Metabolism | Lipoprotein Metabolism | Chylomicrons, VLDL, IDL, LDL, & HDL

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  • Опубликовано: 4 окт 2024
  • Official Ninja Nerd Website: ninjanerd.org
    Ninja Nerds!
    In this lecture Professor Zach Murphy will be discussing the metabolism of lipoproteins- Lipoprotein Metabolism. During this lecture we talk specifically about chylomicrons in the exogenous pathway. We also talk about VLDL, IDL and LDL and their role in the endogenous pathway. Lastly, we discuss HDL and it's role in reverse cholesterol transport as well as normal serum cholesterol levels. We hope you enjoy this lecture and be sure to support us below!
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Комментарии • 2 тыс.

  • @chrisreyrojas3369
    @chrisreyrojas3369 3 года назад +185

    An hour long lecture and not a single ad to disturb your learning. Truly, not all heroes wear capes.

  • @whisknbraise
    @whisknbraise 5 лет назад +2044

    Best Biochemistry lessons on RUclips. This man knows what he's talking about and most importantly knows how to explain complicated concepts. Big thumbs up and thank you very much sir.

  • @alih6953
    @alih6953 3 года назад +829

    If we can all become more like HDL, the world would be a better place

    • @kirtisingh4428
      @kirtisingh4428 2 года назад +9

      You didn't understand anything but u know what HDL does.. 😂😂😂

    • @ayshadalieva9929
      @ayshadalieva9929 2 года назад +4

      Like Jesus

    • @milofonbil
      @milofonbil 7 месяцев назад

      It's interesting that IDL donates its ApoE to HDL and becomes the "BAD" cholesterol LDL. It's job is now to deliver cholesterol to the gonads to make Testosterone, Progesterone and Estrogen. It gets the bad wrap from oxidizing and creating plaques.

    • @Chapwiwoop
      @Chapwiwoop 3 месяца назад

      @@kirtisingh4428 it’s the giving tree not gonna lie XD

    • @navneetdhal5986
      @navneetdhal5986 Месяц назад

      ​@@kirtisingh4428he is right

  • @mateuslacerda284
    @mateuslacerda284 3 года назад +282

    This guy deserves a medal, because this is legendary.

  • @ornulusoundeffects6423
    @ornulusoundeffects6423 3 месяца назад +3

    The best thing i like about Ninja nerd that he gives a story like what is happening! And not just throw around facts! Love you Prof. Dr. Zack!

  • @ramachandramurtykrishnamse3025
    @ramachandramurtykrishnamse3025 6 лет назад +548

    Thanks for making this lecture free!

    • @NinjaNerdOfficial
      @NinjaNerdOfficial  6 лет назад +181

      +Ramachandra Murty Krishnamsetty No problem!!! I'm so happy we were able to help!

    • @elenadan1612
      @elenadan1612 5 лет назад +20

      Thank you so much for making me understand what (seemed to me) something so hard and impossible. You really saved my biochemistry exam. You're awesome, keep up

    • @omdah070
      @omdah070 4 года назад +12

      They're getting their money don't worry nothing is free

    • @jeremiahgounder9223
      @jeremiahgounder9223 4 года назад +22

      @@omdah070 but we don't have to pay just like in others lectures channels

    • @omdah070
      @omdah070 4 года назад +8

      @@jeremiahgounder9223 yeah exactly it's RUclips you can watch whatever you want for free

  • @friendsaddiction04
    @friendsaddiction04 5 лет назад +496

    once I graduate from medical school in 3 years I will owe my degree to you your videos are amazing

  • @silentnight8346
    @silentnight8346 6 лет назад +318

    im medical student .. im proud of u as best teacher of my whole life 😊

  • @ΖαχαριαςΚεφαλας-χ6κ
    @ΖαχαριαςΚεφαλας-χ6κ 3 месяца назад +3

    Been trying to get a grip of this concept for 2 weeks now... and here i find a 6 year old video with the most detailed, yet simple and clear explanation of it... Can't thank you enough, keep up the amazing work!!!

  • @hrujulshah9430
    @hrujulshah9430 9 месяцев назад +25

    No one can teach such amazingly for free in this day and age. Hats off to you man and a big big thanks for making me understand this topic by making it so easy. All of my good wishes to you!

  • @zubayraslam876
    @zubayraslam876 6 лет назад +208

    You can't thank us enough? Dude, we are so so so so so blessed to have you. You're the type of teacher we wish we had in our every class from elimentary to university level. You're just amazing and everything you teach sticks right inside our brain. *Thank you* so much for everything and this video as well, which just saved us a hell lot of fighting with the book like your every other video. Now we know we are just gonna read the chapter and we already will have the concepts understood by your video.

  • @nileshgadiya
    @nileshgadiya 5 лет назад +347

    This guy made me fall in love with biochemistry...

  • @extracrispypp5473
    @extracrispypp5473 3 года назад +68

    I have a tradition that after every successfull semster in medschool in which the guys from Ninja nerd science helped me significantly, i donate 10 bucks

  • @nathanbeckett7504
    @nathanbeckett7504 Год назад +12

    I can only imagine how much work this takes but you, sir, were born to teach

  • @kjmoran
    @kjmoran Год назад +18

    Dude thank you. Finishing my first year of medical school next week and I've found this to be the most complex topic so far. Watching this made it really understandable!

  • @ingeborgmarievatne5695
    @ingeborgmarievatne5695 4 года назад +81

    The emphasized “testosterone” at 46:10 cracked me up 😂 thank for an amazing series. Loved every single one!

  • @piyushsumera9076
    @piyushsumera9076 6 лет назад +76

    1 freaking hour lecture!!!
    Here in India you would get standing ovation for this in my college...Now Please Make videos on Molecular Biochemistry..

  • @kat.msidou
    @kat.msidou 4 года назад +52

    Just found out i passed my Biochemistry exam ! I'm so thankful I came across this channel and I can assure you I wouldn't pass without it! Thank you thank you thank you !!!
    You're a hero Zach! :)

  • @tasiecabrera2491
    @tasiecabrera2491 5 месяцев назад +1

    Studying for my adult cardio boards. The basic biochem is glossed over in most discussions on lipoprotein disorders, and I can’t for the life of me imagine cracking open Devlin when I have all of Braunwald to go through. This was INCREDIBLE and so detailed and easily contextualized from bench to bedside. You’re a hero among men.

  • @AodhanBeag
    @AodhanBeag 2 года назад +50

    The amount of whiteboard markers you must go through is insane! If I tried to draw all that out I’d constantly run out of space and have to start over, you do it all so flawlessly! Wish my college lecturer explained biochemistry as well as you, love the channel

  • @fatimafakhirmusharraf3652
    @fatimafakhirmusharraf3652 6 лет назад +36

    1 hour video of organised chaos might just save my semester. THANK YOU!!

  • @williamkim2483
    @williamkim2483 4 года назад +163

    I laughed everytime he said, "The HDL is so good. He's so good to us. He's such a giver"
    haha I love this guy

  • @paulafunesgroverman5179
    @paulafunesgroverman5179 2 года назад +90

    When I started studying this subject I thought I'd never be able to fully understand and remember all of this infinit metabolic pathways, enzymes and processes. Today I'm preparing for my final exam and after watching ALL of your videos I can say that I feel so much more confident and prepared to face this exam that used to terrify me. I don't think I can thank you and your team enough for creating this top quality educational content and this awesome community. ¡Gracias totales Zach!

  • @lina-jg9xb
    @lina-jg9xb Год назад +33

    Being sick but still having to revise for an exam, watching your videos has been a huge save to say the least. I’m deeply grateful for you and the whole ninja nerds team!

    • @JohnM-cd4ou
      @JohnM-cd4ou Год назад

      I'm in the exact same situation right now

  • @sprat3127
    @sprat3127 Год назад +7

    This was incredible. I’m 20 years into my career and this is the best explanation I’ve ever had.

  • @aimmuno
    @aimmuno 5 лет назад +72

    Thank you so much ! And yes , I sticked with you through the whole video man ! This is an absolute masterpiece . Thank you for your dedication . Your videos are contributing the future-doctors , biochemists , pharmacists ! Respect !

  • @jacobkoolen1208
    @jacobkoolen1208 2 года назад +18

    I have ditched my professors biochemistry lectures and just started using you. Thank you for helping me pass biochemistry and getting me closer to obtaining my doctorate.

  • @yachiapatel
    @yachiapatel 2 года назад +26

    What I love most about this guy is, he has so much to offer even after offering more then enough. It might be a smart student who can understand those complex topics, however, it is even more wiser if a teacher has excelled in their teaching skills.
    God bless this man and his team for such an incredible support and efforts. ❤🏆💐
    And Mr. Zach..... I must say... Being a NINJA NERD -
    "AS ALWAYS....! UNTIL NEXT TIME.! "😍😎

  • @drmaryamjallo
    @drmaryamjallo Год назад +4

    It's 2022 and thanks to you i understood a whole Biochem in 8days. Yes 8 days. I will forever appreciate you for making the lectures free. THANK YOU

    • @amine6005
      @amine6005 Год назад

      good job are this vedio enough for med school can we depending on them

    • @shahbaa-fu1lb
      @shahbaa-fu1lb Год назад

      @@amine6005 yes it's enough to understand the basic
      But you should return to the source that depends on it

  • @kath8440
    @kath8440 Год назад +4

    I love how you explain everything and don't leave knowledge gaps. Sometimes the smallest things can cause the biggest confusion, yours was super articulated. Thanks!

  • @polodrt2714
    @polodrt2714 3 года назад +10

    The Best thing i’ve done in my entire medical year has been to watch your video, Thank you from France !

  • @TheJellyfishJam
    @TheJellyfishJam 2 года назад +5

    i was avoiding this topic ALL year because it was so unclear at uni lectures. now i had no choice because it's the finals season. you made it so simple and easy to remember. thank you so much!

  • @zunairamalik7883
    @zunairamalik7883 5 лет назад +71

    Please make a video on purine and pyrimidine metabolism as well... your all other videos on metabolism are too good .. Thank you .. it helped a lot.

  • @evelynfurtado1240
    @evelynfurtado1240 3 года назад +19

    I just wish we had more teachers like you. Life would have been so much easier and studying would be so much fun! This is the best and most in-depth video on lipoproteins that's out there. Can't thank you enough !

    • @mamdohyounis4308
      @mamdohyounis4308 Год назад

      in palestine we have people have his pic on their shirts walking around the streets ! he is a hero of us here .
      you guys dont understand what it feels for us to get this free education .

  • @madhusudanmd2007
    @madhusudanmd2007 3 года назад +7

    You can't thank us enough? sir, we are so so so so so blessed to have you. You're the type of teacher we wish we had in our every class from elimentary to university level. You're just amazing and everything you teach sticks right inside our brain. Thank you so much for everything and this video as well, which just saved us a hell lot of fighting with the book like your every other video. Now we know we are just gonna read the chapter and we already will have the concepts understood by your video.

  • @jorge.limafilho
    @jorge.limafilho 5 лет назад +10

    When I first saw the videos from this channel, I thought they were way too big, and I couldn´t keep up with them. But this is simply one of the best teachers I´ve ever saw. Thank you so much for this incredible work, you´re certainly helping a lot of people!

  • @cheskablaire8498
    @cheskablaire8498 4 года назад +4

    As a 3rd year medical laboratory science student, I'm absolutely amazed! Watched this at 3am (PH time) and it certainly kept me up 😂 truly one of the best lectures on lipoprotein metabolism that I've ever watched! Completely amazing!

  • @greenrocket9344
    @greenrocket9344 5 лет назад +12

    thank you for this illustrative lectures! my lecturer literally give pointless lectures with all those new terms we cannot digest instantly. when you give those terms their own character, like a comic story it all suddenly makes sense! i aspire you!

  • @clarysage4741
    @clarysage4741 2 года назад +4

    I'm currently enrolled in a 2yr diploma program, studying to be a Holistic Nutritionist and health coach. All at home, self-study, and I am SOOOOOO happy to have found your page. I'm a visual learner, these are EXACTLY what I needed to bridge that gap so I'm not trying to read from my textbooks then sit there, breaking it down and trying to visualize it in my head in order to "connect all the dots" in my mind for memory retention. You have no idea how helpful your videos are. I want to be the best I can be for my future clients and help them. So Thank You! Thank you! THANK YOU! 🙌🏼😁

  • @Tolu.Ogb234
    @Tolu.Ogb234 3 года назад +1

    You are amazing. When I pray for my family and loved ones, I will pray for you. You have lifted a burden in my life and your burdens deserve to be lifted too.

  • @JKey902
    @JKey902 6 лет назад +97

    This is so beautifully done. Thanks for an amazing lecture!

  • @sarahmassoud1562
    @sarahmassoud1562 6 лет назад +25

    You are very professional you saved my masters degree thanks

  • @architasaha8917
    @architasaha8917 4 года назад +12

    You have explained this difficult chapter in such a interesting way. A big thanks to you Brother.

  • @Dr.sara.194
    @Dr.sara.194 Год назад +5

    u are such a great teacher I hope that u will continue doing these helpful videos in the future thank u, sir.

  • @jo-annandrews1904
    @jo-annandrews1904 3 года назад +7

    If I had you as a teacher I would have a working brain, well educated brain. My friend you are the definition of teacher.

  • @junaisahabbas6979
    @junaisahabbas6979 3 года назад +3

    This has been the best lecture on biochemistry and you have been the best lecturer I have watched so far. You have no idea how helpful your videos are to us especially medical graduates! God bless you sir!

  • @katherineperkinsschaller357
    @katherineperkinsschaller357 2 года назад +3

    For years I have wondered about trycicerids, ldl and hdl and asked lab technicians to explain them to me. Thankyou. I have watched this video and will watch again.

  • @Scholarhi
    @Scholarhi Год назад +4

    This is one of the best videos I've ever seen on RUclips!! One of the best teachers I've ever had in my life. Thank you so much for all that you do!

  • @lbetters1526
    @lbetters1526 3 года назад +5

    Amazing! Needed this so much. After watching our own profs lecture on this I was utterly confused. You are such an amazing teacher. To be so engaging without live students and to convey everything clearly and in a way that is retainable is a real skill. Thank you!!!!!

  • @ciarabrogan9302
    @ciarabrogan9302 3 года назад +1

    Wow, I stumbled upon this as my doctor told me yesterday I had very high cholesterol, I never imagined I could find something so in-depth in explaining it all to me, you explained yourself so well, even for a layman to comprehend, thank you so much.

  • @nataliehartley6096
    @nataliehartley6096 2 года назад +4

    You are literally getting me through my MSc - thank you a million times over!

  • @EgshigTushig
    @EgshigTushig 3 года назад +4

    Your videos are amazing! I’m so glad to have a teacher like you. Greetings from Mongolia!

  • @madeline8968
    @madeline8968 2 года назад +5

    I love how you explain not only WHAT happens, but WHY it happens. You tie it into other lessons, like when you explain why fatty acids are needed in muscle cells and adipocytes. It helps so much that you take the time to do that! Thank you so much.

  • @ХристинаДимитроваВасева

    THANK YOU for explaining this topic so easily. It really saved me hours of wondering how to understand the convoluted descriptions in the textbook.I wish my teachers were more like you - concerned about what their students are learning.

  • @person1384
    @person1384 8 месяцев назад +1

    I completed entire lipid metabolism through your videos... they are amazingg! Thank you so much 🙏🙏

  • @corwynwarwaruk2141
    @corwynwarwaruk2141 5 лет назад +4

    Please make a video covering lipoproteins in an energy deprived state such as when fasted or immediately after excersize. An energy deprived state results in more triglyceride mobilization from adipose tissue & an increase in LDL.
    I would love to hear the biochemistry behind lipoproteins in the energy deprived state.
    Great video. You really make biochemistry understandable and accessible to everyone. Thanks

  • @hovhannesmanukyan1162
    @hovhannesmanukyan1162 6 лет назад +91

    17:50 Actually the Thoracic duct opens into the left subclavian/internal jugular veins, not the right.

    • @sarmadbaloch432
      @sarmadbaloch432 6 лет назад +3

      Hovhannes Manukian yeah I was about to write this but seen your comment .

    • @froglegs4910
      @froglegs4910 4 года назад

      Correct !

    • @yarakharam5343
      @yarakharam5343 4 года назад +7

      this is what med students are good for, memorizing some anatomy, and leaving the actual problems to the big brains :)

    • @NoLabCoatRequired
      @NoLabCoatRequired 3 года назад

      @@yarakharam5343 dam lol

    • @mayowaoturoko6462
      @mayowaoturoko6462 3 года назад +1

      @@yarakharam5343 Hhhhhahahhahahhahah. correct the minute and unrelated part of the video lol

  • @Outono937
    @Outono937 6 лет назад +25

    Perfect timing! God bless you!!

  • @kushbhardwaj3713
    @kushbhardwaj3713 Год назад +2

    Man I just can't thank you enough you saved my 15 marks In my med university examinations thank you so much ❤️ ♥️

  • @tariqjagmag
    @tariqjagmag 5 лет назад +29

    forget Picasso,this board drawings are a piece of art

  • @HarjinderSingh-pz9be
    @HarjinderSingh-pz9be 5 лет назад +6

    Seriously amazing i can't found a best teacher like u

  • @craigslitzer4857
    @craigslitzer4857 3 года назад +5

    This was an awesome lecture! I don't have any medical training, just a curiosity about how the body really works as I try to get healthier and reverse some of the damage my lifestyle choices have done over the years. I learned so much here it's hard for me to express. Thank you!

  • @meghanac6128
    @meghanac6128 2 года назад +1

    “It is the supreme art of the teacher to awaken joy in creative expression and knowledge.” - Einstein.

  • @doodoobearlove
    @doodoobearlove 8 месяцев назад

    thanks for combining everything into one lecture and one picture, its way more transparent and easy to understand this way.

  • @oysbezarius469
    @oysbezarius469 5 лет назад +4

    sir, you are one of my inspiration
    you teach so well that it makes me even study more to be just like you..
    you are great in teaching ... I hope you continue to share your knowledge in youtube ..
    It really really help me understand the concept that I was missing ..
    you are the best sir ..
    God bless you always

  • @soroushkargahi4501
    @soroushkargahi4501 6 лет назад +24

    this was great, amazing job. Also thank you for the end of the video, walking away from the screen, perfect for a screen shot :D

  • @joshuagarciacolon622
    @joshuagarciacolon622 5 лет назад +13

    Great video!!! Totally helped me understand what my textbook tried to say

  • @Juliet13ish
    @Juliet13ish 3 года назад

    I watched this when I was in 1st yr med school, 3 years after I'm rewatching it for my final exams. Ninja nerd team would always be part of my success! thank you very much! I'll give back once i earn!

  • @RashidMalik-LabVIEW
    @RashidMalik-LabVIEW 3 месяца назад

    Wow, you really know how to explain things! This makes the topic so much easier to understand. You're like a superstar at making complex stuff clear. Great job!

  • @772sumy
    @772sumy 6 лет назад +32

    Just what I needed!! Thank you so much! Keep up the good work.. :)

  • @nouricejaber7042
    @nouricejaber7042 5 лет назад +4

    Wow!!!! That was really amazing thank you so much for spending a whole hour in explaining. You deserve all the best.

  • @blackkingdomgr3188
    @blackkingdomgr3188 6 лет назад +9

    Thank you very very very very very very very much
    I'm from Iraq and I'm medical students your video helps me thank you🌹😊

    • @NinjaNerdOfficial
      @NinjaNerdOfficial  6 лет назад +1

      +Black Kingdom Gr awesome I'm so happy we were able to help!

  • @mixmashmoments_342
    @mixmashmoments_342 11 месяцев назад +2

    Sir You're just love ❤❤
    The entire map of these lipoproteins is just clear now!!
    Thank u so much 🙏❤❤

  • @sonal7426
    @sonal7426 2 года назад +1

    Absolutely awesome. Endocrinology Fellow here and this is so helpful for Boards and making all of the diseases easier to memorize. Thanks so much!! :)

  • @kylesspace5307
    @kylesspace5307 4 года назад +4

    Great videos! Helps me alot in my biochemistry class in med school. I always watch your videos before studying for the related topic. Keep up the good work!

  • @raanoooshh9296
    @raanoooshh9296 5 лет назад +100

    18:28 "I'm glad you asked"😂

    • @Norie1115
      @Norie1115 4 года назад +1

      that made me crack up a little as well.

    • @raanoooshh9296
      @raanoooshh9296 4 года назад

      @@Norie1115 me too😂

  • @ramachandramurtykrishnamse3025
    @ramachandramurtykrishnamse3025 6 лет назад +59

    Very Good Lecture. Learning biochemistry from him is as easy as peeling a banana!

    • @NinjaNerdOfficial
      @NinjaNerdOfficial  6 лет назад +20

      +Ramachandra Murty Krishnamsetty hahaha!! awesome I'm so happy we were able to help!

  • @gregoriocassini6620
    @gregoriocassini6620 2 года назад +2

    Thank You bro if I will pass the biochemistry test is a big thank to you. There should be more professors like you!

  • @shozou3672
    @shozou3672 3 месяца назад

    This is a true gem to watch, when you're struggling with understanding this topic

  • @dr.mayuripatil3621
    @dr.mayuripatil3621 5 лет назад +6

    Found this just when I was about to give up on lipids and it's the best explanation ever. Thanks man! Kudos to your efforts! Keep the good work! 👏

  • @roosifdraculamcdoosif3092
    @roosifdraculamcdoosif3092 3 года назад +4

    Hands down, one of the greatest teachers in history. Thank you so much!

  • @aldocastellani3536
    @aldocastellani3536 3 года назад +4

    i'd like to give you a multiple thumb up! it finally cleared me up the whole thing of lipid metabolism. Great!

  • @aaryanmudaliar937
    @aaryanmudaliar937 10 месяцев назад +1

    Thanks you sir for teaching this stuff free of cost in this age.

  • @cherlgolja5402
    @cherlgolja5402 8 месяцев назад +1

    Our bodies are such a miracle! Thank you God for our bodies and for such bright intelligent young man🧐

  • @ibrahimqahtan1394
    @ibrahimqahtan1394 3 года назад +3

    Thank god that I am in the Engineering field.
    All prayers to people in medicine.

  • @loredanaolsen4323
    @loredanaolsen4323 5 лет назад +5

    Absolutely amazing!!! Thank you for being the reason that I pass 2nd year of med school in Norway !!

  • @aloquoraespada3580
    @aloquoraespada3580 6 лет назад +13

    U saved my life 😭💜Thank u too much

    • @NinjaNerdOfficial
      @NinjaNerdOfficial  6 лет назад +1

      +Fatima Alaa awesome I'm so happy we were able to help!

  • @guysmiley6152
    @guysmiley6152 3 года назад

    After watching this video, and drawing pics, and typing notes to go along with the video, and the hours spent to do so, allowed me to literally go thru your video with no sound. This info is so up to date with the research, that i read an article just published 8 months ago and thought, my ninja nerd literally explained this perfectly. So much info. So well done. Im addictrd to your videos and telling everyone about them.

  • @mderazo
    @mderazo 2 года назад

    Excellent!! I am a medical doctor in Ecuador and I teach new medical students, they are so excited watching your videos.

  • @apoufo
    @apoufo 6 лет назад +7

    you sir, are my new best friend!! Awesome job!

  • @hassankhalid6792
    @hassankhalid6792 6 лет назад +7

    the greatest one that i have ever seen 😍 thanks alot ninja

  • @nataliacruz9851
    @nataliacruz9851 5 лет назад +4

    This is an amazing explanation of something that was translated as a total mess of information in my mind. It helped me organize and make sense of the jumble of words I had. Thank you!

  • @selmakaplan1053
    @selmakaplan1053 2 года назад

    At 71, and learn alot. Lots of love from Turkey.

  • @PawanBishnoi-pp3uh
    @PawanBishnoi-pp3uh 2 месяца назад

    One of the finest to understand this topic, LEGENDARY

  • @drparth1234g
    @drparth1234g 4 года назад +50

    46:08 testosteron 😂😂 didn't expected

  • @diegouribemoreno9258
    @diegouribemoreno9258 5 лет назад +12

    Men im a surgeon learning about nutritial metabolism and this is the best explanation on lipoproteins i have ever seen. Is there a way to get the foull board picture to carry in my cellphone

  • @renadalduhaim
    @renadalduhaim 3 года назад +7

    i actually feel so ashamed when he tells us "please subscribe" i go like ooooh my gaaAaad dont say it!!! we are the most thankful here :(

  • @survivorrr5446
    @survivorrr5446 2 года назад +1

    No word can tell how you're so helpful, i really can't thank you enough...

  • @LeizouItorubofa
    @LeizouItorubofa 3 месяца назад

    You made learning the most complicated things easy
    You're truly an epitome of wisdom
    ❤❤

  • @MrpboDy-jy8ou
    @MrpboDy-jy8ou 5 лет назад +4

    Junction between Left subclavian and internal jugular right? Thoracic duct drainage