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The importance of these pathways in yielding pyruvate in the absence of pyruvate kinase is further supported by many reports showing that inhibition of this enzyme does not lead to a proportional decrease in pyruvate/lactate formation, reviewed in ref

(We note that, as discussed in the FY 2013 IPPS/LTCH PPS final rule (77 FR 53705), there is generally no longer a need for an exceptions payment adjustment factor.) However, in limited circumstances, an additional payment exception for extraordinary circumstances is provided for under 412.348(f) for qualifying hospitals

These subunit types are differentially expressed in the nucleus accumbens, dorsal striatum, prefrontal cortex, and hippocampus (Reimers et al., 2011)