Improved homogenization techniques for sputum cytology counts.

Liquefaction of sputum with dithiothreitol induces regular distribution of cells and facilitates total and differential counting without affecting morphology or staining characteristics. The reagent is cheap and stable. The process is predictable, reasonably quick and obviates the need for examination of multiple preparations, otherwise mandatory in quantitative studies of inflammatory conditions of the lower respiratory tract.     

Platelet counts during normal pregnancy.

Eleven reports of platelet counts were found in the literature which reported a progressive increase, no change, or a progressive fall during pregnancy. The counts had been made using venous or capillary blood, with either simple dilution or red cell lysis prior to enumeration in a haemocytometer, with or without phase-contrast microscopy. It was therefore decided to examine whole blood platelet counts taken during normal pregnancy. Results from 405 venous blood samples, using an electronic platelet counter, confirmed the finding of a significant progressive fall in platelet counts during normal pregnancy, the lowest counts falling in some women outside the recognized normal range of values.     

Platelet counts in capillary blood.

Samples of venous and capillary blood were collected simultaneously from healthy adults to assess the accuracy of platelet counts in capillary blood as determined by an automated particle counter. The difference between the mean venous blood platelet count (248,300) and the mean capillary blood count (215,500) was highly significant (P less than .001). For 24% (7/29) of the subjects, the capillary blood platelet count underestimated the venous blood count by greater than or equal to 25%, with three subjects erroneously classified as thrombocytopenic. A heterogeneous group of thrombocytopenic patients showed a similar difference in mean platelet counts (venous blood: 72,500/microliter; capillary blood: 65,400/microliter; P = 0.01). In most clinical situations, capillary blood platelet counts were adequate for patient evaluation; however, when an accurate platelet count is necessary, venous blood should be used.     

AgNOR counts in endometrial and endocervical carcinomas.

The histologic differentiation between endometrial and endocervical adenocarcinomas is a common diagnostic problem. In the present study, the distribution of nucleolar organizer regions (NOR) is evaluated in the two groups of neoplasm, but it is concluded that NOR counts do not offer any histological discriminant between endometrial and endocervical carcinomas.     

Mucosal-cell counts in ulcerative and granulomatous colitis.

Epithelial and connective-tissue cells were counted in rectal mucosal biopsies from 215 patients with ulcerative colitis, 98 patients with granulomatous colitis, and 50 controls. The results were analyzed statistically. Significantly decreased mucous goblet cells were found both in sigmoidoscopically abnormal ulcerative colitis and in granulomatous colitis, and they increased during the healing process. More pyknotic and karyorrhectic epithelial cells occurred in active ulcerative colitis than in granulomatous colitis. Inactive ulcerative colitis still manifested histologic evidence of acute and chronic inflammation, while sigmoidoscopically normal granulomatous colitis biopsies after previous gross rectal disease showed significantly increased macrophages in the lamina propria. Cell counts were valuable for differential diagnosis after the sigmoidoscopic appearance became normal. The acute inflammation of ulcerative colitis, as indicated by neutrophils, was decreased most notably following therapy with prednisone or 6-mercaptopurine. Chronic inflammation associated with fewer plasma cells was decreased after salicylazosulfapyridine as well as either of the other two drugs; macrophages, indicators of healing, increased most after 6-mercaptopurine combined with another anti-inflammatory agent.     

AgNOR counts are useful in cervical smears.

Because they present marked cellular changes, the cytological appearances of epithelial repair may be confused with those of cancer. To see whether the Ag-NOR staining technique for nucleolar organizer regions would be useful to distinguish benign proliferative reactions (squamous metaplasia and repair) from cervical intra-epithelial neoplasia (CIN I, CIN II, and CIN III), we studied a series of cervical smears. The smears, previously stained with the Papanicolaou technique, were destained and restained with Ag-NOR silver. Significantly different (P less than 0.05) Ag-NOR counts were found in squamous metaplasia, epithelial repair, and various degrees of CIN. The Ag-NOR technique appears useful in the diagnosis of cervical cytology and particularly in cases with marked cellular change, which could be confused with neoplasia.