Youtube News: Youtube daily report w Jun 28 2017

The next question.

Hello Alexei. My name is Zhenya. When did you understand, that the state needs you as an athlete?

I guess they need us only when we win.

Though I want to say that a kind of the Olympic stipend or slash pension exists in our country.

Yet it exists for the Olympic champions, as for other athletes... I don't know.

How much is it?

Well, I don't like to speak about money in our country, I always depart from this question. So using the rules of our show, I depart about how much.

You know, Alexei, looking into somebody's pocket is likely not good indeed, yet according to the rules of our show we should note the first refusal.

Y: Thank you, the voice from up above. H: You are welcome, Alexei. You still have a right to refuse to answer two questions.

We continue the talk. The next question, the red microphone.

Hello Alexei. My name is Ira. I'd like to ask you: are you offended, that the sport has took so much of your health?

No, because thanks to the sport I sit here and socialize with you.

In my situation the sport has given an enormous chance, has opened many doors in my life where I can go.

If there was no sport... I was dreaming of being a long distance trucker, when I was a child.

Maybe I would be going along those bumpy roads somewhere between Moscow and Peter. E95 highway.

Yet not many are as successful as me or Zhenya.

Millions of children do sports. Many of them maybe not ruin their health,

but do cross that line, when the sport demands more than their body can give, and they can't win.

So as for education, their education isn't very good and as for sport, they didn't succeed to win.

Yet I'm lucky. I'm lucky, because the sport bent to me,

and I have many opportunities in my life thanks to the Olympic title, so I am not offended.

G: Thank you very much. H: The question on the right.

Hello Alexei. My name is Anya, and I'd like to ask: do you beep, when you go through a wanding station?

You are prepared! In America I do. Maybe their stations are more delicate.

In Russia... only in Domodedovo airport, as far as I remember. Yet Sheremetievo has new devices now, so in Sheremetievo as well.

I often see people who hear: "Put off all the metallic things," - yet they leave their belts on them, their watches or glasses.

Many people are waiting, but they put off the things one by one, and something beeps again...

I know in advance... (we often fly) I put off everything, even my shoes...

they say: "You don't need to put off the shoes." I say: "I need." And it beeps. She asks: "What else do you have?"

I put up my hands, I say: "It's my hip." Yet usually they recognise me, they check it at once: "Yes, OK."

Sometimes I ask them: "Show it to me! Show how it looks like!" Sometimes they show. So yes, sometimes I beep.

What is the most difficult for you in the figure skating?

I think the most difficult in the figure skating will be retiring from it. This step will be difficult.

Retiring from the competitions was a very difficult step for me. I did it because of my health, I couldn't bear pain any more.

I couldn't skate on the same level, what was needed for serious competitions. It was a really difficult step.

As for the skating, I can't say, that something is harder or easier.

Jumps are one thing, the stamina (so that one could do it from beginning to the end) is another thing. Everything is OK.

I think the most difficult is ahead, the most difficult moment will come, when I'll have to put off the skates,

to hang them on a nail and to say: "Enough". So the most difficult is ahead, thanks to God.

One more question, the yellow microphone.

Hello, my name is Elizaveta. Can you show your tongue?

Alexei Yagudin is the guest of the show "100 questions to an adult" today.

Alexei, unfortunately the time for the questions from the participants of the show is over.

Now you have a right to ask any of children your questions. You are welcome.

A question to the girl (about the tongue): why?

Just for fun.

Ah, I've got it. Thank you.

Alexei, is that all or would you like to ask something else?

I would ask this girl: what do you think about man's tears or disappointment? does a man have such a right or he doesn't?

I think he has.

I just think some people are more emotional, some are less emotional, everyone expresses oneself his own way.

Many of us will be breaking hearts, somebody will be breaking our hearts. Yet such is life, we can't escape from it.

So let it be, may these unpleasant situations teach us something, because I was getting much information from these moments as well.

So the last question is usual, as the voice from up above says: was it interesting for you?

Yes. Y: Thank you.

Alexei Yagudin is the guest of the show "100 questions to an adult". We are seeing our guest off. Alexei, I am waiting for you at the entry.

Thank you.

I ask you to stop here for a while, Alexei, I have a question: which of the questions was the most difficult for you today?

Frankly, none of them. I was absolutely calm, I understood what I should say.

I didn't think, that I should worm out of it, no, there were estimable questions, I knew what I should answer,

and I can't say, that there was a question which knocked me off my stride.

Did you hear some traditional questions today, questions which you are tired to answer?

"How did you start skating?" It is a frequent question. About the figure skating. I've been skating for 26 years,

so when I hear again "how did you start skating?", "what did you want to be?"...

yet it is OK for me, this is an absolutely new audience, I am absolutely new for them, so it was interesting for them.

OK. You succeeded to answer 17 questions out of 100 which were planned. If you'll be invited again to such an audience, will you agree to come?

Yes, with pleasure. And it seems to me, that now, when I know more about this show, I'll succeed to answer 100 questions in the available time.

Now I'd like to ask the participants of the show: guys, would you like to invite Alexei again? Yes.

OK. Thank you, that we hear so many voices.

Now guys, could you tell, please, why did you like Alexei so much?

Alexei, you impressed us today, actually! We all know, that athletes often are not very talkative,

and you didn't need to think each time when you answered a question. Thank you very much for your openness. Y: Thank you.

It seemed to me, that you are a very young man who has reached his goals, and today I understood, that you are very adult and serious man.

I am already 30 years old.

Alexei, it was nice to meet you, to see you, and I have a dream, I'd like to become a reporter on TV,

and I'd like to meet you again and to do an interview, a real one. It would be a pleasure.

Y: I can give my contacts. Now. B: Cool! Thank you.

Who else would like to speak?

I'd like to say, that it was nice to listen to your answers, I'd like to see you again in this show, because I didn't have time to ask my questions.

Alexei, according to our tradition, our guest has the final word. Summarise the talk, please. You have 30 seconds.

It is strange, that I had a minute to speak about me, but I have only a half to summarise the talk. It is always needed more time for summarising than for describing oneself.

I'm happy, that I've spent these hours with you. You are young people of an absolutely different age.

It was very interesting to hear what's going on in your heads and what questions you have.

I'd like to wish you... I had such a sense of purpose as well. We should always understand what do we want from ourselves,

we should set goals and do our best to reach them, and set new ones when those are reached. So remember, guys, that always everything depends on you, only on you.

You should overcome yourselves, overbear, should do these first steps, may they be difficult, but... you are the future,

so never lose hope, believe in yourselves. Good luck to all of you!

The world-class Merited Master of Sport, the Olympic champion Alexei Yagudin was the guest of the show "100 questions to an adult" today. See you next week, friends!

For more infomation >> (subs) Yagudin - 2010 -PART3- "100 questions to an adult" - Duration: 12:38.

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Dota 2 Cheater - PUDGE with AUTO HOOK! - Duration: 7:05.

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Manhã Leve | Cresce o número de mulheres no mercado de trabalho - 28 de junho de 2017 - Duration: 40:53.

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8 Ball Pool Free Coins - Duration: 0:32.

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Seat Ateca - Duration: 1:06.

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Just A Gent - You'll Never Know (feat. MOZA) [Lyrics] - Duration: 3:30.

I can't speak another word,

I think I'm 'bout to lose my nerve,

All with thinking down and moving my head backwards.

It's been so long since I felt this,

I blame it on your winding hips.

What I wouldn't do to taste the grooves of your lips.

Left foot,

Right foot,

Turn around.

Keep that motion on the ground.

What I wouldn't do to say your comin' home now.

Left foot,

Right foot,

Turn around.

Keep that motion on the ground.

What I wouldn't do to feel your skin to mine now.

I just,

Breath it in.

Save my breath.

Never know,

When I'll need it next.

I'll lose it all,

Just to here you call.

Ain't it strange?

Darling, you'll never know.

You never seem to leave my head,

You won this town, I'll paint it red.

Conthoughted in ya now, I wish you knew what I meant.

'Cause I know your thoughts,

And you know mine.

We're flexable, We chose to be blind but,

Is it such a stress to call you one of my kind?

Left foot,

Right foot,

Turn around.

Keep that motion on the ground.

What I wouldn't do to say your comin' home now.

Left foot,

Right Foot,

Turn around.

Keep that motion on the ground.

What I wouldn't do to feel your skin to mine now.

I just,

Breath it in,

Save my breath,

Never know,

When I'll need it next.

I'll lose it all,

Just to hear you call,

Ain't it strange?

Darling, you'll never know.

I just,

Breath it in,

Save my breath,

Never know,

When I'll need it next.

I'll lose it all,

Just to hear you call,

Ain't it strange?

Darling, you'll never know~

For more infomation >> Just A Gent - You'll Never Know (feat. MOZA) [Lyrics] - Duration: 3:30.

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Renal tubular acidosis - causes, symptoms, diagnosis, treatment, pathology - Duration: 15:08.

With renal tubular acidosis, renal refers to the kidney, tubular refers to the main

tube-portion of the nephron, and acidosis refers to having too many protons or increased

acidity in blood, so renal tubular acidosis or RTA describes increased acidity in the

blood because the renal tubules can't get rid of protons.

The kidneys contain millions of nephrons, each of which has a renal corpuscle, and a

renal tubule that ends in a collecting duct.

The renal corpuscle filters large amounts of solutes that go from the blood into the

filtrate and eventually the urine, and the renal tubule and collecting duct are responsible

for fine tuning the reabsorption and secretion of solutes to adjust the amount that ultimately

gets retained by or removed from the body.

Broadly speaking, renal tubular acidosis can develop in either the proximal convoluted

tubule, sometimes called just the proximal tubule, or the distal convoluted tubule, or

distal tubule, and the nearby collecting duct.

The proximal tubule is lined by brush border cells which have two surfaces.

One is the apical surface that faces the tubular lumen and is lined with microvilli, which

are tiny little projections that increase the cell's surface area to help with solute

reabsorption.

The other is the basolateral surface, which faces the peritubular capillaries, which run

alongside the nephron.

Now - when a molecule of bicarbonate approaches the apical surface of the brush border cell

it binds to hydrogen to form carbonic acid.

At that point, an enzyme called carbonic anhydrase type 4 which lurks in tubule among the microvilli

like a shark, swims along and splits the carbonic acid into water and carbon dioxide.

The overall equation looks like this:

The water and carbon dioxide happily diffuse across the membrane into the cells where carbonic

anhydrase type 2 facilitates the reverse reaction - combining them to form carbonic acid, which

dissolves into bicarbonate and hydrogen.

A sodium bicarbonate cotransporter on the basolateral surface snatches up the bicarbonate

and a nearby sodium, and shuttles both into the blood.

Meanwhile, a sodium-hydrogen exchanger on the apical surface, pulls sodium into the

cell, while pushing hydrogen back into the tubule.

So at the end of the day, there's a movement of bicarbonate from the tubule to the blood.

Okay - so now let's shift over to the distal tubule and collecting duct which we'll talk

about together.

First off, one type of cell these are lined with are the alpha-intercalated cells.

Like the brush border cells, the alpha intercalated cells move bicarbonate and hydrogen from the

tubule into the cell using carbonic anhydrase.

The alpha intercalated cells have two major ways to get rid of that hydrogen across the

apical surface.

First, they have a H+/ATPase which simply pushes hydrogen into the tubule.

Second, they have a hydrogen potassium ATPase (H+K+ATPase) which pushes hydrogen into the

tubule in exchange for potassium.

With regard to bicarbonate, there is a bicarbonate/chloride antiporter which moves bicarbonate into the

blood in exchange for chloride.

To prevent chloride from piling up within the cell, there's a potassium/chloride symporter

on the basolateral surface that moves both of these ions into the blood.

In addition, there's a chloride channel on the basolateral surface that allows chloride

to passively move down its concentration gradient into the blood.

Finally, it's worth mentioning that like all cells - sodium and potassium levels are

controlled by Na/K ATPase pumps on the basolateral surface which move two potassium ions into

the cell and three sodium ions out of the cell.

So overall, there's a net movement of sodium, chloride, and bicarbonate into the blood,

while hydrogen is pushed into the tubule.

Once in the lumen, hydrogen binds to phosphate or ammonia to form relatively weak acids like

dihydrogen phosphate or ammonium, which then get peed out in the urine.

This allows protons to get removed without making the urine too acidic and damaging the

cells lining the tubules and the rest of the urinary tract.

The other group of cells are the principal cells.

They have two pumps on the apical surface, an ATP-dependent potassium channel pump that

pushes potassium into the tubule, and an epithelial sodium channel pump called ENaC that pulls

sodium into the cell.

There's also a Na/K ATPase pump on the basolateral surface that again moves 2 potassium ions

in for every 3 sodium ions out.

All three of these are stimulated by aldosterone, and the combined effect is resorption of sodium

and loss of potassium.

In RTA type I or distal renal tubular acidosis, the main issue is that alpha intercalated

cells of the distal tubule and collecting duct are unable to secrete hydrogen.

The buildup of hydrogen in those cells leads to a buildup of hydrogen in the blood - resulting

in acidemia.

The underlying cause could be a genetic mutation in the H+ATPase pump or the H+K+ATPase pump

of alpha intercalated cells.

Alternatively it could be due to an acquired defect from a medication like lithium or amphotericin

B, both of which can make cells permeable, allowing hydrogen to simply diffuse from the

tubule right back into the cell.

A less common mechanism, is a defect in the bicarbonate/chloride antiporter, which causes

a decrease in bicarbonate reabsorption, and less bicarbonate in the blood, also leads

to an acidemia.

In RTA type II or proximal renal tubular acidosis, the main issue is that brush border cells

of the proximal tubule are unable to reabsorb bicarbonate.

As a result, bicarbonate gets lost in the urine and it means that there is nothing to

counterbalance the hydrogen ions - resulting in acidemia.

One known cause is a genetic mutation in the sodium bicarbonate cotransporter on the basolateral

surface that makes it less functional.

Being able to move less bicarbonate out of the cell, alters the intracellular bicarbonate

concentration and makes it imore difficult for bicarbonate to get brought across the

apical surface into the cell.

As a result, less bicarbonate gets reabsorbed by the brush border cells, and more is left

behind in the lumen of the tubule.

Eventually losing bicarbonate in the urine, means that there's less bicarbonate in the

blood - resulting in an acidemia.

Unlike RTA type I, the distal intercalated cells are still functional and can produce

hydrogen ions, and can therefore can generally still acidify the urine.

RTA type II can happen independently or can be part of a broader disfunction of the proximal

tubular cells called Fanconi syndrome.

In Fanconi syndrome, in addition to the loss of bicarbonate, there is also phosphaturia,

glycosuria, aminoaciduria, uricosuria, and proteinuria - the loss of phosphate, glucose,

amino acids, uric acid, and protein in the urine.

Fanconi syndrome can be inherited, but can also be acquired, for example, it can be a

side effect of taking certain medications like tetracycline class antibiotics.

In RTA type III there is a defect in both the distal and proximal tubule, a fairly uncommon

situation.

The causes are not well understood, but some cases have been associated with congenital

carbonic anhydrase deficiency, this is because carbonic anhydrases are present in both distal

and proximal tubule.

Finally, there's RTA type IV, sometimes called hyperkalemic acidosis, and it's classically

due to aldosterone deficiency or aldosterone resistance in the collecting ducts, which

would affect both the principal and alpha intercalated cells.

Aldosterone has an important role in the regulation of sodium, potassium,, and hydrogen levels.

An example of aldosterone deficiency is Addison's disease, where the adrenal gland doesn't

produce enough of it.

An example of aldosterone resistance is a mutation in the epithelial sodium channel

(ENaC), so that it doesn't respond well to normal levels of aldosterone.

Either way - a reduced effect of aldosterone can decrease the function of the Na+K+ATPase,

making sodium levels fall and potassium levels rise in the blood.

A reduced effect of aldosterone on the H+/ATPase in the intercalated cells, means that more

hydrogen gets retained in the cells and eventually in the blood, causing the acidemia.

Overall, this causes high potassium, hyperkalemia, and high levels of hydrogen ions, acidemia,

in the blood.

Also, since hydrogen usually combines with ammonia in the tubule to form ammonium, with

less hydrogen there'll be less ammonium formed and excreted in the urine.

There are some other causes of RTA type IV as well.

One of them is severe hypovolemia.

Or low fluid, which means less sodium is available for reabsorption in the principal cells.

The result is lower sodium levels in the cell, which alters the ion exchange between sodium

and potassium - resulting in low sodium and high potassium levels in the blood, and the

hyperkalemia contributes to the acidosis.

Another cause of RTA type IV is systemic lupus or medications like lithium and amphotericin

B, all of which can make the distal tubule and collecting duct cells more permeable to

hydrogen ions, allowing them to diffuse into the blood and causing acidosis.

Initially, symptoms of renal tubular acidosis include gastrointestinal problems like decreased

appetite, vomiting, and abdominal pain.

But, if left untreated, severe metabolic acidosis can lead to vasodilation of peripheral arterioles

which can cause shock.

Like other causes of metabolic acidosis, there is a compensatory pattern of breathing called

Kussmaul breathing-- where a person initially takes rapid shallow breaths that become more

deeper over time - in order to blow off the carbon dioxide.

Also, the urine tends to be more alkaline than normal, typically greater than a pH of

6; this especially happens in RTA type I and sometimes in the acute setting for RTA type

II.

This causes hypercalciuria and leads to the precipitation of calcium oxalate which can

cause painful kidney stones.

Renal tubular acidosis is a metabolic acidosis - a pH below 7.35 and a low bicarbonate level

- with a normal anion gap.

That means that the difference between measured anions --Cl- and HCO3- and cations -- Na+

and K+-- is between 8 mEq/L and 12 mEq/L. In addition, blood potassium and urine pH

are typically done to identify the exact type of RTA.

Low levels of HCO3- in the blood also lead to elevated levels of chloride, so hyperchloremia

is a classic finding in RTA.

In RTA type I and II, the main goal is to replenish bicarbonate and correct hypokalemia

with potassium citrate.

In RTA type II, this can be achieved with thiazide diuretics which cause water loss

and increased reabsorption of bicarbonate.

For RTA type IV, the goal is to treat hypoaldosteronism with fludrocortisone or loop diuretics, which

increases sodium delivery to the collecting duct and increases potassium hydrogen exchange.

Alright, as a quick recap, renal tubular acidosis describes a condition in which the kidney

is unable to secrete acids or reabsorb bicarbonate from the body.

And this most commonly results in metabolic acidosis with a normal anion gap.

If left untreated, the acidemia can cause peripheral vasodilation

and shock.

For more infomation >> Renal tubular acidosis - causes, symptoms, diagnosis, treatment, pathology - Duration: 15:08.

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(subs) Yagudin - 2010 -PART3- "100 questions to an adult" - Duration: 12:38.