Accuracy and Precision Study: Body Fluid White Blood Cell (WBC) Analysis (Peritoneal, Pleural and Peritoneal Dialysate) Using a Light Scatter Technology (ADVIA®2120/2120i) Versus Hemocytometer Manual Counts

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4730-4730 ◽  
Author(s):  
Donna D Castellone ◽  
Ellinor I.B. Peerschke ◽  
Nenita Francisco ◽  
William Canfield ◽  
Gail Kling
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Body Fluid ◽  
The Body ◽  
Light Scatter ◽  
Laboratory Assessment ◽  
Peritoneal Dialysate ◽  
Manual Method ◽  
Reproducibility Study

Abstract Abstract 4730 Background: The ADVIA® 2120/2120i body fluid application is an in vitro diagnostic test for the enumeration of the total nucleated cell (TNC) or white blood cell (WBC) count and RBC (red blood cell) count for pleural, peritoneal and peritoneal dialysis (PD) specimens collected in K2 EDTA. Total nucleated cell (TNC) and RBC counts are used in the laboratory assessment of these fluids. The TNC count is an absolute count of the nucleated blood cells, mesothelial cells, and other non-hematopoietic cells in these fluids. Objective: The objective is to demonstrate concordance between the manual (hemocytometer) method versus the light scatter principle used on the ADIVA® 2120i analyzer. Methods: The ADVIA® 2120/2120i Body Fluid Application uses the Basophil/Lobularity and RBC/PLT channels to enumerate the WBC and RBC counts. WBC counts are derived from the Basophil/Lobularity channel by a process in which the cytoplasmic membrane is stripped and the suspension of cells is intercepted by light from the laser diode where the low-angle light scatter (2° to 3°) and high-angle light scatter (5° to 15°) signals of each cell are counted. The manual method uses a hemocytometer in which a chamber is charged with fluid and both areas of the chamber are counted and the result averaged. De-identified remnant peritoneal, pleural and peritoneal dialysate samples were processed within 2 hours in the Hematology Laboratory according to their standard operating procedure. Samples with TNC counts that fell in the range of 0.030 to 400 × 103 cells/μ L (30 to 400,000) for each type of fluid were included. Ten consecutive runs were performed for each type of fluid to determine precision. Results: The WBC reproducibility study (n=10) demonstrates that within the run, precision of the body fluid counts demonstrates a coefficient of variation (CV) ≤ 10 CV. Regression analysis (n=34) demonstrates an r=.93 using samples across the reportable range. Conclusion: These results suggest that the light scatter technology used on the ADVIA® 2120/2120i gives both accurate and precise WBC determinations and compares very well to the manual method for determination of WBC analysis in peritoneal, peritoneal, dialysate, and pleural fluids. Utilizing this method will decrease turn-around time for this process, resulting in a faster time to result and ultimately better patient outcomes. Disclosures: Castellone: Siemens Healthcare: Employment. Canfield:Siemens: Employment. Kling:Siemens: Employment.

Effect of Acid Stress on the Behavior of Soil Nematodes

2014 ◽  
Vol 522-524 ◽  
pp. 341-345
Author(s):  
Dan Dan Liu ◽  
Yan Ling Cui ◽  
Chang Feng Liu ◽  
Xin Lin Gao ◽  
Yin Yao Xia
Keyword(s):  
Body Fluid ◽  
Acid Stress ◽  
Optical Microscope ◽  
The Body ◽  
Individual Development ◽  
Movement Behavior ◽  
Soil Nematode ◽  
In Vitro Test ◽  
Stylet Length

In vitro test was used to determine the effect of acid stress on soil nematode (Meloidogyne incognita) J2 survival, behavior, individual development and fluid extravasations. The effects of acid stress on J2 survival is C2H2O4>C6H8O7>C4H6O5. Inhibition on J2 movement behavior increased with time prolonged. Effect on nematode body length, stylet length, tail transparent area length, body fluid extravasations: C2H2O4>C6H8O7>C4H6O5. At high magnification optical microscope can be clearly observed symptoms of poisoning J2. Compared with the control, acid inhibited the nematode survival, movement and individual development, promote the body fluid extravasations, destroyed the normal physiological metabolism of nematodes, even lead to death.

Dietary Determinants Of The White Blood Cell Count

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1705-1705
Author(s):  
Pauline D Balkaransingh ◽  
David Wheeler ◽  
Yi Ning ◽  
Marieka A. Helou ◽  
Gita Massey
Keyword(s):  
Immune System ◽  
Blood Cell ◽  
White Blood Cell ◽  
Extreme Values ◽  
Conflicts Of Interest ◽  
White Blood Cells ◽  
The Body ◽  
Outcome Variable ◽  
Subsequent Decrease ◽  
Wbc Count

Abstract Introduction White blood cells are key components of the immune system. They defend the body against a host of diseases and infections. Various studies have explored the possible influence of dietary nutrients on the white blood cell (WBC) count. If it can be demonstrated that nutrients affect the WBC count, they may offer an inexpensive way of modulating the immune system and in turn, the body's ability to fight against disease and infection. The sample sizes of previous studies, however, have been relatively small. The results have therefore been variable and conflicting. The purpose of this study is to continue to explore the dietary determinants of the WBC count, using a database that allows for a larger sample size, the 2005-2006 National Health and Nutrition Health Survey (NHANES). Methods The main outcome variable, WBC count, was recoded to the normal range for ages ≥ 18 years, of 4-11(±2). This was done in order to account for extreme values; particularly high and low values secondary to disease or infection. The population means and 95% confidence intervals were obtained using the statistical weights for the key variables of interest (Table 1). Multiple linear regression and backward elimination were used to predict the final model (Table 2). Variables with p < 0.1 were kept in the model. SAS 9.3 was used for all statistical analyses. Results Associations for age, gender, race and Body Mass Index (BMI) and WBC count, were consistent with previous studies and were all statistically significant (p< 0.0001). It has been shown that more intense physical activity usually leads to an increase in the WBC count. In this study, however, more vigorous forms of activity were associated with a lower WBC count (p < 0.0001). Increases in dietary copper and iron were associated with a subsequent decrease in the WBC count (Table 2, p < 0.05). An increase in vitamin K was also associated with a decrease in WBC count, however, it was not statistically significant (Table 2, p > 0.05). Increases in vitamin B1 were associated with an increase in WBC count (p < 0.05). Conclusion The results of this study suggest that further prospective studies are needed to investigate the role of these nutrients as determinants of the WBC count. Disclosures: No relevant conflicts of interest to declare.

White Blood Cell Mechanics Mediate Glucocorticoid- and Catecholamine-Induced Demargination

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3459-3459
Author(s):  
Meredith E Fay ◽  
David R Myers ◽  
Amit Kumar ◽  
Rebecca Byler ◽  
Todd A Sulchek ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Blood Cell ◽  
White Blood Cell ◽  
Whole Blood ◽  
Inflammatory Responses ◽  
Conflicts Of Interest ◽  
Microfluidic Channel ◽  
Epinephrine Infusion ◽  
Hematopoietic Stem

Abstract After treatment with glucocorticoids (e.g. dexamethasone) or catecholamines (e.g. epinephrine), the white blood cell (WBC) count substantially increases. This is primarily due to WBCs shifting from the marginated to circulating pools (Nakagawa et al., Circulation, 2008) and is traditionally attributed to down-regulation of adhesion molecule expression (Weber et al., J Leukoc Biol, 2004).Recent research has described how mechanical properties determine the radial position of blood cells within the intravascular space (Reasor et. al, Ann Biomed Eng., 2013). In addition, because WBC demargination occurs rapidly (e.g.,<15 min after IV epinephrine infusion (Dimitrov et al., J Immunol. 2010)) on a timescale that may be shorter than that expected for alterations in gene expression, we hypothesized that alterations in WBC mechanical properties upon exposure to glucocorticoids or catecholamines mediate demargination. To that end, we developed an in vitro microfluidic system as a simplified microvasculature model (Fig 1A), which our laboratory has expertise in (Tsai et al., J Clin Invest., 2008 and Rosenbluth et al., Biophys J. , 2006). In the absence of confounding factors such as WBC release from bone marrow or endothelial interactions, this type of assay is ideally suited to determine the role of glucocorticoid and catecholamine treatment on the demargination of WBCs. By flowing whole blood into similar non-functionalized microfluidic devices, other groups have demonstrated that non-activated WBCs marginate to the microfluidic channel wall, which is likely due to their mechanical properties (Jain et al., PLoS One, 2009). Human whole blood was incubated at 37° C with acridine orange (WBC stain) and either dexamethasone or epinephrine at physiologically relevant concentrations. The blood was then flowed through our microfluidics at physiologic shear rates while confocal videomicroscopy was used to image the center plane of the channel. We developed custom analysis software that extracts the position of individual WBCs from a series of confocal images and plots histograms of their locations, tracking over 10,000 WBCs per experiment (Fig 1B). Overall, we found that both dexamethasone and epinephrine (to a slightly lesser extent) cause WBCs to demarginate from the walls of the vessel compared to control conditions (Fig 1C). This glucocorticoid and catecholamine-induced movement of WBCs toward the microchannel center mimics in vivo demargination and our reductionist microfluidic approach strongly suggests that alterations in WBC mechanics play a key role in this process. Indeed, using computational modeling, we confirmed that a reduction in the mechanical stiffness of WBCs is sufficient by itself to explain the observed demargination (Fig 2A) (Kumar et al., Phys Rev Lett., 2012). Using a range of WBC stiffnesses, our simulations revealed that decreases in WBC stiffness correlated with the degree of demargination. To corroborate our microfluidic data, we also directly measured WBC stiffness using atomic force microscopy. WBCs treated with dexamethasone were significantly softer (p< 0.0002) than control WBCs (Fig 2B), supporting our hypothesis that the demargination phenomenon is related to the biophysical changes in WBCs. Experiments measuring the stiffness of epinephrine-treated cells as well as experiments evaluating how these drugs affect the actin cytoskeleton are currently underway. Overall, our data suggest that WBC mechanics play a major role in glucocorticoid- and catecholamine-induced demargination and that the underlying mechanisms may, at least in part, be biophysical in nature. This novel finding may have important implications in other hematologic processes such as WBC margination and recruitment during inflammatory responses or hematopoietic stem cell mobilization and homing. Disclosures: No relevant conflicts of interest to declare.

Implementation of Vancomycin Monitoring Criteria in a Pediatric Hospital

2004 ◽  
Vol 9 (3) ◽  
pp. 179-186
Author(s):  
Kelley R. Lee ◽  
Stephanie J. Phelps
Keyword(s):  
Blood Cell ◽  
Serum Creatinine ◽  
White Blood Cell ◽  
Primary Objective ◽  
Serum Concentrations ◽  
Cell Counts ◽  
Group 2 ◽  
Serum Vancomycin ◽  
Group 1

OBJECTIVES The primary objective of this retrospective study was to determine if implementation of vancomycin monitoring criteria could reduce the number of serum vancomycin concentrations obtained without adversely affecting patient outcomes. BACKGROUND Controversy regarding the correlation between serum vancomycin concentrations and its efficacy and/or toxicity persists. Little evidence has shown a correlation between vancomycin peak concentration (20–40 mg/L) and toxicity. Likewise, there is little information that supports an association between trough (5–15 mg/L) serum concentrations and clinical cure or in vitro killing rates. For these reasons, many question the clinical utility and cost-effectiveness of monitoring serum vancomycin concentrations. METHODS We reviewed medical records of 193 patients (1 d-19 yrs) who received vancomycin during a 2-month period before (Group 1; n = 100) and after (Group 2; n = 93) implementation of vancomycin monitoring criteria. RESULTS There was no difference (P &gt; 0.05) in baseline age, weight, white blood cell count, temperature, serum creatinine, and blood urea nitrogen between Groups 1 and 2. Although 49.5% of all patients had vancomycin serum concentrations performed, significantly (P &lt; 0.005) fewer patients in Group 2 (32%) were monitored when compared to Group 1 (65%). Peak serum vancomycin concentrations were within the reference range (20–40 mg/L) in 48% of patients in Group 1 compared to 80% in Group 2 (P = 0.03). The mean duration of vancomycin therapy was greater (P = 0.004) for patients in Group 1 (7 ± 7.5 days) compared to Group 2 (4 ± 4.4 days) and the medians for the two groups were also different. Mean ending temperatures (P = 0.23), white blood cell counts (P = 0.71), serum creatinine (P = 0.3) and BUN (P = 0.24) were not different for the two groups. CONCLUSIONS Implementation of criteria to decrease unnecessary serum vancomycin concentration monitoring does not adversely affect patient outcome and may decrease cost to the institution, healthcare system, and patient.

scholarly journals Comparison of Red Blood Cell, White Blood Cell and Differential Counts between UF-5000 System and Manual Method

2019 ◽  
Vol 41 (3) ◽  
pp. 172-178
Author(s):  
Mo Sae Koo ◽  
Jinsook Lim ◽  
Seon Young Kim ◽  
Sun Hoe Koo ◽  
Gye Cheol Kwon
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Red Blood Cell ◽  
Manual Method ◽  
Differential Counts

The effect of prolonged perfusion with a membrane oxygenator (PPMO) on white blood cells

Perfusion ◽  
1994 ◽  
Vol 9 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Per Bergman ◽  
Ali Belboul ◽  
Lars Göran Friberg ◽  
Najib Al-Khaja ◽  
Gösta Mellgren ◽  
...  
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Blood Cells ◽  
White Blood Cells ◽  
White Cell ◽  
Mechanical Trauma ◽  
The Mean ◽  
Pass Through ◽  
Whole Blood Cells

Preserving the rheological properties of whole blood cells is vital for their smooth passage in the capillaries without causing blockage and disturbances in the microcirculation. To evaluate the effect of mechanical trauma on the rheology of white blood cells during prolonged perfusion with membrane oxygenation (PPMO), 16 in vitro experiments were conducted for 72 hours. The St George Carrimed Filtrometer was used to estimate the plasma white cell filtration rates (P-WFR). Also an in vitro estimation of the ability of individual cells to pass through capillaries, the white blood cell clogging rate (WBC-CR), the number of clogging particles (WBC-CP), the total white blood cell count (T-WBC) and two in vitro estimations to assess the effect of aggregates and stiff cells in blocking the microcirculation were performed. The traumatized white cells reduced their mean P-WFR by 37% ± 9, 72% ± 2 and 76% ± 2 at 24, 48 and 72 hours respectively (p < 0.001). The mean WBC-CR was increased to 15.2 ± 1.5, 32.6 ± 2.2 and 40.3 ± 8.3 x 102%/ml at 24, 48 and 72 hours respectively (p < 0.001). The mean WBC-CP was increased to 6.6 ± 1.5, 9.7 ± 1.2 and 13.9 ± 2.1 x 106/ml at 24 hours (p < 0.05), 48 and 72 hours respectively (p < 0.001). The T-WBC was decreased to 55% ± 0.3, 23% ± 0.2 and 14% ± 0.1 at 24,48 and 72 hours respectively (p < 0.001). This study showed a serious loss in white cell rheology during PPMO, which may contribute to the plugging effect of the microvessels in clinical use and may explain the organ dysfunction seen during ECMO on the basis of inadequate tissue oxygenation and nutrition due to areas of reduced perfusion, which results in increased frequency of morbidity.

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