Total protein serum

Signs and symptoms of SBP in a patient with cirrhosis and ascites should prompt a diagnostic paracentesis (Fig. 19-4). In SBP, there is decreased total serum protein, elevated white blood cell count (with left shift), and the ascitic fluid contains at least 0.250 x 103/mm3 (0.250 x 109/L) neutrophils. Bacterial culture of ascitic fluid may be positive, but lack of growth does not exclude the diagnosis. 

More than 99% of total body calcium is found in bone the remaining less than 1% is in the ECF and ICE Calcium plays a critical role in the transmission of nerve impulses, skeletal muscle contraction, myocardial contractions, maintenance of normal cellular permeability, and the formation of bones and teeth. There is a reciprocal relationship between the serum calcium concentration (normally 8.6 to 10.2 mg/dL [2.15 to 2.55 mmol/L]) and the serum phosphate concentration that is regulated by a complex interaction between parathyroid hormone, vitamin D, and calcitonin. About one-half of the serum calcium is bound to plasma proteins the other half is free ionized calcium. Given that the serum calcium has significant protein binding, the serum calcium concentration must be corrected in patients who have low albumin concentrations (the major serum protein). The most commonly used formula adds 0.8 mg/dL (0.2 mmol/L) of calcium for each gram of albumin deficiency as follows ... 

For acute symptomatic hypocalcemia, 200 to 300 mg of elemental calcium is administered IV and repeated until symptoms are fully controlled. This is achieved by infusing 1 g of calcium chloride or 2 to 3 grams of calcium at a rate no faster than 30 to 60 mg of elemental calcium per minute. More rapid administration is associated with hypotension, bradycardia, or cardiac asystole. Total calcium concentration is commonly monitored in critically ill patients. Under normal circumstances, about half of calcium is loosely bound to serum proteins while the other half is free. Total calcium concentration measures bound and free calcium. Ionized calcium measures free calcium only. Under usual circumstances, a normal calcium level implies a normal free ionized calcium level. Ionized calcium should be obtained in patients with comorbid conditions that would lead to inconsistency between total calcium and free serum calcium (abnormal albumin, protein, or immunoglobulin concentrations). For chronic asymptomatic hypocalcemia, oral calcium supplements are given at doses of 2 to 4 g/day of elemental calcium. Many patients with calcium deficiency have concurrent vitamin D deficiency that must also be corrected in order to restore calcium homeostasis.2,37,38... 

As of today, the insertion of PEG-lipid into lipoplexes helped in reducing the nonspecific interaction of lipoplexes with serum protein. However, the PEGy-lation did not totally reach its goal into improving lipoplex circulation time. 

The Cobas Fara 11 provides on-line sample pre-dilution or pre-treatment, enabling total automation of assays such as serum, proteins and urine chemistries. Pre-diluted samples can also he pre-incubated before transfer to the analyser. These on-line features minimize labour and errors while ensuring result integrity. 

Exposure of rats for 6 hours/day, 5 days/ week for 4 weeks to 15 ppm caused corneal lesions in some of the rats along with reductions in total serum protein, lactate dehydrogenase, and serum albumin. Rats exposed to... 

Bilirubin effects depend on the method used for analysis. Interferences in direct serum protein methods are observed at bilirubin levels greater than 5 mg/100 ml (K7). A sample containing 20 mg of bilirubin per 100 ml increased the apparent total protein by 0.2 g/100 ml. Concentrations of bilirubin as high as 20 mg/ml do not effect albumin assays using bromocresol green binding (D12), but have a marked effect on these assays when [2-(p-hydroxyphenylazo)-benzoic acid] (HABA) dye is used (A7b). 

Ultracentrijugation. In those laboratories where an ultracentrifuge is available, the pattern obtained of the serum of a patient with Waldenstrom macroglobulinemia is very characteristic. Frequently more than 30% of the total serum proteins could be accounted for by the 19 S peak. Bence Jones protein is not an uncommon finding in patients with Waldenstrom macroglobulinemia and was detected in patients both in Nigeria and Jamacia with the disease. 

In the case of barrier dysfunction, the serum protein proportion gradually increases and the percentage of CSF protein of local origin decreases. The serum/CSF ratio of total protein is suitable as an approximate indication when the more reliable albumin ratio is not available. In many laboratories, however, total protein is used primarily as an indicator of dilution for immunoglobulin quantification. 

Initially, it was believed that milk contained only one type of protein but about 100 years ago it was shown that the proteins in milk could be fractionated into two well-defined groups. On acidification to pH 4.6 (the isoelectric pH) at around 30°C, about 80% of the total protein in bovine milk precipitates out of solution this fraction is now called casein. The protein which remains soluble under these conditions is referred to as whey or serum protein or non-casein nitrogen. The pioneering work in this area was done by the German scientist, Hammarsten, and consequently isoelectric (acid) casein is sometimes referred to as casein nach Hammarsten. 

About 20% of the total protein of bovine milk belongs to a group of proteins generally referred to as whey or serum proteins or non-casein nitrogen. Acid and rennet wheys also contain casein-derived peptides both contain proteose-peptones, produced by plasmin, mainly from /J-casein, and the latter also contains (glyco)macropeptides produced by rennets from K-casein. These peptides are excluded from the present discussion. 

As hormone-sensitive lipase hydrolyzes triacylglyc-erol in adipocytes, the fatty acids thus released (free fatty acids, FFA) pass from the adipocyte into the blood, where they bind to the blood protein serum albumin. This protein (Mv 66,000), which makes up about half of the total serum protein, noncovalently binds as many as 10 fatty acids per protein monomer. Bound to this soluble protein, the otherwise insoluble fatty acids are carried to tissues such as skeletal muscle, heart, and renal cortex. In these target tissues, fatty acids dissociate from albumin and are moved by plasma membrane transporters into cells to serve as fuel. 

Fractionation of milk and titration of the fractions have been of considerable value. Rice and Markley (1924) made an attempt to assign contributions of the various milk components to titratable acidity. One scheme utilizes oxalate to precipitate calcium and rennet to remove the calcium caseinate phosphate micelles (Horst 1947 Ling 1936 Pyne and Ryan 1950). As formulated by Ling, the scheme involves titrations of milk, oxalated milk, rennet whey, and oxalated rennet whey to the phenolphthalein endpoint. From such titrations, Ling calculated that the caseinate contributed about 0.8 mEq of the total titer of 2.2 mEq/100 ml (0.19% lactic acid) in certain milks that he analyzed. These data are consistent with calculations based on the concentrations of phosphate and proteins present (Walstra and Jenness 1984). The casein, serum proteins, colloidal inorganic phosphorus, and dissolved inorganic phosphorus were accounted for by van der Have et al (1979) in their equation relating the titratable acidity of individual cow s milks to the composition. The casein and phosphates account for the major part of the titratable acidity of fresh milk. 

Clarification by removal of casein with such agents as calcium chloride, acetic acid, cooper sulfate, or rennin has often been employed to obtain a serum more suitable for refractometric measurements. Obviously the composition, and hence the refractive index, of such sera will depend on the method of preparation. Furthermore, some of the serum proteins may be precipitated with the casein by some of the agents used, particularly if the milk has been heated. Refractive index measurements of such sera are not generally considered as satisfactory as freezing point measurements for detection of added water (David and MacDonald 1953 Munchberg and Narbutas 1937 Schuler 1938 Tell-mann 1933 Vleeschauwer and Waeyenberge 1941). Menefee and Overman (1939) reported a close relation between total solids in evaporated and condensed products and the refractive index of serum prepared therefrom by the copper sulfate method. Of course, a different proportionality constant would hold for each type of product. 

Lactoglobulin With a denaturation temperature of 78°C, /3-lacto-globulin is the least denaturable of the serum proteins (Table 11.2). It exhibits a second thermal change near 140°C caused by a breakdown of disulfide bonds and additional unfolding of the molecule (de Wit 1981 Watanabe and Klostermeyer 1976). A change in pH between 6 and 7.5 shifts denaturation between 78° and 140°C, the total denaturation at the two temperatures being nearly constant. pH 6 favors dena-... 

The whey or serum proteins have been parttally resolved into three relatively homogeneous, crysialli/able proteins ill fl-lactoglobulm (50 3 of total scrum protein). (2 an albumin resembling the albumin ol bovine blood S r of ihe serum protein), and (3) a-laclalbumin <12% of Ihe serum protein. ... 

In unhomogenized dairy cream the natural phospholipids contribute to the whipping properties of the cream. However, after homogenization the particle size of the fat globules decreases, and the total fat surface area increases. This means that the interfacial concentration of polar lipids decreases because milk serum proteins adsorb at the newly formed interfaces, and the whipping properties are lost. Consequently, additional polar lipids or emulsifiers are needed to obtain good whipping properties in most industrially manufactured products. 

Most anticonvulsants have linear elimination kinetics, which means that an increase in the dose of drug administered leads to a proportional increase in the blood concentration and pharmacological activity. However, diphenylhydantoin and valproate are exceptions the former does not follow linear kinetics so that the blood concentration is not directly related to the dose administered, while valproate is highly bound to serum proteins so that the total blood concentration may not directly reflect the quantity of drug available to the brain. 

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