Showing papers on "Serum albumin published in 1981"

A candidate reference method for determination of total protein in serum. I. Development and validation.

Abstract: We developed a candidate Reference Method for measuring total serum protein by use of the biuret reaction. The method involves a previously described biuret reagent (Clin. Chem. 21: 1159, 1975) and Standard Reference Material (SRM) 927 bovine albumin (National Bureau of Standards) as the standard. At 25 degrees C, color development for 30 or 60 min provides identical serum protein values. Glucose (up to 10 g/L) and bilirubin (up to 300 mg/L) do not interfere. Hemoglobin, at 3 g/L, increases apparent serum protein by 0.4 g/L. The presence of dextran in serum causes easily detected turbidity, but this interference can be eliminated by centrifuging the reaction mixture. Therapeutic concentrations of ampicillin, carbenicillin, penicillin, oxacillin, nafcillin, chloramphenicol, cephalothin, and methicillin in blood do not interfere, nor do triglycerides up to 10 g/L. Within-run and day-to-day standard deviations of the method are 0.1 and 0.4 g/L, respectively.

Receptor for albumin on the liver cell surface may mediate uptake of fatty acids and other albumin-bound substances.

Abstract: Kinetic analysis of the uptake of carbon-14-labeled oleate in a single-pass perfusion of rat liver and saturable and specific binding of iodine-125-labeled albumin to hepatocytes in suspension suggest the existence of a receptor for albumin on the liver cell surface. The putative receptor appears to mediate uptake of albumin-bound fatty acids by the cell and may account for the efficient hepatic extraction of many other substances tightly bound to albumin.

Nonenzymatic glycosylation of peripheral nerve protein in diabetes mellitus

Abstract: A new affinity chromatography system that selectively retains glycosylated amino acids has been utilized to determine the amount of nonenzymatic glycosylation present in peripheral nerve from diabetic and control rats and dogs. The mean value for glycosylated amino acids in diabetic rats was 2.8 times greater than the mean value in normal rats (P less than 0.001). In diabetic dogs, mean values were 2.15 times greater than normal values (P less than 0.05). Amino acid analysis of reduced, glycosylated amino acids previously isolated by affinity chromatography showed that glycosylated lysine and its hydrolysis rearrangement products were the major borohydride-reducible adduct present. In addition, another glycosylated product was noted to be present in major proportions. This radioactive product did not chromatograph with any of the available glycosylated amino acid standards. The finding that diabetes results in a nearly 3-fold increase of peripheral nerve glycosylation is consistent with a number of previous investigations in which glycosylation was measured in hemoglobin, serum albumin, and urinary amino acids and peptides from diabetics and normals. The results reported here provide evidence that increased nonenzymatic glycosylation is occurring in a tissue where physiological, morphological, and clinical degeneration characteristically develop as a result of diabetes mellitus.

The sequence of human serum albumin cDNA and its expression in E. coli

Abstract: A recombinant plasmid has been constructed which contains the mature protein coding region of the human serum albumin (HSA) gene. Bacteria containing this plasmid synthesize HSA protein under control of the E. coli trp promoter-operator. The DNA sequence and predicted protein sequence of HSA were determined from the cDNA plasmid and are compared to existing data obtained from direct protein sequencing. The DNA sequence predicts a mature protein of 585 amino acids preceded by a 24 amino acid "prepro" peptide.

Serum albumin beads: an injectable, biodegradable system for the sustained release of drugs

Abstract: Biologically active compounds were entrapped in cross-linked serum albumin microbeads. Injection of these drug-impregnated beads into rabbits produced no adverse immunological reactions. Sustained release (20 days) of progesterone was demonstrated in vivo.

Albumin helps mediate removal of taurocholate by rat liver.

Abstract: Perfused rat liver removes 97% of the taurocholate from the afferent circulation when the perfusate albumin concentration is 0.5 g/dl. Increasing the albumin concentration 10-fold reduces the concentration of free taurocholate by a factor of five but produces only a 50% reduction in the apparent uptake coefficient. A similar discrepancy is evident from a model-independent analysis of the extraction fractions. From these observations we argue that uptake is not driven solely, or even predominantly, by the plasma concentration of free taurocholate but also depends on interaction between albumin and the cell surface. Nonequilibrium binding, saturation kinetics, and an inhomogeneous population of liver cells are considered as alternative explanations and excluded. The possibility that albumin exerts its effect by enhancing the diffusion of taurocholate across an unstirred layer in the Disse space appears improbable but cannot be eliminated.

Nucleotide sequence of cloned rat serum albumin messenger RNA

Abstract: The nucleotide sequences of the recombinant DNA inserts of three bacterial plasmid clones containing nearly all of the rat serum albumin mRNA have been determined. A statistical analysis of the nucleotide sequence reveals a pattern of repeated internal homology that confirms the "intragenic triplication" model of albumin evolution.

Induction of hepatic synthesis of serum amyloid A protein and actin

Abstract: Major changes in the mRNA population of murine liver occur after administration of bacterial lipopolysaccharide, an agent that causes increases in the concentrations of acute-phase serum proteins. The mRNA for one of these, serum amyloid A, is increased at least 500-fold compared to the normal level. It becomes one of the most abundant hepatic mRNAs, and serum amyloid A synthesis comprises about 2.5% of total hepatic protein synthesis in the acute-phase response. Its synthesis is tissue-specific in that amyloid A mRNA was not detected in the kidney, an important site of amyloid fibril accumulation. The protein synthesized in largest amount by acute-phase liver tissue in culture is cytoplasmic actin. Its relative rate of synthesis is increased about 5-fold compared to the normal tissue; that of serum albumin is decreased to about one-third of its normal rate. The concentration of mRNA for serum albumin is decreased by a similar amount. Starting with induced liver RNA, we have constructed a recombinant plasmid containing most of the DNA sequence encoding the serum amyloid A polypeptide.

Sequence homology between RNAs encoding rat alpha-fetoprotein and rat serum albumin.

Abstract: We have determined the sequences of the recombinant DNA inserts of three bacterial plasmid cDNA clones containing most of the rat alpha a-fetoprotein mRNA. The resultant nucleotide sequence of alpha-fetoprotein was exhaustively compared to the nucleotide sequence of the mRNA encoding rat serum albumin. These two mRNAs have extensive homology (50%) throughout and the same intron locations. The amino acid sequence of rat alpha-fetoprotein has been deduced from the nucleotide sequence, and its comparison to rat serum albumin's amino acid sequence reveals a 34% homology. The regularly spaced positions of the cysteines found in serum albumin are conserved in rat alpha-fetoprotein, indicating that these two proteins may have a similar secondary folding structure. These homologies indicate that alpha-fetoprotein and serum albumin were derived by duplication of a common ancestral gene and constitute a gene family.

Micropinocytic ingestion of glycosylated albumin by isolated microvessels: possible role in pathogenesis of diabetic microangiopathy

Abstract: Microvessels isolated from rat epididymal fat exhibit differential vesicular ingestion rates for unmodified and non-enzymatically glycosylated rat albumin. While unmodified rat albumin is excluded from ingestion by endothelial micropinocytic vesicles, glycosylated albumin is avidly taken up by endocytosis. Interaction of albumin and glycosylated albumin with endothelium was studied with a double-label fluorescence assay of micropinocytosis. When glycosylated albumin was present at a concentration of 6% with respect to total albumin (the level found in "non diabetic" serum), only glycosylated albumin was ingested. At higher concentrations of glycosylated albumin (those found in diabetic serum), both albumin and glycosylated albumin are ingested. Glycosylation of endothelial membrane components results in stimulated ingestion of glycosylated albumin, persistent exclusion of unmodified albumin, and unaltered micropinocytic ingestion of native ferritin. These results indicate that nonenzymatic glycosylation of serum albumin may result in rapid vesicle-mediated extravasation of albumin. Chronic microvascular leakage of glycosylated albumin could contribute to the pathogenesis of diabetic microangiopathy.

Substitution of a synthetic polymer for protein in a mammalian gamete culture system.

Abstract: Polyvinylalcohol (PVA) was tested as a replacement for protein (bovine serum albumin, BSA) in supporting motility, acrosome reactions, and fertilizing ability of hamster spermatozoa in vitro. Bovine serum albumin is normally required for all of these processes. After incubation for 5--6 hours in a simple culture medium containing BSA and PVA (0.1 mg/ml) and essential low molecular weight factors from blood serum, 85% of motile spermatozoa had undergone acrosome reactions. Sperm motility was equally well maintained by PVA in the absence of BSA but virtually no spermatozoa showed acrosome reactions even after prolonged incubation. Serum factors were later replaced by hypotaurine (10 microM), isoproterenol (1 microM), and penicillamine (20 microM). Spermatozoa incubated in this defined medium with BSA alone or with BSA and PVA fertilized more than 90% of oocytes. No oocytes were penetrated when BSA was replaced by PVA although vigorous sperm motility was maintained. Polyvinylalcohol may help elucidate the mechanism of the acrosome reaction by permitting effects of protein and other substances to be studied without loss of sperm motility (viability). Polyvinylalcohol could also replace BSA in solutions used for manipulation of zona pellucida-free oocytes. It is suggested that PVA may find general application in cell culture media.

Specific quantitation by HPLC of protein (lysine) bound glucose in human serum albumin and other glycosylated proteins

Abstract: A specific and sensitive method for quantification of the fructose-lysine linkages present in non-enzymatically glycosylated albumin and other proteins is described. Protein is hydrolyzed for 18 h in 6 mol/l HCl at 95 degrees C to yield furosine (epsilon-N-(2-furoylmethyl)-L-lysine) known as a specific degradation product of fructose-lysine. Furosine is then separated on HPLC and quantified by its UV-absorbance against a prepared fructose-lysine standard. The method has been successfully used for the determination of glycosyl-albumin in diabetic patients starting from 100 microliter serum or less, as well as for various other proteins. Unlike the usually employed thiobarbituric acid assay the present procedure is truly specific for the detection of ketoamine linkages of glycosylated proteins.

Magnetic modulation of release of macromolecules from polymers

Abstract: Sustained-release systems were made by incorporating bovine serum albumin and magnetic steel beads in an ethylene-vinyl acetate copolymer matrix. When exposed to aqueous medium, the polymer matrix released the albumin slowly and continuously. Application of an oscillating magnetic field increased the release rate by as much as 100%. Intervals of 6-hr periods of magnetic exposure and nonexposure were alternated over a 5-day period, resulting in corresponding increases and decreases in release and establishing a pattern of modulated sustained release.

Homology between the primary structure of alpha-fetoprotein, deduced from a complete cDNA sequence, and serum albumin.

Abstract: The entire DNA complementary to murine alpha-fetoprotein mRNA has been cloned in the plasmid vector pBR322 and its complete nucleotide sequence determined. The deduced amino acid sequence identifies a hydrophobic prepeptide of 19 amino acids and the complete primary structure of alpha-fetoprotein. Its structure reveals extensive homology to serum albumin and suggests that there are 15 disulphide bridges in the alpha-fetoprotein molecule, all at the same positions as those found in albumin. The AFP molecule can be organized into a three-domain structure almost identical to that of serum albumin, suggesting a common ancestral origin of the two proteins.

Role of serum IgA. Hepatobiliary transport of circulating antigen.

Abstract: The IgA mediated hepatobiliary excretion of antigen from the circulation was studied using a radiolabeled haptenated protein (dinitrophenyl-human serum albumin) injected intravenously in mice together with monoclonal anti-dinitrophenyl antibodies of different immunoglobulin classes. Antibodies were obtained from ascitic fluids of mice bearing the MOPC315 myeloma (IgA), or immune spleen cell hybridomas (IgG and IgM). IgA antibody brought about the transport of large amounts of antigen from the circulation to the bile during 1-3h. Analysis of bile by gel filtration showed that a large part of the transported antigen remained intact and complexed with IgA. Neither IgA of different specificity nor anti-dinitrophenyl IgM medicated biliary transport of antigen. With anti-dinitrophenyl IgG, only small amounts of low molecular weight fragments of labeled antigen were found in he bile. Preformed immune complex of radiolabeled antigen and IgA antibody were rapidly transported from the circulation to the bile, resulting in threefold-higher levels of radioactivity in bile than in serum. It is proposed that an important function of serum IgA is to mediate the hepatobiliary excretion of corresponding circulating antigens.

The role of vesicles in the transport of ferritin through frog endothelium.

Abstract: 1. The transport of ferritin molecules by endothelial cell vesicles has been quantitatively investigated by electron microscopy. Single mesenteric capillaries of pithed frogs were perfused with solutions containing 6.7 g ferritin 100 ml.-1 for known periods before fixation in situ with osmium tetroxide. 2. Two series of experiments were carried out: in the first series the perfusate contained bovine serum albumin (1.0 g 100 ml.-1); in the second series the perfusate contained no protein other than the ferritin. To assess the molecular radius of ferritin in solution, the free diffusion coefficient of ferritin was measured in the presence and absence of albumin. 3. The free diffusion coefficient of ferritin in saline solution (110 m-mole 1.-1) was found to be 0.35 X 10(-6) cm2 sec-1 at 21 degrees C and was not affected by the presence of bovine serum albumin. This indicates that there is no significant binding of albumin to ferritin in solution and yields a value for the Stokes-Einstein radius of ferritin of 6.1 nm. 4. In all perfusion experiments the percentage of luminal vesicles containing ferritin exceeded the percentage of labelled cytoplasmic vesicles, which in turn exceeded the percentage of labelled abluminal vesicles. 5. Labelling of all vesicle populations was seen after perfusions lasting less than 1 sec. At this time luminal vesicles were more heavily labelled in the absence of albumin. 6. The labelling of luminal vesicles increased with lengthening perfusion times up to 30-40 sec, after which steady levels of labelling were achieved. The rate of rise in luminal labelling and the steady-state levels reached were both greater in the absence of albumin. By contrast cytoplasmic labelling increased above its initial value only after perfusions of longer than 10 sec. 7. In the steady state, labelled cytoplasmic vesicles contained, on average, fewer ferritin molecules than labelled luminal vesicles. This finding is inconsistent with translocation of labelled luminal vesicles across the cell. 8. It is suggested that the early constant labelling of cytoplasmic and abluminal vesicles is consistent with the existence of vesicular channels. Later cytoplasmic labelling may result from the transient fusion of cytoplasmic vesicles with labelled luminal vesicles for periods long enough to allow mixing of vesicular contents. Albumin may affect vesicular transport by its interaction with the endothelial glycocalyx.

Covalent Binding of Methotrexate to Immunoglobulins and the Effect of Antibody-linked Drug on Tumor Growth in Vivo

Abstract: In an attempt to design cancer chemotherapeutic agents of improved specificity by linking them to antibodies against tumor-associated antigens, we studied the binding of methotrexate (MTX) to immunoglobulins by three different methods, initially using a model system that consisted of bovine serum albumin and rabbit anti-bovine serum albumin immunoglobulin G (IgG). One method used coupling via water-soluble 1-ethyl-3-(3′-dimethylaminopropyl)carbodiimide (ECDI), whereas two others used reactive intermediate derivatives of MTX, i.e. , an active ester formed by reaction with N -hydroxysuccinimide or a mixed anhydride formed by reaction with acetic anhydride. The ECDI and active ester methods yielded covalent conjugates as established by: ( a ) lack of binding of MTX to IgG in the absence of ECDI or when MTX was added without prior activation; and ( b ) the presence of a constant amount of MTX in the IgG fraction after gel filtration. The active ester method was the most effective. Ten mol of MTX per mol of IgG could be incorporated with retention of 90% of the anti-bovine serum albumin activity of an equimolar amount of unconjugated IgG and with recovery of 70% of the original protein. In the ECDI procedure, there was 50% loss of protein, and the recovered protein retained only 50% antibody activity at an incorporation level of 8 mol of MTX per mol of IgG. Conjugates containing 12 mol of drug per mol of IgG lost all antibody activity. MTX conjugated by both the active ester and ECDI methods partially retained the ability to inhibit dihydrofolate reductase. The mixed anhydride procedure failed to incorporate more than 2 to 3 mol of MTX per mol of IgG even when there was a 200-fold molar excess of anhydride in the reaction mixture. The conjugate retained full antibody activity, but neither it nor the product resulting from the reaction of MTX with acetic anhydride inhibited dihydrofolate reductase. The demonstrated superiority of the active ester method in producing active conjugates prompted us to use this technique for linking MTX to a rabbit IgG antibody against the mouse EL4 lymphoma. Conjugates containing 13 mol of MTX per mol of IgG retained their reactivity with EL4 cells on membrane immunofluorescence assay. When tumor-inoculated mice (104 EL4 cells/animal) were given injections of this conjugate on Days 1, 4, and 7 after inoculation (MTX dose, 4 mg/kg/injection), they survived significantly longer than did mice treated with equivalent amounts of drug alone, antitumor IgG alone, drug followed by antibody, or drug linked to non-tumor-specific IgG. Eight of 11 mice treated with this MTX-anti-EL4 IgG conjugate survived tumor free for an observation period of 90 days, whereas control mice died at 17.3 ± 2.47 (S.D.) days after tumor inoculation.

Immune Complexes in Serum and in Cerebrospinal Fluid in African Trypanosomiasis: CORRELATION WITH POLYCLONAL B CELL ACTIVATION AND WITH INTRACEREBRAL IMMUNOGLOBULIN SYNTHESIS

Abstract: The possible occurrence of immune complexes (IC) in serum and in cerebrospinal fluid (CSF) has been studied in 36 patients with African trypanosomiasis (Trypanosoma brucei gambiense). In serum, very high levels of IC were detectable by the (125)I-C1q-binding and by the conglutinin-binding assays with positive results in 94 and 87%, respectively, of untreated patients. Circulating IC were found in both early and late stages of the disease, without significant quantitative differences; their size was 15-25S. There was a significant negative correlation between C3 values and C1qBA. Our studies suggest that circulating IC occurring during trypanosomiasis may be the expression of a polyclonal B cell activation. Indeed, there was a significant correlation (P < 0.001) between the levels of circulating IC and either the levels of IgM (mean value 12.5+/-7.2 mg/ml) or with the levels of rheumatoid factor-like antiimmunoglobulin antibodies that were detected by solid phase radioimmunoassay in 74% of the patients.IC were detected in 31 of 35 CSF samples, with a marked elevation in patients with definite involvement of the central nervous system as compared with earlier stages of sleeping sickness. The occurrence of IC in CSF was not related to an impairment of the blood-brain barrier as shown by analysis of CSF/serum albumin ratios. The level of IC in CSF did not correlate with the serum level and, therefore, circulating IC do not appear to cross efficiently an unimpaired blood-brain barrier. The analysis of IgG, IgM, and albumin concentrations in serum and CSF demonstrates a marked intracerebral immunoglobulin synthesis in patients with manifestations of meningoencephalitis. There was a correlation between CSF-C1q binding assay and this local IgG synthesis. These data are consistent with a local formation of IC in CSF in patients with active meningoencephalitis. The results obtained in eight patients followed during therapy suggest that the presence of IC in CSF may be an indicator of a continuing central nervous system disease and that the quantitation of CSF-IC may be useful for monitoring patient care.

Development of gastrointestinal mucosal barrier. II. The effect of natural versus artificial feeding on intestinal permeability to macromolecules.

Abstract: We have recently reported that the intestinal transport of intact macromolecules into the circulation decreases with age presumably due to maturation of mucosal barrier factors. To extend this observation and determine the effect of natural versus artificial feeding on maturation of intestinal mucosal "barrier function" we conducted experiments which assessed both macromolecular transport and epithelial cell morphology. To study barrier function, we gavage fed a physiologic quantity (100 mg) of bovine serum albumin (BSA) to weight-matched breast- and bottle-fed infant rabbits at 1 and 2 wk of age and quantitated intestinal macromolecular transport by measuring circulating plasma concentrations of the intact antigen 4 hr later. a significant decrease (P less than 0.02) in immunoreactive bovine serum albumin (I-BSA) concentration was noted in breast-fed (6.12 +/- 0.77 micrograms I-BSA per ml plasma) compared with bottle-fed (9.19 +/- 0.93 micrograms I-BSA per ml plasma) animals at one wk. However, at 2 wk, no difference could be demonstrated between the two groups. Furthermore, small intestinal morphology evaluated by light and electron microscopy was similar in both groups each age. To determine if the lower plasma I-BSA noted at one wk in naturally fed animals was related to the presence of anti-BSA antibodies in breast milk and/or in plasma of the pups, breast milk and plasma from the breast-fed animals was evaluated by counterimmunoelectrophoresis and hemagglutination. No anti-BSA antibodies were detected. Moreover, plasma from breast- and artificially fed rabbits not gavage fed BSA contained no I-BSA. These data suggest that intestinal transport of antigens in the immediate neonatal period is decreased earlier in breast- as compared to bottle-fed animals. Therefore, we suggest that breast milk may exert a protective function to control the transport of potentially antigenic molecules into the systemic circulation of newborn animals by either facilitating the early maturation of intestinal barrier function or by providing passive barrier factors until the newborn's natural barrier can develop.

Immunocytochemical localization of albumin in the secretory apparatus of rat liver parenchymal cells

Abstract: The localization of albumin was investigated in rat liver, fixed by perfusion, with peroxidase-labeled monospecific antibodies against rat serum albumin purified by affinity chromatography. By light microscopy, albumin is present uniformly in all parenchymal cells with no difference in the intensity of reaction in the different parts of hepatic lobules. By electron microscopy, albumin is localized in the entire secretory apparatus including the rough and smooth endoplasmic reticulum, Golgi complex, and secretory vacuoles. In the rough endoplasmic reticulum, focal negative segments are interposed between positive regions. In the Golgi region, albumin is found both in stacked cisternae and at the trans aspect in the portion called GERL (Golgi-endoplasmic reticulum--lysosome). Whereas albumin and lipoprotein particles are separated in terminal dilatations of the endoplasmic reticulum and in the cisternae on the cis face of the Golgi apparatus, they are usually intermixed in vacuoles of the trans face. Similarly, most secretion vacuoles below the sinusoidal lining contain albumin and lipoprotein particles together, although a few are also found with only one secretory product. These observations suggest that, after synthesis in the rough endoplasmic reticulum, albumin is segregated into smooth transitional elements and transported to the Golgi region where it is packaged together with other secretory products such as lipoproteins. These secretion vacuoles move up the sinusoidal surface, where they are discharged. The possible involvement of GERL in the proteolytic cleavage of proalbumin to albumin is considered.

Clinical pharmacology: plasma protein binding of drugs.

Abstract: they have fatal illnesses ? In a study from a cancer ward less than one-third of patients suspecting themselves of having malignant disease wished to have it confirmed, and even fewer wanted information about their prognosis.6 Nevertheless, in another group of patients who had cancer, and knew it, 81% thought that doctors should disclose the diagnosis.5 In contrast doctors often seem reluctant to tell patients that they have cancer or are dying.4 7 In many ways problems of communication with patients with acute leukaemia are different. Though a rare disease, leukaemia is often publicised by books and the media, and its rapidly fatal course is well known. The combination of the terms \"blood disease,\" \"bone marrow examinations,\" and \"treatment by injections\" are quickly translated by most alert patients into a diagnosis of leukaemia. As a result it may not be necessary to make a decision whether to tell an adult patient; he will already know. Such was the pattern in several of our own patients with leukaemia. In those in whom the diagnosis has not suggested itself to the patient already the harrowing and prolonged nature of treatment makes disclosure of the diagnosis mandatory. Certainly few would agree to such measures unless they knew that their lives were at stake. There are, nevertheless, some patients with acute leukaemia who do not wish to have the diagnosis confirmed or who may be too ill throughout their illness to ask about it. Whether we should tell such patients just for the sake of being truthful is uncertain. Undoubtedly management is easier for doctors and nurses when the patient knows the diagnosis, but it is uncertain whether the patient is happier in knowing the diagnosis. \"I don't want to go through all that wretched treatment again if I am likely to die a few months hence\" said one patient who did, in fact, have a short but happy remission. Sometimes a knowledge of the diagnosis does bring peace of mind and acceptance, but if the diagnosis is disclosed prematurely, casually, or uncritically it may bring unnecessary grief for one who needs only comfort. The results of our survey of our own patients have taught us that there can be no standard answer for the standard patient and relative with a standard disease. We believe that relatives must know the diagnosis and are obviously entitled to more hope than perhaps was given in the past. We have learnt that it is as important to listen to relatives as to talk to them. One relative, a general practitioner, was told by one of the doctors, \"There's nothing to be said, is there ?\" Although she did not need information, she did need someone just to talk to. She felt deserted and left on her own to cope. The social chats that may seem trivial to us are comforting and reassuring to frightened and bewildered relatives.

Instant nutritional assessment in the intensive care unit.

Abstract: Instant nutritional assessment of the critically ill patient using serum albumin level and total lymphocyte count is reported When an intensive care unit population is compared to the general hospital population a 6-fold increase in albumin level depressions, a 2-fold increase in lymphocyte count depression, and an 11-fold increase in depression of both parameters was noted in the intensive care unit population Surgical intensive care unit (SICU) patients with depressed albumin levels and total lymphocyte counts had twice the complication rate and 45 times the death rate of those SICU patients with normal albumin levels and lymphocyte counts It is concluded that serum albumin levels and total lymphocyte count determinations are valuable tools for instant nutritional assessment of the critically ill patient