Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
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Physicians have to confront an enormous output of laboratory data. Normally, only a few experts manually perform the interpretation of highly specialised laboratory tests. PC Windows based 'MDI-LabLink' automates interpretation and expands traditional rule-based expert systems with flexibility and graphic illustrations of complex laboratory data. The laboratory can adjust the interpretation database to its specific needs, maintaining full control over program output. The structured input that 'MDI-LabLink' requires, supports dynamic test scheduling. It can be used to train personnel in the interpretation of laboratory test results. The program provides the clinician with a report that visualises the defect of the evaluated organ system with bitmap pictures and 3-dimensional graphics. Patient follow-ups present in tabular and graphical form. Changes in the severity of the pathobiochemical defect, induced, for example, by therapy, are monitored automatically. Applications available include interpretations of isoenzyme patterns, diagnosis of urinary proteinuria and cerebrospinal fluid analysis.
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PMID:Computer assisted interpretation of laboratory test data with 'MDI-LabLink'. 874 May 75

The measurement of urinary marker proteins is not a generally accepted laboratory practice because the results are difficult to interpret. MDI-LABLINK is software for classifying patterns of specific urinary marker proteins. The interpretations are completely user definable thanks to a specific 'pattern definition database'. Our interpretation set is based on Hofmann and Guder's work in measuring and interpreting single urinary proteins. We include additional marker proteins in order to adapt Boesken's SDS-PAGE classification. During the last 3 years, 1905 patterns were fully differentiated and identically interpreted. Firstly, the samples were classified into three patterns: normal (25.8%), predominantly glomerular (27.2%, selective, unselective, mixed, and with additional tubular proteins) and predominantly tubular (36.9%, complete/incomplete form, with additional glomerular proteins); 8.9% showed postrenal proteinuria. Secondly, glomerular selectivity measured by using urinary transferrin/IgG ratio alone correlates well with the established SI index (the ratio between IgG and transferrin clearances). Thirdly, the creatinine concentration substantiates the validity of the sample. The quality of the preanalytical phase can be improved through the ongoing education of the medical staff. Finally, measurement of urinary albumin and alpha-1-microglobulin is mandatory where kidney disease is suspected, has to be ruled out, or requires close monitoring, even when the total protein concentration is normal.
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PMID:Interpreting complex urinary patterns with MDI LABLINK: a statistical evaluation. 1084 27

Determination of the protein composition of urine is a non-invasive method helping to diagnose renal lesions and evaluate therapeutic interventions. We present here five observations that highlight the performance and relevance of urine protein analysis combining selected glomerular and tubular protein measurements. Total urine protein level and measurements of urinary IgG, albumin, transferrin alpha-1 microglobulin and retinol binding protein were performed on a urine sample by immunonephelometry. The results were normalized for urine creatinine concentration and integrated in the MDI interpretation software that provides a "urine protein profile" (UPP). Sequential UPP were performed in two patients with drug-induced tubular toxicity. One resolved after drug withdrawal. The second concomitantly developped glomerular lesions and repeated UPP was warranted to follow evaluation of the distinct renal lesions. Two cases illustrate two distinct clinical situations in patients with multiple myeloma, respectively myeloma cast nephropathy and toxic acute tubular necrosis. Those differential diagnoses were early anticipated by UPP. In one case, UPP was in favour of the presence of large amount of urinary monoclonal light chain excretion before performing urine electrophoresis analysis and renal biopsy while this was not in the other case. In the last case, we compared sequential UPP, renal function and kidney biopsies in a patient with a diagnosis of membranous nephropathy, and demonstrated a good correlation between urine glomerular and tubular protein excretion and progression of the renal lesions. The use of the UPP in clinical practice, particularly through the accurate quantification of tubular markers, is a more efficient tool for the diagnosis and follow-up of renal diseases than the less sensitive semi-quantitative urine electrophoresis or combined assays of both total proteinuria and albuminuria.
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PMID:Interest of the combined measurement of selected urinary proteins in the diagnosis approach in nephrology. 2854 Aug 55