Department of Clinical Chemistry
University of Turku

COURSE ON CLINICAL CHEMISTRY AND HEMATOLOGY

The goals of the teaching of clinical chemistry:

The aim of the course is to provide the student with such knowledge of laboratory medicine that a beginning physician, working in a health care center or on a hospital ward, needs. During the course the student becomes familiar with the theoretical background of clinical chemistry tests and hematological laboratory investigations, their practical application and clinical interpretation. The course builds upon the previously acquired knowledge of medical biochemistry and physiology and, to some extent, on other clinical instruction. The exercises familiarize the student with sample collection and the performance of simple laboratory tests common in health care centers as well as with the use of laboratory information systems. Other small-group teaching discusses the appropriate use of laboratory tests and interpretation of their results, often in the light of actual patient cases. Optional instruction deepens the student's knowledge of the analytics of clinical chemistry and of laboratory data processing and its relation to the treatment of the patients.

After the course, the student is expected to:

• master the theoretical principles of common laboratory investigations and their appropriate clinical application
• master the principles of the interpretation of laboratory results, especially the significance of findings as a mirror of the functioning of a healthy or a sick cell, an organ or a whole organ system
• be able to carry out simple laboratory tests often performed in a health care center
• be familiar with the interrelating of the laboratory operations of clinical chemistry into the staggered regional health care system

The education in clinical chemistry consists of core (3.0 credit units) and optional (0.5 credit units) instruction. In this program optional instruction is printed in italics.

Core instruction

Instruction is given in courses C6 (4 hours of lectures), C8 (22 hours of lectures, 14 hours of small-group teaching, a 2-hour seminar, and 10 hours of exercises), and C11 (4 hours of lectures and 6 hours of seminars).

Optional instruction

Optional instruction deepens the student's knowledge of the investigations of clinical chemistry and of laboratory data processing and their relation to the treatment of the patients. Instruction is mainly given in course C8 (4 hours of lectures and 6 hours of small-group teaching). The enrollment for the optional instruction can be done at the beginning of the first optional lecture of course C8. After the enrollment of all participants, changes may occur in the time schedule for optional instruction. The final schedule will be announced during the first optional lecture on 4 May at 14.00.

Advanced studies

Students can also undertake advanced studies. Those interested are requested to contact the lecturer or the professor.

DEPARTMENT OF CLINICAL CHEMISTRY / INSTITUTE OF CLINICAL MEDICINE

Central Laboratory, University Hospital, U-hospital, Floor 13, tel. 2611611 / extension 1931

• Professor Kale Juva, Chief Physician of the Central Laboratory, tel. 2611900
• Lecturer Veli Kairisto, tel. 2612899

Instruction Nurse Tarja Lehto

• Dept of Dermatology and Venereal Diseases, tel. 2611636

Other teachers:

• Kerttu Irjala, M.D., Docent, Central Laboratory
• Pertti Koskinen, M.D., Docent, Central Laboratory
• Aila Leino, Ph.D., Docent, Central Laboratory
• Veikko Näntö, M.D., Professor emeritus, Dept of Clinical Chemistry
• Tarja-Terttu Pelliniemi, M.D., Docent, Central Laboratory
• Kari Pulkki, M.D., Docent, Central Laboratory
• Satu Pietilä, Senior lab. techn., Laboratory Dept 931 (clinical chemistry)
• Allan Rajamäki, M.D., Docent, Central Laboratory
• Inkeri Nykänen, Senior lab. techn., Laboratory Dept 932 ( clinical chemistry)
• Kati Sirkiä, Senior lab. techn., Laboratory Dept 933 (hematology)
• Riitta Rytkönen, Senior lab.techn., Laboratory Dept 930 (Blood Center)

TEXTBOOKS:

Clinical chemistry:

Marshall: Clinical Chemistry, 3rd ed., Mosby 1995

Hematology:

Hoffbrand & Pettit: Essential Haematology, 3rd ed., Blackwell 1993

Additional information:

Laboratoriotutkimusten ohjekirja 1996, TYKS Keskuslaboratorio

In addition to these, hand-outs will be distributed during exercises and lectures.

Supplementary reading:

• Törrönen, Hänninen, Länsimies & Penttilä: Elimistön toiminnan tutkiminen SHKS/WSOY 1991
• Lamberg, Nikkilä & Pelkonen: Kliininen endokrinologia, 3rd ed., Duodecim 1992
• Fernlund, Fex, Hanson, Stenflo & Lundh: Laurells Klinisk kemi i praktisk medicin, 6th ed., Studentlitteratur 1991
• Philip D. Mayne (Zilva-Pannall-Mayne): Clinical Chemisry in Diagnosis and Treatment, 6th ed., Edward Arnold 1994
  

EXAMINATIONS:

Entrance examination

The half-hour entrance examination will cover the central themes of the lectures concerning hematological investigations, reference values, electrolyte and hydrogen ion balance, investigations of renal diseases, and the thyroid. These themes are treated on the following pages of the text books:

Hoffbrand & Pettit: pp. 1-94, 141-186

Marshall: pp. 1-71, 137-150

or Fernlund et al.: pp. 21-119, 562-597, 626-650

or Törrönen et al.: pp. 13-24, 90-132, 248-255, 289-314

Hand-outs of articles about reference values and decision levels

Mid-course examination

course C8

(lectures, small-group teaching and exercises)

Final examination

after the instruction given in the 11th term.

Advanced Studies in Clinical Chemistry

1. Use of patient data bases in the quality control and interpretation of laboratory investigations

Aims and content: to familiarize the student(s) with modern data processing used in laboratory medicine and to help them to learn how to apply the received information to a clinical situation.

Number of students: 1 or 2 students

Starting date: To be agreed on with the teacher. No course restrictions. Suitable to a student with an interest in data processing.

Application: Lecturer Kairisto, Turku University Central Hospital, Central Laboratory, tel. 2612899.

2. Development of teaching material in laboratory medicine - an international project

Aims and content: The aim of the project is to prepare and produce teaching material of clinical chemistry and hematology. It will be done in cooperation with the teachers of the discipline and with the foreign disciplines participating in the TEMPUS project (Tartu, Odense, Glasgow).

Number of students: from 1 to 3 students

Starting date: During 1996. The project includes an introductory period at the discipline of Laboratory Medicine in Tartu and co-operation with the Estonian teachers working on the project in Turku. ( The purpose of the introductory period is to help the student to understand the starting point of the project. )

Application: Lecturer Kairisto, Turku University Central Hospital, Central Laboratory, tel. 2612899.

3. Biology of myeloma in vivo and in vitro

Aims and content: Induction of apoptosis and regulation of myeloma multiplex, by using new methods (1L-6 antagonist, HSP Heat Shock Protein Regulation). In cooperation with Docent Stina Syrjänen (MediCity); Docent Lea Sistonen and Docent John Eriksson (Centre of Biotechnology, MediCity).

Number of students: 1 student

Starting date: During 1996

Application: Docent K. Pulkki, Turku University Central Hospital , Central Laboratory, tel. 2611908

• Types of advanced studies in Clinical Chemistry either currently under way or completed in 1995

• multiple drug resistance in myeloma

• production of reference values; as an example, reference values of the red blood cell values of the newborn
• regulation mechanisms of the functioning of neutrophils
• IL-6 receptor in myeloma patients
• growth of cardiac muscle cells in vitro
• apoptosis of cardiac muscle cells
• UVB radiation and antioxidant defence
• UVB radiation and the cell cycle
• activation of neutrophils and expression of receptors
• myoglobin and carbonic anhydrase in the diagnostics of cardiac muscle damage

On a separate agreement, advanced studies in clinical chemistry and hematology can be performed also in other topics. Moreover, a study project related to laboratory investigations can be realized in cooperation with another clinical discipline. Opportunities to do further research are good. Further information and applications: teachers of the discipline.