Comparison of four hematology analyzers, CELL-DYN Sapphire, ADVIA 120, Coulter LH 750, and Sysmex XE-2100, in terms of clinical usefulness.

We evaluated the clinical usefulness (leukocyte distribution classification, morphologic classification, and morphologic flags) of the following four hematology analyzers: CELL-DYN Sapphire (CD-Sapphire) (Abbott Diagnostics, Santa Clara, CA, USA), ADVIA 120 (Bayer Diagnostics, Tarrytown, NY, USA), Beckman Coulter LH 750 (Beckman Coulter, Miami, FL, USA), and Sysmex XE-2100 (TOA Medical Electronics Co., Kobe, Japan). Four hundred thirty samples from patients and 100 samples from healthy individuals were analyzed. For distributional classification, the sensitivity rates of CD-Sapphire, ADVIA 120, LH 750, and XE-2100 were 93.1, 95.9, 94.9, and 94.9%, respectively, and the efficiency rates were 80.7, 81.6, 84.1, and 84.2%, respectively. For morphologic classification, the sensitivity rates of CD-Sapphire, ADVIA 120, LH 750, and XE-2100 were 88.6, 93.2, 77.3, and 94.3%, respectively, and the efficiency rates were 80.9, 73.0, 79.5, and 74.2%, respectively. Comparing the findings in different morphologic flags, XE-2100 showed the highest sensitivity for Blasts flag (90.9%); CD-Sapphire showed the highest sensitivity for Immature granulocytes and/or Left-shift flag (85.5%); ADVIA 120 showed the highest sensitivity for Atypical lymphocytes flag (60.0%); and LH 750 showed the highest sensitivity for Nucleated RBC flag (75.0%). Our results demonstrate that the four analyzers are comparable in overall performance.

Prognostic value of platelet indices as determined by ADVIA 120 in patients suspected of having disseminated intravascular coagulation.

Recent technological advances have made it possible to record a variety of platelet indices using automated hematology analyzers. Disseminated intravascular coagulation (DIC) is associated with the dramatic hemostasis activation, with evidence of fibrin formation and platelet consumption. We investigated the prognostic significance of platelet indices as measured by ADVIA in 222 patients suspected of having DIC. The presence of overt DIC was defined using the scoring system of the International Society of Thrombosis and Haemostasis Subcommittee. Twenty-eight day hospital mortality was used as a clinical prognosis parameter. Median platelet count and platelet-crit (PCT) levels markedly decreased in nonsurvivors, whereas mean platelet volume (MPV), platelet component distribution width (PCDW) and platelet dry mass distribution width (PMDW) were significantly increased in nonsurvivors. In terms of ROC analysis, which was conducted to predict 28-day mortality, areas under the receiver operating characteristic curve (AUC) were; 0.73 platelet count, 0.72 for PCT, 0.69 for PCDW, 0.65 for PMDW and 0.61 for MPV. The odds ratio of a reduced platelet count for the relative risk of 28-day mortality was 5.249 (95% CI: 2.399-11.486), and the odds ratio for PCDW was 3.240 and for PMDW 3.262. Among these indices, platelet count, PCDW and PMDW were found to be more predictive of 28-day hospital mortality. Our results suggest that these indices may provide prognostic information on hospital mortality in the patients suspected of having DIC.

Skull molding caps: an adjunct to craniosynostosis surgery.

External cranial vault molding using dynamic splinting is an adjunct to surgery in the treatment of craniosynostosis skull deformities. The skull molding cap not only maintains desired skull form, but also provides further active molding to normalize skull shape. Dynamic skull remodeling from these devices occurs primarily by translational movements of bone. Traction and compression result in bony repositioning which allows further reshaping as the osteoblasts and osteoclasts respond to these stresses. Three basic designs have been described. In practice, each one must be modified to meet individual needs, and adaptations are made according to established principles of dynamic splinting.