Changes In Differential Counts Research Articles

Effect of 2 anesthetic techniques on the postoperative proinflammatory and anti-inflammatory cytokine response and cellular immune function to minor surgery

Study Objective The aim of this study was to investigate the influence of 2 established anesthetic techniques: total intravenous anesthesia and balanced inhalation anesthesia (BAL) on the perioperative-induced changes of peripheral blood mononuclear cells (PBMCs), changes in lymphocyte subsets, and the balance of proinflammatory and anti-inflammatory cytokines. Design This is a prospective, randomized, clinical comparison study. Settings This study was set at a university hospital. Patients This study involved 50 patients with American Society of Anesthesiologists physical status I who were scheduled for elective minimal invasive partial diskectomy. Interventions There was no intervention involved in this study. Measurements Changes in differential counts, lymphocyte subsets, and proliferation rates were determined before surgery and in the early postoperative period. Plasma concentrations of proinflammatory cytokines (IL-2, IL-6, IL-12, interferon γ) and anti-inflammatory cytokines (IL-10, IL-1RA, transforming growth factor β), and plasma concentrations of cortisol, epinephrine, and norepinephrine were measured before, during, and after surgery. Main Results Absolute number of CD3 +, CD4 +, and CD8 +, and expression of HLA-DR and activation marker CD25 +, CD26 +, and CD69 + decreased more in response to surgery after BAL. Changes in distribution of T-lymphocyte cells seem to be in part related to severe postoperative pain. Plasma concentration of IL-6 significantly increased during and after surgery with BAL without relation to pain. Conclusion Anesthetic management may have varying influences on the postoperative immune response. Surgery-induced inflammatory response and alteration in cell-mediated immunity seem to be more pronounced after BAL. These effects were attributed to the enhanced stress response after BAL.

Effect of inhaled endotoxin on induced sputum in normal, atopic, and atopic asthmatic subjects

BACKGROUNDInhalation of lipopolysaccharide (LPS) causes an inflammatory response in the lungs. To explore this response, inflammatory indices were measured in induced sputum from atopic asthmatic patients and compared with atopic...

Amiodarone-induced Pulmonary Inflammation: Correlation with Drug Dose and Lung Levels of Drug, Metabolite, and Phospholipid

To investigate the hypotheses that amiodarone-induced pulmonary inflammation may be related to direct drug toxicity, groups of 10 or more Wistar rats were fed amiodarone by gavage at concentrations of 175, 300, 400, and 500 mg/kg/day, or vehicle alone. After 6 wk of drug feeding, the rats were examined for histologic and cellular evidence of pulmonary inflammation. In addition, the amounts of amiodarone, the major metabolite of amiodarone N-desethylamiodarone (N-des), and phospholipid in the lungs were determined. We found that rats fed 175 mg/kg of amiodarone were essentially no different from control animals. The 175 mg/kg group had normal lung histologies, no change in lavage cell counts or differential counts, and very little amiodarone, N-des, or phospholipid in the lungs. In contrast, the three high-dose groups had abnormal lung histologies along with increases in lavage cell counts and change in differential counts. There were also significant increases in the amounts of amiodarone, N-des, and phospholipid in the lung. We conclude that the development of amiodarone-induced pulmonary inflammation is dose dependent, and that there is a direct correlation between the amount of amiodarone, N-des, and phospholipid in the lung with the development of inflammation. It therefore appears that the drug is directly toxic to lung tissue.

Peripheral blood leukocyte counts, erythrocyte sedimentation rate and C-reactive protein in tularemia caused by the type B strain of Francisella tularensis.

The behavior of leukocytes, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in tularemia caused by Type B of Francisella tularensis was analyzed in different clinical forms and severities of disease in 101 adult tularemia patients. The mean leukocyte count was 8.3 X 10(9)/l and the leukocyte differential count was also usually normal. The behavior of leukocytes was similar in different clinical forms and severities of tularemia. The changes in differential counts were milder than reported earlier. Both CRP and ESR were higher in severe than in milder forms of tularemia (p less than 0.05 and p less than 0.01, respectively), and CRP was higher in pulmonary than in ulceroglandular tularemia during the second week (p less than 0.05). There were high individual CRP concentrations of up to 225 mg/l in acute tularemia but there were also low CRP values (10-40 mg/l). Thus the behavior of CRP in tularemia resembled that seen in tuberculosis, and CRP did not always allow differentiation of tularemia from viral diseases.

Effects of Fluocinolone Acetonide Cream on the Skin Window Record of Inflammatory Exudates

In order to study the pathophysiologic mechanism of steroidal action at a cellular level, the skin window technique was used in determining the effect of topically applied fluocinolone acetonide cream under plastic occlusion. Fluocinolone acetonide cream was applied to the normal skin of the volar aspect of each subject's forearm. The cream was left on for twenty four hours in six subjects and ninety six hours in another six subjects. Skin window abrasions (inflammatory stimuli) were then performed on the area where the cream had been applied. A control abrasion was done on the untreated forearm. No change in differential counts done on coverslips from control versus fluocinolone acetonide cream treated areas could be found using ranking of paired comparisons as a means of analysis. This investigation suggests that this topically applied steroid does not exert its anti-inflammatory effect by suppressing polymorphonuclear cells, mononuclear cells, eosinophiles or basophiles.

Pathogenicity of serratia marcescens in pulpitis

In this article we have described four cases in which Serratia marcescens was isolated from infected root canals. One strain was unusual in that it persisted in the root canal and in different parts of the mouth for two months, disappearing from the root canal only after iodine iontophoresis. During its presence in the oral cavity, Serratia marcescens was also isolated from the blood stream. There was a definite drop in the white blood count and a small change in differential count when the patient complained of a “queer feeling.” This suggests the influence of endototoxin. The characteristics described here are peculiar, since Serratia marcescens is not known as a pathogenic organism or as a usual constituent of the oral flora. Serratia marcescens dentalis differed from the classic strain by its beta hemolytic properties, by its lack of motility, and by its well-developed capsule.