Reference values for the total and differential leukocyte count

Since 1971, the National Health and Nutrition Examination Surveys have collected data on white blood cell counts and on white cell differential counts that are valid for the U.S. population. This article discusses the validity of the differential counts that result from the availability of a set of reference values for all cell types.     

The routine differential leukocyte count vs automated differential counts

The clinical use of the proposed performance standards for differential leukocyte counts is determined by multiple factors. Their use must be considered according to the specific use of the differential count, the sources of variability in differential counting, the relation between specific use and sources of variability, the role of analytic errors in the detection of nonspecific changes, the use of qualitative vs quantitative data, the sensitivity and specificity of the routine eye count, the role of disease or specific cell prevalence in determination of predictive value, the effect on use of automated instruments for screening, and whether abnormal specimen flagging can be done. The routine eye-count differential method, as performed by a well-trained technologist or technician, seems to lack both sensitivity and specificity. Because of the magnitude of technique- and method-related and biologic sources of variability, the 100- or 200-cell eye-count differential method is not a good screening method for detection of hematologic illnesses, particularly those that are uncommon. The automated differential leukocyte instruments address many of the technique- and method-related errors and are thus able to equal or exceed the performance of the routine eye-count differential method.     

Leukocyte isolation by sedimentation: the effect of rouleau-promoting agents on leukocyte differential count.

The rouleau-promoting agents dextran and polyvinylpyrrolidone (PVP) were used to accelerate erythrocyte sedimentation in order to harvest the leukocyte rich plasma (LRP). The objective of the work was to determine if agent concentration or blood: agent ratio had any effect on the leukocyte differential count and if so at what agent concentration and agent:blood ratio did the LRP leukocyte differential count most closely match the whole blood leukocyte differential count. With both sedimentation agents the data clearly indicate that both parameters effect LRP differential counts and that low concentrations of sedimentation agents are most important in obtaining LRP differential counts which most closely match the whole blood differential counts.     

Use of runs statistics for pattern recognition in genomic DNA sequences.

In this article, the use of the finite Markov chain imbedding (FMCI) technique to study patterns in DNA under a hidden Markov model (HMM) is introduced. With a vision of studying multiple runs-related statistics simultaneously under an HMM through the FMCI technique, this work establishes an investigation of a bivariate runs statistic under a binary HMM for DNA pattern recognition. An FMCI-based recursive algorithm is derived and implemented for the determination of the exact distribution of this bivariate runs statistic under an independent identically distributed (IID) framework, a Markov chain (MC) framework, and a binary HMM framework. With this algorithm, we have studied the distributions of the bivariate runs statistic under different binary HMM parameter sets; probabilistic profiles of runs are created and shown to be useful for trapping HMM maximum likelihood estimates (MLEs). This MLE-trapping scheme offers good initial estimates to jump-start the expectation-maximization (EM) algorithm in HMM parameter estimation and helps prevent the EM estimates from landing on a local maximum or a saddle point. Applications of the bivariate runs statistic and the probabilistic profiles in conjunction with binary HMMs for pattern recognition in genomic DNA sequences are illustrated via case studies on DNA bendability signals using human DNA data.     

A role for human Sp alpha as a pattern recognition receptor

Human Sp alpha is a soluble protein belonging to group B of the scavenger receptor cysteine-rich (SRCR) superfamily for which little functional information is available. It is expressed by macrophages present in lymphoid tissues (spleen, lymph node, thymus, and bone marrow), and it binds to myelomonocytic and lymphoid cells, which suggests that it may play an important role in the regulation of the innate and adaptive immune systems. In the present study we show that recombinant human Sp alpha (rSp alpha) binds to the surface of several gram-positive and gram-negative bacterial strains. Competition studies indicated that such binding is mediated by the recognition of lipoteichoic acid (LTA) and lipopolysaccharide (LPS), respectively, through nonoverlapping sites on the Sp alpha molecule. The most conserved part of LPS (2-keto-3-deoxyoctulosonic acid and lipid A) was shown to be involved in the recognition by Sp alpha. Bacterial binding studies using the SRCR domain 1 of Sp alpha showed that this domain retains both the LPS and LTA binding activities, indicating that both bacterial interacting sites are retained in a single SRCR domain. Furthermore, rSp alpha induced aggregation of gram-positive and gram-negative bacteria strains. On the other hand, rSp alpha inhibited tumor necrosis factor-alpha secretion by human monocytes stimulated with LPS or LTA. Binding of Sp alpha to conserved components of bacterial surfaces and modulation of the monocyte response indicate that this molecule is an active constituent of the innate immune response of the host.     

The statistical analysis of the differential blood count

The differential blood count obtained by unbiased sampling mathematically follows a multinomial distribution. The variation between individuals can be formalized by a mixing distribution of the parameters of the multinomial distribution. By DIRICHLET-distributions used as mixing distributions the main phenomena of the observed data can be described, and they are useful in estimating and testing treatment effects. If the correlation between the different types of leucocytes is taken into account in an appropriate manner, univariate test procedures can be applied also.     

Characterization of human tactile pattern recognition performance at different ages

This study examined tactile pattern recognition performance in human observers (N = 44) in the context of a letter recognition task at the fingertip. Participants were recruited from three different age groups (youth, n = 17; young adults, n = 14; seniors, n = 13) to examine age-related differences in performance. The influence of gender (males vs females) and hand (right vs left) was also examined. Performance was characterized in terms of both response accuracy and associated response times (RTs). Patterns of confusion between letters were also examined. Results showed that age was the most important factor in determining the capacity of our participants to perform fast and accurate pattern recognition. In this respect, younger participants (i.e., youth and young adults) clearly outperformed seniors by showing not only better accuracy and less confusion but also 2–3 times faster RT. By comparison, the combined influence of “hand” and “gender” on recognition performance was only marginal. These results indicate that the ability to perform complex tactile pattern recognition is already well established in youth 10–14 years of age with only minor refinements occurring later in early adulthood. With advancing age, such ability becomes far less efficient, as judged by the drastic increase in RT observed in seniors, in spite of a relatively good accuracy. This suggests that alterations not only at the peripheral receptor level but also at the central processing level might play an important role in limiting the ability of seniors to perform fast and efficient pattern recognition at the fingertip.     

Effect of relocating to areas of reduced atmospheric particulate matter levels on the human circulating leukocyte count.

A high level of atmospheric particulate matter induces an increase in circulating polymorphonuclear leukocyte (PMN) counts and an increase in serum inflammatory cytokine levels. The particulate level in Antarctica is extremely low compared with that in industrial countries. We hypothesized that this low level would reduce circulating leukocyte counts and serum inflammatory cytokine levels in people visiting Antarctica from industrial countries. The number density of particulates with aerodynamic diameters of <10.0 microm was measured in Japan and in Antarctica during the 41st Japanese Antarctic Research Expedition. Circulating leukocyte counts, granulocyte colony-stimulating factor and interleukin-6 levels, and pulmonary function were determined at regular intervals in 39 expedition members. The particulate number density was <1% of that measured in Japan. Total leukocytes, segmented and band-formed PMN, monocyte counts, and serum interleukin-6 levels decreased in Antarctica compared with the initial values measured in Japan. Pulmonary function parameters did not change except for maximal voluntary ventilation. Particulate matter levels had more significant effects on segmented PMN, band-formed PMN, and monocyte counts than cigarette smoking and the type of work. Exposure to reduced atmospheric particulates is considered to be a major factor for decreasing circulating leukocyte counts and serum cytokine levels.     

Imprecision of ratio-derived differential leukocyte counts

Differential leukocyte counts are very imprecise if determined as the product of a total WBC and a percentage obtained by differentiation of a relatively small number of cells. The imprecision can be decreased by increasing simultaneously the numbers of both the counted and the differentiated cells. An increase of only one (such as by automated counting of the WBC) without a simultaneous increase of the other one does not lead to an appreciable reduction of the imprecision.