Hematocrit (HCT) The word hematocrit means to separate blood, a procedure which is followed following the blood draw

through the proper use of a centrifuge. Hematocrit is the measurement of the percentage of red blood cells in whole blood. It is an important determinant of anaemia (decreased), polycythemia (increased), dehydration (elevated), increased R.B.C. breakdown in the spleen (elevated), or possible over hydration (elevated) Normal Adult Female Range: 37 47 % Optimal Adult Female Reading: 42% Normal Adult Male Range: 40 54% Optimal Adult Male Reading: 47 Normal Adult Newborn Range: 50 62% Optimal Adult Newborn Reading: 56 Hemoglobin (HGB) Hemoglobin is the main transport of oxygen and carbon dioxide in the blood. It is composed of globin a group of amino acids that from a protein and heme which contains iron atoms and red pigment, porphyrin. As with Hematocrit, it is an important determinant of anaemia (decreased), dehydration (increased), polycythemia (increased), poor diet/nutrition, or possibly a malabsorption problem. Normal Adult Female Range: 12 16 % Optimal Adult Female Reading: 14 Normal Adult Male Range: 14 18% Optimal Adult Male Reading: 16 Normal Adult Newborn Range: 14 20% Optimal Adult Newborn Reading: 17 R.B.C. (Red Blood Cell Count) Red blood cells main function is to carry oxygen to the tissues and to transfer carbon dioxide to the lungs. This process is possible through the R.B.C. containing hemoglobin which combines easily with oxygen and carbon dioxide. Normal Adult Female Range: 3.9 5.2 mill/mcl Optimal Adult Female Reading: 4.55 Normal Adult Male Range: 4.2 5.6 mill/mcl Optimal Adult Male Reading: 4.9 Lower ranges are found in Children, newborn and infants W.B.C (White Blood Cell Count) White blood cells main function is to fight infection, defend the body by phagocytosis against invasion by foreign organism, and to produce, or at least transport and distribute, antibodies in the immune response. There are a number of types of leukocytes (see differential) that are classified as follows. Granulocytes Neutrophiles Neutrophils Eosinophils Basophils Nongranulocytes Lymphocytes Monocytes Normal Adult Range: 130 400 thous/mcl Optimal Adult Reading: 265 Higher ranges are found in Children, newborn and infants Liver Enzymes SGOT (Serum Glutamic-Oxalocetic Transaminase AST)

Serum Glutamic Oxalocetic Transaminase or AST is an enzyme found primarily in the liver, heart, kidney, pancreas, and muscles. Seen is tissue damage, especially heart and liver this enzyme is normally elevated. Vitamin B deficiency and pregnancy are two instances where the enzyme may be decreased. Normal Adult Range: 0 42 U/L Optimal Adult Reading: 21 ALT alanine aminotransferase AST aspirate aminotransferase SGPT (Serum Glutamic-Pyruvic Transaminase-ALT) Serum Glutamic Pyruvic Transaminase or ALT is an enzyme found primarily in the liver but also to a lesser degree, the heart and other tissues. It is useful in diagnosing liver function more so than SGOT levels. Decreased SGPT in combination with increased cholesterol levels is seen in case of a congested liver. We also see increased levels in mononucleosis, liver damage, kidney infection, chemical pollutants or myocardial infarction. Normal Adult Range: 0 48 U/L Optimal Adult Reading: 24 Nitrogen Elements B.U.N (Blood Urea Nitrogen) The nitrogen component of urea, B.U.N. is the end product metabolism and its concentration is influenced by the rate of excretion. Increases can be caused by exercise protein intake, intestinal bleeding, exercise or heart failure. Decreased levels may be dur to a poor diet, malabsorption, liver damage or low nitrogen intake. Normal Adult Range: 7 25 mg/dl Optimal Adult Reading: 16 Creatinine Creatinine is the waste product of muscle metabolism. Its level is a reflection of the bodies muscle mass. Low levels are sometimes seen in kidney damage, protein starvation, liver disease or pregnancy. Elevated levels are sometimes seen in kidney disease due to the kidneys job of excreting creatinine, muscle degeneration, and some drugs involved in impairment of kidney function. Normal Adult Range: 7 1.4 mg/dl Optimal Adult Reading: 1.05 Uric acid Uric acid is the end product of urine metabolism and is normally excreted through the urine. High levels are noted in gout, infections kidney disease, alcoholism, high protein diets, and with toxaemia in pregnancy. Low levels may be indicative of kidney disease, malabsorption, poor diet, liver damage or an overly acid kidney. Normal Adult Female Range: 2.5 7.5 mg/dl Optimal Adult Female Reading: 5.0 Normal Adult Male Range: 3.5 7.5 mg/dl Optimal Adult Male Reading: 5.5 Lipids Cholesterol Cholestirol is a critical fat that is a structural component of cell membrane and plasma lipoproteins, and is important in the synthesis of steroid hormones, glucocorticoids, and bile acids. Mostly synthesis in the liver, some is absorbed (HLD) is desired as posed to the low density lipoproteins (LDL), two types of cholesterol. Elevated cholesterol has been in artherosclerosis, diabetes, hypothyroidism and pregnancy. Low levels are seen in depression, malnutrition, liver insufficient, malignancies, anemia and infection. Normal Adult Range: 120 240 mg/dl Optimal Adult Reading: 180 Triglycerides Triglycerides, stored in adipose tissues as glycerol, fatty acids and monoglyceroids, are reconverted as triglycerides by the liver. Ninety percent of the dietary intake and 95% of the fat stored in tissues are triglycerides. Increased levels

may be present in artherosclerosis, hypothyroidism, liver disease, pancreatitis, myocardial infarction, metabolic disorders, toxemia, and nephrotic syndrome. Decreased levels may be present in chronic obstructive pulmonary disease, brain infarction, hyperthyroidism, malnutrition, and malabsorption. Normal Adult Range: 0 200 mg/dl

What is an MRI scan?

An MRI (or magnetic resonance imaging) scan is a radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed that is inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. The receiver information is processed by a computer, and an image is produced.

The image and resolution produced by MRI is quite detailed and can detect tiny changes of structures within the body. For some procedures, contrast agents, such as gadolinium, are used to increase the accuracy of the images.

When are MRI scans used?

An MRI scan can be used as an extremely accurate method of disease detection throughout the body. In the head, trauma to the brain can be seen as bleeding or swelling. Other abnormalities often found include brain aneurysms, stroke, tumors of the brain, as well as tumors or inflammation of the spine.

Neurosurgeons use an MRI scan not only in defining brain anatomy but in evaluating the integrity of the spinal cord after trauma. It is also used when considering problems associated with the vertebrae or intervertebral discs of the spine. An MRI scan can evaluate the structure of the heart and aorta, where it can detect aneurysms or tears.

It provides valuable information on glands and organs within the abdomen, and accurate information about the structure of the joints, soft tissues, and bones of the body. Often, surgery can be deferred or more accurately directed after knowing the results of an MRI scan. What are the risks of an MRI scan?

An MRI scan is a painless radiology technique that has the advantage of avoiding x-ray radiation exposure. There are no known side effects of an MRI scan. The benefits of an MRI scan relate to its precise accuracy in detecting structural abnormalities of the body.

Patients who have any metallic materials within the body must notify their physician prior to the examination or inform the MRI staff. Metallic chips, materials, surgical clips, or foreign material (artificial joints, metallic bone plates, or prosthetic devices, etc.) can significantly distort the images obtained by the MRI scanner. Patients who have heart pacemakers, metal implants, or metal chips or clips in or around the eyeballs cannot be scanned with an MRI because of the risk that the magnet may move the metal in these areas. Similarly, patients with artificial heart valves, metallic ear implants, bullet fragments, and chemotherapy or insulin pumps should not have MRI scanning.

During the MRI scan, patient lies in a closed area inside the magnetic tube. Some patients can experience a claustrophobic sensation during the procedure. Therefore, patients with any history of claustrophobia should relate this to the practitioner who is requesting the test, as well as the radiology staff. A mild sedative can be given prior to the MRI scan to help alleviate this feeling. It is customary that the MRI staff will be nearby during MRI scan. Furthermore, there is usually a means of communication with the staff (such as a buzzer held by the patient) which can be used for contact if the patient cannot tolerate the scan.

How does a patient prepare for an MRI scan and how is it performed?
All metallic objects on the body are removed prior to obtaining an MRI scan. Occasionally, patients will be given a sedative medication to decrease anxietyand relax the patient during the MRI scan. MRI scanning requires that the patient lie still for best accuracy. Patients lie within a closed environment inside the magnetic machine. Relaxation is important during the procedure and patients are asked to breathe normally. Interaction with the MRI technologist is maintained throughout the test. There are loud, repetitive clicking noises which occur during the test as the scanning proceeds. Occasionally, patients require injections of liquid intravenously to enhance the images which are obtained. The MRI scanning time depends on the exact area of the body studied, but ranges from half an hour to an hour and a half.

How does a patient obtain the results of the MRI scan?

After the MRI scanning is completed, the computer generates visual images of the area of the body that was scanned. These images can be transferred to film (hard copy). A radiologist is a physician who is specially trained to interpret images of the body. The interpretation is transmitted in the form of a report to the practitioner who requested the MRI scan. The practitioner can then discuss the results with the patient and/or family. Future Scientists are developing newer MRI scanners that are smaller, portable devices. These new scanners apparently can be most useful in detecting infections and tumors of the soft tissues of the hands, feet, elbows, and knees. The application of these scanners to medical practice is now being tested.

Pictures of an MRI of the spine

This patient had a herniated disc between vertebrae L4 and L5. The resulting surgery was a discectomy Picture of herniated disc between L4 and L5

Cross-section picture of herniated disc between L4 and L5

MRI Scan At A Glance

MRI scanning uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve x-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet. Claustrophobic sensation can occur with MRI scanning.