The role of maternal serum C-reactive protein and white blood cell count in the prediction of chorioamnionitis in women with premature rupture of membranes.

This study was performed to evaluate the diagnostic performance of maternal serum C-reactive protein, maternal white blood cell (WBC), and neutrophil counts in the detection of histologic chorioamnionitis. One hundred and twenty six pregnant women after at least 28 weeks of gestation with premature rupture of membranes (PROM) were studied. Blood samples for C-reactive protein, WBC and neutrophil counts were taken at delivery. Placental histology was evaluated for histologic chorioamnionitis. Maternal and neonatal complications were observed. Among women with and without histologic chorioamnionitis, the maternal WBC and neutrophil counts were different (P<0.05) but the maternal serum C-reactive protein was not. Cutoff values for C-reactive protein, WBC, and neutrophil counts were 0.5 mg/dL, 15,000 cell/mm3, and 80 per cent, respectively. Sensitivity and specificity were 56 per cent and 58 per cent for C-reactive protein, 60 per cent and 63 per cent for WBC count, and 62 per cent and 54 per cent for neutrophil count, respectively. In conclusion, the maternal serum C-reactive protein, WBC, and neutrophil counts have poor diagnostic performance for histologic chorioamnionitis.

Effect of cold exposure on platelet concentrates: changes in platelet indices and aggregation states.

Samples from platelet concentrates (filtered/non-filtrated, at the beginning/the end of shelf life) were exposed to 4 degrees C overnight, subsequent to dilution in platelet storage media (PSM) and/or exposure to EDTA to induce shape changes. Paired sampling protocol (+/- EDTA) was used and changes in cellular indices and induced-aggregation states were measured by Technicon H*1. Cold induced changes in platelets as identified by increase in MPV (0.5-0.8 fL for EDTA; 1.5-2.0 fL for citrated samples) with concomitant reverse changes in PDW ranging from 2-13 per cent was observed. Processing, storage and cold exposure also induced disparity between leucocyte peroxidase/basophil counts. This in conjunction with changes in platelet counts and cellular indices upon exposure to EDTA provide a unique new tool for assessing the aggregation states of platelets during processing and storage. Both filtration and dilution in PSM affect platelet storage stability. Platelets which have already undergone shape changes (i.e. exposure to EDTA) responded to a lesser degree to cold exposure. Our findings indicate that platelets's response to cold exposure can be used as a simple, reliable and accurate test for assessment of platelet morphological and function integrities.

Leukocyte alkaline phosphatase activity and peripheral changes of granulocyte following administration of granulocyte colony-stimulating factor.

The rhG-CSF had specificity of stimulation proliferation and differentiation of the neutrophil lineage in which there was an increase of younger stages, the earliest was myelocyte, of granulocyte in circulation. The effect of it was demonstrated within 24 hours of administration and reduced immediately after withdrawal. LAP activity in this condition was normal. The pattern of hematologic change in this condition may mimic CML and leukemoid reaction. It differed clearly from CML, since LAP activity in CML was lower than normal, but LAP activity could not define it from leukemoid reaction. The detection of young cells in peripheral blood through automated measurement of nuclear density by TechniconH*1 was observed for the high sensitivity (100%) and low specificity (54.8%). Furthermore, the study of cell kinetic in bone marrow should be evaluated to complete the cell kinetic effect of rhG-CSF and give a better evaluation for the H*1 blast flag.

Changes in white blood cells and myeloperoxidase activity in rhG-CSF prophylactic patients receiving cytotoxic chemotherapy.

The patterns of white blood cell parameters and mean peroxidase index (MPXI) changes in recombinant human granulocyte colony-stimulating factor (rhG-CSF) prophylactic patients, receiving myelosuppressive chemotherapy, have been studied in 8 cases, using flow cytochemistry blood autoanalyser (Technicon R H*1). No severe neutropenia (absolute neutrophil count, ANC < 0.50 x 10(9)/L) appeared in 6 rhG-CSF primary prophylactic patients, but severe neutropenia was noticed in 2 rhG-CSF secondary prophylactic patients for a period less than 1 week. In most of the cases the significant increase of neutrophil during leukocytosis occurred within 24 hours after starting rhG-CSF prophylaxis, and decreased within 24 hours after the end of rhG-CSF prophylaxis. There was a small degree of lymphocytosis, monocytosis, and basophilia in some cases. From this study, there were no significant changes of MPXI during rhG-CSF prophylaxis, the neutrophils produced during proliferative response to rhG-CSF possessed normal myeloperoxidase (MPO) activity. We concluded that the information obtained from automated blood cell analyser Technicon R H*1 especially MPXI and ANC, could be very useful for monitoring rhG-CSF prophylactic patients receiving myelosuppressive chemotherapy. The advantages of the MPXI over other methods is its simplification when performed as part of a routine complete blood count (CBC) on an automated hematology instrument, and its ability to measure even severe neutropenic samples.