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The determination of serum blood urea nitrogen currently is the most widely used screening test for the evaluation of kidney function. The test is frequently requested along with the serum creatinine test since simultaneous determination of these 2 compounds appears to aid in the differential diagnosis of prerenal, renal and postrenal hyperuremia.
Urea is the final degradation product of protein and amino acid metabolism. In protein catabolism the proteins are broken down to amino acids and deaminated. The ammonia formed in this process is synthesized to urea in the liver. This is the most important catabolic pathway for eliminating excess nitrogen in the human body.
Increased blood urea nitrogen (BUN) may be due to prerenal causes (cardiac decompensation, water depletion due to decreased intake and excessive loss, increased protein catabolism, and high protein diet), renal causes (acute glomerulonephritis, chronic nephritis, polycystic kidney disease, nephrosclerosis, and tubular necrosis) and postrenal causes (eg, all types of obstruction of the urinary tract, such as stones, enlarged prostate gland, tumors).
1-17 years: 7-20 mg/dL
> or =18 years: 8-24 mg/dL
Reference values have not been established for patients who are or =18 years: 6-21 mg/dL
Reference values have not been established for patients who are <12 months of age.
Serum blood urea nitrogen (BUN) determinations are considerably less sensitive than BUN clearance (and creatinine clearance) tests, and levels may not be abnormal until the BUN clearance has diminished to <50%. Clinicians frequently calculate a convenient relationship, the urea nitrogen/creatinine ratio: serum bun in mg/dL/serum creatinine in mg/dL. For a normal individual on a normal diet, the reference interval for the ratio ranges between 12 and 20, with most individuals being between 12 and 16. Significantly lower ratios denote acute tubular necrosis, low protein intake, starvation or severe liver disease. High ratios with normal creatinine levels may be noted with catabolic states of tissue breakdown, prerenal azotemia, high protein intake, etc. High ratios associated with high creatinine concentrations may denote either postrenal obstruction or prerenal azotemia superimposed on renal disease. Because of the variability of both the BUN and creatinine assays, the ratio is only a rough guide to the nature of the underlying abnormality. Its magnitude is not tightly regulated in health or disease and should not be considered an exact quantity.
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The Rizal Monument in Luneta was not the work of a Filipino but a Swiss sculptor named Richard Kissling. Furthermore, Kissling was only the second placer in the international art competition held between 1905 – 1907 for the monument design.
The first-prize winner was Professor Carlos Nicoli of Carrara, Italy. His scaled plaster model titled “Al Martir de Bagumbayan” (To the Martyr of Bagumbayan) bested 40 other accepted entries. Among his plans were the use of marble from Italy (in contrast to the unpolished granite now at Luneta) and the incorporation of more elaborate figurative elements.
Many accounts explained that the contract was awarded to Dr. Richard Kissling of Zurich, Switzerland for his “Motto Stella” (Guiding Star) because of Nicoli’s inability to post the required performance bond of P20,000 for the duration of the monument’s construction. Some sources say that Nicoli failed to show up at the designated date for the signing of the job contract. Another narrative declared, “parenthetically, the contract was awarded to Richard Kissling because his quotation was lower that that of Prof. Nicoli’s.” A complaint was reportedly filed by Nicoli through the courts of justice.
Some of the local press lambasted Kissling’s model. It was satirized in a cartoon and labeled vulgar y tosco, meaning “lousy.” The constituents of the Jury of Awards – all Americans and none of whom were artists, architects nor engineers –were also questioned. (Then Governor James F. Smith headed the jury.)
There were plans for the famous Filipino painter Felix Resurreccion Hidalgo to inspect and modify the design. However, the latter was ultimately left “as it is” since the bronze of the statues had already been cast in Switzerland.
During Rizal’s (birth) centenary year in 1961, a controversial stainless steel shaft/pylon was superimposed over the granite obelisk. This increased the height of the structure from 12.7 meters to 30. 5 meters.
The said remodeling undertaken by the Jose Rizal National Centennial Commission (JRNCC) was widely criticized. It drew derisive remarks of it being “carnivalistic,” “nightmarish,” “commercialized,” “pseudo modern,” “hodgepodge of classic and Hollywood modern,” “fintailed monstrosity,” and “like a futuristic rocket ship about to take off for interstellar space,” to cite some.
Many found the gleaming modernistic steel shaft incompatible with the somber granite base. Moreover, the latter seemed to dwarf the much smaller Rizal figure. Others simply dislike the idea of tampering with a popular and traditional image which was already immortalized in stamps, paper currency, books and souvenirs, among others.
The designer of the remodeling was Juan F. Nakpil – later to become the country’s first National Artist for Architecture. He quoted former Secretary of Education and JRNCC chair Manuel Lim as the one who “envisioned it as a part of obelisk that will jut out to serve as a convenient guide for incoming boats and ships and for the people lost in their way around the city.”
The P145,000 shaft was eventually removed two years later under the request of Secretary of Education Alejandro Roces and Director of Public Libraries Carlos Quirino. It was dismantled during the Holy Week “reportedly to prevent any court injunction from restraining them as government offices were closed during holidays.
Until a few years ago, the pylon stood on Roxas Boulevard to mark the Pasay-Parañaque boundary. Its present whereabouts are uncertain.
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