient if this composite document could be used as the basis for browser-based collaboration (whether it is offline or real time) between various participants. Such a composite document generated should combine all relevant information needed for a particular collaboration session into one seamless document so that effective offline or real time collaboration can occur. A user could choose specific pages from document(s) stored locally and automatically have the selected pages converted to HTML format and hyperlinked with each other to form a composite document. Then, he or she could highlight important parts of the document and add personal comments with the help of voice and graphic annotations using our multimedia presentation software, called ShowMe (Sastry, Lewis, & Pizano, 1999). The multimedia annotation technology developed is unique as it not only captures the spatial nature but also the temporal aspects. For instance, the multimedia annotation on a document would capture a synchronized temporal voice, graphic and mouse pointer annotations. Finally, the user could save the composite document along with the annotations on the local web server, and this document is referred to as the collaboration document. Associated with this collaboration document is some metadata in the form of an XML schema that describes this document. This metadata is finally uploaded to the central server and its URL on this central server can then be sent to other participants. Participants can view the collaboration document via the URL of the metadata stored on the central Web server using a lightweight Web-browser player. As the collaboration documents are stored locally, they are amenable to document management tasks, including deleting, moving, and so on. However, any such document management task must be accompanied by making an appropriate change in the metadata located at the central Web server.

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THE MALE AND FEMALE REPRODUCTIVE SYSTEM ✦ 457 Meiosis Spermatic cord Gametes are characterized by having half as many chro- mosomes as are found in any other body cell buy cheap zoloft 50mg online. During their formation, they go through a special process of cell Vein division, called meiosis (mi-O-sis), which halves the Head of Artery number of chromosomes. Lobule ◗ The Male Reproductive System Septum Body of Capsule The male reproductive system, like that of the female, epididymis may be divided into two groups of organs: primary and Seminiferous accessory (see Fig. Specialized interstitial (in-ter-STISH-al) cells that se- crete the male sex hormone testosterone (tes-TOS-teh- The Testes rone) are located between the seminiferous tubules. The gland must descend com- pletely if it is to function normally; to produce spermato- zoa, the testis must be kept at the temperature of the scrotum, which is several degrees lower than that of the abdominal cavity. Primitive cells in the walls of these Primitive Mature Interstitial cells tubules develop into mature spermatozoa, aided by spermatozoa spermatozoa neighboring cells called sustentacular (sus-ten-TAK-u- lar) (Sertoli) cells. In males, these traits in- epididymis (ep-ih-DID-ih-mis), which is 6 meters (20 clude a deeper voice, broader shoulders, narrower hips, feet) long and is located on the surface of the testis inside a greater percentage of muscle tissue, and more body the scrotal sac (see Fig. The secretions in semen serve several functions: ◗ Nourish the spermatozoa Head ◗ Transport the spermatozoa Acrosome ◗ Neutralize the acidity of the male urethra and the fe- Neck male vaginal tract ◗ Lubricate the reproductive tract during sexual inter- Nucleus course ◗ Prevent infection with antibacterial enzymes and anti- Midpiece Mitochondria bodies The glands discussed next contribute secretions to the semen (see Fig. The glandular lining produces a thick, yellow, alka- line secretion containing large quantities of simple sugar and other substances that provide nourishment for the sperm. The thin, alkaline prostatic sum enlarges to form the glans penis, which is covered secretion helps neutralize the acidity of the vaginal tract with a loose fold of skin, the prepuce (PRE-puse), com- and enhance the motility of the spermatozoa. It is the end of the foreskin that prostate gland is also supplied with muscular tissue, is removed in a circumcision (sir-kum-SIZH-un), a sur- which, upon signals from the nervous system, contracts gery frequently performed on male babies for religious or to aid in the expulsion of the semen from the body. Experts disagree on the medical value of circumcision with regard to improved cleanliness and Bulbourethral Glands The bulbourethral (bul-bo-u- disease prevention. RE-thral) glands, also called Cowper glands, are a pair of The penis and scrotum together make up the external pea-sized organs located in the pelvic floor just inferior to genitalia of the male. During ejaculation, the involuntary Checkpoint 23-6: What glands, aside from the testis, contribute sphincter at the base of the bladder closes to prevent the secretions to semen? Out of the The Urethra and Penis millions of spermatozoa in an ejaculation, only one, if The male urethra, as discussed in Chapter 22, serves the any, can fertilize an ovum. At the distal end of the penis, the corpus spongio- ◗ Follicle-stimulating hormone (FSH) stimulates the sustentacular (Sertoli) cells and promotes the forma- Dorsal artery tion of spermatozoa.

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