To establish the hematological reference values in the healthy adults visited our hospitals, following examination were done on 2823 persons by Coulter Counter Model S-plus II ; white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), meant corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), platelet, plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW). The following results are obtained. 1) Male, mean value of WBC; 6,800±2,680 (2SD)/µl Female, mean value of WBC; 5,950±2,380 (2SD)/µl 2) Male, mean value of RBC; 428±60 (2SD)x104/µl Female, mean value of RBC; 415±56 (2SD)x104/µl 3) Male, mean value of Hb; 15.4±1.8 (2SD) g/dL Female, mean value of Hb; 13.0±1.6 (2SD) g/dL 4) Male, mean value of Hct; 45.3±5.0 (2SD)% Female, mean value of Hct; 38.2±4.6 (2SD)% 5) Male, mean value of MCV; 93.8±5.8 (2SD) fL Female, mean value of MCV; 92.2±7.4 (2SD) fL 6) Male, mean value of MCH; 31.8±2.2 (2SD) pg Female, mean value of MCH; 31.4±2.8 (2SD) pg 7) Male, mean value of MCHC; 34.0±1.2 (2SD)% Female, mean value of MCHC; 33.9±1.2 (2SD)% 8) Male, mean value of RDW; 12.7±1.0 (2SD)% Female, mean value of RDW; 12.6±1.4 (2SD)% 9) Male, mean value of Platelet; 242.9±87.8 (2SD) X103/µl Female, mean value of Platelet; 242.2±89.0 (2SD) X103/µl 10) Male, mean value of Plateletcrit; 0.201±0.076 (2SD)% Female, mean value of Plateletcrit; 0.204±0.076 (2SD)% 11) Male, mean value of MPV; 8.20±1.70 (2SD) fl Female, mean value of MPV; 8.36±1.82 (2SD) fl 12) Male, mean value of PDW; 16.1±0.8 (2SD)% Female, mean value of PDW; 16.0±0.8 (2SD)%
Adult* ; Blood Platelets ; Erythrocyte Count ; Erythrocyte Indices ; Female ; Hematocrit ; Humans ; Leukocyte Count ; Male ; Mean Platelet Volume ; Reference Values*

New automated blood cell analyzers, Coulter Counter Model S-Plus series provide an index of red cell volume distribution width (RDW) or heterogeneity and a histogram display of red cell volume distribution. We evaluated the clinical significance of RDW by determining the normal range of RDW in healthy adults, children, and newborns and the change of RDW in pediatric patients with various hematologic diseases. The normal ranges of RDW in adults, children and newborns were 12.3 +/- 0.8, 13.0 +/- 1.0, and 17.1 +/- 1.7% respectively. Increases in RDW were observed in patients with iron deficiency and in those receiving iron therapy, as in those with early iron deficiency. Patients with chronic disease, acute hemorrhage, and aplastic anemia with no transfusion in the previous four months had normal RDW. In contrast patients with immune hemolytic anemia, hereditary spherocytosis mechanical hemolytic anemia, acute leukemia, chronic myelocytic leukemia, and chronic hepatobiliary disease had high RDW, as did those with solid tumor and malignant lymphoma during chemotherapy. Among patients with acute leukemia during chemotherapy, RDW was more increased if accompained by macrocytosis than by normocytosis. It was found that the RDW was proportional to the % reticulocyte. We tried to classify anemia, based on RDW and mean corpuscular volume (MCV) and to guide the diagnosis from the peripheral blood analysis in pediatric patients. The distinction of iron deficiency anemia from the anemia of chronic disease and the detection of early iron deficiency was improved. A change in RDW according to storage time at room temperature was not observed. From this study, RDW could be used as a sensitive parameter of red cell anisocytosis. Thus we recommend the use of these new variables the initial classification of anemia in pediatric patients.
Adult ; Child, Preschool ; Erythrocyte Indices ; Erythrocyte Volume* ; Female ; Hematologic Diseases/blood* ; Human ; Infant ; Infant, Newborn ; Male ; Reference Values

Pseudopolycythemia is a situation in which a raised concentration of hemoglobin in circulating blood, with a red cell mass within normal range, while the plasma volume may be reduced in the absence of overt fluid loss. Relative, apparent, stress, or spurious polycythemia are commonly used synonyms for the same condition. It has been emphasized the association of pseudopolycythemia with hypertension, obesity, stress, and heavy cigarette smoking, especially in middle-aged men. We experienced 3 cases of pseudopolycythemia with several risk factors. They had complained of mild exertional dyspnea, palpitation, dizziness, and paresthesia of extremities. These symptoms were successfully relieved by stress reduction, stopping of smoking, and abstaining from drinking.
Dizziness ; Drinking ; Dyspnea ; Erythrocyte Volume ; Erythropoietin ; Extremities ; Humans ; Hypertension ; Male ; Obesity ; Paresthesia ; Plasma Volume ; Polycythemia ; Reference Values ; Risk Factors ; Smoke ; Smoking

PURPOSE: We conducted randomized study to determine whether high doses (6mg/kg/ day) of iron would exert a more supplemental effect than low doses (3mg/kg/day), and which regimen of recombinant human erythropoietin (rHuEPO) and iron would be more beneficial in the prophylactic treatment of anemia of prematurity. METHODS: We randomly assigned 38 sick premature infants who were more likely than symptom-free premature infants requiring erythrocyte transfusions for infants with anemia of prematurity to receive rHuEPO, 100unit/kg, tiw, subcutaneously, plus iron, 3mg/kg/day, po, daily from the second day of life (group 1), 100unit/kg and 6mg/kg/ day (group 2), 200unit/kg and 3mg/kg/day (group 3), and 200unit/kg and 6mg/kg/day (group 4), respectively. RESULTS: There were no significant differences of hemoglobin levels and iron balances during treatment among all 4 groups. The rates of increase in reticulocyte counts were greater in group 4 and group 2 compared with group 3 and group 1, respectively, though these rates were statistically not significant. The blood volume differences (volume of phlebotomies-volume of transfusions) during treatment were higher in group 4 compared with group 1 (p<0.05). CONCLUSIONS: High doses of iron may be more effective in rapidly increasing reticulocyte counts, and 200unit/kg, tiw of rHuEPO plus 6mg/kg/day of iron is more beneficial in reducing the need for blood transfusions than any other regimen. Therefore the prophylactic treatment of anemia of prematurity and acute blood loss from frequent blood sampling in risky premature infants with rHuEPO, 200unit/kg, tiw, subcutaneously, plus iron 6mg/kg/day, po, daily from the second day of life is effective in reducing the number of blood transfusions. Additional controlled trials utilizing high doses of iron with rHuEPO and larger numbers of patients are justified.
Anemia* ; Blood Transfusion ; Blood Volume ; Erythrocyte Transfusion ; Erythropoietin* ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature ; Iron* ; Reticulocyte Count

The effects of amphotericin B, an antifungal antibiotic, on erythrocyte volume and cation permeability were investigated by measuring the hematocrit, cell volume, cation content, fragility and osmotic behavior in rat erythrocytes, in vitro. 1. When erythrocytes were incubated in a Ringer solution containing amphotericin B (5-25 microgram/ml) the hematocrit and the cell volume increased, the effect being proportional to the concentration of the drug and the incubation time period. 2. Amphotericin B increased the Na content and decreased the K content of the erythrocyte. In normal Ringer solution (NaCl-Ringer)containing amphotericin B the magnitude of cellular Na gain was greater than that of K loss. Therefore, the total cellular cation content increased. On the other hand, when cells were incubated in the amphotericin B containing Ringer solution in which NaCl was replaced by Na2SO4 (Na2SO4-Ringer) the magnitude of cellular K loss exceeded that of cellular Na gain. Consequently, the total cellular cation content was reduced. 3. Amphotericin B increased cell volume (hematocrit) when erythrocytes were incubated in the Na2SO4-Ringer solution. 4. The fragility of erythrocytes increased when cells were preincubated in the amphotericin B containing normal Ringer solution, whereas it decreased in tile cells preincubated in the amphotericin B containing Na2SO4-Ringer solution. 5. The cell volume was linearly related to the reciprocal of medium osmolality(200 to 900 mOsm/kg H2O) in both NaCl-and Na2SO4-Ringer solutions, and the linearity was not altered by amphotericin B. The antibiotic did not change the slope of the correlation line (V vs. 1/OSM). It, however, increased the intercept of the line with the ordinate in normal Ringer solution and decreased that in the Na2SO4-Ringer solution. These results indicate that amphctericin B alters the cell volume by changing the permeability of Na and K across the membrane.
Amphotericin B/pharmacology* ; Animal ; Erythrocyte Volume/drug effects* ; Erythrocytes/analysis* ; In Vitro ; Osmotic Fragility/drug effects ; Potassium/blood* ; Rats ; Sodium/blood*

Platelet distribution width (PDW) is an index for platelet size variation. In this study, we analysed the correlation between PDW values obtained using two different hematology analysers that employ different measurement methods. Complete blood cell parameters including PDW for 153 healthy individuals were measured using both, ADVIA 2120i (Simens AG, Germany) and XN-3000 (Sysmex, Japan). The PDW values measured using the two hematology analysers showed a moderate correlation (r=0.661, P<0.001), while the hemoglobin, mean corpuscular volume, red blood cell distribution width values and white blood cell and platelet counts showed strong correlations (r >0.900, P<0.001). PDW obtained using XN-3000 showed a strong correlation with mean platelet volume, whereas PDW obtained using ADVIA 2120i did not. The reference values in this group were 40.0%–64.2% in ADVIA 2120i and 9.0–16.0 fL in XN-3000. In conclusion, PDW values obtained using ADVIA 2120i and XN-3000 are not interchangeable. In laboratories equipped with more than one hematology analyser, a particular analyser should be used consistently for monitoring a particular patient.
Blood Cells ; Blood Platelets* ; Erythrocyte Indices ; Erythrocytes ; Hematology* ; Humans ; Leukocytes ; Mean Platelet Volume ; Platelet Count ; Reference Values

BACKGROUND: Because blood collection tube can affect the results of various laboratory tests, it is necessary before using a newly developed product to verify its performance stringently and objectively. We compared the performance of Ampulab EDTA and sodium citrate tubes (Soyagreentec, Korea) with that of Vacutainer tubes (BD, USA) in accordance with international guidelines. METHODS: This study was performed as a multicenter study of Chung-Ang University Hospital and Seoul National University Hospital to evaluate the performance of two different instrument platforms. We performed the precision test according to CLSI GP34-A, the accuracy test according to CLSI EP09-A2-IR, and the vacuum test according to CLSI H1-A5 as well as stability, and aseptic condition tests. We evaluated 3 lots of Ampulab tubes for their precision, accuracy, vacuum, and aseptic condition. RESULTS: In precision test, the total precision levels of Ampulab tubes in most measurands were desirable or allowable. The results of mean corpuscular hemoglobin concentration, platelet distribution width, basophil, and reticulocyte counts for Ampulab tubes showed imprecision beyond allowable limits, but were similar to those of Vacutainer tubes. In the accuracy test, the bias in most measurands, except for the mean platelet volume, was within allowable limits. In the stability test, Ampulab showed similar performance to Vacutainer. In tests of the vacuum and aseptic conditions, Ampulab fulfilled both requirements. CONCLUSIONS: The performance of Ampulab EDTA and sodium citrate tubes was equivalent to that of Vacutainer tubes.
Basophils ; Bias (Epidemiology) ; Blood Platelets ; Citric Acid* ; Edetic Acid* ; Erythrocyte Indices ; Mean Platelet Volume ; Reticulocyte Count ; Seoul ; Sodium* ; Vacuum

BACKGROUND: Because blood collection tube can affect the results of various laboratory tests, it is necessary before using a newly developed product to verify its performance stringently and objectively. We compared the performance of Ampulab EDTA and sodium citrate tubes (Soyagreentec, Korea) with that of Vacutainer tubes (BD, USA) in accordance with international guidelines. METHODS: This study was performed as a multicenter study of Chung-Ang University Hospital and Seoul National University Hospital to evaluate the performance of two different instrument platforms. We performed the precision test according to CLSI GP34-A, the accuracy test according to CLSI EP09-A2-IR, and the vacuum test according to CLSI H1-A5 as well as stability, and aseptic condition tests. We evaluated 3 lots of Ampulab tubes for their precision, accuracy, vacuum, and aseptic condition. RESULTS: In precision test, the total precision levels of Ampulab tubes in most measurands were desirable or allowable. The results of mean corpuscular hemoglobin concentration, platelet distribution width, basophil, and reticulocyte counts for Ampulab tubes showed imprecision beyond allowable limits, but were similar to those of Vacutainer tubes. In the accuracy test, the bias in most measurands, except for the mean platelet volume, was within allowable limits. In the stability test, Ampulab showed similar performance to Vacutainer. In tests of the vacuum and aseptic conditions, Ampulab fulfilled both requirements. CONCLUSIONS: The performance of Ampulab EDTA and sodium citrate tubes was equivalent to that of Vacutainer tubes.
Basophils ; Bias (Epidemiology) ; Blood Platelets ; Citric Acid* ; Edetic Acid* ; Erythrocyte Indices ; Mean Platelet Volume ; Reticulocyte Count ; Seoul ; Sodium* ; Vacuum

OBJECTIVETo investigate the effect of stimulation of toss simulated at sea on shock in severe burn rabbits.

METHODSOne hundred and thirty-two rabbits were randomly divided into normal control group (NC group, n = 6), toss group (T group, with treatment of continuous toss, n = 42), burn group (B group, with treatment of burn, n = 42), burn and toss (BT group, with treatment of continuous toss after burn, n = 42). The level of Cr, BUN, HCT and LA from blood samples in T, BT, B groups were observed at 2, 6, 8, 12, 24, 36, 48 post treatment hour (PTH). The changes in urinary volume was measured during 48 PTH. The histopathologic changes in kidney were observed at above-mentioned time points. The above indices in NC group were also observed.

RESULTSThe mean urinary volume in B group during the first and second 24 PTH was (2.59 +/- 0.23) and (2.86 +/- 0.29) mL/h, while that in BT group was (1.61 +/- 0.13) and (1.66 +/- 0.16) mL/h respectively, which were all lower than those in NC group (6.06 +/- 0.18 mL/h, P < 0.01). The levels of HCT and LA in BT group were obviously higher than those in B group at each time point. The levels of Cr and BUN in BT group at 24, 36, 48 PTH were significantly higher than those in B group. The histopathological observation showed the capillary vessels and mesenchymal cells of kidney glomerulus were congestive, epithelial cells in kidney tubules were swollen. The infiltration degree of inflammatory cells in kidney tubule, and the pathological changes of erythrocyte cast in BT group were more serious than those in B group.

CONCLUSIONThe toss simulated at sea can significantly aggravate shock and the renal damages in severe burn rabbits.

Animals ; Burns ; complications ; Creatinine ; blood ; Erythrocyte Volume ; Kidney ; pathology ; Male ; Motion ; Physical Stimulation ; Rabbits ; Random Allocation ; Shock ; etiology ; pathology

To investigate the association between red blood cell volume distribution width (RDW) and osteophytes.
 Methods: This cross-sectional study was conducted in the Department of Health Examination Center of Xiangya Hospital, Central South University in Changsha, Hunan Province, China. A total of 8 334 subjects were included in this study. The severity of osteophytes was graded using the criteria of the Osteoarthritis Research Society International (OARSI). Osteophytes incident was defined as at least one side of the knee had a osteophytes grade ≥1. According to the quartiles of the RDW level, the subjects were divided into 4 groups. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) of the knee osteophytes incidence between each RDW group and the lowest level group. Tests for linear trends were conducted based on logistic regression using a median variable of RDW level in each category.
 Results: Quartile 1 (Q1), RDW≤9.78; Q2, 9.7813.10. The multivariable adjusted ORs (95%CI) of the prevalence of osteophytes were 1.38 (1.06 to 1.79) in the second percentile interval, and 1.27 (0.97 to 1.66) and 1.50 (1.15 to 1.94) in the third and fourth percentile interval, respectively. Test for linear trends suggested that there was a positive association between the RDW level and the risk of knee osteophytes incidence (P=0.019).
 Conclusion: The risk of osteophytes incidence increases with the increasing RDW levels.
China ; Confidence Intervals ; Cross-Sectional Studies ; Erythrocyte Volume ; Humans ; Incidence ; Odds Ratio ; Osteophyte ; blood ; epidemiology ; Risk Factors ; Severity of Illness Index