At Memorial Hospital A'Tale, of-TwoLob S recnnologist Tom varIey monitors an enzyme analyzer in the Memorial Hospital laboratory. Hundreds of different tests can be performed in the various sections of the Memorial lab to help doctors make accurate diagnoses of their patients' illnesses. Perlita Avila, one of several female technologists working at the lab, oversees the operation of the automatic cell counting machine in the Haematology department. Though lab technologists can perfori cell counts manually with the aid of a microscope, this machine can handle up to 48 sDecimens at a time. Kirti Chauhan examines urine sediments under the microscope. Chemical tests are also administered in urinalysis by using a treated cellulose strip which checks for certain substances (such as sugar and blood) which should not be present in the specimen. by Liz Armstrong Your part la the process is simple. T h e nurse stretches a rub- ber tourniquet around the upner part of your arm to the veins stand out. With e ready, she swabs the insîde of your elbow with alcohol and picks a likel spot. Then she takes carefu aim, jabs the needle into your arm and quickly extracts two vials of blood. The s ringe is removed, a bandaidappiedto, stop the bleeding and you're on your way. En route past the reception deskyou turn in your (bottled) urine specimen ... and the final segment of this year's annual medical is over. What ha ppens to those samples a short time later is quite a bit more complicated. Microscopic World Suitably labelled and pack- ed, the specimens journey to the microscopic world of the hospital lab to be put through their paces under the exper- iençed eye of a trained technologist. With the help of lab results of these samples, the doctor ca round out his opinion of your overall state of health and isolate trouble spots. There are literally hundreds of tests that can be performed in the average hospital labor- atory, ranging from examin- ation of surgically-removed tissue to cross-matching blood specimens and testing bac- teria and viruses from sites of' infection. Though lab technologists would classify blood and urine tests as routine, they're really quite comprehensive. Not only are these specimens easy to obtain, they can reveal a lot about a atient's general state of healtb In simple terms (for my sake as much as anyone else's) here's what happens to those two contributions that you (should) make on an, annual basis to your family doctor. Blood Tests One of the basic series of tests for blood is called the Complete Blood Count,' whhch ineludes white and red cels hemoglobin and the 'packed cell volume' which measures the ratio of solids to liquids in the sample. In a healthy human, the normal count for white cells is between 5,000 - 10,000 per cubic millilitre of blood. Their, purpqse is to fight infection antsince each one is equipped with a simple brain, in the form of a nucleus, it can think in a rudimentary way and then move to the part of your body where it's needed. If the white count is low, the bone marrow is not producing enough cells, perhaps as a result of age or toxic chem- icals in the system. On the other hand, i the count is hi h, the cause may be ifection or perbaps a more serious isorder like leu- kemia. Hemoglobin is a protein which carries oxygen to al parts of te bod and is found in red blood cehis. In females, the average count is between 12-16 grams per 100 millilitres, of blood. In males the count is usually higher, between 14-18 grams. A low count often indicates anemia. Generalhy speaking, women need more iron than men to keep their hemoglobin at an acceptable hevel. In rare cases, the hemo- globin exceeds 18 grams. The cure for that condition sounds almost medieval - the patient is 'bled' (though only about a pint) to relieve the problem. Counting Cells How are these minute cells counted? In the old days, technologists added various diluting agents to the sample and counted the white cells within a certain microscopic field by sight. That method is still used when there are only a few specimens to handle, but when there are a large number, the task is left to a device which anal yses the blood automaticaly. This machine can handle as many as 48 specimens at a time including 'controls' and blanks, which assure that the counter is working properly. The 'packed cel volume' is determned by putting blood samples into tiny tubes which are spun to separate the solid and hiquid content. A low ratio indicates that there aren't enough cehis to carry oxygen to various parts of t e boy. Though much of the analysis is done by machine, the examination of the cells under a microscope can tell another story. In order to prepare a slide for viewing, a drop of blood is placed on the glass, thinned out and then stained to make the cells distinct. Under the lens, red blood shows up a scarlet color, the platelets (which act as co- agulants) are deep purple, and the white cells are distinguished by their nuclei and their purplë shade. Under the microscope, the cells are examined for their shape, size and colour. Tech- nologists also note the ratio of different cells to one another. For example, pale red cells indicate that the patient has what the Geritol people call 'tired blood' or anemia. If white blood cells are released into the blood stream before they're fully developed they "really don't do any good," Tom explained. "It's lik e sending a boy out to do a man's job. A lack of Vitamin B12 can also result in irregularities. In this case the cells are 'post- mature' - they have stayed in the bone marrow too long and have consequently become larger than necessary. Another test which can indicate if something is wrong is the 'sedimentation rate' of the blood. The sample is mixed and then the tube containing it is stood up on end. Results depend on how quickly the solid cells sink to Tiny tubes of blood are placed in this machine and spun at a high speed to separate and measure the solid and liquid content of the samples. A low solid count indicates that there aren't enough cells to carry oxygen to the various parts of the body. In the photo, the solid matter in the blood is at the bottom end of the tubes. -Photos by Liz Armstrong the bottom, and if they drop quickly, there's something amiss.Though the cause could be as simple as a common cold, other conditions such as pregnancy can induce a high sedimentation rate too. Since there are a variety of causes, Tom explained that the sedimentation rate is a non-specific test, 'and others will have to be administered to narrow the possibilities. Urinalysis Every lab technologist has a little Sherlock Holmes in him. From the major clues in bis test resuits, be follows many leads in an attempt to trac k down the culprit causing the disorder. Some of his in- vestigations show nothing, others promise more. "It takes combinations of tests to figure out what the problem is, Tom noted. Urinalysis is a screen test, and if there's nothing wrong n the resuits of the basic check, there's no need to ursue t further. If there is a problem, we proceed with more comp- licated tests.«" Can't be Colorblind In addition to being a good sleuth, a lab technologist must possess good color perception to read test results accurately. Many results, includin urin- alysis, are based on como- gen or color changes - when the sample is tested with certain chemicals it will closely match a standard color if it's normal. If not, the sample will be another shade and the difference is often s 11lit. By dipping a single treated cellulose strip into the urine specimen, the technologist can make seven different tests at the same time. NormaPly the body excretes standard waste materials into the urine. When a person is sick, there are extra chem- icals present or too much of one. The technologist isn't concerned about the normal components; he's looking for substances that shouldn t be there. For example sugar is not normalhy founci in the urine, and when it is present it usually indicates diabetes. The sample is also checked for acetone which is a chem- ical similar to nail polish remover. Acetone results when the body metabolizes fats, and since a diabetic can't burn sugar, he ets energy from dissolving fàtty tissue. Though it's normal for people on diets to have a certain amount of acetodle in their sample, too - much can be toxic. Another chemical indicator tests for albumin, which is a protein that is a major constituent of the body. When found in the sample albumin often indicates kidney dam- age. Hepatitis can be detected through urinalysis too. A chemical called bilirubin is usually passed through the intestinal tract, but when the liver is unable to handle it that way, bilirubin is excreted through the urinary system. Finally, the specimen is also treated for blood content. Since the urinary system is a closed tract, there should be no blood present. An infection or rupture in the kidney or bladder can allow blood to pass through. Further Tests In addition to the chemical tests, the urine is also routine- ly checked under the micro- scope to analyse the sediment. or the sake of argument, let's say that the sample contains too much albumin. Under low magnification ther sediment will be checked fort tube-shaped 'casts'. Tfhese casts are protein tfhat have become stuck in the nephrons (filtering tubes) of the kidney. When they get stuck, the protein takes on a cylindrical shape which is squared off at the ends. Occasionaly these break loose and go into the bladder, which is a definite sign of kidney problems. Under high-powered ;icro- scopic examination, the tecb- nologist can then look at these casts to find out what kind of material, if any, is found inside. He will also look for star-shaped crystals of uric acid and coffin-shaped (!) crystals of alkaline. All of bis results are recorded. Notify Physician Based on the results of laboratory tests, the doctor can make an accurate diagno- sis and proceed with treat- ment to control or cure the problem. Tom emphasized that the technologist's func- tion is solely to perform the tests, record his findings and the notify the physician of the resuits. The, diagnosis is then left entirely up to the doctor. Even if diagnosis was part' of their duty, t e technologists at Memorial probably would- n't find time for it. Last year the hospital laboratory hand- led about three-quarters of a million test units and many of them were routine blood and urine checks like the ones that have just been described. The staff in Memorial's lab numbers ten, including six full-time technologists, two part-time employees, a lab attendant, and a receptionist. Supervising the quality of the work they perform is part of the role of the hospital patbologist. To an untrained eye, blood cells and color tests and endless test tubes full of chemicals are more than a little confusing. In learning to become adept at interpreting the results and performing the wide range of tests done at the lab, a technologist needs_ SECTION TWO BOWMANVILLE ONTARIO, WEDNESDAY, FEBRUARY 18, 1976 Exchange Dauahters for One Year Af ter welcoming Rotary Exchange student Janet Stewart from New Zealand into his home two weeks ago, Don Morris says farewell to his own 17-year-old daughter Jane who flew to the land of the Kiwis on Feb. 6th. Jane is going to spend a year in New Plymouth on the north island and she will be sponsored by four Rotary clubs during her stay. Ten Per Cent Wage Hik For Management Officiai In RegÎon4's Governmen Non-union management than they were receiving in Adams, Jack Gartley, Doug positions in Durham Region Durham. Johns and Bob Richardson were recently given a 10 per Another reason theincrease will now be receiving $35,400 cent raise by regional council, was needed was to keep the yearly. with a maximum increase of salaries of regional super- Regional Solicitor S.K. Jain$2400 effective from Jan. 1, visors abovesor at least even and Commissioner of Person- 1976. with salaries of employees nel Terry Stephens now will be The total cost of the raises that belonged to the union, he making $33,150 under the new has been estimated at $343,000. said. increases. The only employees which Under the new wage in- were not included in the raises creases, the region's top The director of engineering were those who have already employee, Chief Administra- (works), W.A. Twelvetrees, received increases through a tive Officer Bill Manning has director of operations reclassification to a higher received a $2,400 raise, bring- (works), Vik Silgailis, and salary range. ing his yearly salary to director of planning, Mofeed Management committee $37,400. Michael will each be making chairman, Alan Dewar, told (ommissioners Bill Mc- $30,900 a year. council that the committee was recommending the in- creases for three reasons. th recommended raise of 10 per A charge of careless driving Early Saturday morning, cent was within the federal has been laid against Thomas Robert Scott Donoghue of 35 wage and price guidelines set MacMillan of 111 Taunton Waverly Road was charged down by the government. Road East, Oshawa, by Dur- with exceeding .08 following ne also told couneil that ham Regional Police following a collision of his vehicle with a non-uni'on management staff a morning accident,, Feb. 6th farked vebicle in, a parking were paid a considerable on Regional 57, two-tenths of a r ot. amount less than people in the mile north of the Waverly Donoghue was operating a same positions in other mun- Road intersection. 1969 Pontiac which reportedly icipal governments were paid. The mishap occurred at 7:20 skidded on the icy surface of The Oshawa alderman said a.m. as the southbound Mac- the IGA lot and struck a '72 that commissioners in other Millan vehicle went out of Chev owned by Walter George municipalities were receiving control when it struck the west Woodward of 44 Prospect St. an average of $10,000 more shoulder of the road. The Woodward vehicle sus specialized training. After completing Grade 13, the student is required to take two years ot training at a certified institute before hie is eligible to erform his skills as a te. hnoloiist in a clinic or hospital ab. Providing excellent patient care requires teamwork from all departments in the hospit- al. While many other services are visible to t he patient, what goes on in the laboratory usually happens behind the scenes. Nonetheless, down there in the depths among the bubbling concoctions and test tubes, the lab technologists are doing their part on behalf of your physical well-being. The vehicle proceeded across the road, colliding with some 10 or more guideposts on the east shoulder while the guidewires kept it from plunging into the ditch at the, pedestrian underpass. The vehicle finally came back onto the road, coming to a stop, sideways, in the northbound lane. Steam caused by antifreeze leaking onto the. motor was thought at first to be fire and Bowmanville firemen were called to the scene. Fortunate- ly, all that was required was a washdown of the road from a fuel line leak. ' MacMillan is reported to have sustained a bump on the head in the mishap invest- igated by Constable Les Ric- ard. tained damage of $300 in the 1:45 a.m. incident invest- igated by Const. Larry Wood Take No Acion A motion to take no action was adopted Feb. 9 by the Committee of the Whole with respect to the sale of vacant property adjacent to 180 Simpson Avenue. Council having previously refused an offer of some $13,000 for the property, the committee agreed to take no further action on an offer received Monday from David Mott of 180 Simpson Avenue to purchase the propertv for the sum of $15,000. Youngsters Complete 50-Mile Snowmobile-A-thon Eight-year-old Keith Gallagher, left, and his 10-year-old sister Sandra of R.R. 1, Bowmanville, raised a btotal of $340 for the Crippled Childrens Society on Sunday, February lst in The Great Pine Ridge Snowmobile-A-Thon. On these special five horsepower snowmobiles, the two youngsters completed the 50 mile course accompanied by their parents who followed behind on their own machines. The event, held at the Northumberland Reforestation area near Peterborough was sponsored by the Port Hope Rotary Club.