Scandinavian journal of clinical and laboratory investigation. Supplementum
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 2008
ReviewKidney Injury Molecule-1 (KIM-1): a specific and sensitive biomarker of kidney injury.
There is an urgent need for the detection and monitoring of kidney injury in both the acute and chronic disease setting. Urinary kidney injury molecule-1 (Kim-1), a type-1 transmembrane protein, is not normally present, but is expressed on the proximal tubule apical membrane with injury. Kim-1 has proved to be an outstanding indicator of kidney injury in the rat, outperforming blood urea nitrogen and serum creatinine as predictors of histopathological changes in the proximal tubule in response to many pathophysiological states or toxicants. Studies in man indicate that tissue expression and urinary excretion of the ectodomain of KIM-1 are sensitive and specific markers of injury as well as predictors of outcome.
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 1999
ReviewNeurochemical monitoring of the acutely injured human brain.
The main goal of modern neurointensive care (NIC) of patients with acute brain injury (traumatic brain injury, neurovascular disease) is to prevent additional loss of viable brain tissue due to secondary injury processes. It is generally held that secondary injury, mediated by, for example, cerebral hypoxia/ischemia and destructive molecular cascades on the cellular level, contributes significantly to the extent of brain damage after head injury and stroke. ⋯ This paper describes intracerebral microdialysis as a novel approach to neurochemical monitoring of the human brain. The main objectives are (i) to monitor cortical energy metabolism in order to detect secondary ischemia and (ii) to monitor secondary injury processes, such as glutamate receptor overactivation and increased free radical production, in NIC patients.
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 1999
ReviewBiochemical markers of cardiac damage: from traditional enzymes to cardiac-specific proteins. IFCC Subcommittee on Standardization of Cardiac Markers (S-SCM).
Measurement of cardiac markers in blood has been the mainstay for diagnosis of acute myocardial infarction for nearly 50 years. The field has evolved from measurement of enzyme activity to mass concentrations of proteins using automated non-isotopic immunoassays. With changing clinical practices, cardiac markers are now needed to detect the presence of minor myocardial infarction in patients with unstable angina. ⋯ In the case of cardiac troponin, clinical observations and animal studies suggest that cytosolic free troponin may be released in reversible ischemia in addition to irreversible cell damage. The IFCC S-SCM has recommended use of two cut-off concentrations for cardiac troponin to differentiate normal from minor myocardial injury and AMI. A low cut-off may detect reversible ischemic events in some cases.
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 1996
Review Comparative StudySimultaneous measurement of total hemoglobin and its derivatives in blood using CO-oximeters: analytical principles; their application in selecting analytical wavelengths and reference methods; a comparison of the results of the choices made.
Optical methods of quantifying total hemoglobin (tHb), applying the principles of the Lambert-Beer law, have been used both on untreated whole blood and on blood mixed with chemicals to form a stable chromophore, since the earliest days of laboratory medicine. The same principles may be applied for quantitation of the individual hemoglobin derivatives, such as oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb)1, as well as the non-oxygen transporting "dyshemoglobins", including carboxyhemoglobin (COHb) and methemoglobin (MetHb). The total hemoglobin measurement is typically carried out using a light source with a broad band of visible wavelengths. ⋯ Either general-purpose, narrow band-pass spectrophotometers, or special-purpose photometers utilizing a set of fixed wavelengths, commonly referred to as "CO-oximeters" are suitable. Rapid, direct, photometric quantification of the derivatives, necessary in the clinical environment, relies on the specific light absorption characteristics of each hemoglobin derivative at the wavelengths selected, which in turn requires independent and exact knowledge of the concentrations of each entity in reference materials. This report examines the process involved in the selection of wavelengths and reference methods, contrasts the effects of the choices made and discusses some implications and limitations for routine measurement.