RICHARD DAVID SILVESTRE, RMT

ADVANCED HEMATOLOGY
COMMON ENZYME DEFICIENCIES

Mr. Gallardo discussed all the information regarding enzyme deficiency, and he said
that there are 2 signs of Enzyme Deficiency that we can't miss, Digestive enzymes unlock
the nutrients in your food. They are categorized by the macronutrients that they release
proteins, carbohydrates, and fats. Raw dairy also contains enzymes that help the body to
break down milk sugars, which are often difficult to digest. He also mentioned that
Low levels of these enzymes and proteins are normally found in your blood, but if your
heart muscle is injured, such as from a heart attack, the enzymes and proteins leak out of
damaged heart muscle cells, and their levels in the bloodstream rise. You could
be deficient in enzymes if your body isn't able to activate the necessary enzymes for
digestion. Symptoms like abdominal pain, skin rashes, brain fog, and mood swings are all
signs of enzyme deficiency. Digestive trouble is not the only thing to worry about when you
are missing enzymes.

Reporter also mentioned all the enzyme deficiencies and these are the following,
G6PD Deficiency is a genetic disorder that is passed down on the x chromosome. A person
who has this diagnosis cannot get rid of it, the reporter also said that this is the most
common type of enzyme deficiency. Congenital Adrenal Hyperplasia, Gauchers Disease and
Pyruvate Kinase Deficiency the reporter differentiate all those enzyme deficiencies.

MSMT
RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
KARYOTYPING

Karyotyping is one of the topic last Saturday in Hematology Class, Ms. Almazan
discussed this topic, while listening to her its only almost the same with the past topic, I
thought its a new topic. According to resources, karyotyping is a test to identify and
evaluate the size, shape, and number of chromosomes in a sample of body cells. Extra or
missing chromosomes, or abnormal positions of chromosome pieces, can cause problems
with a person's growth, development, and body functions. But how we can analyze these
chromosomes, a karyotype is a photograph of the chromosomes in a cell. Karyotypes can be
taken from blood cells, fetal skin cells (from amniotic fluid or the placenta), or bone
marrow cells.

The reporter also mentioned, what it is used for? She said using using Karyotypes is
to Diagnose Genetic Disorders and the reporter also said that a regular human cell has 46
chromosomes: 44 autosomes, which come in pairs, and 2 sex chromosomes, which specify
gender (XX for female and XY for male). The pairs of autosomes are called "homologous
chromosomes. Other reasons why it is done, to find out whether the chromosomes of an
adult have a change that can be passed on to a child. Also it is used whether a chromosome
defect is preventing a woman from becoming pregnant or is causing miscarriages, whether a
chromosome defect is present in a fetus. Karyotyping also may be done to find out whether
chromosomal problems may have caused a fetus to be stillborn. Find out the cause of a
baby's birth defects or disability. Help determine the appropriate treatment for some types
of cancer. Identify the sex of a person by checking for the presence of the Y chromosome. This
may be done when a newborn's sex is not clear.

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RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
INTRINSIC FACTOR and ANTIBODY MEASUREMENT

Ms. Panganiban reported Intrinsic factor and antibody measurement, she first
defined what intrinsic factor is, and she said that Intrinsic factor (IF), also known as
gastric intrinsic factor (GIF), is a glycoprotein produced by the parietal cells of the stomach.
It is necessary for the absorption of vitamin B12 (cobalamin) later on in the ileum of the
small intestine. In humans, the gastric intrinsic factor protein is encoded by the GIF gene.
Last of this factor can lead to develop a type of vitamin B12 deficiency called pernicious
anemia because this vitamin B12 is needed for red blood cells to form and grow. Some
people do not make enough intrinsic factor or have a condition that destroys it.

Among having functional roles in the brain and nervous system, vitamin B12 is
important in the production of red blood cells. Without sufficient intrinsic factor, vitamin
B12 goes largely unabsorbed and the body cannot produce enough normal red blood cells,
leading to anemia. Besides anemia, decrease in the numbers of neutrophils and platelets
(neutropenia, thrombocytopenia) may also occur.

Anemia that is due to a lack of intrinsic factor is called pernicious anemia. This is
primarily an autoimmune condition that occurs when the body's immune system targets its
own tissues and develops antibodies directed against the parietal cells and/or the intrinsic
factor. These antibodies can damage the parietal cells and disrupt intrinsic factor
production or prevent intrinsic factor from carrying out its biological function.

There are two types of IF antibodies can be tested by the laboratory: Intrinsic factor
blocking antibody (type 1), which is more specific for pernicious anemia and is the one that
is usually tested and Intrinsic factor binding antibody (type 2), which interferes with the
uptake of the vitamin B12-instrinsic factor complex.

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RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
GENOTYPING

This topic is very short and Ms. Pen only discussed this in a very short period of time
. She said that genotyping Genotyping is the process of determining differences in the
genetic make-up (genotype) of an individual by examining the individual's DNA sequence
using biological assays and comparing it to another individual's sequence or a reference
sequence. It reveals the alleles an individual has inherited from their parents. Traditionally
genotyping is the use of DNA sequences to define biological populations by use of
molecular tools. It does not usually involve defining the genes of an individual. Genotyping
applies to a broad range of individuals, including microorganisms. For
example, viruses and bacteria can be genotyped. Genotyping in this context may help in
controlling the spreading of pathogens, by tracing the origin of outbreaks. This area is often
referred to as molecular epidemiology or forensic microbiology.

Humans can also be genotyped. For example, when testing fatherhood or

motherhood, scientists typically only need to examine 10 or 20 genomic regions
(like single-nucleotide polymorphism (SNPs)), which represent a tiny fraction of the
human genome.

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RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
BLOOD SUBSTITUTE

A blood substitute (also called artificial blood or blood surrogate) is a substance

used to mimic and fulfill some functions of biological blood. The main categories of 'oxygen-
carrying' blood substitutes being pursued are hemoglobin-based oxygen carriers (HBOC) it
is an oxygen-carrying blood substitute, sometimes called artificial haemoglobin, is an
artificially made red blood cell substitute whose main function is to carry oxygen, as does
natural hemoglobin. The use of oxygen-carrying blood substitutes is often called oxygen
therapeutics to differentiate from true blood substitutes. The initial goal of oxygen carrying
blood substitutes is merely to mimic blood's oxygen transport capacity. and
perfluorocarbon-based oxygen carriers (PFBOC), defined by Ms. Guadalquiver.

According to studies of outcomes of transfusions given to trauma patients in

2008,blood substitutes yielded a 30% increase in the risk of death and about a threefold
increase in the chance of having a heart attack for the recipients. More than 3,711 patients
were tested in sixteen studies using five types of artificial blood. Public Citizen sued the
U.S. Food and Drug Administration (FDA) to obtain information on the duration of these
studies which were found to have been conducted from 1998 until 2007. The FDA permits
artificial blood transfusions in the US without informed consent under a special exemption
from requirements of informed consent during traumatic care.

MSMT
RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
HODGKINS LYMPHOMA

Ms. Parayno defined first what is cancer all abpout, she said that cancer starts when
cells in the body begin to grow out of control. Cells in nearly any part of the body can
become cancer, and can then spread to other areas of the body. Lymphomas are cancers
that start in white blood cells called lymphocytes. There are 2 main types of lymphoma.
Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). They behave, spread, and
respond to treatment differently, so it's important for you to know which one you have.

Ms. Parayno discussed the following types of lymphomas, she said that we have
classic HL has 4 subtypes: Nodular sclerosis Hodgkin lymphoma: This is the most common
type of Hodgkin disease in developed countries. It is most common in teens and young
adults, but it can occur in people of any age. It tends to start in lymph nodes in the neck or
chest. Mixed cellularity Hodgkin lymphoma: This is the second most common type and is
seen mostly in older adults (although it can occur at any age). It can start in any lymph
node but most often occurs in the upper half of the body. Lymphocyte-rich Hodgkin
lymphoma: This subtype usually occurs in the upper half of the body and is rarely found in
more than a few lymph nodes. Lymphocyte-depleted Hodgkin lymphoma: This is the least
common form of Hodgkin disease. It is seen mainly in older people. It is more likely to be
advanced when first found, in lymph nodes in the abdomen as well as in the spleen, liver,
and bone marrow.

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RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
VITAMIN B12 ASSAY

What is Vitamin B12 as discussed by Ms. Ruby, Vitamin B, also called cobalamin, is
a water-soluble vitamin that has a key role in the normal functioning of the brain and
nervous system via the synthesis of myelin, and the formation of red blood cells. She also
said what are the source of vitamin b12, Foods high in Vitamin B12 include shellfish, liver,
fish, crab, fortified soy products (tofu, soymilk), fortified cereals, red meat, low fat dairy,
cheese, and eggs. Vitamin B12 or folate deficiency anaemia can cause a wide range of
symptoms. ... Anaemia is where you have fewer red blood cells than normal or you have an
abnormally low amount of a substance called haemoglobin in each red blood cell.

People who are obese or eat a lot of meat also tend to have higher-than-normal
levels. High levels of vitamin B-12 can be a sign of liver disease, certain types of leukemia,
or diabetes. Vitamin B-12 deficiency is a common condition. Between 1.5 and 15 percent of
Americans have low levels of vitamin B-12, according to the National Institutes of Health.
Many people, especially older adults and people with intestinal disorders, have trouble
absorbing vitamin B-12 from food and oral supplements.

Some vitamin B12 assay are the following, Serum Vitamin B12, is very useful in
detecting Vitamin B12 Deficiency, Quantaphase II Folate a radioimmunaasy kit for
detecting vitamin B12 deficiency. And methylmalonic acid assay, is a sensitive biomarker of
vitamin B12 deficiency.

MSMT
RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
FISH GENETICS

FISH genetics or Fluorescence in situ hybridization (FISH) provides researchers

with a way to visualize and map the genetic material in an individual's cells, including
specific genes or portions of genes as discussed by Ms. Yutuc, so what is FISH, she said that
Fluorescence in situ hybridization (FISH) is a kind of cytogenetic techniquewhich uses
fluorescent probes binding parts of the chromosome to show a high degree of sequence
complementarity. . This may be used for understanding a variety
of chromosomal abnormalities and other genetic mutations.

Reporter discussed on how this test work, she said that, FISH is a type of DNA
hybridisation, which uses the ability of DNA to stick to a 'complementary copy' of itself. The
chemical letter A always pairs up with T, and C with G. To carry out FISH, scientists first
unzip the DNA that makes up both the tagged gene and the chromosomes into two separate
strands.

MSMT
RICHARD DAVID SILVESTRE, RMT
ADVANCED HEMATOLOGY
OTHER BLOOD PARASITES

Blood-borne parasites are found worldwide and usually spend a certain part of their
life-cycle in the blood of the host. Blood-borne parasites may be transmitted in two ways
according to the Centers for Disease Control and Prevention: parasites may be spread
through infected blood transfer during needle exchange or blood transfusion, or they may
also be transmitted by a vector such as an infected insect that bites a host and injects the
parasites into the bloodstream.

Mr. Toriano gave us all the other blood parasites aside from the most common
which is the Plasmodium, he mentioned the Hemoflagellates, Leishmania spp which
includes the L. donovani, L. braziliense and L. tropica and Trypanosomes spp. Cruzi,
rhodesiensi and gambiense. He also discussed to the class the life cycle and how you can
acquire those parasites. It is a vector/arthropod borne parasite, meaning the mode of
transmission of that parasite is skin inoculation of the vector which is the sandfly and
tsetse fly for the two hemoglagellates. He also mentioned the Babesia microti, Babesia is
spread through the bite of an infected tick. The parasites are present in the saliva of the tick
and are transmitted when the tick bites the host.

The prevention and control is also discussed by Mr. Toriano, he said that Chagas
disease which cause by Trypanosoma cruzi, can be prevented by eliminating the triotomine
insect with insecticides. Proper treatment of infected individuals will also help stop the
spread. Babesia can be prevented by using pest control sprays to kill ticks. Careful
observation should be done after a walk or run in wooded areas to avoid bringing ticks into
the home. Leishmania is treated by preventing sand fly bites. Avoid being out from dusk to
dawn. The use of insect repellents and long clothes will also prevent bites.

MSMT