Applications of Hematology Procedures

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A standard hospital has a department dedicated composed of branches in hematology, clinical chemistry, serology and bodily fluids, blood bank, and microbiology.  The seven main tests involved in medicine are phlebotomy, hematology, blood coagulation test, chemical pathology, urinalysis, microbiology, and serology.

Clinical tests are carried about hematologists, clinical chemists, microbiologists, immunologists, medical technican. Most of these position require a Bachelors in Science degree.

Specimen tests include inspection of blood (whole blood, serum, plasma), body fluids (urine, CSF, gastric fluids and sweat) and body specimens (sputum, stool, tissue biopsy).Whole blood tests for blood cell count. Only serum is needed to assess the level of CO2. Most blood tests are not comprehensive, specific panels need to be ordered by the doctor to be studied. Antibotics and enzyme markers are necessary for assessment of disease resistance.

Granulocytes come from myeloblasts. Most leukocytes are formed in the bone marrow. The precursors of white blood cells are larger in size. Basophils, eosinophils are derived from amphophilic myleocytes. On the blood panel, RBC, Hb, Hct, MCV, MCH, MCHC, WBC, neutrophils, lymphocytes, monocytes, eosinophils and basophils are all studied.

Physicians are keen on whether the patient’s values are or are not within of healthy range. 

Erthrocyte Sedimentation Rate (ESR). Blood the settles faster are in the form of a stacked rouleaux. What makes them stack together , When doctors suspect of this erthyrocpathology, they will order C-reactive proten and heat shock protein. This indicates the injury of the liver. The three main diseases considered are anemia, leukemia and hematological infections.

Cell counting can now be attained by flow cytometry (Hemalog D). The agents used are alkaline peroxidase and esterase (monocytes). Alkaline peroxidase is the enzyme found in granulocytes. Hemalog 8 can count hemaglobin, hematocrit, and all the other tests on the blood panel. If counting of cells is ordered after business hours, the sample is manually counted in the hematology lab.

Hemostasis. “Blood static” The blood is stopped from movement, resulting in blood clotting.

1. Blood Test. There are three types of blood collected: arterial, venous and capillary. Arterial blood drawn from arteries. Venous blood drawn from basilic vein, cephalic vein and median cubital veins. Capillary blood is collected by fingertip puncture commonly performed by diabetics. The blood vessel is located by tying a rubber band at the site, forming a tourniquet that helps the vessel bulge in place. Arterial blood can sometimes be hemolysed and this interferes with proper assessment because this type of blood contains higher levels of potassium ions. This arises from using wrong anticoagulant.

A venipuncture blood draw contains EDTA, citrate, oxalate, heparin. The first three collects Ca. Heparin 0.01mg/mL is used for blood clotting. Antiheparin in aspirin prevents blood clotting and is given to hypertensive or artherovascular disease.

2. Blood Clotting. Fibrinogen —-thrombin—-> fibrin –> blood clot. Heparin is an anticoagulant or thinning of the blood.

Blod coagulation tests for intrinsic factors, extrinsic factors, platelet functions that give insight to inherited diseases (hemophilia A and B), hemorrhage disorders. There are Factors I-VIII. Factor IV = calcium.

The Lee-White Clotting Time is a three test tube test. A coagulating agent is added to the test tubes, timed and monitored in increments of 1/2 minutes for coagulation activity.

The Hematology and Clinical Chemistry departments are different. There are only 2-3 microscopes in the hematology department whereas the clinical chemistry department have boxes of equipment. This is because the CC performs of over 60 tests. These tests analyzes enzymes, hormones, carbohydrates, electrolytes and gases (O2 and CO2) panels. They also evaluate serum, cerebrospinal fluids, whole blood, plasma, urine, sweat. Lastly, there are organ function tests to evaluates the overall function of the organs such as liver and kidneys. Biopsy tissue samples are also sent to the CC for analysis. 

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The microbiology department of HKU is solid and an informative branch. I was enlightened by the second lecturer of the Microbial Biotechnology course today, and wanted to share what microbiologists do in their lab on a daily basis.

The human ancestors dated back 2 million years ago. Microbes are found to have existed since 3.5 million years ago. Microorganisms constitutes as half of living organisms, which includes animals, plants, protozoa and fungi. Up to date, only 1% of bacteria species are identified and studied in the laboratory.

As more governmental funding are given to the field biotechnology, the development of many branches are as follows:

1. Medical diagnostic tests. Microbes are industrially applied in the recombinant DNA technology, which involves the transfer of target genes from one organism to another. This process can be used for the development of new vaccines and medicines. The protein products on the medicine market are produced from animal sources. The quintennsence example of microbial biotechnology is insulin. Industrial production of insulin comes from pigs and cows. In the past, natural souces insulin was collected in small amounts from these livestock and was sold very expensive. There is also the chance of microbial contamination from the livestock and must undergo purification to exclude other protein byproducts and surrounding microbial/viral contaminants. But now thanks to industrial technology, larger amounts of insulin are synthesized in the lab and made available for diabetes treatment.

Genentech is considered the founder company of the biotechnology industry.

Proprietary market of medicines are sold under brand names. Example: Aspirin is the brand name of acetaminophen.

2. Biotechnology food. Enzymes are used to process leather, wine, beer, yogurt. Feed enzymes are used for feeding livestocks. The Denmark company, Novozyme, is the largest company of industrial enzyme market.

3. Environmental biotechnology. The cleanup of natural disasters and hazardous waste spills. Organic fuel like gas and diesel can also be produced.

4. Biopesticides.

5. Industrial biotechnology.

6. DNA fingerprinting. The most elegant application of microbial biotechnology is the fingerprinting of DNA in forensic medicine. This branch of technology also allows for the parental testing where parents and childen relationship is identified by profiling their DNA.

In recombinant protein technology, the benefit of manufacturing synthetic penicillin is that they can be modified to confer resistance to the defense mechanisms of bacteria to the drug. Another instance, recombinant yeast far triumphs the natural baker’s yeast in all aspects of associated with its functions.

Where are biodegradable plastic found on campus? The biodegradable plastics are used for packaging take-out food.

The pharmaceutical industry is continually growing with the support of an increase growth of markets and development of R&D models. The drug market is undergoing an annual growth of 12% and spreads to more and more countries. As synthetic drugs are in higher demand, more and more projects arise in research and development.

Examples: Amgen, Genentech, Biogen Idec, Cephalon, Medimmune are American biotechnology companies that invest billions of dollars in the R&D of medicinal drugs. These companies hold large market shares and rack up large amounts of revenue. The two big players are Amgen and Genentech invests $3.4 billion and $3.0 billion, respectively. Hong Kong government funds for all Hong Kong universities with only $0.053 billion. Thus, America supplies more funding for pharmacetical companies than Hong Kong.