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Posts Tagged ‘internal medicine’

Macroenzymes

Posted by iskanbasal on March 31, 2009

Macroenzymes, what are they?

“Macroenzymes are enzymes in plasma that have a higher molecular mass than the corresponding enzyme normally present under (patho) physiological conditions. They may arise through self-polymerization or by association with other plasma components, in particular immunoglobulins”.

This citation from an article:

“A paediatric case of macro aspartate aminotransferase”

Read the article here doi:10.1258/acb.2007.007094 Ann Clin Biochem 2008;45:323-324

Why I’m interested? I encountered this subject during studying for liver function tests after having finished the disorderds of lipid metabolism which I posted about below.

Type-1 macroenzymes result from the formation of antigen-antibody complexes, using GPT, GOT, gama-GT, and AP

Type-2 macroenzymes result from oligomerization using gama-GT, AP, LAP and 5′-NU.

In the absence of clinical findings continuous elevation of measured GPT(and also GOT) is found with the appearance of macroenzymes.




Posted in Lab | Tagged: , , , | Leave a Comment »

Edema: why begins in the left leg

Posted by iskanbasal on November 19, 2008

I’m reviewing signs and symptoms, differential diagnoses, methods of physical and history taking and these are some of my notes i encountered today:

The best method for determining the cause of an edema is to consider each of the pathophysiologic categories; there are four categories:

1. edema caused by INCREASED PERMEABILITY

2. edema caused by INCREASED INTRAVASCULAR PRESSURE.

3. edema caused by DECREASED ONCOTIC PRESSURE ( the intravascular).

3. edema caused by OBSTRUCTION OF LYMPHATIC DRAINAGE OF TISSUES.

There are good note or clues that help in the diagnosis of edema, some are :

“Increased permeability affects all tissue beds equally; edema of the upper and lower extremities (and face) suggests increased permeability as the etiology”.

“Increased intravascular pressure is due to either volume overload or an obstruction of venous blood to the heart. Because pressure is greatest in the lower extremities due to gravity, edema due to increased intravascular pressure always begins in the lower extremities and ascends superiorly to the site of the obstruction. Venous pressure is higher in the left leg because the left iliac vein must cross under the aorta to join the vena cava. Edema due to increased intravascular pressure almost always begins in the left leg, eventually involving both legs”.




Posted in History&Physical examination, internal medicine, Signs and symptoms | Tagged: , , , | Leave a Comment »

 
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