Sheshadri Narayanan

Miniaturization in Futuristic Clinical Laboratory Medicine

Time and space are very precious. Time can save money as well as life. Speedier diagnosis can make the difference between life and death with the quality of life hinging on the time between specimen collection and analysis. Hence, speed is of the essence in completing a clinical diagnostic task. In the 21st century, space, needless to say, is at a premium. We have seen in the last 30 years diagnostic devices getting smaller and smaller. In the future, an individual’s genome may be sequenced on a credit card sized device resulting in even greater miniaturization. The trend is clearly towards miniaturized miniaturization! It has been speculated that the pairing of miniaturization with nanotechnology may one day enable us to shrink the size of a mainframe computer to a size that it can be fitted inside a bacterium. This may not seem farfetched in an age bent on developing not only infinitely faster supercomputers but also infinitesimally smaller diagnostic devices. In this brief review, I will explore current trends and driving forces towards miniaturization and how it might impact on the practice of laboratory medicine in the next 2 decades.

Biochemical hematology of platelets and leukocytes

Publisher Summary This chapter focuses on selected aspects of platelet and leukocyte function and dysfunction in order to illustrate important biochemical pathways. It essentially describes the complexity of biochemical pathways regulating platelet and leukocyte function in health and disease. In specific, platelets play a key role in hemostasis and thrombosis. Their surface membrane is exquisitely designed for interaction with specific components of the vascular endothelial cell matrix. During hemostasis, circulating platelets rapidly adhere to the exposed vascular subendothelium of damaged blood vessels. This adhesion induces a variety of intracellular biochemical events that lead to platelet aggregation, the secretion of granule contents, and the expression of procoagulant activity to support fluid phase coagulation. On the other hand, the function of neutrophils is to phagocytose invading pathogens—such as—bacteria, or other foreign material. Once pathogenic material has been phagocytosed, it is then degraded in lysosomal granules within the neutrophil via lysosomal enzymes—such as—lysozyme, and myeloperoxidase.