• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.144-152
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• 2004

With technological advances in automatic hematology analyzers, primary and screening differential counts of white blood cells (WBC) are done with automatic hematology analyzers. They are using different measurement and analysis principles, so differences in WBC differentials and WBC morphology flag exist. This study was carried out to analyze WBC differential counts and WBC morphology flags comparing them with the manual method. Patient EDTA samples in Vacutainer requested for WBC differentials were analyzed with XE-2100. And those samples with suspect flags messages index over 100 were selected and were analyzed with ADVIA-120. Peripheral blood smear film was subsequently made. Three investigators counted 200 cells each (600 cells) in 111 Wright-Giemsa stained blood films. Between two automatic hematology analyzers, neutrophil, lymphocyte, eosinophil, and monocyte showed good correlations, but basophil had moderate correlation. Among automatic hematology analyzers and manual count, neutrophil, lymphocyte, and eosinophil had good correlations, but monocyte had moderate correlation. XE-2100 had higher monocyte, which was due to atypical lymphocyte and myeloblast. LUC in ADVIA-120 was not due to monocyte in XE-2100. Morphology flagging rates were 146.9% in XE-2100 and was 93.2% in ADVIA-120. Positive predictive values of morphology flag were 58.2% in XE-2100 and 54.4% in ADVIA-120. Flags such as atypical lymphocyte, immature granulocyte, and left shift had higher predictive values and those such as N-RBC, platelets clump, and blast had lower ones. Between automatic hematology analyzers, WBC differentials showed good correlations. Predictive values for morphology flags can be variable with changing criteria. Reviewing criteria for WBC differentials and morphology flags should be established in each laboratory with regards to size of laboratory and patients it serves.

• Biomedical Science Letters
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• v.12 no.4
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• pp.337-341
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• 2006

Platelets clearly play an important role in inflammatory responses. In this study, we aimed to evaluate the relationship between aging and platelet activation. A total number of 799 persons (383 males and 416 females), who were apparently healthy and aged more than 20 years were recruited by a health promotion center in a community-based hospital in Seoul, Korea. We collected material data about their medical history and health behavior. Platelet parameters including mean platelet component (MPC), mean platelet volume (MPV), and platelet component distribution width (PCDW) were determined within 1 hour after blood collection using the ADVIA 120 automated hematology analyzer. The MPC of the women ($27.2{\pm}1.2$) was significantly love. than that of the men ($27.5{\pm}1.3$). The MPC of all participants was found to decrease with increasing age (P<0.01). Study participants in their twenties had the highest MPC ($27.7{\pm}1.1$), followed by those in their thirties ($27.6{\pm}1.1$), forties ($27.4{\pm}1.3$), fifties ($27.2{\pm}1.3$), sixties ($27.2{\pm}1.2$) and seventies ($27.1{\pm}1.2$). Multiple regression analysis showed that aging and gender were related with MPC after adjusting for confounding factors, including age, gender, smoking habit, hypertension, diabetes, body mass index and total cholesterol level. The this study shows that aging is related to platelet activation. Future research will need to determine the implications of increased platelet activation with aging, especially regarding the increased incidence of cardiovascular diseases and related mortalities that occur in older age groups.

• Advances in environmental research
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• v.11 no.1
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• pp.31-38
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• 2022

The current observational epidemiological study analyzed blood lead levels (BLLs) in occupationally exposed workers from Riyadh region, Saudi Arabia and correlated them with the alterations in the differential cell populations of the WBC panel (lymphocytes [Lym %], mixed [Mid %] cells, and neutrophils [Neu %]). In addition, we examined the effect of confounding factors and their relation to BLLs. BLLs were estimated using the LeadCare II analyzer and hematological parameters using the ADVIA 120 analyser. An inferential analysis was conducted to detect association between the observations and the subjects' clinical characateristics. A total of 132 male subjects were included in the final analyses. Based on CDC guidelines, the subjects were categorized as Group I (BLL <10 ㎍/dL; n=118) or Group II (BLL >10 ㎍/dL; n=14) with average BLLs of 4.4 ㎍/dL and 18.1 ㎍/dL, respectively (p <0.0001). The percentages of Mid cells (p <0.0001) and neutrophils (p=0.048), were significantly altered in subjects with High BLL. A regression analysis indicated that subjects > 50 years of age had significantly higher BLLs (53.2 ㎍/dL) than younger age sub-groups (p <0.0001). Age, education, and profession were significant predictors for lead toxicity. Pb exposure is a major public health issue in Saudi Arabia and calls for further investigations on the cellular and molecular effects on hematological system.

• Clinical and Experimental Pediatrics
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• v.48 no.3
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• pp.284-291
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• 2005

Purpose : Flow cytometric automated reticulocyte analysis is a superior method to manual reticulocyte counting, with respect to precision and sensitivity. Furthermore, flow cytometric analysis is able to measure immature reticulocyte fraction(IRF) and reticulocyte cellular indices(RCI : cell hemoglobin content : CHr, mean cell volume : MCVr, cell hemoglobin concentration mean : CHCMr, distribytion width : RDWr, HDWr, CHDWr). In this study, we investigated the mean values and clinical significances of IRF and RCI in healthy children and pediatric anemia patients. Methods : IRF and RCI were measured with an automated blood cell analyzer, ADVIA 120(Bayer, USA) using oxazine 750 dye, in 57 healthy children and 61 children with anemia. The anemia group consisted of 27 iron deficiency anemia(IDA) patients and 34 patients with anemia associated with acute infection(AAI). We compared the mean values of IRF and RCI in the control group classified according to age, between anemia groups and the control group, and between the IDA group and the AAI group. Results : For the normal control group, the mean values of IRF, CHr, MCVr and HDWr were higher in neonates when compared to older children. The mean values of IRF and RDWr were significantly higher, and the mean values of CHr and CHCMr were significantly lower in the IDA group when compared to the control group. The mean value of IRF was significantly higher, and the mean value of CHDWr was significantly lower in the AAI group when compared to the control group. The mean values of IRF, CHr and CHCMr were significantly lower in the IDA group when compared to the AAI group. Conclusion : We could determine the normal mean values of IRF and RCI in healthy children classified according to age for understanding of hematopoietic response differences according to age. The evaluation of IRF and RCI by automated reticulocyte analyzer seemed to be accurate and clinically useful for the early diagnosis of anemia and the differentiation of IDA from AAI.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.827-833
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• 2008

Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.188-193
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• 2018

Objectives : Clozapine is a widely prescribed antipsychotic drug for schizophrenia and is known to increase the risk of cardiovascular disease due to its metabolic side effects. However, little is known about the effect of clozapine on the platelet activation, another important factor in the development of cardiovascular disease. In this study, we tried to investigate the effect of clozapine on platelet activity in patients with schizophrenia by comparing the mean platelet component (MPC) values before and after the clozapine administration. Methods : A retrospective review of medical records of patients with schizophrenia, who newly started clozapine treatment from September 1st, 2003 to April 30th, 2007 at the Department of Psychiatry, Konyang University Hospital in Republic of Korea was performed. The final statistical analysis included 14 participants. Bayer ADVIA $120^{(R)}$ system was used to measure MPC. Results : Among the 14 participants, five subjects were males (28.60%), and ten subjects were females (71.40%). The mean age of participants was $37.50{\pm}11.64years$. Average of duration of illness was $91.00{\pm}93.96months$, with the mean dosage of clozapine taken by participants at the time of the last blood test was $337.50{\pm}109.52mg$. The mean MPC measurement before and after receiving clozapine was $26.12{\pm}2.22g/dL$ and $25.14{\pm}2.08g/dL$ respectively. Wilcoxon signed rank test showed that there was a statistically significant decrease in MPC levels after clozapine administration (V=16, p=0.024). Conclusions : Decreased MPC levels after clozapine administration implies that clozapine may increase platelet activation which could have an adverse effect on the occurrence of thromboembolic disease. Our findings also suggest that careful monitoring of the risk factors of cardiovascular diseases, such as platelets activity, is necessary when administering clozapine.