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Download scientific diagram | Equivalent circuit diagram of 3TSMC (assuming u a > u b > u c and u b < 0). (a) Forward power flow. Download scientific diagram | Schematic feature representation of the OPC UA interface from publication: Subject-Oriented BPM as the Glue for Integrating. Search Electronic Circuits Diagrams Free. Look Up Results on innerselfstudio.com MOSER STORE Go to Ubuntu Dash Home and by leaving comments, I haven't tried. For details please used only for is allowed to. The combined licenses of that you'll the interface must.

Urinary casts are formed only in the distal convoluted tubule DCT or the collecting duct distal nephron. The proximal convoluted tubule PCT and loop of Henle are not locations for cast formation. Hyaline casts are composed primarily of a mucoprotein Tamm-Horsfall protein secreted by tubule cells. The Tamm-Horsfall protein secretion green dots is illustrated in the diagram below, forming a hyaline cast in the collecting duct:.

Even with glomerular injury causing increased glomerular permeability to plasma proteins with resulting proteinuria, most matrix or "glue" that cements urinary casts together is Tamm-Horsfall mucoprotein, although albumin and some globulins are also incorporated. An example of glomerular inflammation with leakage of RBC's to produce a red blood cell cast is shown in the diagram below:.

The factors which favor protein cast formation are low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation, particularly that of the Tamm-Horsfall protein. Protein casts with long, thin tails formed at the junction of Henle's loop and the distal convoluted tubule are called cylindroids.

Hyaline casts can be seen even in healthy patients. Red blood cells may stick together and form red blood cell casts. Such casts are indicative of glomerulonephritis, with leakage of RBC's from glomeruli, or severe tubular damage. White blood cell casts are most typical for acute pyelonephritis, but they may also be present with glomerulonephritis. Their presence indicates inflammation of the kidney, because such casts will not form except in the kidney.

When cellular casts remain in the nephron for some time before they are flushed into the bladder urine, the cells may degenerate to become a coarsely granular cast, later a finely granular cast, and ultimately, a waxy cast. Granular and waxy casts are be believed to derive from renal tubular cell casts. Broad casts are believed to emanate from damaged and dilated tubules and are therefore seen in end-stage chronic renal disease. The so-called telescoped urinary sediment is one in which red cells, white cells, oval fat bodies, and all types of casts are found in more or less equal profusion.

The conditions which may lead to a telescoped sediment are: 1 lupus nephritis 2 hypertensive emergency 3 diabetic glomerulosclerosis, and 4 rapidly progressive glomerulonephritis. In end-stage kidney disease of any cause, the urinary sediment often becomes very scant because few remaining nephrons produce dilute urine. Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature.

Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms. Diagnosis of bacteriuria in a case of suspected urinary tract infection requires culture. A colony count may also be done to see if significant numbers of bacteria are present. Multiple organisms reflect contamination.

However, the presence of any organism in catheterized or suprapubic tap specimens should be considered significant. Yeast cells may be contaminants or represent a true yeast infection. They are often difficult to distinguish from red cells and amorphous crystals but are distinguished by their tendency to bud. Most often they are Candida, which may colonize bladder, urethra, or vagina. Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates.

Very uncommon crystals include: cystine crystals in urine of neonates with congenital cystinuria or severe liver disease, tyrosine crystals with congenital tyrosinosis or marked liver impairment, or leucine crystals in patients with severe liver disease or with maple syrup urine disease. General "crud" or unidentifiable objects may find their way into a specimen, particularly those that patients bring from home.

Spermatozoa can sometimes be seen. Rarely, pinworm ova may contaminate the urine. In Egypt, ova from bladder infestations with schistosomiasis may be seen. Random collection taken at any time of day with no precautions regarding contamination. The sample may be dilute, isotonic, or hypertonic and may contain white cells, bacteria, and squamous epithelium as contaminants.

In females, the specimen may cont contain vaginal contaminants such as trichomonads, yeast, and during menses, red cells. Early morning collection of the sample before ingestion of any fluid. This is usually hypertonic and reflects the ability of the kidney to concentrate urine during dehydration which occurs overnight. If all fluid ingestion has been avoided since 6 p.

Clean-catch, midstream urine specimen collected after cleansing the external urethral meatus. A cotton sponge soaked with benzalkonium hydrochloride is useful and non-irritating for this purpose. A midstream urine is one in which the first half of the bladder urine is discarded and the collection vessel is introduced into the urinary stream to catch the last half. The first half of the stream serves to flush contaminating cells and microbes from the outer urethra prior to collection.

This sounds easy, but it isn't try it yourself before criticizing the patient. Catherization of the bladder through the urethra for urine collection is carried out only in special circumstances, i. This procedure risks introducing infection and traumatizing the urethra and bladder, thus producing iatrogenic infection or hematuria.

Suprapubic transabdominal needle aspiration of the bladder. When done under ideal conditions, this provides the purest sampling of bladder urine. This is a good method for infants and small children. To summarize, a properly collected clean-catch, midstream urine after cleansing of the urethral meatus is adequate for complete urinalysis. In fact, these specimens generally suffice even for urine culture. Another important factor is the interval of time which elapses from collection to examination in the laboratory.

Changes which occur with time after collection include: 1 decreased clarity due to crystallization of solutes, 2 rising pH, 3 loss of ketone bodies, 4 loss of bilirubin, 5 dissolution of cells and casts, and 6 overgrowth of contaminating microorganisms. Therefore, get the urine to the laboratory as quickly as possible. Specific Gravity sp gr Specific gravity of urine is determined by the presence of solutes represented by particles of varying sizes, from small ions to larger proteins.

Protein Dipstick screening for protein is done on whole urine, but semi-quantitative tests for urine protein should be performed on the supernatant of centrifuged urine since the cells suspended in normal urine can produce a falsely high estimation of protein. Glucose Less than 0. Nitrite A positive nitrite test indicates that bacteria may be present in significant numbers in urine.

Leukocyte Esterase A positive leukocyte esterase test results from the presence of white blood cells either as whole cells or as lysed cells. Examination The sediment is first examined under low power to identify most crystals, casts, squamous cells, and other large objects.

Red Blood Cells Hematuria is the presence of abnormal numbers of red cells in urine due to: glomerular damage, tumors which erode the urinary tract anywhere along its length, kidney trauma, urinary tract stones, renal infarcts, acute tubular necrosis, upper and lower uri urinary tract infections, nephrotoxins, and physical stress. Red blood cells in urine Dysmorphic red blood cells in urine White Blood Cells Pyuria refers to the presence of abnormal numbers of leukocytes that may appear with infection in either the upper or lower urinary tract or with acute glomerulonephritis.

White blood cells in urine Epithelial Cells Renal tubular epithelial cells, usually larger than granulocytes, contain a large round or oval nucleus and normally slough into the urine in small numbers. Oval fat bodies in urine Oval fat bodies in urine, with polarized light Transitional epithelial cells from the renal pelvis, ureter, or bladder have more regular cell borders, larger nuclei, and smaller overall size than squamous epithelium.

Squamous epithelial cells from the skin surface or from the outer urethra can appear in urine. Squamous epithelial cells in urine Casts Urinary casts are formed only in the distal convoluted tubule DCT or the collecting duct distal nephron. The Tamm-Horsfall protein secretion green dots is illustrated in the diagram below, forming a hyaline cast in the collecting duct: Even with glomerular injury causing increased glomerular permeability to plasma proteins with resulting proteinuria, most matrix or "glue" that cements urinary casts together is Tamm-Horsfall mucoprotein, although albumin and some globulins are also incorporated.

An example of glomerular inflammation with leakage of RBC's to produce a red blood cell cast is shown in the diagram below: The factors which favor protein cast formation are low flow rate, high salt concentration, and low pH, all of which favor protein denaturation and precipitation, particularly that of the Tamm-Horsfall protein. Hyaline casts in urine Red blood cell casts forming in tubules Red blood cell cast in urine White blood cell cast in urine Renal tubular cell cast in urine Granular casts in urine Granular cast in urine Waxy cast in urine Bile stained hyaline casts in renal tubules Bacteria Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature.

Yeast Yeast cells may be contaminants or represent a true yeast infection. Crystals Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates. Oxalate crystals in urine Triple phosphate crystals in urine Cystine crystals in urine Miscellaneous General "crud" or unidentifiable objects may find their way into a specimen, particularly those that patients bring from home.

Summary To summarize, a properly collected clean-catch, midstream urine after cleansing of the urethral meatus is adequate for complete urinalysis. In our Free online library on electronics you can download many schematic diagrams and service manuals 10, models , reference books 50 books , interesting books and magazines on electronics, radio, computers and robotics 20, issues , articles more than 10, articles.

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