Description: Incretins are a group of gastrointestinal hormones that cause an increase in the amount of insulin released from the beta cells of the islets of Langerhans after eating, even before blood glucose levels become elevated. They also slow the rate of absorption of nutrients into the blood stream by reducing gastric emptying and may directly reduce food intake. As expected, they also inhibit glucagon release from the alpha cells of the Islets of Langerhans. The two main candidate molecules that fulfill criteria for an incretin are glucagon-like peptide-1 (GLP-1) and Gastric inhibitory peptide (aka glucose-dependent insulinotropic polypeptide or GIP). Both GLP-1 and GIP are rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4).

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Description: Lesch-Nyhan-Syndrome

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Description: Adrenergic receptors (adrenoceptors) are receptors that bind adrenergic agonists such as the sympathetic neurotransmitter NE and the circulating hormone epinephrine (EPI). The most important adrenoceptor in the heart (not including coronary vascular adrenoceptors) is the β1-adrenoceptor. When activated by a β1-agonist such as NE or EPI, heart rate is increased (positive chronotropy), conduction velocity is increased (positive dromotropy), contractility is increased (positive inotropy), and the rate of myocyte relaxation is increased (positive lusitropy). There are also β2-adrenoceptors in the heart and stimulation by β2-agonists has similar cardiac effects as β1-adrenoceptor stimulation. The β2-adrenoceptors become functionally more important in heart failure because β1-adrenoceptors become down regulated. NE can also bind to α1-adrenoceptors found on myocytes to produce small increases in inotropy. Circulating catecholamines (epinephrine) released by the adrenal medulla also binds to these same alpha and beta adrenoceptors on the heart on myocytes. In addition to sympathetic adrenergic nerves, the heart is innervated by parasympathetic cholinergic nerves derived from the vagus nerves. Acetylcholine (ACh) released by these fibers binds to muscarinic receptors in the cardiac muscle, especially at the SA and AV nodes that have a large amount of vagal innervation. ACh released by vagus nerve binds to M2 muscarinic receptors, a subclass of cholinergic receptors. This produces negative chronotropy and dromotropy in the heart, as well as negative inotropy and lusitropy in the atria (the negative inotropic and lusitropic effects of vagal stimulation are relatively weak in the ventricles).

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Description: Renin-angiotensin-aldosterone system

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Description: Renin-angiotensin system in man

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Description: Leksell Gamma Knife

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Description: Image transfer and dose planning.Gamma plan

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Description: Frame fixation and imaging:The treatment starts with fixation of the Leksell Stereotactic Frame to the patient\\\'s head.

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Description: Local anaesthesia

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Description: Stereotactic Frame Fixation

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Description: Thats me at RANCAN Gamma knife centre,VIMHANS

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Description: Taking a break between operations

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Description: Dr Gaur, Head of the Gamma knife centre VIMHANS

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Description: Collimator helmet (predetermined coordinates)

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Description: Stereotactic Frame Fixation

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Description: Gamma Plan

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Description: Control center

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Description: Christina & Johanna

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Description: Sabine

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Description: Sabine und Tanya

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