[Flow cytometry].

Flow cytometry (FCM), which has been elaborated and refined in conjunction with the development of both immunological engineering and information technology, is now indispensable for the diagnosis and treatment of patients with leukemia and lymphoma. FCM had better be regarded as being complementary to, but not competitive with, immunohistochemistry. Histopathologic features are often useful not only for interpretation of the FCM data, but also in evaluating quality of samples used for FCM. In interpretation of the data, one should not put excessive emphasis on bar chart, because conversion of dot plotting to it is associated with loss of many data. Although FCM gives digital data on each thousands of cells, correct interpretation of the data requires an analogue standpoint.

[Relationships among frequency domain and non-linear parameters from heart rate variability].

Frequency domain analysis of heart rate variability (HRV) is used for the evaluation of autonomic activity. Non-linear domain parameters from HRV are also considered useful. However, properties of the latter have not yet been clearly characterized. Therefore, we studied the relationships among the frequency domain and non-linear parameters from HRV. Continuous Holter electrocardiographic monitoring was conducted on 43 healthy female medical staff including laboratory technologists and nurses during an 8-hour working period in our hospital. Low and high frequency components (LF and HF, respectively) of the frequency domain, recurrence rate (REC%) on recurrence plot analysis, scaling exponents al and a2 on detrended fluctuation analysis, and approximate entropy (ApEn) were obtained from HRV. Both the LF/HF ratio and HF were correlated with al and ApEn. REC% was correlated with ApEn and alpha2, whereas alpha2 was correlated only with REC%. Although autonomic parameters from the frequency domain are closely related with some of the non-linear parameters, it is suggested that a2 and REC% reflect different physiological activities.

Rapid detection of spontaneous bacterial peritonitis by granulocyte elastase latex immunoassay and reagent strip.

Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with liver cirrhosis that requires rapid recognition for effective antibiotic therapy. Elevated levels of granulocyte elastase (GE), an enzyme that is released from degranulated polymorphonuclear neutrophils(PMN), have been reported in ascitic fluid of SBP patients. The aim of this study was to assess the utility of GE measurement by a latex immunoassay (LIA) and by reagent strips for rapid diagnosis of SBP. In 26 ascitic samples which had differing GE concentrations, the results of this LIA method closely correlated with those of a GE/alpha1-PI complex ELISA and an EIA using monoclonal antibodies against GE. The evaluation parameters of linearity (r > 0.99), analytical recovery (96-107%) and within-assay variation[coefficient of variation(CV): 0.97-2.35%] were found to be satisfactory. In 58 ascitic samples from patients with liver cirrhosis, GE levels confirmed by LIA in SBP ascites (n=14) at the time of diagnosis were higher (1436.9 +/- 715.1 ng/ml) than those in non SBP ascites (n=44)(13.1 +/- 3.9 ng/ml). The receiver operating characteristic (ROC) curve showed that ascitic GE by LIA enabled discrimination between SBP and non-SBP, and a cut-off value of 49.5 ng/ml had a sensitivity of 85.7% and specificity of 97.7%. In addition, the usefulness of reagent strips designed for testing cervical mucus for rapid bedside detection of SBP was assessed for GE. The sensitivity, specificity, and positive and negative predictive values of the reagent strips for diagnosis of SBP were 92.9%, 90.9%, 76.5%, and 97.6%, respectively. These results indicate that GE-LIA and GE reagent strips are rapid and sensitive and can aid diagnosis of SBP.

[Determination of fractal dimension using digital nuclear image of lymphocyte].

Microscopic morphological findings in smeared and stained blood cells are difficult to be characterized quantitatively. However, a recent progress in digital image processing has been enabled to express some of these findings quantitatively. In this report, we propose the usefulness to determine "box" fractal dimension of nuclear image of lymphocyte. Fractal dimension was determined in digital 256-grayscale images of normal, atypical and leukemic lymphocytes by a box-counting method after extracting a nuclear image out of a cellular image, binalyzing and thinning it. The results suggest that fractal dimensions of nuclear images are mainly correlated with changes in chromatin appearance. Fractal dimension could be a useful quantitative parameter for cytological differentiation between normal and atypical lymphocytes.