USING SIX SIGMA TO EVALUATE ANALYTICAL PERFORMANCE OF HEMATOLOGY ANALYZER

Background: Many medical decisions in hospital are based on hematology examination results. We must be aware about their method performance. Sigma-metric is an excellent way to evaluate analytical performance quality. We will display the performance of our laboratory hematology analyzer, Cell Dyne Ruby, by sigma-metric analysis.Method: sigma analysis was calculated by a formula, sigma = (TEa – CV)/ Bias. Total Error Allowable (TEa) was specified by the CLIA proficiency testing criteria. The coefficien of variant (CV) and bias data were supplied from analyzer running three levels of control low (L), normal (N), and high (H) include following analytes: hemoglobin (Hb), Red Blood Cell count (RBC), Hematocrit (HCT), White Blood Cell count (WBC), and Platelet count (PLT).Results : Sigma value as follows Hb(L:4,33 N:6,68 H:2,62), RBC(L:3,43 N:3,84 H:3,46), HCT(L:2,52 N:1,73 H:2,27), WBC (L:7,14 N:8,44 H:6,38),and PLT (L:2,46 N:8,75 H:7,84). Average sigma value for all parameters were 4,75. Minimum sigma value for any business or manufacturing process was 3. More than 6 sigma value was world class performance.Conclusion: Hematology Analyzer Cell Dyne Ruby provides “Good” performance by sigma-metric.

Automated detection of malaria: a comparison with microscopy

Objective: To compare the automated detection of malaria with microscopy. Methods: In this study 250 blood samples submitted for malaria investigation were studied microscopically for malaria parasites. All samples were additionally analyzed for same parameters with automated hematology analyzer, Cell Dyn 3700 (CD3700). The results from the instrument generated as scatter plots (derived by laser light depolarization), were compared with microscopy results. Results: The atypical depolarizing events or positive patterns were observed in 43 out of 250 samples on cell Dyn 3700, while microscopically 3 7 samples were found to b e positive. Three samples positive on microscopy, were found t o b e negative on CD-3700. Compared with microscopy the sensitivity of CD3700 was 92.5% and specificity was 97.3%. Maximum parasitaemia was 6.5%. Conclusions: Automated detection of malaria by CD3700 automated hematology analyzer is feasible for screening purpose in malaria endemic and non-endemic areas.

Korelasi Jumlah Netrofil, Limfosit, dan Monosit dengan Kadar Albumin Urin pada Pasien DM Tipe 2 dengan Mikroalbuminuria

The most common complication of diabetes is diabetic nephropathy which is a progressive disease and in the terminal stages, needs a very large cost of care. Nephropathy diabetic can be prevented if it is detected earlier. Microalbuminuria is a test to detect nepropathy diabetic early nowadays, but it is still considered expensive by the majority of the community and has not been widely done in laboratories. What ever it needs other alternatives, such as neutrophils, lymphocyte, and monocyte counts. The purpose of this study is to analyse the correlations between neutrophils, lymphocyte, monocyte counts and urine albumin levels in type2 diabetes with microalbuminuria. The research design is analytic observational with cross sectional approach. Twenty two patients met the inclusion criteria. Their urine albumin levels tested by Nycocard® U-ALBUMIN reagent. Neutrophils, lymphocyte, monocyte count was examined by hematology analyzer CELL-Dyn 3700. The correlations between neutrophils, lymphocyte, monocyte counts and urine albumin levels analyzed using coefficient correlation Spearman's. No correlation between neutrophil countsand urine albumin levels (r= -0,250;p=0,263). No correlation between monocyte counts and urine albumin levels (r= -0,191;p=0,395). No correlation between lymphocyte counts and urine albumin levels (r=0,130;p=0,565) in type 2 diabetes with microalbuminuria. No correlation between neutrophils, lymphocyte, monocyte counts and urine albumin level in type 2 diabetes patients with microalbuminuriaKeywords: type 2 diabetes, neutrophils, lymphocytes, monocytes, microalbuminuria.

Reference limits for routine haematological measurements in pre-school and school-children living at an urban area

The aim of this study is to estimate 95% reference limits for eight haematological constituents of blood in order to provide medically reliable evaluation of haematological laboratory results. Blood counts were performed using an automated haematology analyzer (Cell-Dyn 1500) on capillary blood samples from 1918 children (1?16 years old) residing in a region of Novi Beograd. Physiological variations corresponding to age and sex were studied as the most important factors affecting biological variation in haematological constituents of blood. Children were divided in four groups according to age: 1?3 yrs (281 boys and 241 girls), 4? 6 yrs (196 boys and 150 girls), 7?12 yrs (322 boys and 368 girls) and 13 ?16 yrs (174 boys and 186 girls). In this study all investigated parameters were not sex dependent until the age of 13. Boys between ages 13 and 16 years have higher mean values of haemoglobin (143.81 ? 13.40 g/L) and red blood count (4.81 ? 0.49 ? 1012/L), but lower MCV (86.6 ? 5.27 fL) than girls in same age group (136.81 ? 13.42 g/L, 4.57 ? 0.47 ? 1012/L and 88.0 ? 6.96 fL respectively). There was no significant difference according to sex in the oldest group for mean values of haematocrit (boys 0.42 ? 0.049 L/L and girls 4.57 ? 0.47 L/L), MCH (boys 29.9 ? 1.92 pg and girls 30.2 ? 1.96 pg), MCHC (boys 345.9 ? 18.4 g/L and girls 342.2 ? 19.7 g/L), platelet (boys 219.8 ? 49.6 ? 109/L and girls 225.3 ? 59.2 ? 109/L) and white blood count (boys 8.0 ? 2.60 ? 109/L and girls 8.01 ? 2.08 ? 109/L). Haemoglobin level, red blood count, haematocrit, MCV, MCH and MCHC increased with age. Levels of platelet count and white blood count decreased with age.

Evaluation of haematology analyzer CELL-DYN 3700 SL

Research on the parameters of full blood count and differential white blood count is included in the program of all medical laboratories of primary, secondary and tertiary health care levels. Today, all haematological tests are exclusively performed on the haematology analyzers. Automation of haematology laboratories is a result of the huge requires for haematological test performing, timely issuing of the haematological findings, and possibility of the usage of modern techniques.This work is an evaluation of laser haematology analyzer Cell-Dyn 3700 SL. It investigates the reliability of test results throughout the following parameters: precision, accuracy, sensitivity and specificity of determination methods. It also explores the influence of sample transferring and correlation with haematology analyzer MAXM Retti. Haematology parameters that have been investigated are: white blood cell (WBC), neutrophils (NEU), lymphocytes (LXM), monocytes (MONO), eosinophils (EOS), basophils (BASO), red blood cells (RBC), haemoglobin (HGB), haematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCHC) red cell distribution width (RDW), platelet (PLT), mean platelet volume (MPV), plateletocrit (PCT), and platelet distribution width (PDW).The results confirms that precision of analyzer fulfils the reproducibility of testing parameters: WBC, RBC, HGB, MCV, MCH, MCHC, and PLT. Correlation coefficient values (r) gained throughout the statistical analysis, that is linear regression results obtained throughout the comparison of two analyzers are adequate except for MCHC (r = 0.64), what is in accordance with literature data.Accuracy is tested by haematology analyzer method and microscopic differentiating method. Correlation coefficient results for granulocytes, lymphocytes and monocytes point the accuracy of methods. Sensitivity and specificity parameters fulfil the analytical criteria.It is confirmed that haematology analyzer Cell-Dyn 3700 SL is reliable for the determination of full blood count in everyday work. Analyzer and its program for differential white blood count can be used for the research and separation of normal and pathological blood counts with addition of microscopic methods confirming distribution or morphologic changes of leukocytes.

A Simple, Lensless Interface of an RF Glow Discharge Device to an FT-ICR (FTMS)

High mass resolving powers ( m/Δ m = 39,000) are achieved by coupling an rf-powered glow discharge device to an FT/ICR mass spectrometer (FTMS). Introduction of the ions from the externally mounted ion source into the ICR analyzer cell is accomplished without the use of ion optics, relying simply on the ions' kinetic energy in the z (magnetic axis) direction. Magnetic focusing is believed to facilitate efficient ion transport. Basic improvements in the instrument design are expected to yield resolving powers of > 100,000—sufficient to overcome almost any isobaric interference encountered in plasma source mass spectrometry.