Diagnostic Cells In Human Body Fluids - The PjProblemStrings
Strings (SiPjAjk) = S7P1A16 Base Sequence = 12735 String Sequence = 12735 - 1 - 16
Specific human cells and specific chemicals in human body fluids, constitute the primary human-body-health informants. Their amounts in human body fluids relative to normal amounts can indicate the presence of disequilibrium in the health of the body.
(a) Describe the human cell.
(b) What are some of the important diagnostic cells in human body fluids?
(c) How are diagnostic cells in human body fluids measured?
(d) Use PjProblemStrings to summarize the reasons for measuring
diagnostic cells in human body fluids.
S7P1A16 (Containership - Density).
Pj Problems of Interest is of type Containership and identity.
(a) The human body has two basic bodily objectives: survive and reproduce. The human cell (there are trillions of them in the human body) is the basic building unit used to realized these objectives. Cells group to form functional structures called tissues. Tissues group to form functional structures called organs. The functionality of organs are expressed in the networks of systems in the human body.
The human-cell consists of a nucleus, a jelly-like fluid (cytosol), a skeletal frame (cytoskeleton) and other structures (organelles). The cytosol together with the organelles constitute the cytoplasm. The cell is bounded by the plasma membrane which separates the cell from its surrounding and permits access in and out of the cell.
Cell Structures Within The Plasma Membrane
Cytoskeleton: network of long fibers that make up the cell's structural framework. It establishes cell shape, aids in cell division, allows cell mobility and directs the cellular movements of organelles and other substances.
Nucleus: the control center. It is bounded by a protective membrane called the nuclear envelope. A cell's division, growth, maturity and even death is controlled by signals sent from the nucleus. The twenty three pairs of chromosomes that contain the cell's hereditary material, Deoxyribonucleic Acid (DNA), is housed in the nucleus.
Mitochondria: complex organelles that possess their own DNA (i.e separate from DNA in nucleus) and are capable of replicating themselves . They convert food energy into a form the cell can use.
Endoplasmic Reticulum (ER): facilitates the processing of molecules created by the cell. It also transports these molecules to the specific places where they are needed within or outside the cell.
Golgi Apparatus: packages outbound molecules processed by the endoplasmic reticulum.
Ribosomes: float freely in the cytoplasm or are attached to the endoplasmic reticulum. They process the genetic instructions used by the cell to create proteins.
Lysosomes and Peroxisomes : the environmentalists: entities not part of the cell environment are removed by them. For example, they digest foreign bacteria that invade the cell. They also clean up the cell-space by removing toxic substances and re-cycling worn-out cell parts.
(b) The diagnostic cells in human body fluids can be categorized broadly, into two groups: friends (e.g. red blood cells, white blood cells, platelets, friendly bacteria, spermatozoa) and foes (e.g. unfriendly bacteria, cancer cells). The friends help to sustain the body. The foes in the course of ensuring their own survival, destabilize the body's equilibrium.
Friendly Diagnostic Cells
Red Blood Cells (RBC, also called erythrocytes)
Normal count - male: 4.7 - 6.1 million cells/microLiter
Normal count - female: 4.2 - 5.4 million cells/microLiter
RBC are produced in the bone marrow and released into the blood stream on maturity. They are the transporters of oxygen to all parts of the body. Their role as oxygen-carriers is possible because they contain the protein, hemoglobin which binds readily to oxygen. Average lifespan of healthy red blood cells is about 120 days and they constitute about 40% of blood volume. Hematocrit (HCT), measures how much of blood is made up of red blood cells. The amount of hemoglobin (HGB in g/dL) is also of interest.
anemia: RBC count is less than normal
possible diagnostic inferences:
-loss of blood due to trauma
-Sickle cell anemia
-Acute or chronic internal bleeding in digestive tract, bladder, uterus, etc.
-Iron, B12 and foliate deficiency
-Chronic Inflamatory disease
-Bone marrow damage due to infection, radiation, drugs, toxins
-Bone marrow disorders (leukemia, multiple myeloma, lymphoma,etc)
-Decreased production of erythropoietin (may suggest kidney malfuction). Erythropoietin is a hormone produced by the kidney that promotes red blood cells production.
polycythemia: RBC is more than normal
Possible diagnostic inference:
-Lung disease: insufficient intake and absorption of oxygen rsults in short supply of oxygen to tissues. Body tries to correct deficit by increased production of red blood cells.
-Congenital heart disease: pump action of heart is impaired. Less oxygen gets to tissues. Body tries to correct deficit by increased production of red blood cells.
-Excess production of erythropoietin due to kidney tumor
-Dehydration: RBC count per volume of blood fluid increases due to a decrease in blood fluid
-Genetic abnormalities of oxygen sensing and hemoglobin oxygen release.
White Blood Cells (WBC, also called Leukocytes)
Normal count: 4,000 -10,000 cells/microLiter
WBC are produced in the bone marrow by the process called hematopoiesis (all blood cells are descedants of homotopoiesis stem cell) and released into the blood stream on maturity. WBC are important components of the body's immune system (they fight to sustain survival of the body). There are several types of white blood cells:
-Neutrophils: about 50% of white blood cells. They are the first responders when the body has been invaded by bacteria or viruses. They engulf the intruders, then they send signals to other white blood cells to report to the battlefield. Neutrophils are the primary cells in pus (a mixture of cell debris and white blood cells. Large amount of undrained pus is abscess). About 100 billions produced daily by the body. Average lifespan is about 8 hours.
-Monocytes: about 5%-12% of white blood cells. They are second to arrive at the battlefield. Their main function is to consume dying neutrophils (take care of fallen heroes). Some monocytes also help in the formation of antibodies (proteins that neuralize the proteins that make up the outer sheath of bacteria and viruses).
-Lymphocytes (B cells and T cells):
B cells produce the specific antibodies that remembers and can neutralize specific antigens. The memory and neutralization capabilities of antibodies produced by B cells are primary reasons why most vaccines are effective.
T cells are of three types:
Helper T cells (T4 or CD4+): help other WBC in their functions
Suppressor T cells (T8 0r CD8+): prevents WBC from destroying normal tissues
Killer T cells (a type of CD8+): the actual killers of the bacteria or viruses.
T cells also play important role in the efficacy of some vaccine like tuberculosis and pertusis vacines.
-Eosinophils: about 5% of white blood cells with high concentration in the digestive tract. They help in the fight against unfriendly bacteria and parasitic infections (e.g. worms). They respond vigorously against allergens (even simple allergens like pollens). Their overeaction to simple allergens is due to their misinterpretation of the dangers the simple allergens pose to the body.
-Basophils; about 1% of white blood cells. Needed for non-specific defense against pathogens. They release histamine and other chemicals when stimulated. Histamine can cause inflammation and brochoconstriction of the airways. Basophils are often associated with asthma.
Normal count:150,000 - 450,000 cells/microLiter
Platelets are the smallest of the blood cells. They are formed from megakaryocytes (very large cells) in the bone marrow and released into the blood on maturity. Their average lifespan is about 8 to 10 days. Platelets are called to action when a blood vessel is damaged. Their role is to clot the blood at the damaged site (with the help of clotting factors) so as to stop the bleeding. Platelets count can be too high (thrombocytosis) or too low (thrombocytopenia).
Thrombocytopenia: platelet count is less than normal:
Possible diagnostic inferences:
-Bone marrow dysfunction (bone marrow cannot produce enough platelets)
-Cancer (e.g. lymphoma, leukemia, or other mestastasized cancer that has spread to the bone marrow)
-Viral infection (e.g. mononucleosis, HIV, hepatitis, measles)
-Antibody production against platelets due to immune system disorder(e.g. idiopathic thrombocytopenia, also called immune thrombocytopenic purpura)
-Certain drugs (e.g. antibiotics, NSAIDS, diuretics)
-Aplastic anemia (reduction in production of all blood cells)
-Autoimune disoders (e.g. lupus)
-Toxins (e.g. arsenic, pesticides, benzene)
Thrombocytosis: platelet count is more than normal:
Possible diagnostic inferences:
-Cancer (e.g. lung, gastrointestinal, ovarian, breast, lymphoma)
-Inflamation (e.g. rheumatoid arthritis, inflamatory bowel disease)
-Infectious disease (e.g. tuberculosis)
-Anemia (e.g.iron-deficiency anemia, hemolytic anemia)
-Surgical removal of spleen
Platelets may be uncountable if they stick together (a risk factor in heart attack and stroke).
Nomal count: 15 million - 200 million/milliliter of semen
They are produced in the testes and immersed in the seminal fluid and are slightly structurally different from other cells (the sperm-cell has a head, mid-section and a tail). The head contains the nucleus wherein lies the X and Y chromosomes. Consequently, the sperm determines the gender of a human offspring. The mid-section houses the mitochondrion that provides the energy the sperm cell needs to journey in the female reproductive tract to the ovum (the female egg). The tail or flagellum enables the cell's movement. On reaching the ovum (usually in the fallopian tube), the proteolytic enzymes in the acrosome in the sperm's head destroys the ovum's outer layer so as to allow the sperm to penetrate the ovum for fertilization. A successful fertilization produces a zygote which becomes an embryo which becomes the fetus in the uterus that develops into the human offspring after about 9 months gestation.
Sperm count is usually tied to issues of male fertility. The number of sperm, physical appearance of sperm, chemical profile of sperm (sugar and PH level) and motility (vigor of motion) are important factors in the determination of a sperm cell fertilization profile. For example, low sperm count decreases the probability that an ovum will be fertilized.
Unfriendly Diagnostic Cells
Cancer Cells: are abnormal cells caused by abnormal cell divisions. Each human cell contains the instructions it must follow for its normal activities (e.g. division for the purpose of growth and repair). When a cell's mutation instructions are compromised, it will divide disorderly. Such disorderly divisions produce tissue growths called tumors or neoplasm. A tumor may be benign or malignant. A cancer is a malignant tumor that can grow continually until it kills the body.
Due to their disorderly and rapid divisions, the cells of a malignant tumor generally show less specialization and have no surrounding capsule. So, they can invade, destroy adjacent tissue and eventually metastasize (spread from their original or primary site to a secondary site). Metastasis (the process by which cancer cells spread from the original site to other parts of th body) is initiated when the cells get into the flow of the blood or lymph. The blood or lymph transports the cells until they are established in another part of the body. Secondary sites for lymph transported cancer cells are usually in the glands. Secondary sites for blood transported cancer cells are usually in the bones, lungs and liver. Cancer cells that originate in the brain do not metastasize, however, the brain can be a secondary site. Other common secondary sites include the kidney, bladder, larynx, testes and the female breast.
A cancer can also spread through the body simply by growing. Malignant tumors are almost always fatal unless the cancer cells are killed either by the body's immune system or by medical treatment.
Unfriendly Bacteria: Bacteria in general are round or rod shaped tiny (1-20 thousandth millimeter in diameter) single celled plant life. Their simple structure consists of an outer wall within which there is protoplasm and DNA. They reproduce almost always by dividing into two. They generally like moist and not too acidic environment. They dislike too much heat and too much cold. Bacteria are numerous and everywhere. There are good ones (e.g. bacteria in the digestive system and bacteria in air and soil that play important role in the decay process of dead matter) and bad ones (e.g bacteria that cause illnesses in humans such as tetanus bacilli, anthrax bacilli, tuberculosis bacilli, etc).
Illnesses from bacteria are generally initiated in two ways:
(1) When good bacteria already in the body access the wrong space in the body. For example, urinary infection in women can occur if good bacteria in the rectum enters the urinary tract and some mennigitis are due to throat bacteria gaining access to the brain.
(2) When bad bacteria access the body through any of the body openings ( e.g nostrils, mouth, skin, genital openings). For example, tuberculosis bacilli and anthrax bacilli can access the body through the nostrils.
Viruses (not considered to be cells), fungi and parasites are other harmful microorganisms, but they are not in focus in this presentation. However, several tests used to identify bacteria can also be used to identify them.
(c) The Complete Blood Count (CBC) is a primary means for determining the number of blood cells in blood. The CBC is also called, the Full Blood Count (FBC) and the Full Blood Exam (FBE).
A sample of blood is drawn from the vein into a test tube containing an anticoagulant (eg.EDTA, or citrate). The anticoagulant prevents the blood from clotting. The sample is then analyzed by an automated hematology analyzer (e.g. the 3-part differential cell counter and the 5-part differential cell counter). Automated hematology analyzers use the concepts of flow cytometry, spectrophotometry and electric impedance (Coulter's Principle) to identify and count cells. Microscopy is used in cases where the automated hematology analyzer is unable to identify abnormal cells.
Cancer of blood cells may be suggested by a CBC if too many or too few of the blood cells are found or are abnormal. A biopsy (the sampling of tissue to determine if it contains cancer cells) of the bone marrow will confirm the presence of cancer cells.
Blood Protein Test (electrophoresis) and Tumor Marker Test are used for other cancer cells not observable in the blood. Blood Protein Test examines various blood proteins to see if there is an elevated amount of abnormal immune system proteins (immunoglobulins) in the blood. Tumor Marker Test look for unusually high amount in the blood, of specific chemicals produced by tumor cells. For example, Protein-specific antigen (PSA) and alphafetoprotein (AFP) are tumor markers for prostate cancer and liver cancer respectively.
Bacteria stains and bacteria cultures are commonly used to identify bacteria. The Gram stain (a violet-colored stain) is frequently used. Bacteria are grouped according to the retention of the Gram stain (Gram-positive - bacteria look blue because of retention), or the non-retention of the Gram stain (Gram-negative - bacteria look red because of non-retention). In general, the stain used is dependent on the probable bacteria of interest.
Bacteria are cultured (grown) in the lab when the number of the bacteria observed through the microscope are very few. The sample is placed in a sterile dish (plate) and nutrients supplied based on probable bacteria of interest. The rate of bacterial growth (bacteria are now many enough for proper observation) varies: some grow easily (e.g. streptococci), some not so quickly (e.g. tuberculosis bacilli) and some cannot be cultured (e.g. siphillis bacteria).
Immunologic tests such as antibodies (substances produced by the immune system to help fight infection) and antigens (foreign substances that cause immune response and the production of antibodies) tests are used to identify bacteria that cannot be cultured.
(d) Given an initial dynamic equilibrium, measurement objective is to determine change in the amount and identity of diagnostic cells in human body fluids.
So, for initial dynamic equilibrium: PjProblemString - S7P7A72 (dynamic equilibrium),
measurement is interested in change : S7P5A51 (physical change), S7P5A52 (chemical change).
1(i) change in the amounts of diagnostic cells in a given volume of human body fluids relative to normal amount:
For normal amount, PjProblemString: (S7P1A16)normal.
For measured amount, PjProblemString: (S7P1A16)measured
Where S7P1A16 is containership - density.
When (S7P1A16)measured is different from (S7P1A16)normal, S7P5A51 and or S7P5A52 is established and problem with S7P7A72 is suggested.
(ii) change in physical and chemical characteristics:
Normal physical identity (e.g shape, size, color):
Observed physical identity:
When (S7P2A21)observed is different from (S7P2A21)normal, S7P5A51 and or S7P5A52 is established and problem with S7P7A72 is suggested.
In the case of unknown harmful bacteria and other harmful microorganisms (viruses, fungi and parasites), measurement is interested in identifying them.
PjProblemStrings: S7P2A21 (physical identity), S7P2A22 (chemical identity).
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