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Haematuria present in 4% of adult population is not always connected with clinical symptoms. This article presents the current state of the art of using phase-contrast microscopy in examination of urinary sediment in differential diagnosis of haematuria.
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Despite the recognized superiority of traditional culture methods to investigate bacteriuria their routine use in population studies is costly. We proposed to use Phase contrast microscopy (PCM) which allows clear visualization of bacteria with no centrifugation or staining. Urine samples from 214 patients were studied by PCM and results compared to those obtained by quantitative culture. MCF had 95% sensitivity and 96% specificity. Therefore, PCM may be used to screen urine samples for further bacteriologic study with the highest chance of obtaining positive cultures.
The urinary erythrocyte morphology of 120 patients with haematuria of diagnosed cause (41 glomerular, 79 non-glomerular) was examined by red cell analyser (RCA) and by phase contrast microscopy (PCM). By RCA three distinct ranges of modal erythrocyte cell volume (ECV) were observed. The modal ECVs in glomerular haematuria (35-50 fl) were significantly lower than in non-glomerular haematuria (65-148 fl) and both were clearly distinct from 'debris patterns' (12-33 fl). In duplicate specimens very similar ECVs were observed before and after centrifugation and after storage for up to 15 h. There was no correlation between the modal urinary ECV and the urinary specific gravity or the peripheral venous ECV. The source of the haematuria (glomerular or non-glomerular) was identified correctly by RCA (PCM) in 100% (60%), 68% (71%) and 22% (39%), respectively, of patients with macroscopic, 3+ microscopic and 1-2+ microscopic haematuria. In no patient was the haematuria localised incorrectly by RCA as compared with 10% incorrect localisation by PCM. RCA and PCM are complementary non-invase tests and both should be performed whenever possible in the investigation of haematuria.
A new method was developed to prepare permanent asbestos slides with relocatable fields of view by imprinting these fields directly on the cleared wedges of filters containing asbestos fibers. The image quality of the fibers is comparable with that of the fibers prepared by the acetone/triacetin and the dimethyl formamide/Euparal method. The slides are suitable for evaluating the intercounter precision and accuracy of fiber counts by phase contrast microscopy. Seventeen chrysotile and 16 amosite slides, prepared from American Industrial Hygiene Association/National Institute for Occupational Safety and Health Proficiency Analytical Testing program samples, were evaluated by 58 analysts of 38 government and private laboratories in Canada. By asking the analysts to examine the same fields of view of the slides, the present study found that when examined at 400x, an average of 59.2 fiber counting errors were made for every 100 chrysotile fibers reported and 24.4 errors for 100 amosite fibers reported. The chrysotile fibers were underestimated by 25.0%, but there was no bias in counting amosite fibers. Remedial steps have been proposed to control the major source of errors, which is the subjective ability of the analyst to observe and size fibers. The slides may also be used to harmonize various phase contrast optical microscopy methods and proficiency testing programs.
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AIM: In the last 10 years the tumors of cervix have showed a significant reduction in incidence, while the preneoplastic lesions are increased (linked often to human papilloma virus [HPV] infection), and so it is enhanced the role of early diagnosis. METHODS: The Authors have examined 124 patients at colposcopy showing transformation zone anomalies and/or HPV infections. The patients have submitted to PAP-test, phase contrast microscopy and to biopsy. RESULTS: The analysis of our cases show oneself better sensitivity of colposcopy than cytologic exam, in particular in the diagnosis of low grade intraepithelial lesions (LSIL), corresponding to CIN 1 and HPV lesions. CONCLUSIONS: Phase contrast microscopy, by search of possible preneoplastic elements in the smear, is a complementary technique, and if performed systematically and by qualified operators allows to reduce furthermore false negative rate. The synergic use of tools allows to increase of number of intrecervical neoplasia diagnosis. The following cost's increase cannot be considered an obstacle and it is not should be necessary to counsel always the colposcopy in case of anomalous PAP smear revealed during screening.