MLS 221
CHAPTER I
CLINICAL CHEMISTRY
Branch of chemistry that deals with biochemical processes in
relation to health and diseases
Biochemical processes: involves chemical compounds
(e.g. absorption, breakdown of glycogen è glucose)
Deals with quantitative measurement of biochemical substances in
body fluids including tissues
o To determine actual concentration
o E.g. (carbohydrates, proteins, lipids, NPn’s, hormones,
vitamins, enzymes, toxins, peritoneal fluid pericardial
fluid)
For DIAGNOSIS OF DISEASES
For TREATMENT OF DISEASES
AIDS THE PHYSICIAN
Helps the physician in ruling out diagnosis and come up with
diagnosis
The physician provide treatment
The physician monitor course and effects of treatment
§
Noting changes in specific disease parameters (change in
concentration in biochemical substances that serve as a
parameter for a particular disease)
§
Eg. Dibates Mellitus II
o Determine the conc. of glucose of HbA1c
§
Measuring drug levels in body levels
o TDM
o Establish prognosis
DISCIPLINES
1. ENDOCRINOLOGY
o Study of endocrine system
o Study how hormones are produced and affect certain
tissue
o E.g. testosterone
2. PHARMACOLOGY
o Study of drugs: how drugs are manufacture,
components, therapeutic benefits, pharmacokinetics
(evaluation how drug is absorbed, metabolize, and
eliminated)
3. IMMUNOLOGY
o Study of immune system
o Evaluation on how body responds to foreign material
that enters the body
o Antigen- Antibody rxn
4. ENZYMOLOGY
o Study of enzymes
o How enzymes are produced and their clinical
significance
5. ANALYTICAL CHEMISTRY
o Determine the presence of substance on different
methods
6. TOXICOLOGY
o Science of toxins
o Study of abused drugs including toxic effects
o How the body respond when exposed to toxin
7. INSTRUMENTATION
o Study of different principle behind machine operation
8. BIOCHEMISTRY
o Study of physical and chemical characteristics of
compound in relation to biological processes
9. TDM: THERAPEUTIC DRUG MONITORING
o Therapeutic fx: involves evaluation of the concentration
of drug in blood to ensure that given dosage provide a
maximum therapeutic benefit with minimal toxicity
10. DNA TESTING
o Gene analysis in determining diseases not basing on
signs and symptoms
0883|CLINICAL CHEMISTRY (LEC)|BSMLS 2
CHARACTERISTICS OF AN EFFICIENT LABORATORY
OTHER APPLICATION OF CLINICAL CHEMISTRY
Study of Lipoproteins
o Implicated as important in investigation of cardiovascular diseases
Platelet and CSF evaluation
o For schizophrenia
Cortisol determination
o Marker for mental disorder
Cancer detection and Monitoring
o Tumor markers: biological proteins produce by malignant tissue or
nearby tissues affected by tumors
Nutrition Assessment
o Determine deficiencies
HIPPOCRATES
GIOVANNI
MORGAGNI
ANTOINE
LAURENT
LAVOISIER
THE
VITALISTS
THE
MECHANISTS
THE
DARWINISTS
HISTORY OF CLINICAL CHEMISTRY
EARLY BEGINNINGS
§
discovered the four humors:
ü Sanguis (Blood)
ü Chole (Bile)
ü Melanchole (Black Bile)
ü Phlegma (Phlegm)
§
imbalances in these humors will cause a disease
§
how blood functions could lead to disease
§
introduced the anatomic approach of disease process
§
explained diseases in terms of localized pathologic
anatomy, rather than as attributable to an imbalance of
the humors diffused throughout the system
§
against the principle of Hippocrates
§
Father of Modern Chemistry
§
Recognized and named oxygen and hydrogen
§
Discovered the role of oxygen in the process of
combustion and that respiration is a slow combustion
process.
§
Started the belief that chemical analysis is a refined type
of dissection
§
Sparked a renewal of interest in the examination of body
fluids
§
Living organisms contain a vital force and exist because
of this force
§
Living organisms contains a ‘vital force’ that was the
very essence of life
§
Processes within living organisms were unique and
could not be duplicated in the laboratory.
§
In vitro synthesis of ‘organic’ compounds is impossible
§
Denied that chemistry has a role in physiology
§
Vital force – a belief by Marie Francois Xavier Bichat,
Johannes Muller, and Justus Baron von Leibig
§
Life could be explained by chemical and physical
principles and properties alone
§
The activity of one part is not affected by another part
à PARTIALITY
§
Pioneered by René Descartes
§
By Charles Darwin
§
There is no difference in the living and the dead in terms
of its constituents
§
Pioneer of human evolution
§
Human Evolution
ü Physical characteristics of a human being
ü Human being as a whole
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MLS 221
CHAPTER I
BIRTH OF CHEMISTRY
Pioneer of the Mechanist
Life could be explained by physical and chemical
laws
§
A certain substance in a certain organism can
reflect the totality of the organism
§
Bence Jones protein – when excreted in urine in
high amounts will result to multiple myeloma
§
§
HENRY BENCE
JONES
ANTOINE
FRANCOIS AND
COMTE DE
FOURCROY
§
Isolated urea (salt in urine) from urine
§
Synthesized urea in vitro from ammonium
cyanate
Urea was the first organic substance to be
synthesized wholly from inorganic compounds
and thus creating a bridge between the organic
and inorganic worlds
First synthesis that disproves the belief of the
vitalist
Was able to synthesize organic components from
the elements (e.g. Ethanol, Fomic acid)
Discovered that glycogen was formed by the liver
Contradicted vitalism belied that only plants
could synthesize complex compounds which
were subsequently consumed by animals
Suggested the presence of albumin in urine
Noticed that the increase substance in urine
leads to decrease concentration in blood
e.g. albumin excreted in the urine in large
amounts would increase concentration in blood
Bright disease aka chronic nephritis
Studied renal diseases and clearly established
the overall correlation of edema, albumin in urine
or albuminuria, and diseased kidneys (renal
disease) observed after death
Discovered that Urea circulates in blood and can
be eliminated by the kidneys
§
FRIEDRICH
WÖHLER
§
MARCELLIN
BERTHELOT
§
§
§
CLAUDE
BERNARD
§
§
JOHN BOSTOCK
§
§
§
RICHARD BRIGHT
§
PREVOST
pH PAPER
VAN SLYKE
APPARATUS
FOLIN-WU
TUBE
§
§
§
§
DUBOSQ TYPE
COLORIMETER
§
§
20TH CENTURY
Traditional way of measuring pH
It is a volumetric gas measuring apparatus for
determination of carbon dioxide concentration in
blood
Discovered PFF (Protein Free Filtrate) Method
Developed by Otto Knut Folin and Hsein Wu – they
are the first to establish reference values
It measures the amount of creatinine in urine
1st type of colorimeter
COLORIMETER
ü Measures color intensity in correlation
with the amount of substance
ü Led to the development of the
spectrophotometer (auto-analyzer)
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