Journal of Pathology and Translational Medicine

Volume 9(2); December 1998

Etc

Effect of Inhalation Anesthesia with Several Anesthetics on the Ultrastructure of the Rat Lung: Suk Jae Hong; Korean J Cytopathol. 1975;9(2):115-129.

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Abstract: This study was undertaken to investigate the ultrastructural changes of the lung with special references to the alveolar lining cells of rats after inhalation anesthesia with ether, halothane and methoxyflurane respectively. The results were summarized as follow: 1) Light microscopically, the findings of lung tissue were very similar in the all groups. Immediately after anesthsia, mild congestion arid interstitial edema were noted. Four and 12 hours after anesthesia, the alveolar linings cells were increased in number with mild thickening of the alveolar septae. Increase of bronchiolar secretory activities were not prominent. 2) Electron microscopically, no significant change was noted in type I alveolar cell in the all groups. Most prominent changes were occurred in the type II alveolar cells in the all groups. with the ether anesthesia, marked changes of osmiophilic inclusion bodies, such as increased number, pleomorphism, decreased density and vacuolization were noted immediately after anesthesia. These changes were considerably recovered at 4 hours and completely returned to the normal pattern at 12 hours. Halothane and methoxyflurane anesthesis also induced similar changes in the type Ⅱ ceIls, but they were milder than ether anesthesized animals. Osmiophilic inclusion bodies were increased in number, with pleomorphism of the shape, decreased density, vacuolization and extrusion of their contents. After 4 and 12 hours, the number of type Ⅱ cells was also increased. The endothelial cells of alveolar capillaries showed nearly normal pictures in the ether anesthesized groups, but showed mild swelling, increase of pinocytotic vesicles, dilatation of rough ER and vacuolar formation in the both halothane and methoxyflurane anesthesized groups immediately after anesthesias. These changes were markedly recovered at 4 hours an completely returned to normal at 12 hours. The number of alveolar phagocytes were slightly increased in all experimental groups at 4 and 12 hours, with increase of autophagic vacuoles. 3) These findings suggest that ether anesthesia induces marked degenerative and adaptive changes in the alveolar type Ⅱ cells, particularly in their osmiophilic inclusion body, but does not effect alveolar capillary endothelial cells. On the other hand, halothane and methoxyflurane induce relatively milder degenerative and adaptive changes on the alveolar type Ⅱ cells, while mild degenerative changes are induced in the alveolar capillary endothelial cells. All these changes, occurred on the type Ⅱ epithelial cells and alveolar capillary endothelial cells, are reversible changes and times required for their recovery are relatively short.

Original Article

Quality Improvement Methods in Cervico-vaginal Cytology: Cytologic/Histologic Correlation vs. 10% Random Rescreening .: Ghil Suk Yoon, Jooryung Huh, Kyung Hee Son, On Ja Kim, Gyungyub Gong; Korean J Cytopathol. 1998;9(2):129-138.

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Abstract PDF: Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists 2-5% of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8), whereas six cases were screening errors(categories B;2 and C;4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytote chnologists reviewed 3,196 of 30,922 smears during the same period. There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and quality assurance(cytologic/histologic correlation) programs.

Etcs

The Changes of Endothelial Cells in Rat Lung Alveoli Induced by Carbon Monoxide Poisoning: Jong Chul Ahn, In Soo Suh, Tae Joong Sohn; Korean J Cytopathol. 1975;9(2):131-135.

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Abstract: The blood capillaries of alveolar wall were the route of gas exchange, so that some morphologic and functional changes were suspected in these capillaries in case of altered gas exchange states, such as carbon monoxide poisoning. This study was carried out to investigate the morphologic alteration in these capillaries. Rabbits were forced to inhalate 0.2％ CO gas for 2 hours (3 animals) and 4 hours (3 animals) and 0.1％ CO gas for 2 hours daily for 5 days respectively. The lungs were extracted out and observed by the electron microscope. Results were summarized as follow: Pinocytotic vesicles were increased in number with occasional large vacuole formation. Also noted were increase of lysosome, swelling of mitochondria with loss of crests, dilatation of interendothelial gap and irregularity of plasma membrane. No significant change was noted in the nuclei. The results suggested that CO poisoning induced increased permeability with degenerative changes of the endothelial cells, although these cells could easily contact to oxygen of alveolarlumen.

The Changes of Myocardial Mitochondria Induced by Carbon Monoxide Poisoning: In Soo Suh; Korean J Cytopathol. 1975;9(2):137-143.

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Abstract: It was well known that carbon monoxide induced significant derangements of various parameters of cardiac functions. Recently, Adams et al. reported considerably decreased myocardial oxygen consumption which suggested deranged function of myocardial mitochondria. In order to observe the morphologic changes of the myocardial myocardria, ten rabbits were exposured to the carbon monoxide: Three animals were exposured to 0.2％ CO gas for 2 hours: Three were exposured to 0.2％ for 4 hours: Four were exposures to 0.1％ for 2 hours daily for 5 days. Results obtained were summarized as follow: Mitochondria of myocardial fiber showed marked degenerative changes. Cristae were fragmented and decreased in number with partial disruption. Numerous electron dense granules were occurred in the site of cristae disruption. Mitochondria were fused together to form large irregular shaped body, chondriosphere of de Robertis. No significant changes were noted in the nuclei, myofilament and intercalated disc in all of the experimental groups. Sarcoplasmic reticulum is markedly dilated and glycogen particles and lipid droplets were slightly decreased.

Original Article

Sensitivity and Scoring of AutoPap 300 QC System for Abnormal Cervicovaginal Cytology .: Sung Ran Hong; Korean J Cytopathol. 1998;9(2):139-146.

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Abstract PDF: The AutoPap 300 QC System is an automated device for the analysis and classification of conventional cervical cytology slides for quality control purpose. These studies evaluated the sensitivity of the AutoPap 300 QC System, and estimated morphologic features other than epithelial abnormality to identify a high quality control(QC) score with the AutoPap 300 QC System. The sensitivity of the AutoPap 300 QC System at 10% review rate for 210 cases of cervicovaginal cytology with low grade squamous intraepithelial lesion(LSIL) and higher grade lesion was assessed, and compared with a 10% random rescreening. The morphologic features, such as presence of endocervical component, dirty background, atrophy, abnormal cell size, and cellularity of single atypical cells were estimated in 45 cases of no review and 30 cases of QC review cases. The AutoPap 300 QC System identified 119(56.7%) out of 210 cases with LSIL and higher grade lesion at 10% review rate. It was more sensitive to squamous cell lesions(50-62%) than to glandular lesions(10%). The dirty background and the scanty cellularity of single atypical cells were significantly related to low QC score. Conclusively, AutoPap 300 QC System is superior to human random rescreen for the identification of false negative smears. The upgrading of this device is required to enhance the detection of glandular lesion and certain inadequate conditions of the slides.

Etc

Pathological Findings of 2,235 Cases of Endometrial Biopsies and 518 Cases of Cervical Biopsies: Ok kyung Kim; Korean J Cytopathol. 1975;9(2):145-154.

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Abstract: Total 2753 cases of endometrial and cervical biopsies during 12 years period from Jan. 1964 to June, 1975 were examined at the Dept. of Pathology, Ewha Womans University Hospital. The total 2235 endometrial biopsies revealed 1187 cases (53％) of necrotic decidual or placental tissue, 115 cases (5％) of endometritis, 101 cases (4.5％) of endometrial hyperplasia, 24 cases(1.2％) of polyp, and 16 cases(0.8％) of malignancies. Among the 115 cases of endometritis, 92％ of non-specific chronic endometritis and 8% of tuberculous endometritis were found. 101 cases of endometrial hyperplasia revealed 62 cases (62%) of cystic hyperplasia and 39 cases (38％) of adenomatous and atypical hyperplasia. 16 cases of malignancies showed 50% of choricarcinoma, 21% of adenocarcinoma, 21％ of squamous cell carcinoma, and 8% of adenoacanthoma. The 518 cervical biopsies show 216 cases(41%) of chronic cervicitis, 100 cases(19%) of cervical polyp, 9 cases(1.7％) of cervical dysplasia, and 189(36％) of malignancies. The 189 cases of malignancies revealed 4.8％ of Carcinoma in situ, and 31.7% of invasive cancer in which 94％ of the squamous cell carcinoma, and 2％l of adenoacanthoma, were identified. Materials and Methods; The present study based on the pathological findings of the 2235 cases of endometrial biopsies and 518 cases of cervical biopsies which were performed at the OB-Cyn clinic with variable symptoms in different age groups. Most of the cases were specimens derived from the dilatation and curettage (D&C)with anesthesia. Few of them were the performances of the menstrual regulation (M-R) which was followed by the suction curettage. The average 5 gms of tissue obtained from the performances were immediately placed in 10% buffered formalin, and submitted to our histology. Biopsies were sectioned at least 3 levels and stained with H&E. Results and Summary: Histopathologic studies were made on the 2235 endometrial biopsies. Following results are obtained. 1. Most frequent age group of patients with endometrial biopsies was in between 20-40 years old with average age of 30 years. The cervical biopsies were in between 30-50 years old with average age of 40 years. 2. Most common clinical symptoms of endometrial biopsies were bleeding, amenorrhea, and sterility in order. The cervical biopsies were bleeding, leukorrhea, and backache in order. 3. The endometritis was 5％ of all endometrial biopsies which were slightly higher than the report made in the United State. Tuberculous endometritis was 8% of all endometritis and was 2% of all sterility patients. 4. 4,5％ of all endometrial biopsies showed endometrial hyperplasia in which cystic hype rplasia was 60%, and adenomatous and atypical hyperplasia was 38％. The average age was 39 years old which was 15 years earlier than the average of the endometrial adenocarcinoma. 5. The hydatidiform mole was 2.6% of all endometrial biopsies which was higher incidence than the report made in the United State. The average age was 26 years old which was relatively younger than other University Hospital reports. 6. 0.8% malignancies of all endometrial biopsies were diagnosed. Of these malignancies, the choriocarcinoma was one-half with average age of 54 years old, and the squamous cell carcinoma was one-fourth with average age of 54 years old. 7. Majority of 41％ cervicitis among all cervical biopsies were non specific chronic cervicitis. The cervical dysplasia with average ages of 39 years old and the carcinoma in situ with average of 43 years old were 6% of all cervical biopsies. 8. The invasive carcinoma was 31.7% of all cervical biopsies. It is significant to note the large difference of incidence in between the carcinoma in situ and invasive cancer of this study in comparison with the reports made in the United State and Western Europe where the precancerous lessions were much higher than invasive cancer. The average age of invasive cancer was 4 years higher than Carcinoma in situ while the difference of years was 10 years in the western countries. 9. Among the cervical carcinoma, the squamous cell carcinoma was 94% and adenocarcinoma was 3.7%. The conclusion of the study is that all pathogists are familiar with histologic interpretation of endometrial specimens. On the contrary, meaningful interpretation of cytologic material from the endometrium requires considerable experience. therefore the confirmatory diagnosis should be made on the basis of a endometrial biopsy. Among the Korean female, the analysis of endometrial biopsies revealed greater incidence of hydatidiform mole and choriocarcinoma in comparison with greater incidence of adenocarcinoma in the United State and Europe. Tuberculous endometritis is one of the frequent causes of sterility in Korea. The lower incidence of precancerous lesion in perhaps due to the lack of understanding for routine screening of cancer among ordinary female. Therefore, understanding on routine screening of cancer should be emphasized.

Original Articles

Cytologic Analysis of Adenocarcinoma of the Cervicovaginal Smears .: Jung Yeon Kim, Hye Jae Cho, Kyung Ja Cho, Hong Kyoon Lee; Korean J Cytopathol. 1998;9(2):147-154.

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Abstract PDF: We have investigated the cervicovaginal smears in order to define the cytologic features of uterine adenocarcinomas. Total 22 cases were reviewed(12 cases from the Sanggye Paik hospital, Inje university and 10 cases from the Korea Cancer Center Hospital) from January 1992 to December 1997. Five cases were endometrial adenocarcinomas and the remaining 17 cases were cervical adenocarcinomas. Se venteen cases of cervical adenocarcinomas were divided into endometrioid(6 cases), endocervical(7 cases), mixed endometrioid and endocervical(1 case), papillary (2 cases), and adenosquamous(1 case) carcinomas. The background of endocervical adenocarcinoma was hemorrhagic or inflammatory. The tumor diathesis was less prominent than that of the squamous cell carcinoma. The prominent features of the endocervical type adenocarcinomas were large and loose clusters, large intra cytoplasmic vacuoles, and prominent overlapping and peripheral palisading of nuclei. In contrast, the endometrioid adenocarcinomas showed small and compact clusters, and small intracytoplasmic vacuoles. The detection rate of endometrial adeno carcinoma was lower than that of the endocervical adenocarcinoma.

Fine Needle Aspiration Cytology of Intraoral Lesions .: Ho Jung Lee, Gyungyub Gong, Dong Hae Chung, Jooryung Huh, On Ja Kim; Korean J Cytopathol. 1998;9(2):155-160.

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Abstract PDF: Fine needle aspiration cytology(FNAC) has become a popular method for the diagnosis of a wide variety of both superficial and deep-seated lesions. However, there are few reports about the potential of FNAC for the diagnosis of intraoral lesions. We experienced 44 FNACs from intraoral lesions at Asan Medical Center: 22 from the palate, 6 from the tongue, 5 from the parapharyngeal space, 5 from the lip, 2 from the floor of mouth, 1 from the buccal mucosa, and 3 from other intraoral sites. Histological confirmation was obtained in 32 cases and we analyzed 27 cases excluding 5 cases of inadequate aspirates. Diagnosis was specifically made in 19 of 27 cases(70%) including 1 mucoepidermoid carcinoma, 1 undifferentiated carcinoma, 1 chordoma, 9 pleomorphic adenomas, 1 neurofibroma, and 6 benign lesions. There were three false negative cases(sensitivity, 62.5%) and no false positive cases(specificity, 100%): Two cases diagnosed as "cystic lesion" were confirmed to be mucoepidermoid carcinomas and a case diagnosed as pleomorphic adenoma was proved to be adenoid cystic carcinoma. The results of our study suggest that FNAC is a useful technique in the diagnosis of intraoral lesion.

Etc

Studies of PAS-Positive Material in Circulating Lymphocytes in Patients with Various Diseases: Moon Sook Cho; Korean J Cytopathol. 1975;9(2):157-162.

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Abstract: In an attempt to elucidate the relationship of PAS-positive material of circulating Iymphocytes to the numbers of circulating lymphocytes in various diseases, the author investigated changes in periodic acid-Schiff reaction and absolute count of the circulating lymphocytes in 79 cases of the patients with various diseases and 18 healthy persons. The results thus obtained were summarized as follows: In the patients with Pulmonary tuberculosis, typhoid fever, nephritis, pleurisy, meningitis, CVA, essential hypertension, liver cirrhosis, hepatoina, drug intoxication, diabetes mellitus, and peptic ulcer, the PAS-positive material in the circulating lymphocytes significantly increased. This increase in the PAS-positive material in the circulating lymphocytes was not related to the number of the circulating lymphocytes. It was suggested that the PAS positive material of circulating lymphocytes may be influenced by some substance, which would be related to any immunological reaction and produce in various diseases.

Original Article

Nuclear Morphometry of Fibroadenoma and Carcinoma of Breast: Comparison between fine needle aspiration cytology and biopsy.: Jin Hee Sohn, Young Hee Choi, Young Eui Park; Korean J Cytopathol. 1998;9(2):161-168.

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Abstract PDF: Primary breast lesions diagnosed by fine needle aspiration cytology, confirmed by histologic examination were analyzed by morphometry to evaluate the difference between benign and malignant lesions, and the methods obtaining the sample. Four size factors and 5 form factors were evaluated in 22 fibroadenomas and 20 carcinomas by image analyzer(Zeiss Ibas 2000) using the H-E stained slides. Nuclear size was significantly larger in the carcinoma cells than fibroadenoma cells both in the cytology and biopsy specimens, but the form factors were not significantly different. Both fibroadenoma and carcinoma cells were significantly larger in cytologic smear than histologic section. The cells in the cytology were more regular and round than those in histology, but not statistically significant. Fibroadenomas having cellular proliferation and atypism exhibited larger size and more irregular nuclei than non-proliferative fibroadenoma, but not statistically significant. Therefore nuclear morphometric analysis can be a helpful method to diagnose the questionable breast lesions and is a method appropriate for use as a quality control procedure in the fine needle aspiration cytology.

Etc

A Histopathologic Study on Primary Tumors of Oral Cavity: Byung Gill Kim, Eui Keun Ham, Sang Kook Lee, Chae Koo Lee; Korean J Cytopathol. 1975;9(2):163-169.

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Abstract: A histopathologic study was made on 393 primary tumors of oral cavity that were examined at the Department of Pathology, College of Medicine, Seoul National University, during a period of twelve years from 1963 to 1974. Following results were obtained. 1. Of three hundred ninety three primary tumors of oral cavity, there were 164(41.7%) benign and 229 (58.3%) malignant tumors. 2. Among all tumors of oral cavity, the tumor type in the highest incidence was squamous cell carcinoma(38.9%), and next the common type were mixed tumor (18.8%) and hemangioma (9.2%). 3. The benign oral tumors occurred frequently in the fifth decade (28. 3%) with mean age of 43.9 years, and the malignant oral tumors occurred frequently in the third facade(24.6%) with mean average of 39.0 years. In all them examined, two months of age was the youngest, who had hemangioma and 83 years of age with squamous cell carcinoma the oldest. 4. Out of 393 all tumors of oral cavity examined, 220 cases(56%)were in male and 173 cases (44%) in female. Among them, the malignant oral tumors showed male predominance over female in ratio of 1.7:1, while there was no significant sex difference in the benign oral tumors. 5. The site incidence in all oral tumors were the highest in tongue (26.0%) and next common in palate (17.3%) and parotid gland (12.5%) in orders.

Original Article

Cytopathologic Analysis on Fine Needle Aspiration Cytologic Misdiagnoses of the Thyroid .: Chan Pil Park, Joo Seob Keum, Won Mi Lee, Moon Hyang Park, Jung Dal Lee; Korean J Cytopathol. 1998;9(2):169-180.

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Abstract PDF: Fine needle aspiration cytology(FNAC) has been used effectively as the initial modality in evaluating various thyroid lesions. We correlated cytologic and histopathologic features to investigate the diagnostic pitfalls of FNAC of the thyroid. A total of 1,593 FNACs of the thyroid were diagnosed at the Department of Pathology, Hanyang University Hospital, from January 1993 to December 1997. There were 963 cytologically benign cases(60.5%), 97 suspicious cases(6.1%), and 75 malignant cases(4.71%). The remaining 458 cases(28.8%) were unsatisfactory. Subsequent surgical resection was done in 192 cases. Seventy-two cases(37.5%) were cytologi cally diagnosed as benign, 45 cases(23.4%) suspicious, 56 cases(29.2%) malignant, and 19 cases(9.9%) unsatisfactory. Histopathologically, 101 cases were benign(11 thyroidites, 52 adenomatous hyperplasias, 34 follicular adenomas, and four Hurthle cell adenomas), and 91 cases malignant(72 papillary carcinomas, 16 follicular carcinomas, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor). After excluding 19 unsatisfactory cases, 63 were misdiagnosed. They included 17 benign(three thyroidites and 14 adenomatous hyperplasias), 27 suspi cious(16 follicular adenomas, four Hurthle cell adenomas, and seven follicular carcinomas), and 19 malignant(16 papillary carcinoma, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor) lesions. The accuracy rates in the benign, suspicious, and malignant categories were 54.9%, 49.8%, & 92.8%, respectively. The cytological pitfalls were as follows: (1) bloody background, (2) crowded follicular cell clusters indistinguishable between follicular neoplasia and adenomatous hyperplasia, (3) papillary structure, irregular nuclear membrane and pleomorphism mimicking those of papillary carcinoma, (4) indistinct eosinophilia in follicular epithelial cells, (5) unusual cellular components not commonly seen in FNACs of the thyroid.

Etc

Hematological Study on Aplastic Anemia Emphasizing Bone Marrow Findings: In Ki Baik, Sang In Kim; Korean J Cytopathol. 1975;9(2):171-178.

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Abstract: A hematological study on the 161 cases of aplastic anemia was done emphasizing the correlation between the bone marrow finding and the etiological background and hematological values. The cases involved in this study were selected from the accumulated cases during a period of 13 years from 1960 to 1973, in the Department of Clinical Pathology, College of Medicine, Seoul National University. The results are summerized as follows. 1. Age distribution of aplastic anemia was highest in 10 to 19 years of age group and male to female ratio was l.6 : 1. 2. Idiopathic type of unknown etiology was 75.2 percent of the total 161 cases and the most common etiological agents suggested in secondary type were benzene (5%), chloramphenicol (5%), herb medicines (5%), and the antibiotics other than chloramphenicol (3.7%) 3. Anemia was the most commonly encountered initial symptom with the hematocrit value of 0∼19 volume percent in 53% and hemoglobin value of 0∼5.9gm/dl in 50% of the total aplastic anemia patient respectively. The initial value of corrected reticulocyte count was less than 0.55 percent in 77 percent of total cases. 4. Initial WBC count was ]ess than 2,000/mm3 in 24% of total cases, however the lowest WBC count during hospital course was less than 2,000/mm3 in 45 percent of total cases. 5. Initial platelet count was less than 30,000/mm3 in 29 percent and only 19 percent of total cases showed more than 100,000/mm3. The lowest platelet count during hospital course was less than 30,000/mm3 in 45 percent and more than 100,000/mm3 in 10 percent of the total cases respectively. 6. The cellularity of bone marrow was normocellular to hypercellular in 14 percent and the remaining cases were hypocellular to acellular. Total nucleated cells and immature granulocytes are decreased in reverse proportion to the increase of lymphocytes. There was no definite relationship between the number of normoblast and the cellularity of bone marrow, but the number of lymphocytes and plasma cells were significantly increased in hypocellular marrow. 7. Tissue basophils and reticulum cells were more frequently encountered in hypersensitivity type and especially in hypocellular type of marrow. 8. Some cases of aplastic anemia due to herb medicine showed an increased number of tissue basophils and reticulum cells in bone marrow. In summary, the bone marrow findings of the aplastic anemia, especially those of hypersensitivity type showed an increased number of lymphocytes, plasma cells, tissue basophils and reticulum cells strongly suggesting the immunologic reactions in the initiation of aplastic anemia.

Case Report

Fine Needle Aspiraton Cytology of Polymorphous Low Grade Adenocarcinoma in the Hard Palate: A Case Report .: Wan Seop Kim, Seok Hoon Jeon, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee; Korean J Cytopathol. 1998;9(2):181-186.

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Abstract PDF: Polymorphous low grade adenocarcinoma(PLGA) is a rare malignant tumor of the salivary gland. It is characterized by diverse histology, bland-looking cytology, indolent behavior and favorable prognosis. The fine needle aspiration cytologic features of PLGA are described. The aspirates from the hard palate in a 33-year-old woman showed cellular smear composed of monotonous small round to oval cells with scanty cytoplasm. Papillary, tubular and cell ball arrangements with characteristic dense stromal spheres were recognized. PLGA could be suggested by fine needle aspiration cytology, if one encountered cellular smear with various architectures and uniform bland-looking cytologic feature.

Etc

The Influence of Technical Factors on NBT test: Young Hee Choi, Sang In Kim; Korean J Cytopathol. 1975;9(2):181-189.

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Abstract: The results of NBT test were found very depending on how the testis performed. NBT tests performed simultaneously on various concentration of heparin, various length of incubation time, different mixing instruments, venous blood and capillary blood, and scoring of three good trained technicians, from 90 healthy individuals. Heparin increased proportions of NBT positive neutrophils and lowest possible concentration should be used. NBT tests showed a considerably higher proportion of NBT positive neutrophils in capillary blood than in venous blood. 15 minutes incubation time at 37℃ affected unstable and obscure formazan deposits on NBT positive neutrophils than 25 minutes. Scoring of different good trained technicians are the same results on NBT positive neutrophils.

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