546BRITISH MEDICAL JOURNAL 8 MARCH 1975 noted that electron-dense deposits in electronmicrographs were usually on the "endothelial surface of the glomerular capillary wall." Such lesions were clearly not among those we saw.With regard to the relationship between Q.M.N. and the tropical nephropathy seen in Senegal the similarities lie in the histological features rather than in the immunofluorescence findings. Thus in both conditions a fibrillary change in the capillary wall leads to focal and segmental glomerulosclerosis. Moreover, electronmicrographs show intrusion of basementmembrane-like material into the capillary lumen, which was one of the lesions that White (1973) stressed in Q.M.N. He also reported the presence of curious lacunar areas of basement membrane resorption, at the centre of which were electrondense flecks. These were not noted in the study of Q.M.N. made by Allison etal. (1971), though they described conspicuous electron-dense deposits within the glomerular basement membrane in 12 out of 14 cases, deposits which were not seen by White.In short, the two unusual nephropathies we observed in Senegal differed, despite some similarities, from others hitherto reported in West Africa. One
Summary.The most important physiological regulator of megakaryocytopoiesis is the ligand for the c-mpl receptor (thrombopoietin/megakaryocyte growth and development factor, MGDF). We examined the effect of pegylatedrecombinant human MGDF (PEG-rHuMGDF): patients received PEG-rHuMGDF at doses of 0·03, 0·1, 0·3 or 1·0 mg/kg/d or placebo for 10 d maximum in a doubleblinded randomized study. There was a dose-dependent elevation in circulating platelet counts but no alteration in erythrocyte or total leucocyte counts. The number of bone marrow megakaryocytes was increased approximately 2-fold. The frequency of bone marrow progenitor cells was not altered. In contrast, both to the bone marrow results and to published pre-clinical data, there was a dose-dependent mobilization into the blood of progenitor cells of multiple cell lineages. Increased levels of Meg-CFC (maximum increase 30-fold), day 7 and day 14 GM-CFC and BFU-E were demonstrated at doses of 0·3 and 1·0 mg/kg/d PEG-rHuMGDF. At 0·1 mg/kg/d, mobilization of Meg-CFC alone occurred in two-thirds of patients. Maximum blood levels of progenitor cells occurred at day 12. Thus, administration of PEG-rHuMGDF to humans resulted in mobilization of progenitor cells of multiple lineages despite its 'lineage-specific' activity on mature cell development.
The Sysmex NE-8000 is a new, fully automated hematology analyzer capable of providing a five-part white blood cell differential count and identifying abnormal specimens. This instrument was evaluated on 5,000 consecutive blood specimens and compared to the Coulter S Plus-IV analyzer and manual differential cell counts to determine the efficacy of its five-cell differential and screening capabilities. There was a high correlation between the commercial counters for the standard parameters, white blood cell count, red blood cell count, hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and platelet count (r greater than 0.95), except for the mean corpuscular hemoglobin concentration (r = 0.51), for which the NE-8000 was considered the more accurate measurement. Precision and linearity studies were excellent. The white blood cell count, red blood cell count, hemoglobin level, and platelet count were reproducible on specimens stored at 4 degrees C or room temperature for 72 hours and the differential counts were reproducible for 12 hours. The correlations between automated and manual counts for neutrophils, eosinophils, basophils, and lymphocytes were excellent: r = 0.912, 0.945, 0.332, and 0.964, respectively. The monocyte correlation improved with software modification from 0.306 to 0.801. The NE-8000 gave accurate and reproducible differential counts for neutrophils, lymphocytes, and monocytes on specimens with white blood cell counts as low as 0.6 x 10(9)/1. The ability of the instrument to 'flag' abnormal specimens was excellent. The false-positive rate on normal samples was 1.8%, and the false-negative rate on known abnormal samples was 0.3%, due only to nonrecognition of a mild left shift. The identification of specific abnormalities was less precise. The NE-8000 is a powerful hematology analyzer that can perform a five-part white blood cell differential count accurately for a wide range of WBCs and reliably indicate abnormal specimens. It is an excellent screening tool for distinguishing between normal and abnormal specimens and identifying those that require microscopy. Its reliability significantly reduces the need for manual film examination.
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