Normal serum

The parathyroid glands in FHH are reset to maintain a higher than normal serum calcium concentration owing to impaired suppression of PTH release in the face of hypercalcemia (e.g., resistance to CaQ+) (Fig. 2). Similarly the kidneys show a reduced calciuric response to hypercalcemia, which contributes to the hypercalcemia by promoting inappropriately reabsorption of calcium. Mouse models of FHH and NSHPT result from targeted inactivation of one or both CaR alleles, respectively [1,3]. These animals have provided valuable insights into the alterations in tissue function resulting from loss of the receptor. 

Plasma protein fractions include human plasma protein fraction 5% and normal serum albumin 5% (Albuminar-5, Buminate 5%) and 25% (Albuminar-25, Buminate 25%). Plasma protein fraction 5% is an IV solution containing 5% human plasma proteins. Serum albumin is obtained from donated whole blood and is a protein found in plasma The albumin fraction of human blood acts to maintain plasma colloid osmotic pressure and as a carrier of intermediate metabolites in the transport and exchange of tissue products. It is critical in regulating the volume of circulating blood. When blood is lost from shock, such as in hemorrhage, there is a reduced plasma volume. When blood volume is reduced, albumin quickly restores the volume in most situations. 

Hepatic Effects. Normal serum liver function tests (unspecified) were observed in a 35-year-old agricultural pilot approximately 8 hours after a 45-minute dermal exposure (with presumed concurrent inhalation exposure) when his clothing became soaked in endosulfan and methomyl (Cable and Doherty 1999). 

Figure 7-11. Normal and pathologic patterns of lactate dehydrogenase (LDH) isozymes in human serum. LDH isozymes of serum were separated by electrophoresis and visualized using the coupled reaction scheme shown on the left. (NBT, nitroblue tetrazolium PMS, phenazine methylsulfate). At right is shown the stained electropherogram. Pattern A is serum from a patient with a myocardial infarct B is normal serum and C is serum from a patient with liver disease. Arabic numerals denote specific LDH isozymes.

Utility. There Is general agreement that the concentration of Immunoreactlve CT In normal serum Is extremely low (< 200 pg/ml). However, there Is evidence for Immunohetero-genelty of calcitonin In the serum of MTC patients (21) and It Is possible that studies In the future will demonstrate this phenomenon In normal sera as well. This might explain some reports of higher concentrations of Immunoreactlve CT In normal subjects (22). 

Figure 39, A lipid pattern from normal serum which has been scanned for density of the thin-layer chromatograph, showing the various peaks, P, phospholipids C, cholesterol F, free fatty acids S, internal standard, T, triglycerides CE, cholesterol esters.

The LD-1 is less than 30% of total LD in normal serum, whereas in patients with an acute myocardial infarction it is between 50-90% of total LD activity. The ratio of LD-l/LD-2 is usually greater than one in acute myocardial infarction (37). 

Nodular hyperplasia of the prostate is usually associated with a normal serum acid phosphatase activity. Complications such as acute urinary obstruction or prostatic infarction will elevate this serum activity for several days as will cystoscopy and catheterization (98). Digital palpation of the prostate may result in an elevation which subsides within a few hours. 

Amador, E. and sod, M. F. Characterization of the normal serum glutamic-oxalacetic transaminase activity of healthy adults. Am. J. Clin. Path. (1967), 47,... 

This occurs in normal serum at very low levels (30-50 fg mf ) but is the predominant surface component of B cells. Immature B cells express surface IgM without IgD but as these cells mature IgD is also expressed. After activation ofthe B cells, surface IgD can no longer be detected and it would appear that IgD may be involved with the differentiation ofB cells. 

Blake, 1989 Winyard et al., 1989). We suggest that within the inflamed rheumatoid joint (or the artery wall in atherogenesis), the production of ROM and proteases by endothelial cells and/or macrophages may cause the release of copper ions from Cp (see Section 2.2.3.2). It has been reported that Cp is cleaved faster in serum from patients with inflammatory diseases when compared to normal serum (Laurell, 1985). The oxidative modification of LDL by Cp-derived copper ions may explain the observation that increased serum cholesterol values are associated with accelerated atherosclerotic progression in men with high serum copper concentrations (Salonen et al., 1991). 

Fat-soluble vitamin supplementation is usually required in pancreatic insufficiency. Specially-formulated products for CF patients (ADEKs and Vitamax ) are usually sufficient to attain normal serum vitamin levels at a dose of 1 tablet daily for younger children and 2 tablets daily for teenagers and adults. Additional supplementation may be needed in uncontrolled malabsorption or for replacement of severe vitamin deficiency.5,15 Appetite stimulants such as cyproheptadine may be an option for promoting nutrition and weight gain, but efficacy has not been established. 

Increased serum phosphorus levels Low to normal serum calcium levels Increased Ca-P product Increased PTH levels Decreased vitamin D levels... 

When determining the dose of bicarbonate replacement, the goal for therapy is to achieve a normal serum bicarbonate level of 24 mEq/L (24 mmol/L). The dose is usually determined by calculating the base deficit [0.5 L/kg X (body weight)] x [(normal C02) - (measured C02)]. Because of the risk of volume overload resulting from the sodium load administered with bicarbonate replacement, the total base deficit should be administered over several days. Once the goal serum bicarbonate level is attained, a maintenance dose of bicarbonate is necessary and should be titrated to maintain serum bicarbonate levels. 

Normally, the number of anions and cations in each fluid compartment are equal. Cell membranes play the critical role of maintaining distinct ICF and ECF spaces which are biochemically distinct. Serum electrolyte concentrations reflect the stores of ECF electrolytes rather than that of ICF electrolytes. Table 24-4 lists the chief cations and anions along with their normal concentrations in the ECF and ICF. The principal cations are sodium, potassium, calcium, and magnesium, while the key anions are chloride, bicarbonate, and phosphate. In the ECF, sodium is the most common cation and chloride is the most abundant anion while in the ICF, potassium is the primary cation and phosphate is the main anion. Normal serum electrolyte values are listed in Table 24—5. 

Osmolality is a measure of the number of osmotically active particles per unit of solution, independent of the weight or nature of the particle. Equimolar concentrations of all substances in the undissociated state exert the same osmotic pressure. Although the normal serum osmolality is 280 to 300 mOsm/kg (280 to 300 mmol/kg), multiple scenarios exist where this value becomes markedly abnormal. The calculated serum osmolality helps determine deviations in TBW content. As such, it is often useful to calculate the serum osmolality as follows ... 

The body s normal daily sodium requirement is 1.0 to 1.5 mEq/kg (80 to 130 mEq, which is 80 to 130 mmol) to maintain a normal serum sodium concentration of 136 to 145 mEq/L (136 to 145 mmol/L).15 Sodium is the predominant cation of the ECF and largely determines ECF volume. Sodium is also the primary factor in establishing the osmotic pressure relationship between the ICF and ECF. All body fluids are in osmotic equilibrium and changes in serum sodium concentration are associated with shifts of water into and out of body fluid compartments. When sodium is added to the intravascular fluid compartment, fluid is pulled intravascularly from the interstitial fluid and the ICF until osmotic balance is restored. As such, a patient s measured sodium level should not be viewed as an index of sodium need because this parameter reflects the balance between total body sodium content and TBW. Disturbances in the sodium level most often represent disturbances of TBW. Sodium imbalances cannot be properly assessed without first assessing the body fluid status. 

Elevated corrected serum calcium level greater than or equal to 10.5 g/dL (2.6 mmol/L), serum albumin, low to normal serum phosphate... 

Phosphorus is provided as sodium or potassium phosphate in PN. Approximately 10 to 15 mmol of phosphate are needed per 1000 kilocalories to maintain normal serum phosphorus concentrations (provided the patient is well nourished and has normal renal function).15 Patients with renal insufficiency may require phosphorus restriction. 

Rimington and Rowlands165 have isolated an extremely active preparation from the serum of pregnant mares. This material was obtained in a high degree of purity and was shown to contain hexose and hexosamine in the molar ratio of 2/1. In the fractionation it appeared that, at first, the hexose content decreases as the potency is raised, but later this trend is reversed. It was shown that hexose content could not be taken as indication of gonadotropic activity. The hexose/hexosamine ratio was 2/1 as in normal serum mucoproteins, so that this gonadotropic hormone may be a modified serum mucoprotein. 

A 35-year-old male has renal stones and increased calcium (Ca) in the urine that is associated with normal serum Ca and parathyroid hormone levels. Which of the following agents could he used to treat this patient ... 

A 55-year-old female with a blood pressure of 170/105 mmHg has pitting edema of the lower extremities and an elevated serum creatinine associated with a normal serum potassium. Which of the following agents is contraindicated in this patient ... 

Foals fed 29 or 250 mg Zn/kg diets had normal serum copper and zinc concentrations. Those fed 1000 or 2000 mg Zn/kg diet became hypocupremic in 5 to 6 weeks and developed lameness owing to cartilaginous disease similar to osteochondritis dessicous. Foals fed high zinc diets became lame when serum copper fell to 0.3 mg/L for >1 week at end of study arthritic foals had <0.2 mg copper/L serum. Serum zinc concentrations rose to >2 mg/L within 2 weeks at 1000 or 2000 mg Zn/kg diet liver zinc was <333 mg/kg DW at diets of <250 mg Zn/kg, 2728-3511 mg/kg DW at 1000 mg Zn/kg diet, and 4364-4524 mg/kg DW at the highest dietary loading of 2000 mg Zn/kg in 15 weeks Decreased growth, lameness, bone deformities, death. 

Increased urinary excretion, normal serum Mo levels, no change in copper metabolism (11)... 

Cardiac index and blood pressure must be sufficient to ensure adequate organ perfusion, as assessed by alert mental status, creatinine clearance sufficient to prevent metabolic azotemic complications, hepatic function adequate to maintain synthetic and excretory functions, a stable heart rate and rhythm, absence of ongoing myocardial ischemia or infarction, skeletal muscle and skin blood flow sufficient to prevent ischemic injury, and normal arterial pH (7.34 to 7.47) with a normal serum lactate concentration. These goals are most often achieved with a cardiac index greater than 2.2 L/min/m2, a mean arterial blood pressure greater than 60 mm Hg, and PAOP of 25 mm Hg or greater. 

Increased Serum Anion Gap Normal Serum Anion Gap/Hyperchloremic States... 

Fig. 1. Schematic presentation of the protein pattern of the common Hp types in pure form after starch-gel electrophoresis. The protein pattern of a normal serum belonging to Hp type 1-1 is given at the bottom. The cathodic part is excluded.

Dilute the resultant primary antibody Fab fragment complexes in staining buffer containing 10 20% normal serum from the same species as the primary antibody to give the concentration of about 1 10 pg/ml of the primary antibody, and incubate for 15 30 min at room temperature to block unbound labeled monovalent Fab fragments. ... 

Further dilute (if required) the resultant primary antibody Fab fragment complexes to optimal working concentration (usually about 1 5 pg/ml) in staining buffer containing 10% normal serum and then apply to the sample for 30 60 min at room temperature and proceed further with your standard immunostaining protocol. 

Blocking Step 2 to block endogenous Fc receptor, incubate sections for 20 min with PBS or TBS containing 5% normal serum of species in which the secondary antibodies were raised. 

Notes. When using biotin-labeled secondary antibodies instead of enzyme-labeled antibodies, you have first to detect biotin with enzyme-labeled (strept) avidin and proceed further with the Substrate Step (9). Do not add normal serum, non-fat dried milk, culture media or other potential sources of biotin to (strept)avidin-containing reagents. This may result in reduced sensitivity. Solutions containing sodium azide or other inhibitors of peroxidase activity should not be used in diluting the peroxidase substrate. 

Blocking step incubate sections for 20 min with normal serum blocking solution (see Sect. 5.1). 

---