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Studies of the blood of Ascidia ceratodes. Total blood cell counts, differential blood cell counts, hematocrit values, seasonal variations, and fluorescent characteristics of blood cells.

Seasonal, and animal size and weight variations of the blood cells of the vanadium-containing ascidian. Ascidia ceratodes, were determined. The fluorescent properties of various cell types were ascertained, and discussed in terms of cell development, phylogenic position of the species, and chemicals in the cells.

Acclimatization

[Difference of blood cell counts with reference blood cell counters in three different makers].

To determine the difference of CBC values in different blood cell counters, we have measured the values of CBC by using reference cell counters of three major makers; Coulter, Sysmex and Technicon. Thirty ml of whole blood was taken from 2 healthy individuals and mixed with 45 mg of EDTA -2K. The blood samples were then sent to reference laboratory of each maker under identical conditions. The determination of cell counts was performed 4 hours after taking blood. Ten consecutive analysis were then carried out and the mean of 10 values was calculated. The apparent difference was displayed in leucocyte and platelet counts. In both of two samples, the highest values of either leucocyte or platelet count was obtained with Coulter instrument. And second high values were noted with Sysmex counter and the lowest values were observed by Technicon instrument. The extent of difference between each instrument was over 10% in case of platelet count and was 5 to 10% in leucocyte count. The difference of erythrocyte count, Hgb level, hematocrit value and MCV also existed, but the extent of difference was within 5% in all of these examinations. Since CV of each examination was sufficiently low level, this difference might be due to the difference in accuracy of reference cell counter of each maker. These results suggest that distinct differences of CBC count, particularly platelet and leucocyte count can be produced by the different procedures of calibration for reference counter in each maker of automated blood cell counter.

Adult

Acute effects of single doses of recombinant interferon-gamma on blood cell counts and lymphocyte subsets in patients with advanced renal cell cancer.

The object of this study was to investigate the effects of different single doses of recombinant interferon-gamma (rIFN-gamma) on white blood cell counts, differential blood counts, and the relative composition of T-cell subsets in the peripheral blood of cancer patients. Sixteen patients suffering from metastasizing renal cell carcinoma received 10, 100, or 500 micrograms of rIFN-gamma three times at weekly intervals. After a therapy-free interval of 2 weeks, the next dose level was applied. The order of dose levels was assigned randomly to each patient. White blood cells, differential blood counts, and the number of Leu1, Leu3, Leu2a, Leu7, and HLA DR+ cells were measured immediately before and at 4, 24, 48, 72, 96, and 168 h after the administration of single doses of rIFN-gamma. Results indicated that white blood cells were transiently removed from the blood circulation after administration of IFN-gamma. Monocytes, HLA DR+ cells, and Leu7+ cells were reduced to below 50% of pretreatment values 4 h after application of the cytokine. CD8+ cells and granulocyte counts declined to approximately 70% of pretreatment values 24 h after IFN therapy. The preferential reduction of CD8+ lymphocytes resulted in a temporary increase of the T4/T8 ratio in these patients.

Adult

Acute myocardial infarction. Prognostic value of white blood cell count and blood glucose level.

Data obtained in the course of a nationwide study of patients with first acute myocardial infarction (AMI) demonstrated substantially higher hospital mortality among patients with leukocytosis or elevated blood glucose levels, or both. It is suggested that the combination of these two measurements could be used as a handy diagnostic indicator in the evaluation of some AMI patients and as a criterion for the patients' immediate disposition to a coronary care unit, rather than to a general ward.

Acute Disease

[Changes in the blood cell counts with aging].

We analyzed the blood cell counts and serum levels of total protein (TP), total cholesterol (TC) and triglyceride (TG) of 2,231 healthy subjects (1,295 men and 936 women) between age 20 and 99 years in order to clarify the following two subjects. (1) In the approximately 10 years since the report of Shirakura et al in 1978, eating habits have improved and the average life expectancy has extended in Japan. Is there any effect of such betterment on blood cell counts of the aged? (2) It has been pointed out that quality of everyday life, such as staying at home but not in an old-age home, working, traveling, and so forth, had an influence on the blood cell counts of aged. Is there any difference between the blood cell counts of people under 60 years and those of people older than 60 years who have a good quality of life as mentioned above? The hemoglobin concentration, red blood cell count, and hematocrit value began to decrease in men in their sixth decade and in women in their seventh decade and the change was more prominent with advancing age, especially in men. The white blood cell count and platelet count tended to decrease with advancing age. The serum levels of TP, TC, and TG also declined with age in those over 60 years of age. These results confirmed that the hemoglobin concentration, red blood cell count, and hematocrit value decrease in the elderly subjects as they grow older and it may be considered that reduced ingestion of protein is one of the causes of the phenomenon.

Adult

Comparison between a modified haemocytometric technique and electronic counters in goat blood cell counting.

Dilutions of goat blood with Hayem-Jørgensen's fluid ranging from 1:200 to 1:1,000 were used for haemocytometer counting of red blood cells (RBC) in 27 goats. The optimal dilutions were 1:400-1:500. Correlation studies between the results obtained by the haemocytometer and the Coulter counter red blood cell (RBC) and white blood cell (WBC) counts were performed in 551 goat blood samples. The haemocytometer RBC counts were 5.63% higher and WBC counts 2.79% lower than those of the electronic counter. The method of blood cell counting therefore influences the clinical haematological diagnoses and reference values in domestic animals. New cell counters specifically designed to measure cells of small volumes, e.g. goat erythrocytes, are needed.

Animals

Combined blood cell counting and classification with fluorochrome stains and flow instrumentation.

A multiparameter flow cytophotometer was used to count and classify fixed human blood cells fluorochromed with a mixture of ethidium bromide (EB), brilliant sulfaflavine and a blue fluorescent stilbene disulfonic acid derivative (LN). The system measures light scattered by the cells and absorption at 420 nm for all cells. In addition, nuclear EB fluorescence (540 leads to 610 nm) and cytoplasmic fluorescence from LN (366 leads to 470 nm), brilliant sulfaflavine (420 leads to 520 nm) and EB exicted by energy transfer from LN (366 leads to 610 nm) are measured for all nucleated cells. This information is sufficient to perform red and white blood cell counts and to classify leukocytes as lymphocytes, monocytes, basophils, eosinophils or neutrophils. Light scattering and/or nuclear and cytoplasmic fluorescence values may be further analyzed to obtain the ratio of immature to mature neutrophils. Counts produced by the system are in reasonable agreement with those obtained by electronic cells counting and examination of Wright's-stained blood smears; some discrepancies appear to be due to systematic errors in the manual counting method.

Autoanalysis

Accuracy and utility of differential white blood cell count in the neonatal intensive care unit.

The clinical utility of the complete blood cell count (including the differential white blood cell count) as a means to follow the course of infants in a neonatal intensive care unit was assessed. Utility was judged for three purposes: (1) predicting the onset of clinically unrecognized disease, (2) assessing the severity of current disease, and (3) following a trend during treatment. Neither conventional nor automated differential counts were useful for surveillance (predicting the onset of clinically unrecognized disease). The white blood cell count, the platelet count, and the absolute immature neutrophil count and immature/total neutrophil ratio were useful to assess the severity of current clinical events. The white blood cell count was superior to the differential count for following trends in patients' conditions. Information regarding nuclear immaturity derived from automated counts and the cost and slowness of the manual differential count are good indications for decreased use of conventional counts, increased use of certain features of the automated differential, or both, in neonatal intensive care units.

Automation

The relationship of white blood cell count to other cardiovascular risk factors.

Baseline data for the 12,866 men from the Multiple Risk Factor Intervention Trial was used to study factors related to white blood cell (WBC) count. White blood cell count was significantly higher in smokers (7853 cells/mm3) and ex-smokers (7091 cells/mm3) who stopped smoking less than one year before than in ex-smokers who stopped more than one year before (6255 cells/mm3) and those who never smoked (6094 cells/mm3). In current cigarette smokers, white blood cell count was significantly related to number of cigarettes smoked, degree of inhalation, and duration of smoking (p less than 0.001 for each). In addition, white blood cell count was higher in non-cigarette smokers who smoked pipes, cigars, or cigarillos than among men who did not smoke tobacco (p less than 0.001). White blood cell count was lower in blacks (by 877 cells/mm3) and Orientals (by 634 cells/mm3) than in whites. Leukocyte count also showed a strong inverse association with high density lipoprotein (HDL)-cholesterol, a positive association with triglycerides independent of cigarette use, and a positive association with low density lipoprotein (LDL)-cholesterol in smokers only. Leukocyte counts were inversely related to total family income and alcohol consumption. We conclude that elevated leukocyte count is independently associated with other risk factors for coronary heart disease (CHD) such as amount and duration of smoking as well as an atherogenic profile, and these relationships should be considered when using white blood cell count as a predictor of coronary heart disease.

Adult

[C-reactive protein, SR and white blood cell count in acute lower respiratory tract diseases. The usefulness of blood tests in diagnosis of pneumonia].

C-reactive protein (CRP) analysis, erythrocyte sedimentation rate and white blood cell count were evaluated as tests in the diagnosis of pneumonia in 84 patients with acute lower respiratory disease. Marked elevated values of CRP were frequently found in pneumonia patients, whereas in most patients with acute asthma, acute exacerbation of chronic obstructive bronchitis and acute bronchitis the values were within the normal range. The combined sensitivities and specificities of the tests were best for CRP, followed by erythrocyte sedimentation rate and white blood cell count.

Adolescent

Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell collaborative heart disease studies.

BACKGROUND: Recent studies have suggested that hemostatic factors and white blood cell count are predictive of ischemic heart disease (IHD). The relations of fibrinogen, viscosity, and white blood cell count to the incidence of IHD in the Caerphilly and Speedwell prospective studies are described. METHODS AND RESULTS: The two studies have a common core protocol and are based on a combined cohort of 4,860 middle-aged men from the general population. The first follow-up was at a nearly constant interval of 5.1 years in Caerphilly and 3.2 years in Speedwell; 251 major IHD events had occurred. Age-adjusted relative odds of IHD for men in the top 20% of the distribution compared with the bottom 20% were 4.1 (95% confidence interval, 2.6-6.5) for fibrinogen, 4.5 (95% confidence interval, 2.8-7.4) for viscosity, and 3.2 (95% confidence interval, 2.0-4.9) for white blood cell count. Associations with IHD were similar in men who had never smoked, exsmokers, and current smokers, and the results suggest that at least part of the effect of smoking on IHD is mediated through fibrinogen, viscosity, and white blood cell count. Multivariate analysis shows that white blood cell count is an independent risk factor for IHD as is either fibrinogen or viscosity, or possibly both. Jointly, these three variables significantly improve the fit of a logistic regression model containing all the main conventional risk factors. Further, a model including age, smoking habits, fibrinogen, viscosity, and white blood cell count predicts IHD as well as one in which the three hemostatic/rheological variables are replaced by total cholesterol, diastolic pressure, and body mass index. CONCLUSION: Jointly, fibrinogen, viscosity, and white blood cell count are important risk factors for IHD.

Blood Viscosity

Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring.

This study was aimed at establishing the importance of routine monitoring of white blood cell counts in patients with Graves' disease receiving antithyroid drug treatment. In the 12-year period from 1975 to 1987, 15,398 patients with Graves' disease receiving treatment with antithyroid drugs were seen at our clinic. Of these, 55 (0.4%) were found to have agranulocytosis. Agranulocytosis was defined as a granulocyte count of 0.5 x 10(9)/L or less. In only 12 of the 55 patients was agranulocytosis detected after the occurrence of infection (symptomatic; classic agranulocytosis). The remaining 43 patients were asymptomatic when agranulocytosis was detected during routine white blood cell count monitoring. However, 14 of these 43 patients became symptomatic several days after withdrawal of antithyroid drug treatment despite antimicrobial treatment (asymptomatic to symptomatic). Twenty-nine patients who were treated appropriately had no symptom of infection throughout the course of the disease, despite the absence of or an extremely small number of granulocytes in circulation (asymptomatic). These results suggest that a "routine monitoring" of the white blood cell count could be the most effective way of predicting and detecting agranulocytosis due to antithyroid drug treatment.

Adult

Amniotic fluid white blood cell count: a rapid and simple test to diagnose microbial invasion of the amniotic cavity and predict preterm delivery.

The purpose of this study was to determine the value of amniotic fluid white blood cell count in the diagnosis of microbial invasion of the amniotic cavity. Amniotic fluid was retrieved by amniocentesis from 195 patients with preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, as well as for mycoplasmas. The prevalence of a positive amniotic fluid culture was 12.8% (25/195). Patients with a positive amniotic fluid culture had a significantly higher median amniotic fluid white blood cell count than did patients with a negative amniotic fluid culture (median, 6 cells/mm3; range, 0 to 11,000 cells/mm3 vs median, 320 cells/mm3; range, 1 to 4480 cells/mm3; p less than 0.0001). An amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 had a sensitivity of 80% (20/25), a specificity of 87.64% (149/170), a positive predictive value of 48.78% (20/41), and a negative predictive value of 96.75% (149/154) in the detection of a positive amniotic fluid culture for microorganisms. Although the sensitivity of an amniotic fluid white blood cell count (greater than or equal to 50 cells/mm3) in the detection of microbial invasion of the amniotic cavity was greater than that of the Gram stain of amniotic fluid (80% [20/25] vs 48% [12/25]; p less than 0.05), the specificity was lower (87.64% [149/170] vs 98.8% [168/170]; p less than 0.05). However, 88% (15/17) of all patients with an amniotic fluid white blood cell count greater than or equal to 50 cells/mm3 and a negative amniotic fluid culture had a spontaneous preterm delivery. We conclude that the amniotic fluid white blood cell count is a sensitive, simple, and inexpensive test for the detection of microbial invasion of the amniotic cavity. An elevated amniotic fluid white blood cell count is a risk factor for preterm delivery.

Adult

Negative correlation between blood cell counts and serum neopterin concentration in patients with HIV-1 infection.

Hematopoietic disturbances are common in patients with HIV-1 infection. Recent studies on immune activation markers such as neopterin demonstrate that HIV-1 infection is associated with chronic immune activation. We investigated a possible association between serum neopterin concentrations and blood cell counts (CD4+ T cells, white blood cells, platelets, red blood cells) and hemoglobin and hematocrit in 94 HIV-1-seropositive individuals [52 Walter Reed (WR) stage 1, 31 WR2, one WR5, and 10 WR6]. There were significant negative correlations between neopterin concentrations and CD4+ T cells, hemoglobin, hematocrit and platelets. These correlations were also significant if either only WR1 and WR2 patients or the entire set of data were considered for calculations. Thus, hematological abnormalities are associated with chronic immune activation in patients with HIV-1 infection. Large amounts of neopterin are released by human macrophages on stimulation with interferon-gamma (IFN gamma), and tumor necrosis factor alpha (TNF alpha) further enhances the effect of IFN gamma. Therefore, our data suggest that activated immune cells and specific cytokines such as IFN gamma and TNF alpha are involved inhibiting hematopoiesis.

Biopterins

The state of leukocyte adhesiveness/aggregation in the peripheral blood is more sensitive than the white blood cell count for the detection of acute mental stress.

We determined the state of the leukocyte adhesiveness/aggregation in the peripheral blood by using a simple slide test and found it to be more sensitive than the white blood cell count for the detection of acute mental stress. Included were 71 controls, 64 young athletes examined just before their exercise, 14 volunteers who were examined 10-20 min before engagement in rappelling while an additional group of 20 were examined just before the act as they were facing an abyss from the top of a cliff. The state of leukocyte adhesiveness/aggregation correlated significantly (p less than 0.0005) only with the increasing strain assumed to occur from the first to the fourth group. The state of leukocyte adhesiveness/aggregation was 3.3 x more sensitive than white blood cell count in both rappelling groups and 5 x more sensitive than white blood cell count when evaluated in those examined at the last minute. We concluded that the state of leukocyte adhesiveness/aggregation is a reliable marker of acute mental stress.

Adolescent

Changes in the differential white blood cell count in screening for group B streptococcal sepsis.

We compared several previously defined scoring systems using white blood cell indices as part of a retrospective evaluation of infants with early onset Group B streptococcal (GBS) sepsis. Nineteen newborns were diagnosed with GBS sepsis between January, 1988, and April, 1990. Case controls (n = 33) were selected from patients admitted to the Neonatal Intensive Care Unit for suspected sepsis. Complete blood counts obtained at admission and between 12 and 24 hours of age were reviewed. There was a significant change in the ratio of immature to total neutrophils in the GBS group over time. Scoring systems for neonatal sepsis by Manroe et al., Rodwell et al. and Spector et al. had poor sensitivity, specificity, positive predictive value and negative predictive value when initial white blood cell count criteria were used, but scoring systems by Manroe and Rodwell were 100% sensitive and had 100% negative predictive value when applied to the repeat white blood cell count. We conclude that a single early complete blood count may not be an adequate screening tool for early onset GBS sepsis and should not be used to rule out infection. Optimal screening for GBS sepsis requires a repeat complete blood count within the first 24 hours of age.

Female