Today we had a pretty interesting class discussion as to whether or not dentists should have to perform mandatory community service outside of their dental practice. There was definitely mixed feelings: some individuals felt that dentists have the obligation in giving back to their community and should do extra volunteer work such as donating time and money to local organizations. They felt that volunteering was an important part of their application when applying to dental school, and that this is value should be continued on in practice outside of dental school as well.
Others took that stance that dentists should not be made to do additional volunteer work, and that they should be able to use their extra time off work to focus on their family or pursue other hobbies. The dental profession can be a pretty demanding and stressful job; it is imperative for the healthcare professional to relax and reduce stress levels however he or she deems fit.
And others felt that the dentist's obligation was to their own professional bodies. In order to obtain autonomy in the profession, dentists must take care of their own, in other words.
Interesting thoughts.
Biochemistry
Our Biochem lecture was cut short today as we spent a block of time going over review questions for an upcoming midterm. We spent the time finishing up our discussion of gluconeogenesis and gave some examples of diseases arising from problems in its regulation.
We said prior that gluconeogenesis and glycolysis can be quickly regulated through phosphorylation and dephosphorylation. In times of low blood sugar, the body releases glucagon and adrenaline, which work to produce cAMP. cAMP stops the synthesis of glycogen and initiates the breakdown of glycogen by activating phosphorylases.
Another method of regulation involves the functioning of Fructose-1,6-Bisphosphate, which acts as an allosteric effector (small molecule that binds to an enzyme and alters its function). It inhibits fructose-1,6-bisphosphatase which is important in running gluconeogenesis, and inhibits/activates fructose-2,6-bisphosphatase and phosphofructokinase.
Type I glycogen storage disease (aka von Gierke disease) is caused by a deficiency in the enzyme glucose-6-phosphatase. It is an enzyme found in liver/kidneys which removes phosphate to make glucose, so it can leave the cell and enter the blood stream. However, with th edisease, glycogen can't be broken down into glucose and is trapped in the cells. As a result, the liver swells up in size (hepatomegaly), you see hypoglycemia because the liver cannot release glucose, and hyperuricemia, since the body begins to use proteins for energy. The excess nitrogen is converted by the body into uric acid.
Other diseases includes:
- Type 4 glycogen storage disease; a deficiency of a branch enzyme in glycogen. Muscles cannot store up as much glycogen, and you are left with muscle fatigue
- Type 6 glycogen storage disease (Her disease); a deficiency of liver phosphorylase, so you seee the same symptoms as Type 1 glycogen storage disease (but only effects liver)
- Type 2 glycogen storage disease (Pompe disease); a deficiency in lysosomal cells, which affects all organs and leads to cardiomegaly and ultimately heart failure at an early age.
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