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Biochemical tests are diagnostic methods of molecular and cellular chemical reactions (metabolism) by combining chemical, biological, physiological sciences. They give the information of the step of the metabolic disorder caused during the course of these metabolic reactions. Biochemistry science, applies spesific diagnostic techniques to define the clinical cause of that spesific health problem and gives the tool to the clinician to reach the correct diagnosis and treatment. These tests may give either the activities of the enzymes which catalyze those reactions or the amounts of the substrates (amino acids, lipids carbohydrates etc ), vitamins and minerals that take part in realizing the proper progress of that metabolic reaction. Moreover, they give the information whether these compounds are used efficiently in that metabolic process. Biochemistry examines the organelle spesific metabolic reactions and give information to the clinician to find out the source and severity of the health problem.
Other than scientific researches, the branch of Clinical Biochemisty help the clinican to reach the correct diagnosis and follow up the treatment.
Biochemical tests give the productivity of the metabolic reaction and the amounts, activities and causes of the disorders of that reaction.
Biochemical tests are done with spesifically designed and standardized instruments by using physics, chemistry, biology and medical knowledge.
Biochemical tests may be classiified according to these following clinical topics;
- Blood Gasses
- Cardiac Markers
- Coaglometric Chemical Parameters
- Drug levels
- Metabolic and Screening Tests
- Urine Analysis
- Electrophoretic Tests
- Enzymatic Analyses
Microbiology is the science and the Laboratory branch that identifies the microorganisms like virus, bacteria, mould, and yeast nd protozoa that are responsible of the related medical problems. The sample from the infected lesion or body fluid is used to grow the microorganism under in vitro condutions (laboratory condutions) by imitating the in vivo condutions (body condutions). This process is called the culture procedure. This culturing process is sometimes followed by the test which identifies the agents to kill that microorganism and enlightens the clinician about the medical agents that he might choose for his treatment.
Microbiology is the branch that mostly helps Infectious Diseases and Intania Medicine.
The main groups of microbiologic tests are;
- Bacterial Identification Tests performed with Special Dyes
- Microorganism growth tests by using special mediums under the laboratory condutions
- Tests by various chemical reactants to create reactions related to the metabolism of the microorganism.
Serology is the group of the laboratory tests based on the immunological response against the invading microorganism. This test also gives an idea about the onset of infection period and the immunologic strength of the patient against the infection. These microorganizms are generally called the ‘antigens’, while the immune response proteins against those antigens are called the ‘antibodies’.
Tests are preferred because they give earlier results than the microbiological tests and because blood may be used as the specimen. The main purpose of these tests are to search for spesific antibodies in the blood of the related pathogen. In other words, they are focused on proteins produced by the immune system.
The main subjects of the serological tests are;
Tumor markers are the compounds secreted by a cancer tissue or they are the responsive molecules synthesized against cancer. As these compounds are low or absent in healthy tissues, they are used in the diagnosis and prognosis of cancer. Tumor markers may both increase in blood and body fluids like urine, feces, ascites, pleural fluid, cyst fluid and cerebrospinal fluid. Although tumor markers support the diagnosis of cancers not all the increases in tumor markers may be conidered as cancer.
Tumor markers are tested with various methods in the laboratory. This is he reason why they are considered under a seperate topic in the laboratory medicine.
Tumor markers may be classified according to the type of the cancer they represent;
- Liver cancer and germ cell tumors
- Choriocarcinomas and germ cell tumors
- Ovarian cancer
- Gastrointestinal stromal tumors or mucosal melanomas
- Breast cancer
- Gastrointestinal system cancers
- Thyroid cancer
- Neuroendocrin Tumors
- Bladder Cancer
- Prostate Cancer
- Multiple Myeloma and Waldenstrom Macroglobulinemia
- Lung Cancers
Hormones are compounds which are synthesized in tiny amounts and released in blood to be carried to their target organs where they regulate metabolic functions. like digestion of foods, growth, sexual growth, reproduction, emotional behaviours and intelligence, regulation of water balance and body temperature. The basic structure of hormones are various like polypeptides, fatty acids and steroids. Therefore, they have different biochemical detection methods and are considered under a main topic in laboratory medicine.
The tissues where hormones are synthesized are named as endocrine glands. The related clinical branch is Endocrinology. More than one hormone may be synthesized and secreted from a particular gland.
Hormones are classified according to the emdocrine tissue they are synthesized and secreted;
- Pitutiary Gland
Hematological tests are done to diagnose and treat blood diseases like hemophilia, coagulation disorders, leukemia, lymphoma, myeloma and thalassemias.
In blood there are erythrocytes (red blood cells), leucocytes (white blood cells), platelets (thrombocytes). These cells consist 45% of the blood where the remaining is water.
These cells perform entirely different functions. Erythrocytes carry oxygen to the tissues when we breath and collect CO2 for exhalantion from the lungs. Leucocytes are the defense cells of the body. Platelets are the cells responsible for blood coagulation process.
These cells are synthesized in the bone marrow, spleen, thymus and lypmh nodes. The subject of hematology is to find out the disorders during synthesis, metabolism and functions of these cells and thus, diagnose and treat various diseases related to these metabolic steps.
Hematologic tests are performed by using spesific dyes, instruments and microscopes;
Hematologic tests are classified according to the subjects they are related to;
- Hematologic cancers
Sperm Analysis: Sperm analysis are spesific tests designed to investigate the causes of male infertility.The results of these tests are related to the sperm counts, motilities and morphologies. Additionally, they also define some physiologic properties of the semen fluid whcih contain the sperm cells. These properties are liquifaction time, colour, acidity, antibodies in semen, mucus etc. These tests cover the 50% of the causes of male infertility. They also give information about the clinical results of vasectomy where obstructions of the ducts of the testis are opened surgically.
There is a good cooperation between the laboratory and the doctor who is traeating the infertile couple with IUI (Intrauterine Insemination) procedure where the laboratory seperates the high quality and motile spermatozoa, concentrates them and sends to the doctor who injects this concentrate close to the mature eggs of the female by using a catether to facilitate the fertilization procedure . This procedure is called as Sperm Washing in the laboratory.
It is obvious that this branch of the clinical laboratory is all about a particular clinical situation to be considered under a main topic.
The parameters that sperm analysis are important are;
- Kruger (Sperm morphology)
- Semen Analysis
- Sperm washing