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Differential Count (differential + count)
Selected AbstractsTotal nucleated cell differential for blood and bone marrow using a single tube in a five-color flow cytometer,,CYTOMETRY, Issue 2 2008Sven Björnsson Abstract Background: Flow cytometry allows the use of several antibodies in addition to light scatter, and most flow cytometers will provide at least seven measurements on each cell passing through the laser beam. A skilled microscopist will classify at least 14 cell classes in bone marrow or blood. Our goal was to use the seven parameters available in our flow cytometer to provide a reliable differential count using only one tube. Methods: Peripheral blood samples were analyzed on the Beckman Coulter LH750 cell counter, and the flagging and messages from the cell counter were used to select normal or pathological samples. Samples without flags (N = 50), with >2% erythroblasts (N = 80), or with "Blast" or "Verify diff" flags (N = 54) were investigated. We used a lyse-no-wash method to ensure minimal loss of fragile cells with live gating on DRAQ5-positive cells to acquire only nucleated cells. The FL-1 to FL-4 channels were used for the antibodies CD36-FITC, CD203-PE, CD138-PE, CD45-ECD, CD16-Pcy5, and CD56-Pcy5. FL-5 was used for the DNA-stain DRAQ5. Results: Using live gate acquisition on DRAQ5, we were able to classify total nucleated cells into 10 classes. We were unable to identify megakaryocytes, but platelets could be studied by rerunning the sample after dilution and gating on DRAQ5-negative CD36-posive events. Validation against digitized microscopy and cell counter showed linear correlations within each cell class with correlation coefficients that seem reasonable for cellular classification. The lowest correlation was found for basophil granulocytes. Flow cytometry detected twice as many immature neutrophils compared to microscopy. Conclusions: We have designed a one-tube immunophenotyping panel for classification of total nucleated cells and platelets in blood or bone marrow. The seven parameters available in one single tube in our cytometer seem to be enough for reliable differential count even in difficult pathological samples. The analytical imprecision of the flow cytometer differential was much lower than that obtained with microscopy or cell counter differentials. © 2007 Clinical Cytometry Society. [source] Intranuclear cytoplasmic inclusions in fine-needle aspiration smears of papillary thyroid carcinoma: A study of its morphological forms, association with nuclear grooves, and mode of formationDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2005D.SC., Dilip K. Das M.B.B.S., Ph.D. Abstract Intranuclear cytoplasmic inclusion (INCI) and nuclear grooves in fine-needle aspiration (FNA) smears of papillary thyroid carcinoma (PTC) represent cytoplasmic invaginations into the nucleus. Although formation of INCIs is linked to nuclear grooves, they seldom exist together. This study was undertaken to find out the various morphological forms of INCIs, their relation to nuclear grooves, and mode of formation. FNA smears of 54 PTC cases were studied for various forms of INCI, nuclear chromatin pattern, nuclear grooves, and nuclear notches. A differential count of INCIs was made in 19 cases having ,10 INCIs per 200 neoplastic cells. INCIs were present in 48 (88.9%) of 54 PTC cases. Round INCIs were present in 46 (85.2%) cases, followed by oval (48.1%), tear drop/flask-shaped (18.5%), irregular (14.8%), planoconvex/semicircular (13%), rectangular (9.3%), spindle-shaped (3.7%), and bilobed (3.7%). A differential count of INCIs also showed that the round form was the commonest (76.3%). The oval and other forms constituted 19.5 and 4.2%, respectively. INCIs and nuclear grooves were present together in a cell in 15 (27.8%) cases. The formation of INCIs as a cytoplasmic invagination into the nucleus was shown cytomorphologically in rare cells. For the first time in this study, the various morphological forms of INCIs, and the extent of their coexistence with nuclear grooves, (have been highlighted) and showed their mode of formation shown at a light microscopic level. Diagn. Cytopathol. 2005;32:264,268. © 2005 Wiley-Liss, Inc. [source] Significant differences between capillary and venous complete blood counts in the neonatal periodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2003S.M. Kayiran Summary The normal capillary and venous hematologic values for neonates have not been defined clearly. It is well known that capillary blood has higher hemoglobin (Hb) and hematocrit (Hct) values than venous blood. In a recent study, we reported differences between capillary and venous complete blood counts (CBC) in healthy term neonates on day 1 of life. The aim of this study was to extend our previous investigation. Term neonates (n=141) were stratified into four groups by days of postnatal age: group 2 (day 7, n=38), group 3 (day 14, n=35), group 4 (day 21, n=32) and, group 5 (day 28, n=36). Data from our previous study were included in the statistical analysis as group 1 (day 1, n=95). A CBC and differential count were carried out on each capillary and venous sample drawn simultaneously. Within each group, the mean and standard deviation for each parameter in capillary and venous blood were calculated and then compared using the paired sample t -test. In all groups, the capillary blood samples had higher Hb, Hct, red blood cell (RBC), white blood cell (WBC), and lymphocyte counts. In each group, venous platelet counts were significantly higher than the corresponding capillary values. There was also a trend toward higher venous mean corpuscular volume, higher capillary polymorphonuclear leukocyte (PML) count and mean platelet volume in all groups. In both capillary and venous blood, Hb, Hct, RBC, MCV values and WBC, lymphocyte, PML counts decreased and platelet counts increased steadily during neonatal period. This study reveals that CBC parameters and differential counts may differ depending on the blood sampling used. The findings underline the importance of considering the sample source when using hematologic reference ranges for healthy or septic neonates. When interpreting results, the term ,peripheral blood' should be replaced with ,capillary blood' or ,venous blood' so that an accurate assessment can be made. [source] Evaluation of the Sysmex Xe-2100® hematology analyzer in hospital useJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 4 2003Danièle Nakul-Aquaronne Abstract The Sysmex XE-2100® (Sysmex Corp. Kobe, Japan) is a latest-generation hematology analyzer. Its optical and electrical measuring technology is improved by the addition of flux cytometry, fluorescence, and differential lysis. Its analytical performance in terms of precision, reproducibility, linearity, carryover, and time stability was found to be entirely satisfactory. In addition, the results of 500 complete blood counts and differentials correlated perfectly with those obtained by the Coulter STKS® (Beckman Coulter, Villapointe, France). The comparison of 500 leukocyte differential count results analyzed in parallel with optical microscopy and the XE-2100® were surprising, and favorable to the XE-2100®. This analyzer provides the user with an undeniable feeling of security concerning its reliability in detecting and identifying anomalies in the automated leukocyte differential count. With a sensitivity of 96%, a negative predictive value (NPV) of 98%, and a false-negative (FN) rate of 4%, the XE-2100® has perhaps reached the technological limits for a machine performing morphological recognition of normal and pathological blood cells. J. Clin. Lab. Anal. 17:113,123, 2003. © 2003 Wiley-Liss, Inc. [source] Exhaled nitric oxide after a single dose of intramuscular triamcinolone in children with difficult to control asthmaPEDIATRIC PULMONOLOGY, Issue 7 2007Jayachandran R Panickar MRCPCH Abstract In a previous study, we reported that intramuscular (IM) triamcinolone improves symptoms in children with difficult asthma. In 2005, we revised our difficult asthma protocol to include assessment of airway inflammation, both directly using sputum induction and indirectly by measurement of exhaled nitric oxide (eNO). In this retrospective review, we aimed to describe (i) the changes in eNO and symptoms after a single 60 mg dose of IM triamcinolone and (ii) the changes in inflammatory markers in the subgroup with non-eosinophilic asthma (i.e., an induced sputum eosinophil differential count <2.0%). Seven children received IM triamcinolone during the study period. In all children, symptom scores fell in the week following the IM injection (P,<,0.01 vs. the pre-treatment week), and remained reduced for up to 6 weeks. eNO also fell within a week after IM therapy (P,<,0.01), and remained reduced for up to 4 weeks. Non-eosinophilic asthma was definitively identified in three children, and in this group, eNO and symptoms fell after the IM injection. We conclude that IM triamcinolone therapy reduces both eNO and symptoms for up to 4 weeks in children with difficult asthma. Our data provide preliminary evidence that IM triamcinolone is an effective anti-inflammatory therapy in children with induced sputum non-eosinophilic asthma. Pediatr Pulmonol. 2007; 42:573,578. © 2007 Wiley-Liss, Inc. [source] Effect of low-dose theophylline on airway inflammation in COPDRESPIROLOGY, Issue 2 2004Motoko KOBAYASHI Objective: Recent studies have shown that theophylline may exert anti-inflammatory effects on neutrophils. We undertook to assess the effect of theophylline on airway inflammation in COPD. Methodology: We performed a 4-week randomized double-blind, placebo-controlled study in 11 theophylline-naive patients with mild to moderate COPD. After a 1-week run-in period, six subjects were administered 400 mg/day theophylline (Theodur; Nikken Chemicals Co. Ltd, Tokyo, Japan) for 4 weeks, while five subjects were administered a placebo. Induced sputum was obtained before and after the run-in period and then after 2 and 4 weeks of treatment. Cell differential count and levels of interleukin-8, matrix metalloproteinase-9, neutrophil elastase (NE), myeloperoxidase (MPO), ,1 -antitrypsin (,1 -AT), leukotriene B4 and tissue inhibitor of metalloproteinases-1 (TIMP-1) were assessed. Results: No variable was significantly different during the run-in period or with placebo treatment. In contrast, theophylline treatment significantly decreased NE and MPO levels at 4 weeks, although the cell differential count did not change appreciably as a result of treatment. Conclusion: These results suggest that 4 weeks of theophylline treatment attenuates neutrophil-associated inflammation in the airways of mild to moderate COPD patients. However, the clinical benefits remain to be determined. [source] A standardized protocol for the treatment of severe pneumonia in kidney transplant recipientsCLINICAL TRANSPLANTATION, Issue 6 2002Pierpaolo Sileri Abstract:, Although the incidence of pneumonia after kidney transplantation is the lowest among all solid organ transplants, it is associated with high mortality rate (40,50%). We evaluated the efficacy of a protocol consisting of bronco-alveolar-lavage (BAL) for early microbiological diagnosis, reduction of the immunosuppressive therapy, and prompt administration of standardized antibiotic regimen in renal transplant recipients with severe pneumonia. Between 6/1989 and 5/1999, 40 kidney transplant recipients developed 46 episodes of severe pneumonia (hypoxia and/or infiltrate on the chest X-ray). According to protocol, in all these cases, a BAL was immediately performed and empirical antibiotic therapy was initiated with erythromycin and trimethoprim-sulfamethoxazole i.v. Furthermore, the immunosuppressive therapy was drastically reduced. Analyses of BAL fluid included cell differential count, cytopathologic examination and cultures for bacteria, fungi and viruses. Within 48 h, the therapy was switched to proper i.v. antibiotics, if necessary, according to the results of sensitivity testing of BAL specimens. The mortality rate was 12.5% (5 of 40). Mechanical ventilation was required in 20 cases (34.5%) and four of the patients that required intubation died. BAL alone established a diagnosis in 67.4% (31 of 46) of the patients. Bacteria were responsible for 61% of the episodes, with fungi responsible for 29% and viruses for 10%. Seven cases of Pneumocystis carinii pneumonia were treated with the prolongation of the initial therapy. We conclude that a combination of early detection of the responsible pathogen by BAL, aggressive reduction of the immunosuppressive therapy and the immediate empirical administration of erythromycin and trimethoprim-sulfamethoxazole is an effective strategy to treat pneumonia kidney transplantation (KTX) recipients. [source] Quality control of bone marrow cytology; organization and over 7 years experience in the south-west NetherlandsINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2008A. A. M. ERMENS Summary To asses the quality of bone marrow cytology of hospital laboratories in the south-west Netherlands a proficiency testing program was implemented. Two sets of bone marrow and blood smears from two patients were sent to 20 hospital laboratories using a tight time schedule biannually. Required results consisted of differential counts of 500 bone marrow cells and 100 peripheral blood cells, together with the description of morphological abnormalities and final conclusions. Twice a year the collected review data were discussed in a plenary session which was also used for continuous education. Over the past 7 years 30 bone marrow samples were evaluated. The coefficient of variations of specific cells counts was large. The amount of correct conclusions ranged from 12% to 100% (median: 61%). Participant attendance of the meetings was 90,100%. The total cost of this scheme of proficiency testing approximately amounted ,7000 per year. The presented formulae for both proficiency testing and haematopathological/cytological education is feasible and fulfilled the need of the participants. [source] Significant differences between capillary and venous complete blood counts in the neonatal periodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2003S.M. Kayiran Summary The normal capillary and venous hematologic values for neonates have not been defined clearly. It is well known that capillary blood has higher hemoglobin (Hb) and hematocrit (Hct) values than venous blood. In a recent study, we reported differences between capillary and venous complete blood counts (CBC) in healthy term neonates on day 1 of life. The aim of this study was to extend our previous investigation. Term neonates (n=141) were stratified into four groups by days of postnatal age: group 2 (day 7, n=38), group 3 (day 14, n=35), group 4 (day 21, n=32) and, group 5 (day 28, n=36). Data from our previous study were included in the statistical analysis as group 1 (day 1, n=95). A CBC and differential count were carried out on each capillary and venous sample drawn simultaneously. Within each group, the mean and standard deviation for each parameter in capillary and venous blood were calculated and then compared using the paired sample t -test. In all groups, the capillary blood samples had higher Hb, Hct, red blood cell (RBC), white blood cell (WBC), and lymphocyte counts. In each group, venous platelet counts were significantly higher than the corresponding capillary values. There was also a trend toward higher venous mean corpuscular volume, higher capillary polymorphonuclear leukocyte (PML) count and mean platelet volume in all groups. In both capillary and venous blood, Hb, Hct, RBC, MCV values and WBC, lymphocyte, PML counts decreased and platelet counts increased steadily during neonatal period. This study reveals that CBC parameters and differential counts may differ depending on the blood sampling used. The findings underline the importance of considering the sample source when using hematologic reference ranges for healthy or septic neonates. When interpreting results, the term ,peripheral blood' should be replaced with ,capillary blood' or ,venous blood' so that an accurate assessment can be made. [source] Severe periodontitis is associated with systemic inflammation and a dysmetabolic status: a case,control studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2007Luigi Nibali Abstract Background and Aim: A cluster of metabolic factors defines a syndrome that predisposes to diabetes and cardiovascular disease. Chronic infections such as periodontitis might alter these individual metabolic factors and the systemic inflammatory burden. The aim of this study was to investigate the association between severe periodontitis and increase in inflammatory and metabolic risk factors for cardiovascular disease. Materials and Methods: We examined 302 patients with severe periodontitis and 183 healthy controls, and we collected a blood sample from each subject in order to investigate differences in inflammatory (leukocyte numbers and differential counts) and metabolic markers (lipids and glucose). Results: After correcting for differences in age, gender, smoking and ethnicity, periodontitis subjects exhibited a low-grade systemic inflammation (increased white cell counts, 1.10±1.02 × 109/l, 95%CI 1.05,1.15, p=0.0001), dyslipidemia [lower high-density lipoprotein cholesterol, 1.14±1.03 mmol/l, 95%CI 1.08,1.20, p<0.0001 and higher low-density lipoprotein cholesterol, 1.12±1.03, 95%CI 1.05,1.19, p<0.0001) and increased non-fasting serum glucose levels (1.04±1.01 mmol/l, 95%CI 1.02,1.06, p=0.01) when compared with controls. The associations were confirmed in a subpopulation of Caucasian non-smokers. A trend for a dose dependent effect of the number of periodontal pockets on the tested inflammatory and metabolic markers was observed. Conclusions: These data suggest a possible link between severe generalized periodontitis, systemic inflammation and a dysmetabolic state in otherwise healthy individuals. [source] Peripheral blood picture following mild head trauma in childrenPEDIATRICS INTERNATIONAL, Issue 3 2008Bulent Alioglu Abstract Background: The aim of the present study was to investigate changes in peripheral white blood cell, and differential counts following mild head trauma in a pediatric population. Methods: Fifty-one patients (mean age, 79 ± 62 months) with mild head trauma (Glasgow Coma Scale [GCS] score 15) who were admitted to the emergency department, were studied. Two blood specimens were collected from each patient, one on arrival and one after 24 h at the emergency department. Complete blood count was performed using a hemocytometer and the absolute cell counts for each sample were calculated after examination of peripheral smear. Results: No patient developed any complication during the hospital stay or after discharge. Significant differences were found for white blood cell, neutrophil, and immature cell counts just after and 24 h after trauma (P = 0.047, 0.039 and 0.009, respectively). Conclusions: Mild head trauma may cause an increase in white blood cell, neutrophil and band counts in children just after trauma. In a child with a mild head trauma, who is asymptomatic, with GCS score of 15 and absence of risk factors, and without clinical deterioration, complete blood cell count may be omitted from laboratory workup. But a prospective randomized study comparing mild head trauma patients with good and bad clinical outcome is needed to draw a definite conclusion. [source] |