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J. I. Anetor F I Ajose T. S Akingbola 《Indian journal of clinical biochemistry : IJCB》2005,20(1):193-197
A 64-year-old security guard and longstanding known hypertensive presented with hypertensive heart disease (HHD), weight loss,
an enlarged prostate, and a spontaneously fractured rib. Malignancy of the prostate with possible metastases to the ribs was
strongly suspected. Biochemical profiling revealed a paraprotein. Other biochemical and hematological correlates that were
on hand before serum protein electrophoresis were rather atypical. Paraprotein studies by immunofixation revealed IgA myelomatosis.
Unlike previous reports from Caucasians there was normocalcaemia, normal protein level, microcytic hypochromia, low MCHC,
cholesterol level at the lower limit of the reference range and normal urea level (in the face of markedly raised creatinine
level). Nutritional modulation of the classical laboratory features of this disease may account for the fairly atypical laboratory
picture.
The need to appreciate the influence of nutritional status on the laboratory (especially biochemical) features of a disease
and thus interpretation of diagnostic tests appears of exceptional current importance, given the widening gap in socioeconomic
status and the level of poverty between the resource poor and developed countries from which the classical, clinical and laboratory
features of most diseases were first described.
This case report reminds of the need not only to recognize theoretically the impact of nutritional status on the laboratory
characteristics of a disease but of the practical application of the nutritional perspective in the interpretation of diagnostic
investigations, especially in nutritionally disadvantaged communities. 相似文献
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In a perspective study, the ascitic fluid and serum concentration of total cholesterol, total proteins and albumin in a group
of 45 patients was studied. Patients with nonmalignant or cirrhotic ascites were compared with patients having malignancy
related ascites and it was proved that the ascitic fluid cholesterol and the serum ascites albumin gradient helped to differentiate
cirrhotic from malignant ascites. These two parameters showed a remarkable relationship to the presence/absence of malignancy.
Non malignant ascites patients had ascitic fluid cholesterol values of 19.41±8.33 mg/dl, as against the malignancy related
ascites patients, who showed levels of 95.87±1.24 mg/dl. Similarly, the serum-ascites albumin gradient levels were 2.89±0.65
in non malignant ascites patients, while the malignancy related ascites cases had 0.86±0.50. The discrimination values for
cholesterol were taken as 45 mg/dl while that for serum ascites gradient was taken as 1.1. Levels of serum cholesterol, total
protein and albumin were not significantly altered. 相似文献
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T. Malati 《Indian journal of clinical biochemistry : IJCB》2007,22(2):17-31
Tumor Markers comprise a wide spectrum of biomacromolecules synthesized in excess concentration by a wide variety of neoplastic
cells. The markers could be endogenous products of highly active metabolic malignant cells or the products of newly switched
on genes, which remained unexprssed in early life or newly acquired antigens at cellular and sub-cellular levels. The appearance
of tumor marker and their concentration are related to the genesis and growth of malignant tumors in patients. An ideal tumor
marker should be highly sensitive, specific, reliable with high prognostic value, organ specificity and it should correlate
with tumor stages. However, none of the tumor markers reported to date has all these characteristics. Inspite of these limitations,
many tumor markers have shown excellent clinical relevance in monitoring efficacy of different modes of therapies during entire
course of illness in cancer patients. Additionally, determination of markers also helps in early detection of cancer recurrence
and in prognostication. 相似文献
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