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It is shown in a series of cases that phase-contrast microscopy is particularly suitable for intra-operative diagnosis in almost all gynecological operations. Also in smaller diagnostic measures (e. g. punch biopsy from the urinary bladder and rectum as well as curettage), phase-contrast assessment of the extracted tissue is possible with astonishing reliability.
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A total of 291 urine sediments from 255 patients with various renal or urinary tract diseases have been studied by phase contrast microscopy. Based upon morphological criteria, leucocytes were distinguished from renal epithelial cells and the white blood cells were classified either as mononuclear or polynuclear in 179 patients. The percentage of the different cell types varied considerably between and within the different diseases. The median values for polynuclear granulocytes were higher than 90% in bacterial renal or urinary tract disease and in polycystic kidney disease. In interstitial nephritis, nephrosclerosis and in renal transplanted patients the percentage of polynuclear granulocytes was somewhat lower, 76-85%. In diabetes, amyloidosis, tubular nephrosis (necrosis) glomerulonephritis, lupus nephritis and endemic benign nephropathy there were 14-66% polynuclear granulocytes. 29-33% mononuclear leucocytes were found in lupus nephritis and endemic benign nephropathy. The greatest proportion of renal epithelial cells was found in endemic benign nephropathy, namely 49%. 36% renal epithelial cells were found in tubular nephrosis (necrosis) and in glomerulonephritis. The technique is rapid and inexpensive. It facilitates differential diagnostics of urinary tract disease with pyuria.
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Fresh urine samples from twenty patients with macroscopic haematuria were examined by phase contrast microscopy to study the erythrocyte morphology. Other appropriate investigation like - renal biopsy in suspected glomerulonephritis and appropriate urological investigations in other cases to prove the site of origin of erythrocyte were done in all cases. Changes in erythrocyte morphology were observed in all the 12 patients with histological evidence of proliferative glomerulonephritis. These changes included extrusion of cell cytoplasm (39.5%), 'Doughnut' cell (26.5%) budding cell (15%) and cell membrane rupture with loss of cytoplasm (15%). Overall 83.3% of the erythrocytes showed some morphologic change or the other. In 8 patients where bleeding was into the pelvicalyceal system, ureter or bladder, 95% of RBCs showed no discernible morphologic change. It is concluded that the morphological changes in the erythrocyte identified under the phase contrast microscope can help to differentiate between glomerular and non glomerular causes of bleeding.
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Exoerythrocytic stages of Plasmodium knowlesi were obtained in primary culture of rhesus monkey hepatocytes. The development of a single parasite was followed with phase contrast microscopy until release of merozoites in slightly less than 5 days. This direct observation may offer opportunities to determine visually factors that may influence specific steps of schizont development.
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BACKGROUND: A new technique called phase contrast microscopy with modified Hansel's staining (used with bright field microscopy) was developed to identify mast cells (MCs) and granulocytes (eosinophil/neutrophil/basophil [E/N/B]). METHODS: Nasal scratching smears from 618 patients with Japanese cedar pollinosis were examined using this new technique. RESULTS: This technique permitted accurate morphological identification. MCs can be discriminated from E/N/Bs. The surface of the cell membrane appeared as low refractile (lr), moderately refractile (mr), or high refractile (hr). This was caused by the light, which is not related to the phase difference, but rather originated from the difference in the refraction of the direct light. In specimens from the onset stage (i.e., 1-3 days after onset), lr-MC and mr/hr-E/N/B were dominant. In specimens from the early stage (i.e., 4-7 days after onset), lr-E/N/B significantly increased in number. CONCLUSION: The phospholipid bilayers of the cell membrane exhibit a phase transition after the onset, and phase refractivity of the cell membrane is closely related to the activity of the cell. This indicates that in the onset stage, MCs are already activated, whereas most of the E/N/Bs are not. In contrast, the latter cell types become activated subsequently in the early stage.