Unit 5 Scientific Article June 2017 “vaping is far from harmless” Plausible questions 1. Suggest how “long-term randomised placebo-controlled study” can be carried out. (from paragraph 9) A large group of volunteers with similar health status, age, gender and lifestyle are taken. The volunteers are divided into two groups where one group is given a placebo (an inactive drug, if drug testing done) and the other the actual drug to be tested. They are divided randomly into {wo groups. If neither the data colletors nor the subjects know which group is taking the placebo, then can be a double-blinded test. The data collection would be carried out for many ‘years, during which effects of drug would be recorded. After the period of data collection, the data is analysed and compared to see if the drug had a significantly diferent effect than the placebo. 2. Define what is meant by the term placebo, A treatment given with no therapeutic effect, sometimes referred to as a sugar pill. In drug testing it may be given to test whether there isa significant difference in the results due to the actual drug to be tested over the psychological effect of the individual (called the placebo effect). 3. Formaldehyde (mentioned in paragraph 11) is ¢ known carcinogen used to store biological specimens for a long period of time. List some other cancer causing agents, from your own knowledge and the article. Asbestos, ionising radiation (such as X-ray/ gamma rays/UV ), benzene, tobacco ‘Trace metals (cadmium, arsenic, chromium, nickel and lead), tobacco specific N-nitrosamines (TSNA), polycyclic aromatic hydrocarbons (PAHS), volatile organic compounds (VOCs) 4, Define the term cardiovascular disease (paragraph 12) A disorder of the heart or its blood vessels which inhibits their funetion. Paget5. Paragraph 14 states that “standard cigarette smoke has the greatest effect, increasing atherosclerosis risk about three times over the baseline.” Describe how cigarette smoking increases the atherosclerosis risk. Cigarette smoke contains nicotine which increase the heart rate and constrict the blood vessels, This increases the blood pressure, increasing risk of damage to endothelium that can initiate atherosclerosis. It also leads to the formation of more free radicals which can irritate the and begin atherosclerosis. Cigarette smoking also reduces the HIDL levels and increase the LDL tevels in the body. This increases the level of cholesterol Aeposition if the artery wall gets damaged, thus increasing atherosclerosis risk. 6. Describe the process of atherosclerosis. ‘The endothelial lining of an artery gets damaged due to high blood pressure or chemicals in smoke. This initiates the body's inflammatory response, making white blood cells such as macrophages arrive to this area of damage. These macrophages engulf LDLs that entered into the damaged wall and deposit there forming a fatty deposit called an atheroma. This fatty deposit hardens over time due to accumulation of Calcium ions and fibrous tissue, hardening it ‘0 form an atheromatous plaque. This plaque reduces the elasticity of the artery wall and the deposits reduce the Iumen size. Thus, the blood pressure increases leading to further damage elsewhere and initiating atherasclerosis. 7. Paragraph 20 taiks about how certain chemicals can “impair the function of immune cells in the respiratory system”. One such cell is the alveolar macrophages. Suggest the function of these alveolar macrophages. Alveolar macrophages engulf bacteria, viruses or other foreign particles that reach the alveoli ithout being trapped by the“giia-‘These then breakdown these substances using enzymes in their lysosomes so that such foreign substances will not have an effect on the body, as they are removed before they can enter and cause harm, 8, State at least 4 types of immune cells identified inthe article, Macrophages, natural killer cells, neutrophils, eosinophils 9. Natural killer cells (identified in paragraph 21) are a type of cytotoxic cel similar to that of T- killet cells. Natural killer cel act as part of the non-specific response to infection and kill cellular invaders. Describe how T-killer cells carryout their function, T-killer cells attack infected host cells. They do so by releasing substances such as perforins which lead to the lysis of the infected host cell, releasing the pathogen into the body fluids. For them to be able to release these perforins, the inactive T-killer cells that bind to antigen presenting host cell has to be activated by eytokines released from activated T-helper cell. Page?10. State some of the potential health hazards of nicotine addiction from smokeless tobacco products reviewed in the policy statement by the American Heart Association, Hemodynamic effects, endothelial dysfunction, thrombogenesis, systemic inflammation. 11. One health hazard of smokeless tobacco noted in paragraph 31 include thrombogenesis. TThrombogenesis means to form a blood clot in a blood vessel. Deseribe this process. Platelets gets activated due to damage to vessel wall or due to a chemical in the blood. This leads to the release of thromboplastin by platelets which converts inaction prothrombin in blood to thrombin in the presence of vitamin K and Caleium ions. The activated thrombin acts as an enzyme that converts soluble fibrinogen into insoluble fibrin. This fibrin forms a mesh that traps blood cells and debris forming a blood elot (a thrombus) in the blood vessel. 12. Note down some concems of the medical community and opponents of e-cigarettes due to increased availability of e-cigaretes. += Could increase worldwide nicotine dependence, especially among the young as they can be enticed by the various flavour options. ‘Traditional smokers may substitute vaping for smoking in places where smoking is not fed, without any intention of quitting. + E-cigarette commercials on national television, coupled with public smoking may undermine current antismoking regulations. 13, “nicotine have long known to stimulate heart rate and blood pressure” paragraph 40. Suggest how nicotine stimulates the heart rate Nicotine stimulates the sympathetic division of the nervous system, sending impulses to the SAN from the cardiovascular control centre in the medulla and depolarising the SAN more frequently. Therefore, the heart rat 4, Monoamine oxidases are enzymes found atthe synaptic cleft, which breakdown neurotransmiters that are released. Describe the sequence of events that lead to the release of the ‘neurotransmitter into the synapse by a neurone, An action potential that reaches the axon terminal opens the Calcium ions channels on the presynaptic knob, Caleium ions thus rush into the neurone and lead to neurotransmitter containing vesicles to move to the presynaptic membrane. These vesicles fuse with the presynaptic membrane and release the neurotransmitters into the synaptic cleft by exocytosis. Pages1, Suggest how MAO inhibitors work MAOs breaks down certain neurotransmitters released into the synaptic cleft to prevent continuous depolarisation of post synaptic neurone. When MAO inhibitors are given, these enzymes are not able to bind with its complementary neurotransmitter 1 because the active site of MAO is no longer available, cither because the inhibitor is bound (0 ‘the active site or because the inhibitor led to the active site's shape to change. Therefore, no ‘enzyme-substrate complexes are formed and thus they MAQs are not functional. 16, Glycerine was thought to be the causative agent of exogenous lipoid pneumonia in a case study concerning a 42 year old woman (in paragraph 46). Suggest what is meant by the term causative agent. ‘The substance responsible for the symptoms of the disorder. 17, Computed axial tomography (CAT) can be used to observe internal organs such as the lungs and the brain non-invasively. State another non-invasive imaging technique you've learat to observe these organs and compare the two methods, ‘MRI scans. MRI can show more details on the softer tissues that the CAT seans due to its higher resolution. However, the procedure of MRI can be more time consuming and stressful due to the loud noise of the MRI machines, than compared to the faster, quitter CAT scanners. On the other hand, since CAT seans use X-rays they are considered unsafe and cannot be repeated frequently while MRI seanners use a magnetic field and also more expensive than compared to CAT seans. 18, Paragraph 48 identifies some basic pulmonary parameters. Suggest what is meant by forced vital capacity and describe how it can be measured. Forced vital capacity is the maximum volume of air that can be forcefully exhaled right after a forceful inhalation. This can be measured using a spirometer, where the individual will breathe in as deep as possible and exhale forcefully through the mouthpiece of the spirometer. The spirometer will have a specific volume of air inside and would be connected to a data logger or a kymograph, the difference between the highest peak and the lowest trough on the spirogeaph will be the vital capacity. Paget19, “immediate adverse physiological effects similar to some of the effects observed with smoking"(para 49). What are the important physiological effects associated with smoking? ‘Nicotine present in smoke increases adrenaline level, Adrenaline direetly stimulate SAN, increasing the heart rate and thus increasing the blood pressure. This increases the risk of atherosclerosis as the higher blood pressure increases chances of endothelial damage. Carbon ‘monoxide present in smoke increases carboxyhaemoglobin level which will be detected by chemoreceptors present in carotid artery, aorta and medulla, These chemoreceptors will send impulses to cardiovascular control centre in the medulla, from which impulses will then reach ‘the SAN through sympathetic nerve, The SAN depolarises more frequently as a result, increasing heart rate. 20. “Nicotine stimulates afferent nerve endings in the bronchial mucosa which then trigaees parasympathetic cholinergic pathways leading to bronchoconstrction.” (para 50). Describe how nerve impulse conduction occurs. ‘When the neurone is stimulated there is a momentary influx of sodium ions through the sodium channels along a concentration gradient. This is called depotarisation. The change in potential difference across the membrane of the axon from -70mV to +40mV. causes the action potential (+40 mV}. Sodium ions move to the adjacent resting region causing, change in the electrical charge (potential difference). The change in potential difference in ‘the membrane adjacent to first action potential initiates a second action potential. At the of the first action potential the sodium ion channel clase and potassium ion channel open and potassium ions begin fo leave the axon along the concentration gradient. As the potassium ions leave the axon through channels the membrane become repolarised behind the impulse. An overshoot of potassium ions occurs as channel proteins allow movement of more potassium ions cause hyperpolarisation. This causes the potential to fall lower than -70 mV; that is it will fall to-80 mY. A third action pote tiated by the second. In this way nerve impulses move along the axon. 21. Paragraph 50 identifies that nicotine can cause bronchoconstriction, Suggest the effects of bronchaconstriction on gas exchange. Bronchoconstriction leads to the narrowing of the lumen of the airways. This reduces the volume of air that passes through. Therefore, as less air is exchanged, the level of oxygen available in the alveoli decreases and the level of earbon dioxide removed decreases. Thus the steepness of the concentration gradient decreases and hence decreases the rate of diffusion, Pages22, “In recent years there has been an effort to clinically use exhaled nitric oxide as an important ‘non invasive adjunct to pulmonary function testing in order to monitor the degree of airway inflammation and eosinophilia commonly observed in conditions such as asthma.” (para 51). Explain how inflammation occurs. ‘When tissue damage occurs, the damaged tissue as well as mast cells release substances such as histamine and prostaglandins. These chemicals dilate the blood vessels and direct w' blood cells such as macrophages and neutrophils to arrive to the area of damage. Vasodilation ‘makes the area appear redder and warmer up as well due to the inereased blood flow. They also make the capillaries more permeable, leading to accumulation of tissue fluid in the area, ‘causing loca) oedema, 23, “Bahl etal. investigated the effects of @ number of cigerette refill fluids on cultured human tembryonic stem cells (nESCs)" (para 53). Explain the advantages and disadvantages of using, embryonic stem cells, Advantages- Cells are very versatile. Have the potential to successfully treat a wide range of diseases, Easy to identify and isolate embryonic stem cells. Disadvantages- Unethical, as the used embryos are discarded. Limited supply of spare embryos for the extraction of stem cells. Problems associated with tisue rejection. Formation of tumors. 24, List the methods of obtaining embryonic stem cells ‘+ Spare embryos created by In vitro fertilization for fertility treatment, + Therapeutic cloning (Nuclear transfer cloning) ‘Animal human embryos 25. Embryonie stem cells are usually pluripotent cells. Define the meaning of the term pluripotent stem cel. ‘An undifferentiated cell that can divide by mitosis to form more of itself and has the eapability to differentiate into most cell types of the body (excluding extraembryonic cells) Pages‘Some terminology used in text Paragraph ‘onerous: involving heavy obligations/ (ofa task or responsibility) involving a great deal of effort, ‘rouble, or difficulty paragraph 9 in liew of those: instead of those Paragraph 11 serolein: propenal (an unssturaed aldehyde) produced when glycerol in fats are burned. Inhaled acrlein i highly toxic and can severely itte the upper respiratory tract, even in low concentrations Paragraph 19 ‘myriad: countless or extremely great in number paragraph 20 diacetyl: a compound used in in food products to give butter flavour OSHA: Occupational Safety and Health Administration, an agency ofthe department of labour in usa. Paragraph 24 Laissez-fair: an economic system in which transactions between private parties are free from ‘government interventions such as regulation, privileges, tariffs and subsidies. Paragraph 26 Moot point: an irrelevant question, a matter of no importance Paragraph 30 Perils: damage Premise: previous argument, Abstinence: practice of restraining oneself from indulging in something Prudent: acting with or showing care and thought forthe future Page7Paragraph 31 ‘Hemodynamic: forces involved in the circulation of blood (dynamics of blood flow) such as blood pressure, blood volume ete Endothelial dysfunction: compromise of normal function of endothelial cells leading to inability of arterioles to dilate fully (imbalance between vasodilation and vasoconstricting factors produced by oF acting on the endothelium) ‘Thrombogenesis: format ‘ofa thrombus (blood clot in a blood vessel) Paragraph 43, Ameliorating: to make something more bearable/ better Paragraph 44 Mesolimbie areas of the brai “pleasure centre” ofthe brain Paragraph 46 ‘Paueity: the presence of something in only a small or insufficient quantity or amount Exogenous lipoid pneumonia: inflammation of the lungs due to the accumulation of lipids that are inhaled. Dyspnea: difficult or laboured breathing Bronchoalveloar lavage: a procedute where a broncoscope is passed through the nose or mouth into the fungs and fluid is squirted onto a small part ofthe 1ung and then collected for examination Restrictive ventilatory defect: disease ofthe Jungs hat restrict lung expansion, resulting in decreased lung volume, increased work of breathing and inadequate ventilation Reak expiratory flow: maximum rate at which a person can exhale (as hard and fast es possible) sensory neurones Paragraph $1 Adjunct: a thing added to something else as a supplementary rather than an essential part Eosinophil an increase in the number of eosinophils (a type of WBC) inthe blood, in response to some allergens, drugs, parasites and some types of blood cancer PagewParagraph 53 ‘Human pulmonary fibroblast: ceils inthe lungs responsible forthe synthesis of collagen and other connective tissue; important for lung tissue repair Cytotoxicity: death of cells (due to apoptosis/ysis) Paragraph 54 Murine: of mice or other related rodents Chronic idiopathic neutrophilia: an increase ofthe WISCs (neutrophils) overlong tine due to an unknown (no apparent) cause * Drug testing * Heart diseases * The ethics and care of using animals in drug trials * Pulmonary diseases * Immune system * Cancer * Parkinson's disease * Alzheimer's disease * Nervous system * Enzymes and inhibitors * statistics Pages