Healthy Adults Range Research Articles

Potential of cell tracking velocimetry as an economical and portable hematology analyzer

Anemia and iron deficiency continue to be the most prevalent nutritional disorders in the world, affecting billions of people in both developed and developing countries. The initial diagnosis of anemia is typically based on several markers, including red blood cell (RBC) count, hematocrit and total hemoglobin. Using modern hematology analyzers, erythrocyte parameters such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), etc. are also being used. However, most of these commercially available analyzers pose several disadvantages: they are expensive instruments that require significant bench space and are heavy enough to limit their use to a specific lab and lead to a delay in results, making them less practical as a point-of-care instrument that can be used for swift clinical evaluation. Thus, there is a need for a portable and economical hematology analyzer that can be used at the point of need. In this work, we evaluated the performance of a system referred to as the cell tracking velocimetry (CTV) to measure several hematological parameters from fresh human blood obtained from healthy donors and from sickle cell disease subjects. Our system, based on the paramagnetic behavior that deoxyhemoglobin or methemoglobin containing RBCs experience when suspended in water after applying a magnetic field, uses a combination of magnets and microfluidics and has the ability to track the movement of thousands of red cells in a short period of time. This allows us to measure not only traditional RBC indices but also novel parameters that are only available for analyzers that assess erythrocytes on a cell by cell basis. As such, we report, for the first time, the use of our CTV as a hematology analyzer that is able to measure MCV, MCH, mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), the percentage of hypochromic cells (which is an indicator of insufficient marrow iron supply that reflects recent iron reduction), and the correlation coefficients between these metrics. Our initial results indicate that most of the parameters measured with CTV are within the normal range for healthy adults. Only the parameters related to the red cell volume (primarily MCV and RDW) were outside the normal range. We observed significant discrepancies between the MCV measured by our technology (and also by an automated cell counter) and the manual method that calculates MCV through the hematocrit obtained by packed cell volume, which are attributed to the artifacts of plasma trapping and cell shrinkage. While there may be limitations for measuring MCV, this device offers a novel point of care instrument to provide rapid RBC parameters such as iron stores that are otherwise not rapidly available to the clinician. Thus, our CTV is a promising technology with the potential to be employed as an accurate, economical, portable and fast hematology analyzer after applying instrument-specific reference ranges or correction factors.

The Target-Step-Test (TST) to Evaluate Locomotory Differentiation Ability – Evaluation of the Test and Development of Norm Values for Healthy People

Abstract Introduction There is need of a clinical assessment measuring locomotory differentiation ability. Objective The Target-Step-Test (TST) for evaluating the locomotory differentiation ability should be checked for its reliability in the context of practical application. Furthermore, it is necessary to define a standard value range. In addition, an examination of the exercise attempts should enable a statement to be made about the adequate test execution. Materials and Methods 208 healthy adults between 18 and 45 years were asked to perform the TST twice. The test procedures of 205 test persons could be evaluated. The individual experiments and target steps were photo documented. The 4 directions of movement included stepping forward with the right and left leg and stepping to the side with the right and left leg. Each direction contains 3 exercise steps with open eyes and one target step with closed eyes. The difference to the target line was rounded up or down to 5 mm by the raters. Results For the inter-rater and intra-rater reliability as well as the test-retest reliability high intraclass correlation coefficients (ICCs) and corrected kappa values could be calculated. 90 % of the measurements performed are within the range of −4.85 to 5 cm of the target line. The testing of the measured value repetition shows no differences between 2nd and 3rd step with open eyes. Therefore, it should be sufficient to perform 2 exercise steps with open eyes before the decisive target step with closed eyes. Conclusions The TST is reliable regarding inter-rater, intra-rater and test-retest reliability. The standard value range for healthy adults is set to±5 cm distance from the target line. Regarding the test procedure, it is sufficient to execute the target step with closed eyes after practicing twice with open eyes. The Target-Step-Test is reliable and can easily be carried out in daily routine to measure locomotory differentiation ability as a step movement.

Foetal development of endocrine organs in dog.

The canine adenohypophysis starts to be identifiable from 25day of pregnancy. ACTH-immunoreactive cells migrate until day 38 after which the number of ACTH-producing cells increases but their distribution does not change. The STH- and LH-producing cells first appear on day 38 of pregnancy. The primordium of the adrenal glands appears as a slender structure on day 27 and forms the definitive cortical structure on day 35. The histological pattern of the foetal adrenal cortex differs from the post-natal structure in so far as the three cortical zones (definitive zone, transitional zone and foetal zone) extend from the outside towards the inside of gland. The mass of foetal and neonatal adrenals is more than 10 times larger than the adult adrenals relative to body weight. The cortisol concentration in the amnion is slightly lower than in the allantois but the foetal serum cortisol concentration is significantly higher than in the maternal and foetal fluid compartments. The thyroxine concentrations in the allantois and amnion fluids exceed the foetal serum concentrations except in the ninth week of pregnancy, but thyroxine levels in foetal fluids and serum are below the physiological levels of adult animals. The exocrine and endocrine functions of the pancreas develop and act in parallel. Pancreatic cells are first detected at 30days when the branched structure is clearly detectable immunohistochemically, and at that time, insulin-positive β-cells and α-cells are visible as well. The foetal serum glucose concentration exceeds the healthy adult range, but the glucose concentration in the allantois and amnion fluid remains below the physiological blood glucose concentration of mature dogs. The insulin concentration in the allantois fluid greatly exceeds the foetal serum and amnion insulin concentrations.

<span class="caption">CASE REPORT:</span> Delayed Detection of Cytomegalovirus-Specific T-Helper Cells in a Preterm Infant Following Intrauterine Exposure to Tacrolimus

After exposure to tacrolimus and CMV reactivation in utero, a preterm infant had a positive CMV polymerase chain reaction (PCR) in urine on day 2 of life. Naive T-cells were reduced, but stimulation with CMV antigen and a polyclonal T-cell activator in vitro yielded no measurable CD4+ T-cell response. When repeated on day 30, polyclonal activation was in the range of healthy adults, while the immune response to CMV was incomplete with a lack of IFNgamma+ CD4+ T-cells and no anti-CMV IgM. Thus, exposure to tacrolimus in utero caused a transitional T-cell activation defect which did not compromise viral clearance.

Adrenopause und Dehydroepiandrosteron: Pharmakotherapie versus Substitution

Hintergrund: Die Adrenopause ist als alterstypische partielle Nebennierenrindeninsuffizienz durch erniedrigte Blutspiegel von Dehydroepiandrosteron (DHEA) und DHEA-Sulfat (DS) bei unverändertem Cortisol charakterisiert. Für DHEA sind eigenständige Wirkungen sowie solche als Vorläufer von Sexualhormonen im ZNS und in der Peripherie etabliert. Günstige epidemiologische Daten höherer DS-Spiegel bei Männern sowie positive klinische Berichte über eine DHEA-Substitution bei beiden Geschlechtern lassen seinen Einsatz zur Prävention und Beeinflussung von Alterungserkrankungen als sinnvoll erscheinen. Bisher wurden tägliche orale Einheitsdosierungen von DHEA mit 50–100 mg bei Männern und 25–50 mg bei Frauen eingesetzt, die meist supraphysiologische Blutspiegel bewirken. Patienten und Methode: Wir berichten über Dosisfindungsstudien über 6–12 Wochen bei jeweils 100 Männern und Frauen zwischen 46 und 74 Jahren mit Adrenopause, um die individuelle DHEA-Dosis zu ermitteln, welche Tageshöchstwerte von DS, gemessen 3–5 h nach morgendlicher DHEA-Gabe, zwischen 2,0 und 2,8 µg/ml bei Frauen und 4 und 5 µg/ml bei Männern erreichen lässt. Dies entspricht den Blutspiegeln gesunder Erwachsener im dritten Lebensdezennium. Ergebnisse: Für diese Vorgaben waren 5, 10, 15, 25 oder 50 mg DHEA bei jeweils 18, 26, 34, 19 und 3% der Frauen sowie 15, 25, 50, 75 oder 100 mg DHEA bei 5, 13, 51, 17 und 14% der Männer erforderlich. Hierdurch veränderten sich die Blutspiegel (Mittelwert ± SD) signifikant (p < 0,01): a) bei den Frauen bei DS von 0,7 ± 0,4 auf 2,4 ± 0,5 µg/ml, bei Testosteron von 0,4 ± 0,4 auf 0,9 ± 0,5 pg/ml und bei Androstendion von 0,8 ± 0,4 auf 1,4 ± 0,4 ng/ml sowie b) bei den Männern bei DS von 1,4 ± 0,5 auf 4,1 ± 0,7 µg/ml, bei freiem Testosteron von 10,9 ± 4,1 auf 14,7 ± 4,5 pg/ml, bei Androstendion von 1,2 ± 0,5 auf 2,0 ± 0,6 ng/ml, bei Östron von 28 ± 14 auf 41 ± 19 pg/ml und bei Östradiol von 16 ± 8 auf 31 ± 15 pg/ml. Bei inadäquater Dosis wurden Nebenwirkungen wie Müdigkeit, Ruhelosigkeit, Migräne, Akne/Hirsutismus, Effluvium und Odor bei jeweils 34, 17, 9, 31, 21 und 11% der Frauen festgestellt, die sich nach Dosisadjustierung auf 8, 2, 4, 6, 7 und 0% der Frauen signifikant reduzierten (p < 0,05; p < 0,2 bei Migräne). Schlussfolgerung: Wir empfehlen, eine DHEA-Substitution der Adrenopause mit einer individuell adjustierten niedrigen Dosis von 5–50 mg bei Frauen und 15–100 mg bei Männern in den physiologischen Bereich junger Erwachsener hinein durchzuführen. Dies hat sich nach unseren vorläufigen Daten aus den letzten 5 Jahren sowohl klinisch als auch bezüglich der Patienten-Compliance gut bewährt. Eine überphysiologische Pharmakotherapie mit DHEA erscheint dagegen bei speziellen Erkrankungen wie Kollagenosen indiziert.

Pentafraction for superior resuscitation of the ovine thermal burn.

To determine if a new hydroxyethyl starch, pentafraction, will cause better capillary retention of fluid in thermally burned and nonburned tissues when compared with some currently used volume expanders. Randomized, controlled, experimental study. University research laboratory. Twenty-one healthy adult range ewes. Sheep, surgically prepared for chronic study, were randomly assigned to one of three colloid groups for the resuscitation of thermal injuries: a) ovine fresh-frozen plasma group; b) pentastarch group; and c) pentafraction group. Twenty-one sheep were subjected to a 40% total body surface, third-degree flame burn under anesthesia (1.5% to 2% halothane). When awakened, the sheep received 15 mL/kg of one of the above colloids, and then lactated Ringer's solution (2 mL/hr/kg). All animals survived and were killed at 48 hrs after burn injury. We found that cardiac index decreased and systemic vascular resistance increased in the pentastarch and plasma groups. However, cardiac index increased in the pentafraction group, while systemic vascular resistance increased by only half as much as in the other two groups. Cardiac index in the plasma group decreased significantly for the first 8 hrs, and did not return to the baseline value for 48 hrs. Systemic vascular resistance increased significantly for the first 8 hrs in both the plasma and pentastarch groups. Prefemoral lymph flow was significantly more increased in the pentastarch group, while the lung lymph/plasma oncotic gradient was maintained only by the pentafraction group. Pentafraction is as good, or even superior, for volume resuscitation in the burn patients, when compared with pentastarch and plasma. This conclusion is made most evident by the attenuated changes in systemic vascular resistance and cardiac index. Pentafraction decreases the fluid flux and potential subsequent edema significantly in burned tissues and effectively maintains the pulmonary microvascular integrity.

The activity of platelet factor 4 in plasma of healthy and high risk newborns.

The plasmatic platelet factor 4 activity (PF4) and the platelet count were determined in cord blood (group I) and scalp vein blood (group II) of 70 infants. The PF4, measured upon its anti-heparin activity, and the platelet count were found in healthy infants of both groups within the normal range of healthy adults. High risk infants of both groups demonstrated a significant elevation of PF4 activity and a significantly (group I) or markedly (group II) decreased platelet count. There was a positive correlation between the increased PF4 and decreased platelet count in the high risk infants of group I. These changes among the high risk infants are probably due to activation of the coagulation system evoked by fetal or perinatal distress. The high risk conditions encountered in both groups were in accordance with those known to promote disseminated intravasal coagulation in newborns.