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CellaVision® DM96 User`s Manual 3.1-3.2

1. TT N 66 User s Manual CELLAVISION 6 EVAO E B VISTO 6 2 1 Pending Orders Dialog for Peripheral Blood Order Data MT Order 350 560421 2234 7 1956 04 21 s fe m ma LI User s Manual 67 EATEN 97 1 WATS enon D VISTO 6 2 2 Pending Orders Dialog for Body Fluid MT Order 380 IN Levinson 1956 01 21 6 3 Archiving Data Select Tools Archive and the Archiving Guide will appear explaining the procedure Make sure that a valid archiving media has been specified This is done in the Archiving tab under Settings see 10 11 Adjusting Archiving Settings 68 User s Manual CELLAVISION 6 e7 IIT E B VISTO 6 4 6 4 1 6 4 2 Usage Log The system continuously saves data of processed slides and stores it in a Usage log To view this log select 7ools View Log The log consists of two pages Statistics and Specification Statistics Logfile Viewer Nbr of analyses 135 135 Nbr of failed analyses 18 18 Nbr of signed WBC 40 40 Nbr of signed RBC 3 37 Nbr of signed PLT 27 27 Total analysis time The Statistics page contains dates and times of program installation and creation and modification of the Usage log It also displays the number of successfully processed and failed slides the number of signed analyses and the total pro
2. Laborator ird 2011 04 11 14 56 m Order 4 2011 04 11 15 36 DM _008 WA Order 4 3 2011 04 12 10 39 Open Delete Process status Wi Slide processing OK D Slide processing stopped No result exists A The required numbers of WBCs were not found one of the ordered analyses failed or the order was not found in the LIS slide processed with default values Q Processing error No result exists Slide status T Empty field Not signed v Signed Comments Empty field No comments Comments exist 62 User s Manual CELLAVISION CellaVision DM96 6 1 3 Opening an Order Slide When you open an order you automatically open one slide belonging to it In the same manner opening a slide automatically opens the order it belongs to The currently open order and slide are always shown in the toolbar Order status Slide status Order dd Slide MT Order 110 1 Double click on an order in the Order list and the first slide of that order opens You can also click Open in the Order panel In the S ide list you can open specific slides in the same way You may close the order and the slide using a toolbar button Close Order and Slide 6 1 4 Protecting an Order You may protect orders to prevent slides from being deleted or archived 1 Select the order orders 2 Click Protect Unprotect or right click and select Protect Unprotect from the menu To select multiple orders e Select an order
3. BL Precharacterization Enable RBC precharacterization RBC limits 2 1 Slight 2 Moderate 3 Marked 1 Slight 2 Moderate 3 Marked Polychromasia 5 a5 Anisocytosis NN 5 jo Hypochromasia e 20 Microcytosis e 20 Poikilocytosis 2 5 Macrocytosis e 5 20 aca TT Anisocytosis sizes micrometers Microcytosis lt 65 lt Normal lt EE lt Macrocytosis Reset RBC Limits and Anisocytosis size to their default values Reset Note Default values according to O Connor Barbara H amp Color Atlas and Instruction Manual of Peripheral Blood Cell Morphology Lippincott Williams amp Wilkins 1984 Enable RBC precharacterization Deactivate this checkbox if RBC precharacterization shall not be performed Manual RBC characterization will still be possible RBC limits The percentage limits used for RBC precharacterization The default values are set according to O Connor Barbara H A Color Atlas and Instruction Manual of Peripheral Blood Cell Morphology Lippincott Williams amp Wilkins 1984 Anisocytosis sizes Set size limits for precharacterization of Anisocytosis Reset Resets all RBC limits and Anisocytosis sizes to their default values User s Manual 91 CELLAVISION o O7 Fe WATS enon D VISTO 10 6 Adjusting PLT Settings In the PLT tab you set the PLT estimate factor and the limits for the PLT concentration levels You also set the default settings
4. Enter the number of missed cells if any in the input field 4 When the entire area has been viewed check that the result it is within acceptable limits Note It is recommended that you order 10x 50x overview images for cell location slides Note OC labels are not required for running cell location test on body fluid slides Cont d User s Manual 161 ET S CellaVision DM96 Cont d Examining a Cell Location Slide Open the slide in question from the database view Mini Map Analysis Located area cells Diff es Overview uL Sign Slide Navigation asl i al 10x __ 5 Region of Interest Cell Location WBCs Found 200 Non WBCs Found 36 Ratio of WBCs found 100 095 WBCs missed 0 4 Print Result The analysis area used for collecting cells is represented by the bright part of the mini map Navigate through the analysis area and check if it contains any missed nucleated cells Green boxes mark the nucleated cells and blue boxes mark other found objects that are not nucleated cells e g artefacts Missed nucleated cells are those cells not marked with a box in the figure Cont d 162 User s Manual CELLAVISION CellaVision DM96 Cont d Black boxes mark the cells that were located but not needed for the test indicating that the system has located enough cells for the test and is coming to an end Note On screen cell images are not alway
5. RECOMMENDED WORKFLOW 145 Workflow Single Slides Confirm Cell Counter Results 146 Workflow Duplicate Slides nannaa anaa 147 APPENDIX E USER AUTHORIZATION LEVELS 148 APPENDIX F DETERMINING THE PLATELET ESTIMATE FACTOR 149 APPENDIX G SLIDE PREPARATION GUIDELINES 150 Slide Preparation for Peripheral Blood EE Ee eee 150 Example SmearS ccc tenet ee ee ee ee 152 Slide preparation for body fluid llle 156 APPENDIX H CELL LOCATION 157 Cell Location for Peripheral Blood n anaana naaa 157 Cell location for Body Fluids ss ss sr st aru ura e AE DS RA AD Ru EED BU NE 161 APPENDIX GLOSSARY 164 INDEX 166 User s Manual 5 CELLAVISION 6 CellaVision DM96 Preface CellaVision is a trademark of CellaVision AB All other trademarks used in this document are property of their respective owners No part of this document or the products it describes may be reproduced or transmitted by any means or in any form without prior consent in writing from CellaVision AB U S patents no 6268611 and 6341180 Swedish patent no 517626 and 520829 Other patents pending Caution US federal law restricts this device to sale by or on the order of a physician or properly licensed medical practitioner Note CellaVision Image Capture System is not available on all markets Article No PM 10340 Revision 2012 01 03 Copyright 2003 2012 CellaVision AB All rights reserve
6. Sample contains disintegrated cells or smudge cells and the system identifies different parts of a cell as two or more different cells Verify staining procedure To minimize the amount of disintegrated cells make sure the slides are prepared within two hours of collection see Appendix G Slide Preparation Guidelines To minimize the amount of smudge cells verify your smear preparation process To be able to identify and exclude duplicate cells activate the Cell Marker function during verification see 3 1 2 Reclassifying White Blood Cells User s Manual 125 CELLAVISION o CellaVision DM96 13 2 8 Barcode Problems Problem Cause Action The barcode could Blurry barcode Make sure the barcode is resistant to not be read caused by immersion oil immersion oil on the Print the barcode as defined in Appendix barcode A System Specification There is no quiet Make sure there is a quiet zone zone according to specifications and that the barcode is not printed too close to a logotype if applicable Symbology contrast Adjust the printer is too low Use slides with a white smooth frosted area The barcode is Adjust the printer damaged barcode Use slides with a white smooth frosted cells are missing area Critical error in the The Order ID Do not use an Order ID with more than database contains more than 24 characters 24 characters
7. 12 slides can be loaded into a magazine The slide positions in the magazine are numbered 1 12 from the bottom up Caution Use only clipped round beveled corner slides Failing to do so may cause jams and excessive wear on magazines and the system Note The same magazine can be used up to 100 times When this limit is reached a warning is shown Caution If you want to process an already processed slide carefully wipe the oil off and make sure the barcode is clean and undamaged User s Manual 19 CELLAVISION CellaVision DM96 2 5 Processing Slides 2 5 1 Adding Magazines Input hatch Conveyer Output drawer Open the input hatch and put the magazines on the conveyer The magazines must have the barcode turned upwards and the open end of the magazine inwards When all slides in a magazine have been processed the magazine is automatically ejected into the output drawer 2 5 2 Starting the Slide Processing Click on the Start button to start the slide processing If you want the processing to start automatically when a magazine is inserted into the system you can enable autostart in Analysis Settings You still have to manually start the processing if the system has been stopped restarted or if an error has occurred p Start button KY Autostart Replaces the Start button Stop button Cont d 20 User s Manual CELLAVISION e7 FEATS el mE B VISTO Cont d The tree in t
8. Free physical and virtual memory Total physical and virtual memory Licensed software License expiry date User s Manual 81 me CellaVision DM96 9 CellaVision Remote Review Multiple users A CellaVision Remote Review has network access to a database containing data from slides processed by CellaVision DM CellaVision Remote Review CellaVision DM96 CellaVision DM8 Database The operating procedures in Database View Verification View and Report View are the same for CellaVision Remote Review as CellaVision DM Note It is not possible to process slides or archive data using CellaVision Remote Review 9 1 Working with Orders and Slides When opening an order slide with CellaVision DM or a CellaVision Remote Review the order and the slide will be locked for other operators In all other CellaVision Remote Review and CellaVision DM systems connected to the database this is indicated with red text in the Order list and Slide list in the Database View xxxsee 6 1 Database Processed Orders A locked order slide can be opened but not modified i e no changes can be done in Verification View and Report View In the Order data and Slide data panels Locked by indicates who has opened the order slide the person logged on to Windows and on which computer 82 User s Manual CELLAVISION CellaVision DM96 10 Customizing the System Settings are stored in either the system or CellaVision Remot
9. Standard comments of type WBC RBC or PLT will only be available in the respective tab Standard comments can be added and edited in Settings see 10 8 Adjusting Standard Comments Settings To clear comments click Erase 3 5 Order Data To edit order data click Order Data in the toolbar A dialog is shown containing information about the open order If no data is received from the LIS it is possible to edit some of the information The Order ID can only be edited if it starts with ER The Order Data dialog can also be accessed by right clicking on an order in the database view If you can t generate barcode labels printer is broken out of printer ribbon or out of labels you can use pre printed labels with the prefix ER available through your local dealer User s Manual 43 eene ione er IE VERLEP INER 3 6 Signing a Slide A summary of the WBC RBC and PLT analyses is presented in the Sign Slide tab Ml Sian Side The signing procedure is as follows 1 Click Sign The Sign Slide dialog appears Database YourDatabase Type Processing User name my UserName Password IV Sign order when signing slide IV Sendto LIS Print order Cancel 2 Enter User name and Password 3 Activate deactivate the automatic options Sign order when signing slide Send to LIS and Print order 4 Click OK Note If the slide is part of a multi slide order all slides in the order must be signe
10. ie EER ER ER EE ER RE RE RR eee 86 10 1 6 Setting User Restrictions is EE RE ER EE EE RE RE EE ees 87 10 2 Adjusting Users Settings ES eee 87 10 3 Adjusting Analysis Settings EE SS ees 89 10 4 Adjusting Reclassification Settings EE cece 90 10 5 Adjusting RBC Precharacterization Settings llle 91 10 6 Adjusting PLT Settings 0 0 ccc tees 92 10 7 Adjusting Report Sign Settings llli 93 10 8 Adjusting Standard Comments Settings llle 94 10 9 Adjusting Reference Cells Settings 0 0 0 0 ccc ees 96 10 10 Adjusting E mail Settings naana SS tees 97 10 11 Adjusting Archiving Settings liliis 97 10 12 Adjusting Language Settings EE EE EE ees 102 10 13 Adjusting BF Analysis Area SS ES tees 103 10 13 1 Centering the Analysis Area EE ee ee ee 103 10 13 2 Adjusting the Size of the Analysis Area EE ee ee 105 11 QUALITY CONTROL 106 12 MAINTENANCE 107 12 1 Daily Maintenance ss si Bee ehh ERG RU RPG KE dan Rae dd HER ER BE ie DR 107 12 2 Weekly Maintenance sk EERS RENE EER E KEES ER DE BED RES REO Ree wae RE R 107 12 2 1 Cleaning of Objectives ie EE ER EE ER RR ER es 107 12 2 2 Slide Guides EE Ge es 108 12 2 3 Gomputef i cet RE de ndo ope AE iio EORR eek ie dea EE ood 108 12 2 4 Delete Unsigned Orders HERE EER SE RE EE ER RR kn ha 109 12 3 Preventive Maintenance llli es 109 12 4 Remedial
11. 12 2 Weekly objective Maintenance Slide status Dirty objective Perform weekly maintenance on the Light error when using 10x 50x 100x magnification Too dark specimen specified objective see 12 2 Weekly Maintenance Make sure that the slides are prepared according to the recommendations in Appendix G Condenser is dirty Clean condenser The microscope lamp is defective Replace the lamp see 12 4 2 Bulb Exchange High power images are not in focus Dust on the objective Perform weekly maintenance on the current objective see 12 2 Weekly Maintenance Incorrect objective settings Contact your local vendor s technical support Message box Critical internal error Message box An error occurred during oil dispensing Check the oil level The system must be restarted If the problem persists see troubleshooting section in the User s manual Temporary software error The oil container is empty Restart the SSU and the system computer Refill oil container There are air bubbles in the oil hose Restart the SSU run a slide Repeat until there are no air bubbles in the oil hose User s Manual 117 CELLAVISION o CellaVision DM96 Problem Cause Action Seemingly normal slides get slide status Empty or no slide PID The barcode reader is not connected Check the cabling of the barcode reader No bar
12. 3 Tagging Regions of Interest To save an enlarged area as a region of interest for later reference click Tag region Thrombocyte aggregate Blasts Tumor cells Identify your region of interest by adding a comment Tag Region ux e ed 74 User s Manual CELLAVISION e EVITE B VISTO 7 2 4 Copying Regions of Interest to Disk You can copy a region of interest to disk 1 Select a tagged region of interest in the list 2 Right click and select Copy the image to disk 3 Specify the destination path where you want the image to be saved use the browse button to navigate to a suitable folder 4 Click OK 7 2 5 Adding Comments To add a comment to the Overview click Scan comment Scan comment 7 2 6 Order Data To view information about the order e g scanned area and comments click Order Data in the toolbar The Order Data dialog can also be accessed by right clicking on an order in the database view zz To edit order data click Order Data E in the toolbar eM User s Manual 75 even er IE WATS enon D VISTO 7 3 Database View To view processed and pending orders click Database View Click Database View in the toolbar 7 3 1 Processed Orders Scanned slides are automatically signed For more details about Processed orders see 6 1 Database Processed Orders 7 3 2 Pending Orders A pending order ha
13. 75 0 76 0 x 25 0 26 0 x 0 9 1 2 ground edges clipped or round corners frosted end Note CellaVision DM96 analyzers with a serial number higher than 31216 or systems that have been upgraded with the Stage Upgrade Kit CellaVision Part number XU 10043 support slides with the following dimensions mm 75 0 76 0 x 25 0 26 3 x 0 9 1 2 Cont d User s Manual 135 maiin CellaVision DM96 Cont d Slide descriptions Clipped corners Round corner Images provided by Erie Scientific www eriesci com Caution Use only clipped round corner slides Failing to do so may cause jams and excessive wear on magazines and the system Caution Using the magazines more than 100 times may damage the system Barcode The system requires high quality barcode labels on the slides Maximize the barcode width for best result Note The magazines are supplied with barcode labels If you replace the barcode label the new barcode must not contain the character Linear Barcode Scanner The following barcode formats are accepted by the system UPC A Interleave 2 of 5 CODE 11 UPC E Industrial 25 China Postage EAN 13 Matrix 25 MSI PLESSEY CODE 39 CODABAR NW7 CODE 32 CODE 128 CODE 93 BC412 The highest barcode resolution supported is 7 mil Note A quiet zone is required see the barcode specification for more information Cont d 136 User s Manual CELLAVISION 6 er LEVAT mE BY VISTO Cont d The
14. Appendix C Buttons and Indicators System status is shown as a text Idle Analyzing Stopped Paused or Error System status System indicators Cellavision Blood Differential Software DM96 la xj Analyzing Syst trol i EN er MEEN WBC Count x10e9 L amp Y Unidentified s Cells counted 12 of total 100 F Band neutrophil EA Estimated tie left 1714 minules 2 Semona neutrophil 2 167 12E H A 0606201847 Eosinophil i By 0506170369 Basophil m 0506170390 Lymphocyte 10 83 3 55 A 0601270204 T 3 z A 0606201842 MEDE S A 0506170387 Promyelocyte Hf 0606201841 F Myelocyte lassiy Metamyelocyte using high power magnification Blast no lineage spec Lymphocyte variant form Plasma cell 5 Other Total 12 100 70 ao Non WBC Count Enythroblast NRB Porem nate ede 2 167 Patient ID 530101 3578 z Thrombocyte aggregation First name Robert li i 3 Smudge cell 6 A7 Bei home oume Artefact 3 250 Gender Male Birthdate 1953 10 01 Ethnic origin Ward Comment RBC i s 55 Polychromasia OOOO Hypochromasia OOOO Slide data Latest found cells aren 1 Weser 0606201844 i E IERE OOOO Slide position 1 MU OOOO Slide ID 6 E Macrocytosis OOOO Order ID 6 e SIRENE 0000 Slide number 2 2 Sample date 2003 05 16 Lymphocyte Artefact Lymphocyte Ready
15. Could not find the Leading spaces in Remove leading spaces in the Order ID order in the LIS the Order ID See section 12 2 5 for LIS errors Rim H H HM I A N 126 User s Manual 13 2 9 Staining Problems CELLAVISION CellaVision DM96 Problem The red cells appear bright red the white cells will appear indistinct with pale blue rather than purple nuclei and brilliant red eosinophilic granules will be seen microscopically Cause Understaining Action The fixation and staining time may be increased Overwashing The washing technigue may be corrected so that it is adequate but not excessive Use of stain buffer or wash water that is too acidic The pH of the buffer may be checked with a pH meter and adjusted The increased acidity is due to exposure of the stain or buffer to acid fumes Use a new batch of stain or buffer Pale inadequately stained red cells nuclei or eosinophilic granules The erythrocytes appear blue or green the nuclear chromatin is deep blue or black and the granules of the neutrophilic granulocytes are deeply overstained and appear large and prominent The granules of the eosinophils are blue or gray Understaining The fixation and staining ti
16. EE User s Manual 31 E C 07 1 FE WATS enon D VISTO 3 1 3 E mail You may send cell images by e mail 1 Select select for e mail using the right click menu 2 Select Tools Send E mail and the New E mail dialog appears New E mail doctor hospital Mail from CellaVision DM System with cell images For default values see E mail tab in Settings 3 If desired change receiver address 4 If desired add Subject and Message 5 Click Send Note You may only send cells from one slide in each e mail 32 User s Manual CELLAVISION CellaVision DM96 3 1 4 Copying Images to Disk You may copy selected images to disk 1 Select cells for copying 2 In the right click menu select Copy images to disk and the Copy images to disk dialog appears 3 Specify the destination path where you want the images to be saved use the browse button to navigate to a suitable folder 4 Click OK Note The directory you specify in the destination path must exist 3 2 Red Blood Cell Characterization The RBC overview image corresponds to the area of 8 microscopic high power fields HPF 100x objective and a 22 mm ocular See 10 5 Adjusting RBC Precharacterization Settings g wee BE mec PLT il Sion side o ovo E Um 7o OE v C A d sm abe O80 oso opo o9 oh 00 wet oe oats Shed Eie aein Rog 9 90 9e A 99 2 o9 o 9 0o f 9 so Q9009 g 002280 0 20 Ls o S
17. ER RE EE ER ee 63 6 1 4 Protecting an Order its cee eae BEELDE R RR ER SE ER AREA RR Re EE KOR RE R 63 2 User s Manual CELLAVISION e ENA eno B VISTO 6 1 5 Searching for an Order Slide ie EE EE EE Re dd Ee kk ee 64 6 1 6 Deleting an Order Slide ER EE ER RE ee 64 6 1 7 Exporting OSSE SR KERR RR DR RCRCACR ded tea bee A Rack Me eee Ree Ke ee 64 6 1 8 Copying Images to DISK iss ER eren SS RYE BREER RE Ee e 65 6 1 9 Printing Orders RR ER OE EE a ED A 65 6 1 10 The WorklisSt ARE EN OE KIE ORE N ER ORE OR ON 65 6 2 Database Pending Orders 2 ER EE ER EE RE eee 66 6 2 1 Pending Orders Dialog for Peripheral Blood 20 0005 67 6 2 2 Pending Orders Dialog for Body Fluid 0 0 68 6 3 FACTIVA RE ie EN EER NS OE OE EE EE A 68 6 4 Usage LO9 sis BEK SERE RR ERR REEN KOEKE RE EER ER E ROER ER EER EE ER NE E 69 EA Es KERE rm 69 6 4 2 Specification EE EE EE Ee eens 69 6 5 Export Log Filas iem hrc Bron ce SE te i eai c de dr gee ER tga SE Soe pees 70 6 6 Backup and Recovery of the Database 00 00 cece ees 70 7 DIGITAL SLIDES 71 71 Scanning a Slide is ees EES SE ee Mae Ae Maes RE OO ae ba EE eee oe 71 7 1 1 Slide and Magazine Reguirements EE EE EE Ee eee 71 7 2 Stan Overview Image scusa ks eo Re MR ER EER BREER RSD KERE REM DERS CARTA 72 AG EER EE EE IE EL ee eee od eet 72 Ne is ORE SR ces as MD cae ddp Eon i buc bad seus oe eens poa G 73 7 2 3
18. Howell Jolly bodies Pappenheimer bodies Basophilic stippling Parasites and 10 user defined characteristics Platelet Estimation The operator counts or estimates platelets in an overview image Sample Preparation To perform a peripheral blood differential count a thin blood film is wedged on a glass slide a blood smear from a peripheral blood sample and stained with Romanowsky stain see Appendix G Slide Preparation Guidelines for recommended staining recipes User s Manual 11 CELLAVISION o 7 FE WATS enon D VISTO 1 3 2 Body Fluid Application General Functionality e Presents an image on a screen of every located cell or object Organizes and suggests cell classification preclassification for the located blood cells Makes it possible to identify confirm or modify reclassification the suggested classification of the located cells Presents an overview image Preclassification for Body Fluid The system preclassifies the following WBC classes Neutrophils Eosinophils Lymphocytes Macrophages including Monocytes and Other Cells pre classified as Basophils Lymphoma cells Atypical lymphocytes Blasts and Tumor cells are automatically forwarded to the cell class Other Unidentified is a class for cells and objects which the system has pre classified with a low confidence level The system preclassifies the following non WBCs Smudge cells and Artefacts Non WBCS are reported as number of cell
19. MB A processed slide with 100 WBCs and RBC and or PLT ordered will require about 6 MB of hard disk space Hard Disk Space Requirements Body Fluids A processed slide with 100 WBCs collected will require about 5 MB of hard disk space For an analysis area with a diameter of 6 mm thel0x overview images require about 15 MB and 50x overview images require about 130 MB A processed slide with 100 WBCs 10x and 50x overview images ordered will require about 150 MB of hard disk space 6 mm analysis area Increasing the analysis area from 6 mm to 8 mm will require 7896 more disk space for the overview images User s Manual 101 E O7 Fe WATS enon D VISTO 10 12 Adjusting Language Settings In the Language tab you set language for the user interface and manual nglish 102 User s Manual CELLAVISION CellaVision DM96 10 13 Adjusting BF Analysis Area 10 13 1 Centering the Analysis Area Before using the system for the first time or when necessary define the sample spot location This is done in 7ools Settings BF Analysis Area Centrifuge diameter 6 0 mml x position 13 0 mm v position 38 5 mm diameter 7 0 mm er EE e x position 13 0 mm y position 25 0 mmj StatSpin Ee CytoPro x offset 1 71 50 mm Y offset 1 50 mm Diameter 800 mm BF Analysis Area The centrifuge choice provides a rough calibration of the sample position and size Typically the positi
20. Mini map to enlarge another part of the sample A blue trace in the Mini map indicates which parts of the overview image that have been viewed by the operator Hold left mouse button down and scroll in any direction using e the mouse Switch between the two zoom levels by right clicking in the overview image Adjust the zoom level by dragging the sliders in the Zoom panel p Eu a E ee 50 User s Manual CELLAVISION 6 CellaVision DM96 4 2 2 Tagging Regions of Interest The image shown in the right part of the screen can be saved as a region of interest for later reference Thrombocyte aggregate Blasts Tumor cells 1 To save the current image click 7ag region 2 Add a comment as an identifier for the region of interest and click OK Tag Region Ee x d ee EE EE EE EE EE EE SSS User s Manual 51 CELLAVISION o CellaVision DM96 4 2 3 Copying Regions of Interest to Disk You can copy an individual region of interest image to disk 1 Select a region of interest 2 On the right click menu select Copy image to disk and the Copy the image to disk dialog appears 3 Specify the destination path where you want the image to be saved use the browse button to navigate to a suitable folder 4 Click OK Note The directory you specify in the destination path must exist 4 3 Comments Comments can be added to the Overview t
21. ScanDB Scan Disconnect EOMpess 84 User s Manual CELLAVISION EVAO mE B VISTO 10 1 1 Creating a New Database 1 Click Create A dialog appears where you may enter Database name Description Home directory and Database size 2 Select one of the following types of database Processing database a database for processing slides Export database a database that is used when you want to export orders from another database This type cannot be used for processing slides CellaVision Competency Software database a database for use with CellaVision Competency Software A CellaVision Competency Software database cannot be used for processing slides Scan database a database for scanned slides 3 Click Create A new folder with the chosen Database name will be created in the specified Home directory Create a Database Database name Description Home directory JC Program FilesCellavisionsBloodDifferentialN m Type of database Processing database Normal C Scan database C Export database CellaVision Competency Software database Database size 20000 MB Free disc space 58284 MB Note Creating a database can take up to 20 minutes cen Creating a database requires that there is sufficient free disk space A processing database requires 20 GB a scan database requires 20 GB an export database requires 1 GB and a CellaVision Competency Softwa
22. Slide Transport Jam Restart the SSU and the program If error persists Contact your local vendor s technical support Message box Critical temperature error Critical temperature in the SSU Shut down the SSU and contact your local vendor s technical support Message box Critical communication error No connection between the SSU and the system computer Check the connection between the SSU and the system computer Check power connection to the SSU Restart the system and the program Message box Magazine infeed error Remove the magazine if it is stuck Restart the system If the problem persists see troubleshooting section in the User s manual The magazine is stuck Remove the magazine see 13 2 11 Magazine Transport Jam Restart the SSU and the program Message box Positioning failure when reading the slide barcode Remove the slide if it is stuck or broken The system must be restarted If the problem persists see troubleshooting section in the User s manual The slide is stuck or broken Remove the slide see 13 2 10 Slide Transport Jam Restart the SSU and the program User s Manual 119 CELLAVISION 6 CellaVision DM96 BE EE EE ees User s Manual 120 Problem Cause Action Message box Positioning error when moving the slide from the magazine into the slide holder Remove the slide if it is stuck or broke
23. There was a general error when accessing the recorder Check error logs If a problem occurred previously while trying to archive it may be that the recorder has not been unlocked Restart the system computer and the program and try archiving again Message box The chosen location for the temporary archive files used for burning does not have enough space Free up space at the location and try again Automatic deletion is enabled instead of archiving and the deletion starts but does not delete any or all of the older orders matching the criteria The volume or media chosen to store the temporary when recording to CD or actual archive does not have enough room left A database exception occurred either due to an error in the database or due to a transaction conflict when a CellaVision Remote Review Software opens an old order just as it is about to be deleted Contact your Administrator Free up space for the temporary image NOTE When archiving to LAN or a hard drive on the computer the archiving wizard requires at least 1 Gb If CD recording is used the archiving wizard requires 3 times the capacity of the CD in temporary working space i e for a 650 Mb disc 1950 Mb of free space is required Try setting the limit on the number of orders matching the criteria for automatic deletion lower zero and let the program start the deletion again You can also sort the orders in
24. User s Manual Cont d Recommended Staining Recipes CellaVision DM is optimized to analyze samples stained with May Griinwald CELLAVISION CellaVision DM96 Giemsa MGG stain and Wright stain Dip the slides in the solutions according to one of the following recipes MGG Stain Note Differences in staining results may be cause by alterations in pH reagents etc Local adjustments may be needed to achieve best results Be aware of pH variations in water Alternative 1 Solution Reaction time Change solution 1 May Gr nwald stock solution a 5 min Twice a week 2 May Gr nwald working solution b 15 min Every day 3 Buffer working solution d Quick rinsing Every day 4 Giemsa working solution f 30 min Every day 5 Buffer working solution d Extensive rinsing Every day Alternative 2 Solution Reaction time Change solution 1 May Grunwald stock solution a 5 min Twice a week 2 Buffer working solution d Quick rinsing Every day 3 Giemsa working solution f 10 min Every day 4 Buffer working solution d Extensive rinsing Every day Cont d User s Manual 153 CELLAVISION o CellaVision DM96 Cont d a May Gr nwald stain stock solution Merck M1424 Eosin methylenblue solution modified for microscopy contains methanol Store at 15 C to 25 C b May Gr nwald working solution Dilute 1 part of May Gr nwald stock solution with 1 pa
25. a cell class have been displayed It is not possible to sign the slide unless all cell classes have been viewed Reference Cells A library of reference cells for different cell classes is provided with the system These cells are marked with a CellaVision logotype The main gallery always displays WBCs from the slide while the other show reference cells when checkbox Reference cells is activated The main gallery has shortcuts to display reference cells in the other galleries Click Ref cells in Gallery 2 and the 2 4 gallery will display reference cells of the cell class selected in the main gallery a Indicates reference cell provided with the system You may expand this library by saving WBCs from processed slides as custom reference cells 1 Right click on the WBC 2 Select Save as custom ref cell in the menu 3 Restart the program The WBC will be displayed at the top of the 2nd or 3rd galleries followed by the reference cells provided with the system If you want to organize your custom reference cells see 10 9 Adjusting Reference Cells Settings Note Reference cells are not available for body fluids Cont d User s Manual 27 NE E EVAO D VISTO Cont d Cell Class Comments Click Comment in the galleries to add a cell class comment A pen icon will appear to the right in the WBC and Non WBCS panels Click this icon to view edit or add more comments see 3 4 Comments WBC Full Screen Vie
26. a completely different cell thus the same cell can be counted more than once see 13 Troubleshooting Note To make sure duplicate cells are not included in the differential count it is recommended to screen all cell images for duplicate cells when a green square only covers part of a cell A duplicate cell should be removed from the differential 30 User s Manual CELLAVISION CellaVision DM96 WBC Attributes Each cell is associated with attributes Cell has been forwarded from another cell class Indicates the order in the class Reclassified cell Cell is selected for Cell comments exist e mail lt The image has been manually captured on a CellaVision Image Capture System WBC attributes are shown by default Click WBC Attributes to show hide them Note It is not possible to hide the Cella Vision Image Capture System symbol 27 WBC Attributes Right click Menu Right click on a cell to set view attributes A menu appears allowing the following options View DM s Ist 2nd and 3rd suggestions of classification Reclassify cell Add view cell comments see 3 4 Comments Split cell or remove split cell Select cell for e mail Save cell as custom reference cell NNN BL PD Save images to disk Note All alternatives are not available for images captured on a CellaVision Image Capture System EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE
27. admin YourDatabase num SERL A start L German screendumps ir 2 2 System control view uy 2 1 Logon dialog bmp P ra CellaVision Blood Dif E 01 50 PM User s Manual 17 CELLAVISION 6 7 FE WATS enon D VISTO 2 3 Slides and Magazines 2 3 1 Barcodes Important Only slides labeled with barcodes can be processed Use only barcode formats appropriate for the system see Appendix A System Specification Magazine ID The barcode on the magazine is the magazine ID When the system has no LIS connection the magazine ID determines the analysis type Orange magazines with barcodes consisting solely of digits a peripheral blood analysis will be performed e Blue magazines with barcodes consisting of the prefix BFS followed by digits a body fluid analysis will be performed Note LIS order will override the magazine barcode in determining analysis type Slide ID The Slide ID is the barcode printed on the slide s label Cont d 18 User s Manual CELLAVISION CellaVision DM96 Cont d When processing a slide the system searches for order data in the following order 1 In the database unsigned orders with the same Order ID 2 In the database pending orders 3 From the LIS 4 Default values defined in the Analysis tab in Settings 2 4 Loading Slides into a Magazine Load the slide into the magazine with the barcode upwards and towards the operator
28. are always accessible 4 Click OK Deleting a Standard Comment 1 Select the standard comment in the list 2 Click Delete Modifying a Standard Comment 1 Select the standard comment in the list 2 Click Modify and the Standard Comments Editor appears 3 Edit Code Comment type and Comment 4 Click OK EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE M User s Manual 95 eine 7 FE WATS enon D VISTO 10 9 Adjusting Reference Cells Settings Click on a cell class to see a list of all Custom reference cells belonging to it Click on a specific cell to display it in the Preview window Promyelocyte Myelocyte Metamyelocyte Immature eosinophil Immature basophil Promonocyte Prolymphocyte Blast no lineage spec Lymphocyte variant form Plasma cell Large granular lymphocyte Hairy cell S zary cell Dther Erythroblast NRBC Giant thrombocyte Thrombocyte aggregation Megakaryocyte Smudge cell Artefact Click Add to add custom reference cells from disk Valid file formats are JPEG jpg and bitmap bmp All cell images will be stored in the JPEG format You can also store cells from processed slides see Right click Menu in 3 1 2 Reclassifying White Blood Cells as custom reference cells Click Delete to remove the selected custom reference cell FEE SEE ND ET ee 96 User s Manual CELLAVISION 10 10 Adjusting E mail Settings
29. cells Horizontal quiet zone cells Symbology Top Bottom Top Bottom DataMatrix 1 1 1 1 QR 4 4 4 4 QUIET ZONE QUIET ZONE Barcode position The barcode shall be positioned within the area as illustrated in the figure Where X1 gt 2 mm X2 gt 6 mm Y gt 4 mm u User s Manual 139 ET er VIG T2 D VISTO Firefighting Procedures Fire and explosion hazard Flash point immersion oil gt 300 F 149 C Upper explosive limit N A Lower explosive limit N A Fire fighting media Carbon dioxide foam dry chemical and waterfog Fire response procedures Fire fighters must use self contained breathing apparatus Unusual fire and explosion hazards Containers should be kept cool in the event of fire 140 User s Manual CELLAVISION Appendix B Storage and Handling Storage The system shall be stored within the following climate condition 10 C to 40 C 50 F to 104 F at a maximum relative humidity of 80 with no condensation allowed Transporting the System The system shall be packaged transported and unpacked by CellaVision authorized personnel carrier only We recommend saving the package for possible future transports Disposal Information Magazines As combustible plastics PC ABS The system Please contact your distributor User s Manual 141 eek io CellaVision DM96 Appendix C Buttons and Indicators If you place the mouse p
30. label should be positioned as shown in the figure The edges of the label shall be at least 1 mm from the edges of the slide Note Avoid oil on the slide label Barcode length t Barcode width N 2D D Barcode Scanner The following barcode formats are accepted by the system Linear codes CODE 39 CODABAR NWT7 Code 128 Interleave 2 of 5 2D D codes DataMatrix OR Cont d User s Manual 137 CELLAVISION o CellaVision DM96 Cont d Requirements Sample ID When using either a DataMatrix or a QR code the only information allowed in the code is a sample ID i e no other data which may be at most 24 characters long but which may be padded with spaces ASCII code 32 No leading spaces are allowed Print quality The printed barcode shall be resistant to immersion oil and be printed with a high contrast ratio between background and the printed barcode If the barcode is printed directly onto a slide it must be printed on a white smooth frosted area of the slide Barcode size The following barcode resolutions have been verified at CellaVision AB Supported code resolution Code Cell size mil QR 13 DataMatrix 9 Code 39 7 Code 128 7 Codabar NW7 7 Interleave 2 of 5 7 Cont d 138 User s Manual CELLAVISION eL VA TS mE B VISTO Cont d Quiet zone The recommended guiet zone is listed in the table below Vertical quiet zone
31. must exist 6 1 9 Printing Orders You can print order data and data for all slides belonging to it Select the order slide and select Print in the File menu Note Order results exist only if the order contains at least one signed slide 6 1 10 The Worklist The Worklist facilitates an automatic workflow see Appendix D Recommended Workflow The Worklist contains shortcuts to slides It is also active in Verification view to simplify opening of new slides Double click on a slide or click Open to open it Click Remove to remove slides from the Worklist When a slide is signed or closed it is automatically removed Note Show hide the Worklist by pressing Ctrl W Adding Slides to the Worklist Slides may be added to the Worklist both manually and automatically A Manually 1 Select one or more orders 2 Click Add to worklist Al slides belonging to the order s are added B Automatically 1 Slides are added when the system finishes processing them This option is set in Analysis in Settings 2 When you open an order all slides belonging to it are added Note When the program is closed the Worklist is emptied Note BF slides are not automatically added to the worklist User s Manual 65 eeuse er IE VERE INER 6 2 Database Pending Orders This tab contains a list of all pending orders A pending order is an order that has been manually added to the database but not yet processed This is useful if
32. o0 DO Spo 99 2000 c e OS ot eo 9 O OO oF o Number of ABCs used for precharacterization ERN x 90 odo b E Sed eed e ogee d teo 2 S eet eset to Precheracterzation Pe e 99 o 8099 o 9 ie 1 99 90 eo oo o 8 o o Exclude ABC Analysis 9o t 90 g 9e wo Oo 0 Se Bo Soe goe 00088 en 099 See 80 O 0 4 9 o3 e eo 99 oo 009 008099 ORE 9 9 de oo oeo eg oe id e RBC comment o o9 c S 2200 o 396 o 8S Wo a Ei ry voe y Hao K 2 id H o o ads e Ox The RBC panel is used for characterization of the RBC morphology All morphologies handled by the system are listed Morphologies precharacterized by the system are marked with a small dot Cont d User s Manual 33 CELLAVISION o CellaVision DM96 Cont d The columns labeled 0 to 3 grade the morphology characteristics Normal Green dot in column indicates a normal level Slight Red dot in column 1 indicates that the morphology is present at a low level Moderate Red dots in column 1 2 indicate that the morphology is present at a moderate level Marked Red dots in column 1 3 indicate that the morphology is present at a high level The rightmost column shows the percentage of RBCs in the overview image with the characteristic in question If the precharacterization is overridden by manual characterization the percentage is shown dimmed In the bottom right hand corner of the RBC image there is a cross shaped ruler tha
33. of lines is drawn over the image to facilitate the counting of PLTs Note Help Lines are disabled for images captured on a CellaVision Image Capture System There are two ways or modes to perform the PLT estimation This is determined in PLT settings see 10 6 Adjusting PLT Settings 1 Counting PLTs in the overview image 2 Estimating the PLT concentration level Note When a slide is opened for the first time the slide gets mode according to the settings and the mode can then not be changed for that order The system ensures that all slides in a multi slide order have the same mode Note It is not possible to use Counting PLIS in the overview image for images captured on a CellaVision Image Capture System EE EE EE EE EE EE EE EE M User s Manual 37 eave 7 Fe WATS enon D VISTO 3 3 1 Counting Platelets in the Overview Image PLT Count The estimation of the PLT concentration is based on the number of PLTs which must be counted manually You can choose to count the number of PLTs in each grid square or to specify an approximate number of PLTs per grid square PLT count Grid size 4 x4 0 50 HPF square Count PLTs per arid square P P EE M 7 3 3 c EFF EE C Approximate PLTs per grid square Calculate PLT Result a Counting PLTs per grid square 1 Select the Count PLTs per grid square radio but
34. phosphate 6 min 30 sec buffer pH 7 2 4 Rinse in phosphate buffer pH 7 2 1 min 15 sec 5 Rinse in deionized water 45 sec Wright stain alternative 2 can also be used for manual dip method la User s Manual 155 CELLAVISION o Slide preparation for body fluid WARNING Always use protective gloves when in contact with Body Fluids Sample Quantitative assessment of cell counts and preparation of slides should be performed within 2 hours of collection Preparing the Sample Count the WBC and RBC concentration of the fluid For best results dilute samples with high cell density Buffered saline or standard tissue culture media both with a drop or two of bovine serum albumin BSA which promotes cell adhesion to the microscope slide may be used as a diluent The recommendation is to have 5000 12000 cells in total on the slide Note Cells are concentrated approximately 20 fold by cytocentrifugation however the quantitative yield varies from 30 75 The speed and time of centrifugation the amount of sample in the chamber and the filter paper absorbance are factors that can influence both the cell yield and morphology ref Body Fluid Analysis for Cellular Composition CLSI H56 A Vol 26 No 26 Use a clean dry microscope glass slide see Appendix A System Specification for required slide types Centrifuge the sample according to the manufacturer s recommendation Dry the slide rapidly Note Do not use
35. then hold down Ctrl and select each additional order by clicking on it Mark a sequence of orders by clicking on the start order then hold down Shift before selecting the last order of the sequence p User s Manual 63 CELLAVISION o er WATS enon D VISTO 6 1 5 Searching for an Order Slide You select the orders to be displayed using the Search criteria Here you may specify date intervals for desired orders Use View latest as a shortcut for orders less than one week old You may also add search strings for patient data order data and comments If the database contains a slide with images captured on a CellaVision Image Capture System and you choose View CellaVision Image Capture System you may also specify a laboratory in the drop down list to the right 6 1 6 Deleting an Order Slide A selected order slide can be deleted by clicking Delete Select multiple orders slides using Ctrl or Shift When all slides in an order have been deleted the order is automatically deleted Note Signed slides cannot be deleted However deleting an order deletes all slides in the order signed or not Only Administrators can delete signed orders 6 1 7 Exporting Orders You may export signed orders from the current database to another one An export database or a CellaVision Competency Software database must be created before exporting can start This can be done in th
36. they contain any missed nucleated cells Green boxes mark the nucleated cells and blue boxes mark other found objects that are not nucleated cells e g artefacts Missed nucleated cells are those cells not marked with a box in the image Double click in the overview image to magnify the area of interest Black boxes mark the number of cells that were located but not needed for the test indicating that the system has located enough cells for the test and is coming to an end Note On screen cell images are not always presented in the same order as the system is working Cells marked with black boxes may occur in the middle of the test not only towards the end Cont d 158 User s Manual CELLAVISION CellaVision DM96 Cont d n Looking at image X of a total of Y images Overview images Step one image back or forth lt KKKKK Image 4 34 Number of nucleated cells in the image WBCs NRBCs found 11 shown WBCs NRBCs missed i zd Number of missed nucleated cells in the image shown number entered by the user Image status Empty Image has not been viewed of Image has been viewed and has no missed nucleated cells v Image has been viewed but contains missed nucleated cells The Result When a slide has been examined a result is automatically calculated The percentage indicates how many nucleated cells the system found including the manually added number of missed cells It is
37. two or more different cells To minimize the amount of disintegrated cells make sure the blood films are prepared within four hours of blood collection see Appendix G Slide Preparation Guidelines To minimize the amount of smudge cells verify your smear preparation process To be able to identify and exclude duplicate cells activate the Cell Marker function during verification see 3 1 2 Reclassifying White Blood Cells 124 User s Manual CELLAVISION CellaVision DM96 Cell Location Problems Body Fluids Problem Cause Action Too many non Too many smudge Run another slide with less smudge WBCs cells cells Verify sample preparation process Decrease centrifuge speed Too many artefacts Increase wash step Filter the stain Ensure that the stain has not exceeded the expiration date Cells misclassified as Run another slide and if the problem non nucleated cells remains prepare new staining solutions Too few WBCs Few WBCs in Use a larger sample volume located sample Nearly all boxes are far from the cells Stage or calibration error Contact your local vendor s technical support Too many missed cells Same cell counted more than once duplicate cell images are shown by the system Too many WBCs in the sample Do not process slides where the number of WBCs exceeds the recommended amount Poor staining
38. you do not have a connection to the LIS Note When an order has been processed it will be removed from the Pending Orders list and added to the Processed Orders list ES Processed Orders d Pending Orders Orderin 1 1 1 Patien FirstName LastName Bithdate Nbr of cells Sample Date Ordering P MT Order 400 560421 2234 Michelle Lawson 1956 04 21 2001 02 12 Dr Spocl MT Order 390 680124 2334 Margret Clark 1968 01 24 1997 10 30 Ester MT Order 380 560121 2234 Eddie Levinson 1956 01 21 125 2001 02 12 Dr Spock MT Order 370 680224 2334 Mike Elson 1968 02 24 150 1994 10 30 Sister MT Order 360 480624 2234 Sid Fernwilter 1948 06 24 200 1999 12 31 Ester MT Order 350 560421 2234 Clara Spielberg 1956 04 21 2001 02 12 Dr Spock MT Order 340 580124 2334 Louise Clark 1968 01 24 1997 10 30 Ester MT Order 330 560121 2234 Billy Hutchinson 1956 01 21 100 2001 02 12 Dr Spock MT Order 320 680224 2334 Mike Carlson 1968 02 24 100 1994 10 30 Sister MT Order 310 780624 2234 Nicky Rooney 1978 06 24 100 1999 12 31 Ester Add Edit Delete STAT mark Empty field Not a STAT order Order is marked as a STAT order Order type Empty field Peripheral blood order e CellaVision Image Capture System order Gb Body fluid order Click Add to add a new pending order Double click on a pending order or click Edit to view edit the Order Data Ree
39. 1 Customizing Views sos VEER ERGE RE weh ev EDE RR PR SEPT ee sees 27 3 1 2 Reclassifying White Blood Cells is RE EE RE ER RE EER RE ee 29 ENS AI E RE T TERCER TE 32 3 1 4 Copying Images to DISK iis sex Re RAE DEGREE RE en EER EER KAR SR 33 3 2 Red Blood Cell Characterization EE EE EE ER EE EE EE RR RE EE EE Re EE ee 33 3 2 1 Customizing the Red Blood Cell Overview Image EE EE EE 35 3 2 2 Characterizing Red Blood Cell Morphology EE EE EE EE EE ke ee 36 User s Manual 1 CELLAVISION 6 CellaVision DM96 3 2 3 Excluding the Red Blood Cell Analysis llle 36 3 3 Estimating Platelets x sius bao boc ee ce ox Doe RED ER ctio ad Esdr Re 37 3 3 1 Counting Platelets in the Overview Image llli eee eee 38 3 3 2 Estimating the Platelet Concentration Level EE EE EE 0 eee eee 40 3 3 8 Excluding the Platelet Analysis sie is Es RE EE EE ER RE eee 41 OM ING ss OE RR Seda ae ese ood we ee ee dono ey ies itus ioa tue Receta oA etd 41 3 4 1 Adding Comments RE cr pene ei ka DER ER kod ew RR ERE BEER EER KERE 42 oo Order Dale si EE EE BEHOED EO EE DR canbe ses een GR n eee EE 43 3 6 SIGNING a Slide s se sass prepu itia aapa EE Meee Launder RE DAE RD ra Er a a 44 3 6 1 White Blood Cells Red Blood Cells and Platelets 45 4 VERIFYING PROCESSED SLIDES BODY FLUIDS 46 4 1 Body Fluids Differential Ed ERROR BEE ER ES chu EED RE DE GN ed 46 4 1 1 Customizing VIEWS
40. 2 2 1 Cleaning of Objectives 1 Make sure there are no magazines in the system 2 Shut down the system according to the instructions in this manual 3 Open the main hatch 4 Clean the lens on all objectives by wiping them gently with lens paper Always use a fresh lens paper to avoid oil contamination To reach all lenses carefully turn the objective turret 5 Apply step 5 11 only on the high power wet objectives Put a drop of isopropyl alcohol on a piece of crumbled lens paper Do not use an excessive amount of solvent 6 Wipe the objective once to remove most of the oil Do not use a circular motion to clean lenses as this increases the risk of scratching the surface 7 Take a new piece of lens paper and put a drop of lens cleaner in the middle 8 Place the lens paper over the objective 9 Use a cotton swab to gently hold the paper against the objective while you drag the lens paper away from the objective Cont d User s Manual 107 TT E CellaVision DM96 Cont d 10 The cotton swab should remain over the center of the objective and the lens paper under it should be wet If the lens paper dries out then repeat starting on a wet but non oily spot on the lens 11 Repeat once from step 5 Important Make sure there is no oil on the low power 10x dry objective Important Cleaning with alcohol increases the risk of air bubbles on the objective which affects the image quality for the first two
41. Appendix A System Specification for required slide types Note that glass slides may lose their wetability on exposure to air resulting in a poor smear 3 Use the wedge technique performed manually or by a mechanical spreader Manual wedge technique Place a drop of blood near the labeled end of the slide Narrow a spreader slide with polished edges at a 30 to 45 degree angle to the smear slide Allow the blood to spread almost over the entire width of the slide Then rapidly and smoothly push the spreader slide to the opposite end of the slide There should be a gradual transition in thickness without any grainy streaks troughs ridges holes or bubbles The blood film must be at least 30 mm in length terminating 5 15 mm from the edge Cont d 150 User s Manual CELLAVISION 6 CellaVision DM96 Cont d 4 Dry the slide rapidly 5 Stain the slide within one hour i 5 15 mm 33 mm The dot in the figure indicates the analysis starting point The analysis proceeds from the starting point towards the thinner part of the smear User s Manual 151 e CELLAVISION Example Smears The line in the figures indicates the analysis starting point Accepted a These slides are all prepared according to the specifications and will be accepted in the DM8 DM96 Not Accepted Mm n These slides are not prepared according the specifications and will not be accepted in the DM8 DM96 Cont d 152
42. BE is SEER SEER DEER EER EER 68 97 Authorization Levels 148 AMNOStAN ux a dda rec vE E usss 20 143 B BACKS 63 des eee KERE RE ERE 70 Barcode ES eee 18 126 Batch Stat 52 2 oe ER R EER ba tk ee 21 l P rm 9 Blood Films ee es es ee es ee 150 Body Fluids Differential 46 Bulb Exchange EERS ence en 111 BUNO0S REP 142 C Canceling an Order sivo s 57 CellaVision Remote Review Software 13 Color and Brightness 28 Comment Panel si Ee ous Ry ES 55 Comments 41 52 61 62 94 Creating a New Database 85 D le nr 58 Database View 24 46 58 76 142 Default Valves Ss ads sae ers ers 22 Deleting a Database 86 Deleting an Order Slide 64 Digital SERS ii EER yer ER ERR ER 71 Disposal Information 141 Duplicate Slides 00200 147 E E mail cee evade bed e RR 32 48 entry fields cad ak KERR ex ce gee ER 37 Error TERS Sa mae 22 Estinatlng sw ona d ee MEd Os eas deca Ss 37 Excluding the Platelet Analysis 4 Excluding the Red Blood Cell Analysis 36 F Full Screen VIEW ss exa ER ED Ren 28 G Galles ya Ve GEED Suse Y RE AE 27 grid squares i294 ce ak a eri e ER ER 37 H high power fields 33 37 l IndicatoTS EES SE see 142 143 Inserting the slide holder 20 L LIS PR 56 LIS status 42 EER Ee 8 toned 60 123 Loadi
43. Cell Location tool Pre printed QC labels are available from your local dealer Running a Cell Location Test 1 Select a slide that meets the requirements and put a QC label on it 2 Put the slide in a magazine place it in the DM and process the slide 3 Go to the Cell Location tool when the slide has finished 4 Select the new slide at the top of the slide list 5 Go through all the images belonging to the slide and examine them for missed nucleated cells Enter the number of missed cells if any in the input field for each image 6 When all images have been examined the result will appear at the end Check that it is within acceptable limits Cont d User s Manual 157 sendende CellaVision DM96 Cont d Examining a Cell Location Slide Select the slide in question from the list of cell location slides Cell location slides Slide ID Analyzed QC035 2006 08 22 08 30 Qc t 2006 08 22 08 25 v cong 2006 08 22 08 16 v C036 2006 08 21 14 19 ocw20 2006 08 21 08 22 x Slide status v Empty Slide has no result not all images have been examined T Slide has a result and no missed nucleated cells all images have been examined di Slide has a result but contains missed nucleated cells all images have been examined Q Slide error probably due to a failure in slide processing e g not enough nucleated cells were found Go through each image in the list of overview images and check if
44. CellaVision DM96 USER S MANUAL 3 1 3 2 CELLAVISION CellaVision DM96 User s Manual CELLAVISION DIGITAL CELL MORPHOLOGY Software Accessories and Consumables CellaVision Remote Review Software CellaVision Remote Review Software gives remote users access to analyzed slides with the possibility to reclassify cells and sign slides from another location Smears needing a second opinion can easily be reviewed by a pathologist from within or outside the hospital CellaVision Competency Software CellaVision Competency Software is a program for education and competency testing of manual blood cell differentials in laboratories The product allows labs to ensure that staffs are trained to report results consistent with lab policies CellaVision Body Fluid Application By using CellaVision Body Fluid Application body fluids including cerebrospinal peritoneal and pleural fluids can be analyzed on the CellaVision DM Analyzer Utilizing a cytocentrifuge slide preparation the analyzer automatically performs a preliminary differential of nucleated cells and allows the user to scan the entire sample area CellaVision Light tower The CellaVision Light Tower provides visual and audible signals of the status of a CellaVision DM Analyzer easily identifiable even at a distance It advises laboratory professionals when an operation is running is finished or signals an equipment malfunction HemaPrep Automated Bl
45. Community and indicates separate disposal of waste of electrical and electronic equipment On Supply ol h Off Supply 8 User s Manual CELLAVISION e7 LEVAT no B VISTO 1 2 Intended Use of CellaVision DM96 CellaVision DM96 is an automated system intended for in vitro diagnostic use CellaVision DM96 Scans a user defined part of a microscope slide Automatically locates and presents images of cells on smears from various specimens Is intended to be used by skilled operators 1 2 1 Peripheral Blood Application The peripheral blood application PB is intended for differential count of white blood cells characterization of red blood cell morphology and platelet estimation The system automatically locates and presents images of blood cells on peripheral blood smears The operator identifies and verifies the suggested classification of each cell according to type 1 2 2 Body Fluid Application The body fluid application BF is intended for differential count of white blood cells The system automatically locates and presents images of cells on cytocentrifuged body fluid preparations The operator identifies and verifies the suggested classification of each cell according to type User s Manual 9 CELLAVISION 6 CellaVision DM96 1 3 General Description of CellaVision DM96 CellaVision DM96 consists of a slide feeder unit an optic unit consisting of a microscope and camera ref
46. Enter Default recipient of e mail specify Mail server and E mail from i e sender of e mail doctor hospital com mailserver hospital com operator hospital com 10 11 Adjusting Archiving Settings For storage safety reasons and limited hard disk capacity it is recommended that you regularly archive the cell images or delete the orders When you archive the cell images and comments are transferred from the database to a CD or a hard disk However if you delete an order with archived images you will not be able to access these images again Cont d User s Manual 97 enone Cont d Archiving Autodelete Strategy Warn when the following two conditions are met 1 The number of signed orders exceeds 200 Autodelete 2 These orders are older than 30 days Eer menia Path for archiving Network path or local drive f C Documents and Settings CVUser Des Browse C CD archiving Images to archive Cell images PB cell images 10 cells class Normal WBCs Abnormal WBCs Non WBCs PB overview images RBC PLT C None All BF overview images Overview images BF cell images None G 10x 10x 50x WEES Region of interest images NonWBCs C None All Note Only images from signed slides can be archived Orders Archiving Strategy The archiving strategy depends on your daily throughput and the need for saving images for future use The autodelete archiving settings are database specific enab
47. Maintenance llle 109 12 4 1 Immersion Oil Refill 2l BBRIBIRn 109 124 7 Bulb Exchange 45 0646 dede wi ERR ERENS ee hs Eb REEDE Ro e dO d Bis 111 12 5 Database Performance lees es 113 12 5 1 Controlling the Database Size ii EE EE EER EE EE RR RR RE EE ER ee 113 4 User s Manual CELLAVISION CellaVision DM96 13 TROUBLESHOOTING 114 13 1 Troubleshooting SEE qase oe BEER BR RR NR a RR C RC e Ch b o en 114 13 2 Troubleshooting Chart sexa es ER ER RR RE Ba CES und eh chao oe EER RR ACERO RR 114 13 2 1 General Startup Errors iss ss 0 00 se se ee ee eee 114 13 2 2 Hardware Startup Errors n nsona ss ss se eee 115 13 2 3 General Processing Problems iss EE ER EE RR EE ER ke ee ek ek ee 116 13 2 4 Hardware Errors During Processing is Ee ee eee eee 119 1382 6 HUSEN S e ED AD Hodes a ER ED a Ee EE ee ae 123 1426 Archiving ETOS s mag dm 2060 PI 9743 DAE ase SE a erie ER 123 13 2 7 Cell Location Problems EE ER ER ER eee 124 13 2 8 Barcode Problems iis EE EE EE EE 0c 126 13 2 9 Staining Prableni sade EER EDE RE BEDR DEE ED pa anges RE 127 13 2 10 Slide Transport Jam iis EE EE EE EE EE EE ER ER ek ke ke ke ke ee 129 13 2 11 Magazine Transport Jam ie ui RE EE eee es be sh RR Rx x ER N 130 APPENDIX A SYSTEM SPECIFICATION 133 APPENDIX B STORAGE AND HANDLING 141 APPENDIX C BUTTONS AND INDICATORS 142 APPENDIX D
48. S SS EE Se ee 10 1 3 1 Peripheral Blood Application n onana 20 0 0 cee 10 1 3 2 Body Fluid Application iss EE ss EE EE se se GE EE eee 12 1 3 3 CellaVision Remote Review Software EE EE cee lees 13 1 4 Components and Mechanical Operation ss EE EE EE EE eee eee 13 1 4 1 Major Paris of the System ss ss sod Ru RR bed SE de ER Eg Ron Rn 13 2 OPERATING PROCEDURES 16 2 1 Starting the System us si OR ER OR RC OE OE NT N N dara 16 2 2 System Control VIGW sea cari EED eee ROE VER EU RR RE eN CORRE RR a Ae RR 17 2 4 Slides and Magazines sae uae soak ee eek Ge dud ER acm S Eb aee 18 RR NS ese MA IT EET 18 2 4 Loading Slides into a Magazine 0 EE tee 19 2 5 Processing Slides xus RE KG RS eka ek REEN Ka nea wes Rae ee RRA RE ewe ae Ri 20 2 9 1 Adding Magazines vb si RREN RE BEE e ee ED th RED GER RD ER WE aden 20 2 5 2 Starting the Slide Processing 00 EE EE ER RE ee eee 20 2 5 3 Magazine EIS cR Ree Boc ae che eras dd a oe ae a a d 21 2 5 4 Slide StatUS o soes oe bide nce ea eek KAR EER EE BERE BREER KAR ou Ken RE EE 22 2 6 Ejecting Magazines i4 viole RERIG OR eS vice delere dd BRAD d E ED SR awd 23 2 7 Handling of STAT Slides uat uses chek need ER EWER Ee EE RP aA EE EE ges De NE 23 2 8 Shutting Down the System ea ae toh RR ec e ox RR Re RR Da ie dake Ro 23 3 VERIFYING PROCESSED SLIDES PERIPHERAL BLOOD 24 3 1 White Blood Cell Classification EE SS EE EE SS EE ES Se Se ee ee ee 24 3 1
49. Tagging Regions of Interest iss EE ER RE ER ee 74 7 2 4 Copying Regions of Interest to Disk EE EE EE Ee ee 75 7 2 5 Adding Comments se os SERE dee Pob RE aco dre Re EE RA RE dake 75 7 2 0 Order Dale 2 an wink EE HEERS HEER EO RR HOE HEES HARMSE Bde ACH ORE g 75 7 3 D t base VEN p i EE ae n EA Re RE aa Grace ee AE Ean ASENNE neato 76 7 3 1 Processed Drders si EER RES WEE RE RE RE ER RS RE EER DEER RE RE NGSK CR 76 7 8 4 Pending OTUGIS EE Es EER ES EE aee ma sv edet DE P ui PES EE N 76 7 4 Customizing the System a uu aee ac ura diea BE Sor RR RR pia EE EA GER SE oben 78 7 4 1 Adjusting Database Users and Language iis essen 78 7 4 2 Adjusting Default Scan Area ee 78 143 Adjusung AnalysiS 25 aid EER ERG oce E nns Me bu EDE BEERS RE DEE a P EE 79 7 4 4 Adjusting Autodelele iius SERE VR ENE NEE Pe MED HEER RE RE EE Powe Wee ws 80 8 SYSTEM INFORMATION 81 9 CELLAVISION REMOTE REVIEW MULTIPLE USERS 82 9 1 Working with Orders and Slides EE EE eee 82 User s Manual 3 CELLAVISION 6 07 1 FE WATS enon D VISTO 10 CUSTOMIZING THE SYSTEM 83 10 1 Adjusting Database Settings llle 84 10 1 1 Creating a New Database 2 0 2 EE RE RR EER es 85 10 1 2 Deleting a Database 2224 eh mud se De AD MED RR bt Rasa dS VR 86 10 1 3 Creating a New Database Connection EE EE EE Ee ee 86 10 1 4 Deleting a Database Connection 0 0 eee eee 86 10 1 5 Compressing a Database
50. alibration or alignment Too small monolayer found Contact your local vendor s technical support Prepare the slides with longer blood films Artefacts staining precipitates on the slide Make sure that the solutions are changed according to the recommendations in Appendix G Dust on objectives Perform weekly maintenance on the current objective see 12 2 Weekly Maintenance High power cell images are not centered See the trouble shooting sections above Oil or dust on the low power objective Perform weekly maintenance on the current objective see 12 2 Weekly Maintenance The microscope lamp is defective Replace the lamp see 12 4 2 Bulb Exchange System needs calibration or alignment Contact your local vendor s technical support 116 User s Manual CELLAVISION CellaVision DM96 Problem Cause Action Slide status A Incomplete analysis Could not find RBC monolayer Oil on the slide Clean the oil off the slide and process it again Slide status amp Analysis failure View the Slide Information dialog for No monolayer Make sure that the slides are prepared found according to the recommendations in Appendix G Oil on the slide Clean the oil off the slide and process it again details cee Oil or dust on the Perform weekly maintenance on the low power current objective see
51. amera Immersion oil unit Slide feeder unit with barcode reader Magazine feeder unit Control unit Casing User s Manual 13 CELLAVISION 6 Slide Scanning Unit Control unit Digital color camera Casing Immersion oil unit Status lamp Power on lamp Main switch Objective turret Motorized microscope Magazine feeder unit Side feeder unit with barcode reader WARNING Keep your fingers clear from the objective turret otherwise personal injury may result WARNING Do not remove the rear cover dangerous voltages inside WARNING The oil may cause sensitization by skin contact We recommend using gloves 14 User s Manual CELLAVISION O7 1FENATS el noe B VISTO Motorized Microscope The motorized microscope is a fixed X Y stage upright light microscope with a moving objective focus It has a motorized 5 position objective turret and a 100 W halogen illumination system The microscope is motorized for fully automated positioning and focusing of the slide during process Digital Color Camera The camera is a high quality progressive scan CCD color camera for maximum image quality and high speed image acquisition Immersion Oil Unit The unit automatically applies drops of imme
52. as N EE OE N OE EE dido ad om He 48 4 1 2 Reclassirying Cells RE RE rh mk dox ROER RR wee ad OR RR RR N 48 4 1 3 E mallissa Rx neg RAN ook ew ee BEE REXCER ERR ER BR E TR Rc RR KAR LR Ek 48 4 1 4 Copying Images to DISK is ske HE RE RE RR du Rg ee RR Roe Roe ER ER RR mnn 48 42 Body Fluids Overview Image esrb Rr XX EEG WEER EE DEE EE ees wee EER N 49 4 2 1 Navigating in the Overview Image ee EE EE EE ee 50 4 2 2 Tagging Regions of Interest is ss EE EER ER RE ee 51 4 2 3 Copying Regions of Interest to DisK ie EE EE elles 52 4 oie DIS oe SEE HER boe ad EER HAD EERDER Mee ADRES Ed BEES DERDE I 52 4 3 1 Adding Comments i e eA ER ER DR RE RR ow be RUP BEE RR ee eile ey eh ae 52 44 Order Data occ ikea ER EER MEE ROER AE BEER EE DR COREA ACH RR Ped RR DERE 52 4 5 Signing a Slide PDC AE EI ai OR EN a Lon EE DIN 52 5 REPORTING RESULTS 53 5 1 Merging SIDES is eks wick Gea on ei source ieee wks EE EE ide 6 n dr eek he ene 53 5 2 Report Preview ee es 56 5 3 Signing an Order result xs e RRARRRARE GERE OR EER RUE BR ER RE ER RR RD x 56 5 4 Sending an Order to the LIS is ss ss eon heh N MERE REOR HE nb sg ee HE RR EE 56 5 5 Canceling Sn Order 2a uci danda RS dee 6D dpa an sed RES AD SG TU SPEED DE 57 6 DATABASE AND ARCHIVING DATA 58 6 1 Database Processed Orders si RE EE RE RR eee eee 58 Re di RE DIETE 60 6 1 2 ei EER OE ORN Gaede EE EE RE EE EE TEN 62 6 1 3 Opening an Order Slide iss EE EE
53. ate PLT estimate factor Precharacterization Preclassification Processing slides Quick scans RBC Reclassification Description Starts with the loading of slides and ends with the finished report The operator approves the preclassification Two different persons sign one slide each in the order The average result is presented Sub images of a PLT overview Outside the living body in an artificial environment Laboratory Information System A container transporting up to 12 slides in the system The barcode no on the magazine label for magazine identification May Gr nwald Giemsa a Romanowsky stain for blood smears Overview image of analysis area An order including more than one slide from one sample Cells and objects identified as not being WBCs Cells and objects the operator cannot identify and wants to exclude from the differential count The person who works with the system The name of the ordered analyses on the slides from the same sample Order identifier There can be several slides with the same Order ID but different slide numbers Cells that the operator identifies as WBCs but of a type other than those listed Will be included in the differential count Unique number identifying the patient An order manually added to the database waiting to be processed Positive Identifier The barcode on the slide Platelet thrombocyte Estimation of the PLT concentration A predetermin
54. ation View where the tabs for Overview WBC and Sign Slide are shown To open a slide see 6 1 3 Opening an Order Slide Click Verification View in the toolbar Note With DM Configuration tool it is possible to add user defined WBC cell classes and Non WBC classes To do this contact your service personnel 4 1 Body Fluids Differential You can view and reclassify all cells identified by the system WBC panel Main Add cell 2nd gallery gallery class comment Worklist 2 out 5 Overview WBC T Lymphocyte z Unidentified Neutrophil Lymphocyte Eosinophil Macrophage Other Total IF Reference cells Non WBC Smudge cell Artefact Open Remove Patient data Order ID CP18B Last name First name Birth date Ready Worklist Add BF comment Non WBCs panel Cont d 46 User s Manual CELLAVISION CellaVision DM96 Cont d All cell classes handled by the system are displayed in the figure below WBCs and non WBCs automatically preclassified by the system are marked with a small dot z Green Contains no WS A es reclassified cells or Unidentified 3 308 objects Preclassified by the Neutrophil n mom system Lymphocyte 80 8001 Pen icon Indicates Eosinophil E a Cell class comments idi Macrophage 6 0 m y WBC panel Other Tick mark All images Total have been viewed Non WBC Smudge cell Artefact Blue Contains at least o
55. cal vendor s technical support The output drawer is full and there is a magazine waiting to be moved into the drawer Check that no magazine is positioned to the far right in the output drawer Restart the SSU and the program The green power on lamp is never lit The power is out for the SSU Connect the power cable and try again The power on lamp is not working Contact your local vendor s technical support User s Manual 115 CELLAVISION o CellaVision DM96 13 2 3 General Processing Problems Problem Start is deactivated Cause No magazines on the conveyer Action Add magazines see 2 5 1 Adding Magazines One or more hatches are open indicated by Close all hatches See Appendix C Buttons and Indicators for Hatch Indicators An error has occurred during slide processing Restart the SSU and the program Slide process does not start even though Autostart is selected No magazines on the conveyer Add magazines see 2 5 1 Adding Magazines One or more hatches are open indicated by Close all hatches See Appendix C Buttons and Indicators for Hatch Indicators System status is Idle or Stopped Click Start WBC images are not centered on the cell but the cell can still be seen Slide status A Incomplete analysis Less than the ordered number of cells are collected System needs c
56. cells settings X X Cell Location X X E mail settings X Archiving settings X 148 User s Manual CELLAVISION CellaVision DM96 Appendix F Determining the Platelet Estimate Factor The following procedure shows how to determine the PLT estimate factor 1 Perform automated PLT counts with a cell counter on 30 consecutive blood samples 2 Prepare and stain one smear for each sample 3 Perform PLT analyses on the system Let the system calculate the average PLTs HPF values for each sample 4 Divide the cell counter PLT value by the system average PLTs HPF value for each sample to get the conversion factors 5 Add all 30 conversion factors and divide by 30 to get the PLT estimate factor 6 Enter the PLT estimate factor in the PLT tab in Settings User s Manual 149 CELLAVISION o e WATS enon D VISTO Appendix G Slide Preparation Guidelines Slide Preparation for Peripheral Blood WARNING Always use protective gloves when in contact with blood Sample Collect blood from a vein or by skin puncture in an EDTA sample tube K EDTA or KgEDTA 1 5 0 15 mg ml in liquid or powder form Mix the sample carefully with the anticoagulant Store the tube at room temperature Prepare the blood films within four hours of blood collection Preparing Blood Films 1 Mix the tube 20 complete inversions by hand before preparation 2 Usea clean dry microscope glass slide see
57. cessing time The information can be selected for a specific month by entering Year and Month and clicking Update O Nemini Specification The Specification page is only accessible to Administrators It contains a list of dates and times for events that have occurred in the system e g start and completion of slide processing and hardware malfunctions You may specify the month the same way as described above User s Manual 69 ean er IE WATS enon D VISTO 6 5 Export Log Files It is possible to export all logging information from the system If a system error occurs the information is needed for trouble shooting Select Tools Export Log Files The log files can be burnt directly to a CD or exported to the LAN and then for instance attached to an e mail Note CellaVision DM must be idle during export Otherwise the export will not be complete Export Log Files 6 6 Backup and Recovery of the Database It is important to backup the database quite often If a hard disk crash occurs the whole database will be lost It will only be possible to recover the data up to the time when the last backup was made For more information see CellaVision IT Configuration Guidelines or contact your distributors E a Se ee 70 User s Manual CELLAVISION 7 Digital Slides With CellaVision DM96 it is possible to create digital slides Important The digitalized image generated provides a general overview of the p
58. classifies the following non WBCs Erythroblasts NRBC Giant thrombocytes Thrombocyte aggregations Smudge cells and Artefacts Non WBCs are reported as number of cells or objects 100 WBC Unidentified is a class for cells and objects which the system has preclassified with a low confidence level Cont d 10 User s Manual CELLAVISION CellaVision DM96 Cont d WBC Reclassification for Peripheral Blood Besides the cell classes mentioned above the operator can reclassify cells into the following classes mmature eosinophils Immature basophils Promonocytes Prolymphocytes Large granular lymphocytes Hairy cells S zary cells Other Megakaryocytes Not classed and 15 user defined cell classes Other should be used for cells which the operator identifies as a WBC but ofa type other than those listed WBCs put here will be included in the differential count Not classed should be used for cells and objects which the operator cannot identify and wants to exclude from the differential count RBC Precharacterization The system precharacterizes the following RBC morphology characteristics in an overview image Polychromasia Hypochromasia Anisocytosis Microcytosis Macrocytosis and Poikilocytosis RBC characterization The operator can characterize to Target cells Schistocytosis Helmet cells Sickle cells Spherocytosis Elliptocytosis Ovalocytosis Tear drop cells Stomatocytosis Acanthocytosis Echinocytosis
59. code found Check positioning and size of the barcode see Appendix A System Specification The barcode could not be read due to bad print quality Clean the barcode printer head Replace the printer ribbon on the barcode printer Message box Critical error no connection with the database Connection with the database has been lost Check network connection Restart the system computer or the computer on which the database resides Message box Verify that the following hatches are closed At least the hatch specified in the message box is open Close all open hatches and click Retry Database access is slow The database server needs to be restarted Restart the system computer or the computer on which the database resides The database is too large Keep the database size at the recommended level see 12 5 Database Performance The database files are fragmented Compress the database see 10 1 5 Compressing a Database Body fluid sample spot is not centered Incorrect configuration of BF analysis area Configure the BF analysis area settings See10 13 Adjusting BF Analysis Area10 13 Adjusting BF Analysis Area The sample spot location varies too much between samples Make sure your sample preparation process produces slides where the sample spot is always in the same location The analysis area does not cover the entire b
60. count Type of order Type of order Jv WEC Iv Diff ABC Jv Overview 5 PLT I Overview 10g Overview 104 50y v Add processed slide to worklist Enable LIS rd To adjust the analysis settings for individual slides click Database View and choose Pending Orders See 7 3 2 Pending Orders User s Manual 79 EE A er EVER D VISTO 7 44 Adjusting Autodelete fo It is not possible to archive the orders All orders will be automatically deleted after a specified number of days Autodelete Strategy The autodelete strategy depends on your throughput and the need for saving images for future use The autodelete settings are database specific enabling each database to have its own autodelete strategy Delete all images All orders and images are permanently deleted when the time has expired Keep Region of interest images The orders are not deleted but all images except the Region of interest and Mini map images are deleted when the time has expired EMS EE SSS SS ee 80 User s Manual CELLAVISION CellaVision DM96 8 System Information Information about your system is available from Help System Information The information presented depends on your system and installed software Some of the following information is present in the dialog Serial number of your system Thetype of Artificial Neural Network ANN used The computer name The computer s IP address Free disk space
61. created by the system NormalFrench Default report template created by the system NormalGerman Default report template created by the system Normalltalian Default report template created by the system ks ks ke Report All available templates are displayed in the list The currently used template is indicated with an arrow To change which template to use select a template in the list and click Set Active Default settings for Sign dialogs Here you set the default values for the Sign Slide and Sign Order dialogs EE EE EE EE EE EE EE EE EE EE User s Manual 93 ET 10 8 Adjusting Standard Comments Settings Hypersegmentation Pelger form Hypergranulation Hypogranulation Auer rods Doehlie bodies Pyknotic nucleus Vacuolization Cleft nuclei General RBC slide comment 1 2 3 4 5 6 7 8 3 1 Include code in comment If activated the code is written together with the standard comment Always show expanded If activated the standard comments are visible by default when the comment dialog is opened Cont d 94 User s Manual CELLAVISION 6 CellaVision DM96 Cont d Adding a New Standard Comment 1 Click New 2 The Standard Comments Editor appears Standard Comment Editor Auer rods 3 Enter Code Comment type and Comment Standard comments of type WBC RBC PLT or BF will only be available in the respective tab General comments
62. d CellaVision AB Ideon Science Park SE 223 70 Lund Sweden Telephone 46 0 46 286 44 00 Fax 46 0 46 286 44 70 6 User s Manual CELLAVISION 1 introduction 1 1 About this User s Manual This User s manual will guide you step by step through the activity sequence of normal use of CellaVision DM96 also referred to as the system aiming for an efficient way to give you good understanding and knowledge of the system and its features References are made to appendices providing additional information Some self explaining dialogs have been left out in the text Typographical conventions Names of keys and on screen objects with which you interact are presented in italics e g click PRINT Note This User s Manual covers all applications i e the Peripheral Blood and the Body Fluid application available for the CellaVision DM96 system The applicability of some sections in this User manual may therefore depend on the applications installed on the system Contact your local distributor for more information 1 1 1 Warnings and Precautions Study the meaning of symbols and safety alerts carefully and always use the system in the safest possible manner Read all instructions carefully before starting to use the system Using it without being suitably qualified or in a manner not specified in this User s manual may damage or deteriorate the system cause misleading results or even lead to injury Warning alert
63. d the Database View automatically opens Double click on the Order you would like to report fall slides are signed the Report View automatically opens If necessary adjust the calculated RBC and PLT results Click Sign Order If you want to make a printout activate the checkbox Print Order The Database View automatically opens User s Manual 147 CELLAVISION 6 CellaVision DM96 Appendix E User Authorization Levels Action Setting Observer User Restricted Authorized Administrator Start slide processing X X X Search in the database on Order ID and X X X X X Patient ID Search in the database on other criteria X X X X Verify and comment WBC RBC and PLT X X X X Edit Order data X X Add edit pending orders X X X X Sign slides and reports X X X Send results to the LIS X X X Delete unsigned slides orders X X Delete signed orders X Archive X Export orders X X Protect order from archiving X X Send images with e mail X X X X X Export log files X Database settings X Users settings X Analysis settings Default values X X Add processed slide to worklist Enable LIS X Enable autostart X WBC reclassification settings X RBC precharacterization settings X PLT settings TIR xx k k PLT estimate factor Intervals for X average PLTs HPF Report Sign settings X Standard comments settings X X Reference
64. d before the operator is given the option to sign the order Note Slide data cannot be changed after signing Comments may still be added If all ordered analyses have been viewed when the Sign Slide tab is selected the Sign Slide dialog will automatically appear Default values for the Sign Slide dialog are set in Settings under Report Sign The option to send results to the LIS is activated in Analysis in settings When the last slide is signed in a multi slide order the operator has the option to sign the order PETR EE ND IT TT 44 User s Manual CELLAVISION 3 6 1 White Blood Cells Red Blood Cells and Platelets Before signing a slide all ordered analyses must have been viewed by the operator The following conditions must be fulfilled WBC e All cell classes must have been viewed i e there should be tick marks after each cell class No WBCs remain in Unidentified RBC An RBC characterization must be reported or excluded from the analysis Report a characterization by selecting one of the following options C Use characterization OR Click Exclude RBC Analysis PLT A PLT concentration must be reported or excluded from the analysis Report a PLT concentration as described in 3 3 Estimating Platelets OR Click Exclude PLT Analysis User s Manual 45 e CELLAVISION 6 4 Verifying Processed Slides Body Fluids Opening an unsigned slide leads directly to the Verific
65. der than five days are automatically deleted at program startup logon a UU N a 160 User s Manual CELLAVISION CellaVision DM96 Cell location for Body Fluids The cell location performance shall be verified at regular intervals and after changes in staining procedure or staining solutions by running the Cell location test It is also recommended to run cell location test for each new body fluid specimen analyzed in the laboratory For the definition of body fluid specimens see CLSI H56 A Body Fluid Analysis for Cellular Composition Approved Guideline Running the test once or twice a day is a recommended interval at the high load laboratory The test establishes how many percent of the nucleated cells that are found on a slide Region of Interest Cell Location WBCs Found 100 Non WBCs Found 60 Ratio of WBCs Found 100 0 WBCs missed 0 Display Adjacent Areas Print Result The Cell Location tool may be accessed by clicking on the cell location tab in the body fluid overview view Cell location information is available for all BF slides Slide Requirements Use a freshly stained body fluid sample with a total number of WBCs less than 12000 Running a Cell Location Test 1 Select a slide that meets the requirements and process it like a regular BF slide 2 Open the slide and go to the Overview and select the Cell Location tab 3 Navigate through the entire analysis area and look for missed nucleated cells
66. e Review Software or the database A setting that is stored in the system applies to that system only Other systems connected to the same database as the system may have other values of the setting A setting that is stored in the database applies to all systems connected to the same database If you change the setting it will be changed for all systems connected to the database The following settings are stored in the database Restricted user search options e User settings Analysis default values Enable LIS Add processed slide to worklist WBC reclassification settings RBC precharacterization settings PLT settings Active report template Report template contents Default settings for sign dialogs Standard comments Custom reference cells Autodelete Archiving settings The following settings are stored in the system Enable autostart Email settings Language Body fluid analysis area Select 7ools followed by Settings and the appropriate tab to customize the system Different users are allowed to edit different settings see Appendix E User Authorization Levels User s Manual 83 cine CellaVision DM96 10 1 Adjusting Database Settings Here you create new databases and new database connections In the Log On dialog you select which database to use It is also possible to compress an existing local database 20030032 dm96im Processing Database from installer
67. e bulb clamping levers to their original position to secure the bulb 8 Refit the lamp house cover 9 Tighten the screw of the lamp house cover 10 Refit the lamp hatch 11 Tighten the screws of the lamp hatch 12 5 Database Performance To maintain a high database performance it is very important to control the size of the database It is also recommended to restart the system computer at least once a week 12 5 1 Controlling the Database Size A large database will have lower performance access time database search time etc compared to a smaller database The size of the database can be controlled by two methods 1 Activate autodelete of orders 2 Archive images onto CD R RW or LAN Recommendation Keep the size of the database below 20 GB See 10 11 Adjusting Archiving Settings for more information Note Select Compress Database to view the database size see 10 1 5 Compressing a Database Note Delete all unsigned and failed orders User s Manual 113 CELLAVISION 6 CellaVision DM96 13 Troubleshooting 13 1 Troubleshooting Steps If a problem occurs follow these steps 13 2 1 1 Observe any unusual circumstances surrounding the problem 2 Note any error messages displayed 3 See 13 2 Troubleshooting Chart to find possible remedies 4 If the problem persists contact your distributor for assistance 13 2 Troubleshooting Chart General Startup Errors Problem Cause Action Y
68. e connection to the LIS After each slide the system has processed it checks the positioning of the microscope objective While the program is running the database size is compared intermittently to the rules set for archiving or automatic deletion of old entries thus ensuring that the database is kept at a reasonable and maintainable size The communication with and response of the hardware is tested continuously during the operation of the system and a message will inform the operator if an error occurs during slide processing or other operations on the system Cell Location Performance The Cell location test is used to verify the slide preparation process and the system hardware The cell location performance shall be verified at regular intervals and after changes in staining procedure or staining solutions by running the Cell location test see Appendix H Cell Location Running the test once or twice a day is a recommended interval at the high load laboratory 106 User s Manual CELLAVISION CellaVision DM96 12 Maintenance Caution Be careful not to bend or put excessive force to any part of the system interior 12 1 Daily Maintenance 1 Make sure there are no magazines in the system Shut down the system according to the instructions in this manual Open the main hatch Clean the XY stage from immersion oil with a lint free soft cloth nA BW ND Close the main hatch 12 2 Weekly Maintenance 1
69. e database settings tab see 10 1 1 Creating a New Database a Exporting to an export database 1 Select one or several orders 2 Click Export 3 Select a database in the list 4 Check Delete orders after export to perform an export the order will be copied if unchecked 5 Click Export b Exporting to a CellaVision Competency Software database 1 Select one or several orders 2 Click Export 3 Select a database in the list 4 Click Export Orders will not be deleted and patient data will not be copied Restrictions Only signed orders can be exported Orders imported to an export database will always have a protected flag preventing them from being auto deleted if autodelete is enabled Only peripheral blood orders can be exported to CellaVision Competency Software databases Orders residing in a Scan database cannot be exported 64 User s Manual CELLAVISION CellaVision DM96 6 1 8 Copying Images to Disk You can copy all images from selected orders to disk 1 Select one or several orders 2 On the right click menu select Copy images to disk and the Copy images to disk dialog appears 3 Specify the destination path where you want the images to be saved use the browse button to navigate to a suitable folder 4 Uncheck WBC images or Overview images RBC PLT images to exclude this type of images 5 Click OK Note The directory you specify in the destination path
70. ect prevents changing of objectives Remove the object that prevents changing of objectives Rotate the objectives by hand to make sure that nothing is preventing the objective rotation Restart the SSU and the program CellaVision DM96 Problem Cause CELLAVISION Action Message box Positioning error occurred when calibrating the motors The system must be restarted If the problem persists see troubleshooting section in the User s manual The error was reported for the following motors Something prevents motor movement during calibration of motors Remove the obstacle that prevents motor movement Restart the SSU Message box Temperature too high in the Control Unit Shut down the system Check that the air filter on the back of the SSU slide scanning unit not is dirty The system must be restarted If the problem persists see troubleshooting section in the User s manual The air filter is dirty Check that the air filter on the back of the SSU is not dirty The fan in the control unit does not function The fan has to be exchanged Message box Communication error between the system computer and the SSU slide scanning unit Reconnect the network cable between the system computer and the SSU The system must be restarted If the problem persists see troubleshooting section in the User s manual Network cable between the system computer a
71. ed factor to calculate the PLT estimate The system suggests RBC morphology characteristics The system suggests WBC classification The sequence of events from when the system starts working with a slide until it is finished Quickly scanned slides for cell counter verification The results are not sent to the LIS Red blood cell erythrocyte The operator changes the preclassification User s Manual Term Reference cells Region of interest Romanowsky stain Signing Slide ID Slide number Slide position Unidentified Verification WBC Wright CELLAVISION CellaVision DM96 Description Cells with typical characteristics available in the 2nd and 3rd galleries Part of the BF or Scan overview image tagged by the operator An eosin methylene blue solution for staining of blood smears Wright and MGG are examples of different Romanowsky stains Finally confirming analysis results before locking and reporting them The barcode number on the slide PID Same as Order ID A number that uniquely identifies slides within the same order The position of a slide in the magazine Cells and objects which the system cannot preclassify The operator s review of WBC RBC and PLT e g reclassification and confirmation of WBCs White blood cell leukocyte A Romanowsky stain for blood smears 165 CELLAVISION 6 CellaVision DM96 Index A Archive status isi de ERGER ER RA EN 61 AXGDIVI
72. ee ee 31 Report Preview acre SWERE e ee 56 WBC Galleries 27 Report template 5 dedu cohort 83 WBC panel sede bi RR e xe aer 24 46 Report VIEW stscneeseuatdane oe se 53 142 Workflow Ee SEE EE GE EE RD 145 Reporting Results ee ee eer 53 WY OOH NE EE NG 24 46 65 Restricted user n o y xx SEE EE ER 83 Wight Gus Ene ES AE ER ie 155 Result Panel is sd pons EE nd ra 3 53 Right click Menu ie EE se se 31 X bero m 15 S Scanning a Slide uei RE 71 Search criteria coa scusa deena EER 24d 58 Searching for an Order Slide 64 SEDES soes std kd debeat ug 145 SUM COW 4 SKEER GR RES RD ER EE 23 Signing a Slide vicios exu I CYR 44 52 Signing an Order se ee 56 Single slide differentials 145 Side TE as EES teak i ireke niii 18 Slide Information Dialog 22 Slade Mergers daba e he en e tiani 53 Slide Preparation n naana se se 150 Slide scanning unit 13 14 Slide Status n on nananana aana 22 SOU ee E EA 13 Staining Recipes c usen arre 153 Standard Comment 0005 95 SIES eed ARE ER DAE 16 20 143 Statistics 243 45 cia SES EER SDA GER EE 69 wire ru P 141 System Control iss SS ee 17 System indicators iese see ee 17 User s Manual 167 CE CELLAVISION o CellaVision AB Ideon Science Park SE 223 70 Lund Sweden Telephone 46 0 46 286 44 00 Fax 46 0 46 286 44 70 infoGcellavision com www cellavision co
73. erred to as a slide scanning unit and a computer system containing the acquisition and classification software CellaVision DM software It is important that slide preparation is performed according to standardized methods see Appendix G Slide Preparation Guidelines General Functionality of the System Receives order information from and sends results to the LIS Locates and presents images of every located cell or object found on the smear Stores images and results in a database Presents an overview image of a user defined area on a slide 1 3 4 Peripheral Blood Application General Functionality Presents an image on a screen of every located cell or object Organizes and suggests cell classification preclassification for white blood cells Makes it possible to identify confirm or modify reclassification the suggested classification of white blood cells Presents and suggests morphological characteristics precharacterization in an overview image of red blood cells Makes it possible to confirm or modify the precharacterization of red blood cell morphology Presents an overview image and facilitates platelet estimation WBC Preclassification The system preclassifies the following WBC classes Band neutrophils Segmented neutrophils Eosinophils Basophils Lymphocytes Monocytes Promyelocytes Myelocytes Metamyelocytes Blast cells Lymphocytes variant forms and Plasma cells The system pre
74. for the grid size PLT count and PLT concentration result It is also possible to enable the option to use manual PLT concentration estimation 3x3 0 89 HPF sauare Ri Count PLTs per grid square v Calculated estimate Use only manual PLT concentration estimation When this checkbox is activated PLT estimation is done by estimating the concentration level to Significantly decreased Decreased Normal or Increased No values for the PLT count can be entered and no calculation can be performed This setting takes effect the very first time a slide is opened and can then not be changed for the order PLT estimate factor See Appendix F Determining the Platelet Estimate Factor for how to determine the PLT estimate factor Important You have to determine your own PLT estimate factor By default it is set to 0 Cont d 92 User s Manual CELLAVISION EVAO no B VISTO Cont d 10 7 Defaults for PLT tab Sets the default values for Grid size PLT count and PLT concentration Intervals for average PLTS HPF value These intervals are used to calculate the PLT result Calculated level Adjusting Report Sign Settings In the Report Sign tab you set the template to use in printed reports and the default settings for the signing dialogs MINIMALGerman Default report template created by the system MINIMALItalian Default report template created by the system gt Normal Default report template
75. he RBC image to enlarge a limited area and use the scroll wheel to zoom in out User s Manual 35 season 07 1 FE WATS enon D VISTO 3 2 2 Characterizing Red Blood Cell Morphology There are two ways to report the RBC result C Use characterization a Report all as normal 1 Select radio button Report all as 0 Normal b Use characterization 1 Select radio button Use characterization 2 If you disagree with a precharacterization click the dot that corresponds to your opinion Click Reset to Precharacterization to restore the precharacterization result done by the system All manual characterization will be lost Note If you want to remove a specific type of morphology from the report deselect the dot by clicking on it 3 2 3 Excluding the Red Blood Cell Analysis Click Exclude RBC Analysis to exclude the RBC analysis results from the slide 36 User s Manual CELLAVISION O7 1FENATS el no B VISTO 3 3 Estimating Platelets The complete PLT overview image same image as for RBC corresponds to the area of 8 microscopic high power fields HPF 100x objective and a 22 mm ocular The overview image is divided into 4 9 or 16 sub images grid squares as defined by the grid size The grid size options are 2x2 3x3 and 4x4 The 4x4 grid size gives the largest magnification of the image There are as many entry fields as there are grid squares By clicking Help Lines in the toolbar a grid
76. he System Control panel displays a status log of processed magazines and slides System control 4433444444 No magazine PID 6699666666 o 12 51218538 455 11 01818931 t 10 31818538 9 71018531 Analysis failure Slide t 8 01918331 t 7 01310535 M 6 11118591 QD 5 94118921 i 4 Empty t 3 83118441 H 2 01144531 Default values 1 01118531 2277777777 Hf 8889887788 Magazine 8 8 E E B To empty the log from all information click Clear Log 2 5 3 Magazine Status The following information is available for each magazine Magazinestatus Magazine ID barcode A 012345678912 Magazine Status Analyzing X Finished The slide holder is processed and all slides have status OK A Waring A slide with status Warning Stopped Failed or Cancelled exists in the magazine Failed The magazine has no magazine ID User s Manual 21 CELLAVISION 6 er IE WATS enon D VISTO 2 5 4 Slide Status The following information is available for each slide Slide status Slide position OE EWE DE barcode text A 7 012345678912 Default values Slide Status p Processing m d OK Slide processed with no warning or error A Warnin Slide processed with a warning see Warning 8 Texts Results exist D Stopped Slide processing stopped by user No results exist o Bw All ordered analyses failed see Error Texts No results exist 6 Cancelled The slide was cancelled in the LIS Slide not processed E
77. he differential result each cell class and all individual cells Note All comments except comments on individual cells are printed in the report 4 3 1 Adding Comments To add a comment click Comment For more details see 3 4 1 Adding Comments ah Comments 4 4 Order Data To view or edit the order data see 3 5 Order Data 4 5 Signing a Slide The Body Fluid differential is presented in the Sign slide tab To sign a slide see 3 6 Signing a Slide EET M He 52 User s Manual CELLAVISION CellaVision DM96 5 Reporting Results See 10 7 Adjusting Report Sign Settings for Report Sign settings Click Report View in the toolbar In the Report View you compare the results of each slide in the order and you can exclude slides from the reported result You sign the order send order data to the LIS and cancel an order You can also write a general comment on the order 5 1 Merging Slides In the Slide Merge tab you compile analysis results for the whole order based on one or several slides You can also look at all comments associated with an order Result Panel Result 7 MT Order 120 1 MT Order 120 2 Reported Result WBC i DE io Band neutrophil 4 2 4 2 Segmented neutrophil 22 0 22 0 Eosinophil 15 3 15 3 Basophil 5 1 5 1 Lymphocyte 16 1 16 1 Monocyte 14 4 14 4 Promyelocyte Myel
78. ils Lymphocytes variant forms Prolymphocytes Promyelocytes Plasma cells Large granular lymphocytes Myelocytes Immature eosinophils Hairy cells Metamyelocytes Immature basophils S zary cells Blast cells Promonocytes User defined WBCs Non WBCs Other Giant thrombocyte Smudge cell Not classed Thrombocyte aggregation Artefacts Erythroblast NRBC Megakaryocyte User defined Non WBCs BF Cell Images Overview images 10x overview images and 50x overview images Region of interest images regions of interest tagged by the user WBCs Neutrophils Eosinophils Lymphocytes Macrophages Other User defined WBCs Non WBCs Smudge cell Artefacts User defined Non WBCs Cont d EETL EED SS ee 100 User s Manual CELLAVISION CellaVision DM96 Cont d Archiving Recommendations It is recommended to keep the size of the database around 20 GB for optimal database performance Always combine archiving with a backup of the database see 6 6 Backup and Recovery of the Database The database contains the path to the archived images If a hard disk crash occurs it will not be possible to restore the archived images unless a backup exists Note Select Compress Database to view the database size see 10 1 5 Compressing a Database Hard Disk Space Requirements Peripheral Blood A processed slide with 100 WBCs collected will require about 5 MB of hard disk space RBC and PLT use the same overview image and will require about 1
79. ine your own PLT estimate factor and enter it in PLT settings By default it is set to 0 Note In the calculations several decimals are used The presented results are truncated to 1 decimal which means that the results may seem incorrect Note It is not possible to use Calculate PLT result for images captured on a CellaVision Image Capture System User s Manual 39 CELLAVISION o er IE WATS enon D VISTO 3 3 2 Estimating the Platelet Concentration Level Images captured on a CellaVision DM System The PLT concentration level can be estimated by setting it to four levels Significantly decreased Decreased Normal or Increased directly from viewing the image 343 0 88 HPF square Tod pn n jen pr EES Entry field t NU mn Increased 1 Use the entry fields to view all parts of the overview image 2 Select Concentration level Images captured on a CellaVision Image Capture System The PLT concentration level can be estimated by setting it to four levels Significantly decreased Decreased Normal or Increased directly from viewing the image The image has been manually captured on a CellaVision Image Capture System nam purs Reet Mine Select Concentration level Important The area covered by each square may vary between different CellaVision Image Capture Systems 40 User s Manual CELLAVISION O7 1 FENATS el no D VISTO 3 3 3 Excluding the Platelet Analysis Click E
80. isabled Send order to LIS when signed Enabled Review the cells in the WBC Galleries EE EE EE EE EE EE EE EE EE EE EE EE EE EE User s Manual 145 EE iA CellaVision DM96 Workflow Single Slides Confirm Cell Counter Results Go to Database View Shift F 1 Y em Select orders Y Click Add to worklist Double click on the first slide in the Worklist Y Verify WBC Y Click RBC tab Perform RBC review Y Click PLT tab Perform PLT review Y Click Sign Slide tab Sign the slide The next slide in the Worklist will automatically be opened When the last slide in the worklist has been signed the Database View automatically opens 146 User s Manual CELLAVISION CellaVision DM96 Workflow Duplicate Slides Go to Database View Shift F 1 B Select orders Y Click Add to worklist Y Click on the Slide Nbr header in the Worklist p A od Select all slides with Slide Select all slides with Slide Nbr 1 Click Remove Nbr 2 Click Remove d Mn di the first slide in the Worklist Y gt Verify WBC Click RBC tab elm RBC review Y Click PLT tab Perform PLT review Y Click Sign Slide tab Y Sign the slide Y When the last slide in the order is signed answer No to question whether to sign order The next slide in the worklist will automatically be opened When the last slide in the worklist has been signe
81. ision DM96 Problem In startup test lt LIS Communication Server ERROR No contact could be established with remote LIS server gt Cause LIS cable is disconnected Action Make sure that the cable to the LIS is connected Restart the program In startup test Camera 1394 Communication Server Could not initialize camera Please check camera cable The camera cable is disconnected Make sure that the camera cable is connected to both the camera and the system computer Restart the program In startup test Instrument Communication Server SSU error No connection with the CCU ERROR Initialization failed No connection between the SSU and the system computer Check the connection between the SSU and the system computer Restart the system and program The yellow status lamp is not lit even 30s after power on The status lamp is not working Contact your local vendor s technical support The yellow status lamp is flashing but the startup test was successful The oil level is low Fill up the oil container The yellow status lamp is flashing and the startup test fails on System Control Server One of the hatches is not closed Make sure all hatches are closed and restart the program There was a jam Remove any magazines and slides see 13 2 10 Slide Transport Jam Restart the SSU and the program If error persists Contact your lo
82. ling each database to have its own archiving strategy Cont d SSS T 98 User s Manual CELLAVISION Cont d 1 Autodelete Autodelete instead of archive activated Warn when the following two conditions are met 1 The number of signed orders exceeds 300 2 These orders are older than 30 days All signed orders are permanently deleted when the time has expired However autodelete will not begin until the specified number of candidates has been reached Example With the setting above autodelete will not begin until there are 300 orders older than 30 days 2 Archive images Autodelete instead of archive deactivated Keep locally at least Specify the minimum number of days that images from signed slides shall be stored Warn when candidates reach Specify the minimum number of non archived signed orders at which the program shall prompt the user with a warning message Archive Media Select your archive media CD Archiving Network path or local drive Archived Images The images are divided into groups Use the radio buttons to archive either a certain number of images from each cell class in a group or all available images or no images at all from a group Cont d User s Manual 99 CELLAVISION o CellaVision DM96 Cont d PB Cell images Overview images RBC and PLT Normal cells Segmented neutrophils Monocytes Basophils Lymphocytes Eosinophils Abnormal cells Band neutroph
83. m PM 10340 2012 01 03
84. me may be increased Overwashing Overstaining The washing technique may be corrected so that it is adequate but not excessive Decrease the fixation time The amount of stain used may be decreased shorten the staining time and the amount of buffer increased increase the stain buffer time Inadequate Increase the wash step washing Too high an The pH of the buffer may be checked alkalinity of stain or buffer with a pH meter and readjusted to a lower pH Thick blood smears Prepare a thinner blood smear User s Manual 127 CELLAVISION o CellaVision DM96 User s Manual 128 Problem Cause Action Samples have dark areas of stain or other artefacts Drying is occurring during the period of staining Ensure the adequate drying of samples previous to staining Unclean slides Use clean slides Inadequate washing not washing enough to remove the metallic scum Increase wash step A stain is forming precipitate in the solution Filter the stain Ensure that the stain has not exceeded the expiration date Same cell counted more than once duplicate cell images are shown by the system Understaining The fixation and staining time may be increased Overwashing The washing technique may be corrected so that it is adequate but not excessive CELLAVISION 6 13 2 10 Slide Transpor
85. move the magazines to the right 4 Click Start 2 8 Shutting Down the System Shut down the system as follows 1 Eject any remaining magazine from the system 2 Select Exit in the File menu 3 Switch off the system computer 4 Switch off the slide scanning unit OM ee ee User s Manual 23 T A er TEER rH D VISTO 3 Verifying Processed Slides Peripheral Blood Opening an unsigned slide leads directly to the Verification View where various tabs can be selected in order to review WBC RBC and PLT and to Sign the Slide To open a slide see 6 1 3 Opening an Order Slide Click Verification View in the toolbar Note With DM Configuration tool it is possible to add user defined WBC cell classes and RBC characteristics To do this contact your service personnel 3 4 White Blood Cell Classification You can view all WBCs identified by the system You may also reclassify WBCs and add comments WBC panel Opened Main Add cell Shortcutsto 2nd gallery order slide gallery class reference comment cells B Ref cells in Gallery 2 Unidentified sandeep EEEH Segmented neutrophil Eosinophil Basophil Lymphocyte Monocyte 4 Promyelocyte F Myelocyte F Metamyelocyte Immature eosinophil Immature basophil Promonocyte Prolymphacyte Blast no lineage spec Lymphocyte variantform Plasma cell La
86. mpty slide position in the magazine or no Empty Empty or no slide PID barcode om slide Warning Texts Default values The order was not found in the LIS The required number of WBCS were not found or one Incomplete ande of the ordered analyses failed Error Texts Invalid slide PID Invalid barcode on the slide Analysis failure Slide processing failed Critical failure A critical error occurred Invalid batch PID Invalid barcode on the magazine Analysis type not available A BF plug in is missing Light error when using 10x Insufficient light Remove any dust and dirt from 50x 100x magnification the objective Check the bulb Slide Information Dialog Double click on a slide to open the Slide Information dialog Additional information on the processed slide e g the cause of an error is displayed here 22 User s Manual CELLAVISION EVARA B VISTO 2 6 Ejecting Magazines The slide holder currently being processed can be ejected 1 Click Stop A Stop Continue dialog appears 2 Click Stop 3 Select Eject Magazine in Tools menu An OK Cancel dialog appears 4 Click OK The magazine is ejected into the output drawer 2 7 Handling of STAT Slides 1 Eject the magazine 2 Load the STAT slide in slide position 1 in a magazine 3 Open the input hatch and put the magazine to the left of the other magazines Note The lefimost magazine can be hard to pull out Open and close the input hatch and the conveyor will
87. n The system must be restarted If the problem persists see troubleshooting section in the User s manual The slide was stuck broken or fell out during transport to the slide holder Remove the slide see 13 2 10 Slide Transport Jam Restart the SSU and the program Message box Positioning error when moving the slide from the slide holder into the magazine Remove the slide if it is stuck or broken The system must be restarted If the problem persists see troubleshooting section in the User s manual The slide was stuck broken or fell out during transport back into the magazine Remove the slide see 13 2 10 Slide Transport Jam Restart the SSU and the program Message box Magazine eject error Remove the magazine if it is stuck or broken The system must be restarted If the problem persists see troubleshooting section in the User s manual The magazine is stuck Remove the magazine see 13 2 11 Magazine Transport Jam Restart the SSU and the program Slides are not fully inserted into the magazine since it is worn out Push the slides back into the magazine Restart the SSU and the program Discard the worn out magazine Message box An error occurred when changing objectives Make sure that nothing is preventing the objective rotation The system must be restarted If the problem persists see troubleshooting section in the User s manual Some obj
88. nd the SSU is disconnected Reconnect the network cable Restart the SSU and the program Network card in the SSU or system computer is broken The network card has to be exchanged Message box This operation can not be performed at this time The system must be restarted If the problem persists see troubleshooting section in the User s manual Communication error between SSU and system computer Restart the SSU and the program User s Manual 121 CELLAVISION 6 CellaVision DM96 122 Problem Cause Action Message box No camera found Check cable between the camera and the system computer Restart the software If the problem persists see the troubleshooting section in the User s manual to solve this problem The camera cable is disconnected Make sure that the camera cable is connected to both the camera and the system computer Restart the program Message box Camera initialization error Check cable between the camera and the system computer Restart the software If the problem persists see the troubleshooting section in the User s manual to solve this problem The camera cable is disconnected Make sure that the camera cable is connected to both the camera and the system computer Restart the program Message box Connection with the camera lost Check cable between the camera and the system computer Restart the s
89. ne reclassified cell or object Non WBC panel Not classed User s Manual 47 EE A CellaVision DM96 4 1 1 Customizing Views To Customize views see 3 1 1 Customizing Views 4 1 2 Reclassifying Cells To reclassify cells see 3 1 2 Reclassifying White Blood Cells 4 1 3 E mail To email cell images see 3 1 3 E mail 4 1 4 Copying Images to Disk To copy cell images see 3 1 4 Copying Images to Disk 48 User s Manual CELLAVISION CellaVision DM96 4 2 Body Fluids Overview Image The body fluid overview image displays the entire sample area see 10 13 Adjusting BF Analysis Area The overview image can be used to find cells of interest and for getting an overall impression of the sample The overview image can either have one 10x zoom level or both 10x and 50x zoom levels Using both zoom levels will increase the processing time see 10 3 Adjusting Analysis Settings Mini map Trace Current position Slide Comment cm Zoom panel Add slide comment Region of interest Navigation buttons panel EE EEE EE EE EE EE EE EE User s Manual 49 sendende CellaVision DM96 4 2 1 Navigating in the Overview Image Navigate in the overview image by using the keyboard arrow buttons or the navigation buttons The image shown in the right part of the screen is an enlargement of the area inside the red rectangle shown in the Mini map Click on the
90. nel Cont d 58 User s Manual CELLAVISION 6 CellaVision DM96 Cont d Worklist Opened order and slide Selected order marked Data for selected order written in blue text blue or grey Worklist Focersed Ode M Pending Orders DrderlD L4 Order 2 1 Search criteria Order data Order 2 2 Oder 4 3 Mew at sz miens kafee S BEER ED Anais completed 2011 04 12 1038 ined status Data received Type af oder RECPLT Patient ID 30525124 Doris Davidson Ent dae 2009 0525 Analyz Ethnic origin NA Muliple Labs 20704121038 Ward P Location 305251234 1004 1567 Ken Kitoy Multiple Labs 2011 04 12 10 38 Baien canen bo2181234 Linda Lindtord DM 00 2001104111541 Extra comment to patient 30525 1234 pa Eric Ericson 2011 04 11 15 33 1806133875 Ben Benson admin 2011 04 11 15 32 Ee commen der aus H oder 530101 3578 Adam Anderson 2011 04 11 15 31 d Ofier12 2011 04 11 15 01 Ofder 11 2011 04 11 1501 Gide 10 Gb 580421331 Isax Irving 2011 04 11 15 01 Open Pirder 9 2011 04 11 14 57 z Order 8 6506110521 Heny Henrysson 2011 04 11 14 57 paiite Order 7 700611 1122 Glen Gordon 2011 04 11 14 57 Order 6 511201 9553 Felicia Foster 2011 04 11 14 56 Order 3 3610251234 Claudia Crawford 2011 04 11 14 55 Slide z Order 4 1 2011 04 11 14 56 Mg Order 4 2 200104111536 DM _008 i Order 4 3 G 2011 04 12 10 39 Open Delete Slide data hdd to Worklist Export Open Delety Mark U
91. ng Slides EE EE ee 19 M Magazine ID ese ES nae KEER RR EE 18 Magazine Status 00e eee 21 main Gallery va oe cee Rr wp eR 27 Maintenance sui ace bec AER e b 107 May Gr nwald Giemsa 135 Merging Slides EE EE ee 53 Minit Map oi oo EER EER ER RE REG 49 72 73 N Navigating RR DA N EP 50 73 O Observer N SS RIP VER GENE P RR RN 88 Oid Real sis os atit Sn Re d GR he ed 109 Opening an Order Slide 63 Order List ie es se EE KAR x e Res 60 Order SAWS o abb Sore ERR cues 60 Overview Image 49 50 72 P j IT 9 Pending Orders iius o RR CR 66 PET GOUE RS sa wat OE anes 38 PLT estimate factor esse 39 92 PET Result ses iex v achten Y Shore DER 39 User s Manual CELLAVISION CellaVision DM96 Printing Orders oe ag aca madsz index d 65 T Process status i GEE EER SEER NE ER 62 Tagging Regions of Interest 51 74 Protecting an Order 63 el tes ia RE ee me eo 17 Troubleshooting EE se 114 Q Quality Control ss sa Ra 82 106 U Usage Log 24 2424 dot wees ER DER rd 69 R RBC characterization 91 V RBC US ooste seke SEGE Ee etna 91 Verification View 24 46 142 RBC overview image 33 Reference Cells 0 27 96 W Regions of Interest vices KERE Ke 32 73 Warning 16X18 users DE tera yews 22 Report ss sek SESSE ribee ERG nnn 142 WBC Attributes
92. nmark as STAT Protect Y nprotect a Orders locked by another Slides in Selected slide marked Data for selected slide user written in red text selected order blue or grey An open order and slide is always written in blue text An order slide opened by another operator on a CellaVision Remote Review Software CellaVision DM is written in red text In the Order data and Slide data panels Locked by indicates who has opened the order slide the person logged on to Windows and on which computer p Xx User s Manual 59 E E 7 EWA enon D VISTO 6 1 1 Order List The Order list displays an overview of the orders Click the column headers to sort the list The date in column Analyzed corresponds to the processing date for the last slide in an order TER Order ID i Patient ID First Name Last Name 5i by Laborato Analyzed HE orders 0305251234 Doris Davidson Multiple Labs 2011 04 12 10 39 Order 13 581004 1567 Kent Kilroy Multiple Labs 2011 04 12 10 38 Order 14 720219 1234 Linda Lindford DM _001 2011 04 11 15 41 Bj orders 021114 Eric Ericson 2011 04 11 15 33 A H Order 2 150613 9875 Ben Benson admin 2011 04 11 15 32 4o Order 1 530101 3578 Adam Anderson 2011 04 11 15 31 te Order 12 2011 04 11 15 01 te Order 11 2011 04 11 15 01 Order 10 EP 580421 3311 Isax Irving 2011 04 11 15 01 Order 8 2011 04 11 14 57 Order 8 650611 8521 Henry Henrys
93. o the LIS and or printed 4 Click OK Note No order data can be changed after signing Comments may still be added 5 4 Sending an Order to the LIS If the LIS is activated in the Analysis tab in Settings it is possible to send signed order results to the LIS 1 Open a signed order 2 Select the Slide Merge tab in the Report View 3 Click Send to LIS 56 User s Manual CELLAVISION CellaVision DM96 5 5 Canceling an Order To cancel an order you sign the order with no included slides When the order is sent to the LIS the order will be reported as cancelled Open the order in the Database View Select the Slide Merge tab in the Report View Make sure no slides are included Click Sign Order The Sign Order dialog appears Sign the order as described in 5 3 Signing an Order result aA BW NO User s Manual 57 sense 6 Database and Archiving Data Click Database View in the toolbar Processed and pending orders are stored in the database You can switch between the two types using the tabs Processed Orders and Pending Orders 6 1 Database Processed Orders You can search for and open processed orders and slides stored in the system Orders are displayed according to the Search criteria Select an order to display more information in the Order data panel All slides belonging to the order are shown in the Slide list Select a slide to display more information in the Slide data pa
94. ocyte Metamyelocyte Immature eosinophil Immature basophil 5 1 5 1 Promonocyte Prolymphocyte Blast no lineage spec Lymphocyte variant form Plasma cell 2 5 2 5 Large granular lymphocyte Hairy cell 1 7 S zary cell z Other 1 7 Non WBC Erythroblast NRBC 5 1 5 1 Giant thrombocyte Thrombocyte aggregation Megakaryocyte Smudge cell Artefact Not classed Here you see the results of each slide in the order In the Reported Result column you see the summarized results An unsigned slide has a Slide ID written together with slide number in cerise color Cont d User s Manual 53 CELLAVISION 6 CellaVision DM96 Cont d Including Excluding Slides in from the Reported Result When a slide is signed it is automatically included in the reported result To include exclude a slide activate deactivate the checkbox next to the Slide ID When a slide is excluded a dialog is shown where you may write a comment explaining the exclusion Note It is only possible to include signed slides Note It is not possible to merge slides if one or more slides have a confirm cell counter result flag The calculated result in the reported result column will be displayed incorrectly Changing the Reported Result It is possible to change the RBC results and the PLT concentration if reported as a level for the order Results that can be changed are written in bold te
95. ody fluid sample spot Incorrect configuration of BF analysis area Configure the BF analysis area settings See 10 13 Adjusting BF Analysis Area10 13 Adjusting BF Analysis Area Seemingly normal scan slides get slide status Analysis failure with the additional information No image data in scanned area Too little specimen Prepare a slide with more specimen on the slides Wrong area Select the correct area and process the selected slide again 118 User s Manual CELLAVISION CellaVision DM96 13 2 4 Hardware Errors During Processing Problem Message box Critical jam error Cause At least the motor specified in the message box reported a jam error Action Remove any magazines and slides see 13 2 10 Slide Transport Jam Restart the SSU and the program If error persists contact your local vendor s technical support Magazine is broken and fragments are blocking the slide Remove any magazines and slides see 13 2 10 Slide Transport Jam Load the slides to a new magazine Restart the SSU and the program If error persists contact your local vendor s technical support The barcode could not be read after the slide was processed Wipe off oil from the barcode label Message box Critical calibration error At least the motor specified in the message box reported a jam error Remove any magazines and slides see 13 2 10
96. oftware If the problem persists see the troubleshooting section in the User s manual to solve this problem The camera cable is disconnected Make sure that the camera cable is connected to both the camera and the system computer Restart the program Message box The configuration of the Control unit is incorrect Please contact support The Control unit has lost its configuration Contact your local vendor s technical Support Message box File system or registry error Restart the system If the error persists see troubleshooting section in the User s Manual The File system or registry is corrupt Reinstall the program User s Manual CELLAVISION CellaVision DM96 13 2 5 LIS Errors 13 2 6 Archiving Errors 123 User s Manual Problem Slide status Default values The slides are analyzed with default values even though LIS is used for order information Cause The orders are not in the LIS Action Make sure that orders for the slides that are to be processed are already available in the LIS The connection to the LIS is broken Make sure that the cable to the LIS is connected LIS status The connection to the LIS has been broken Make sure that the cable to the LIS is connected Results are automatically resent when connection is established Problem Cause Action Message box
97. ogin name The checkbox Account Active indicates if the account is active Full Name Full name of the operator Access Level Level of user authorization E mail The operator s e mail address Note When you create a new user the user name must be unique and start with a letter a z or A Z The following words are reserved SYSTEM SYSADM SYS SELECT TABLE USER UPDATE IF IS ia EE EA ET N User s Manual 88 CELLAVISION O7 1 FENATS eno B VISTO 10 3 Adjusting Analysis Settings Default values These values are used if the order to analyze is not found in the database or in the LIS Type of order is the analysis to perform Enable LIS Activate this checkbox and restart the program if the LIS will be used Add processed slide to worklist If this checkbox is activated processed slides will automatically be added to the Worklist Note BF slides are not automatically added to the worklist EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE User s Manual 89 BELA CellaVision DM96 10 4 Adjusting Reclassification Settings m mi T F LI Forward preclassified cells Select your forwarding criteria using the checkboxes 90 User s Manual CELLAVISION 10 5 Adjusting RBC Precharacterization Settings Here you adjust the percentage limits for the different levels of the morphology characteristics It is also possible to disable the RBC precharacterization
98. ointer over the buttons or indicators you can view tool tips in the Status bar bottom left hand corner Buttons CellaVision DM software System Control View F4 Database View F5 Verification View F6 Report View F7 Close Order and Slide Order Data Help tines Enables help lines for PLT estimate Confirm Cell Counter Results Comments WBC Full Screen View WBC Galleries Zoom Mode Zoom In Zoom Out Scroll Mode 142 User s Manual CELLAVISION CellaVision DM96 Adjusts image color and Color Brightness brightness Toggles between default color Toggle Color Brightness and lights settings and personal settings Shows Hides square for cell Hee ee Cell Marker identification WBC Attributes Shows Hides WBC attributes Entire RBC Image Shows the entire RBC image Start E Stop Indicators Q Autod Automatic start of slide processing Tb Oil Level Indicates an empty oil container Indicates need for refilling of a oil nh Indicates a full oil container Output Drawer Indicates room left in the output drawer e Indicates a full output drawer Hatch Indicates all hatches closed Indicates an open hatch or oil m immersion arm in wrong position User s Manual 143 eeuse CellaVision DM96 Indicates the number of magazines in the system o Viaene except those in the output drawer Keyboard shortcuts Ctrl W Show hide Worklist 144 User s Manual CELLAVISION CellaVi
99. on has to be fine tuned using the offset values The offset values are taken relative to the position given by the centrifuge choice and the following constraints apply 5 0 lt x offset lt 5 0 mm 10 0 lt offset lt 10 0 mm 1 0 lt diameter lt 10 0 mm The entire analysis area must also be contained within the following intervals 6 5 lt x position lt 19 5 mm 6 5 lt y position lt 50 0 mm 1 Go to Tools Settings BF Analysis Area and select the desired setting for Centrifuge 2 Run an analysis of a Body Fluid slide with a representative sample spot location 3 Go to the Overview tab Use the Navigation display to establish whether the analysis area needs to be adjusted 4 If further adjustments are needed go to Tools Settings BF Analysis Area and adjust the X offset and Y offset settings see example below 5 Restart the program delete the order and rerun the slide to verify your new settings Note It is important to delete the order before the slide is rerun Otherwise the settings from the previous run will be used which means that your changes to the analysis area settings will have no effect Cont d User s Manual 103 caine CellaVision DM96 Cont d The Diameter setting was 8 mm in the example below In order to center the analysis area on the sample spot the analysis area needs to be offset by 1 5 mm in the positive x direction and 1 5 mm in the negati
100. oo 8 9 O00 0 95 O Do p ges doe 0 9 Poe 0005 Q 3690 079 o oo eo Polychromasia 00000 o HY 09020 60 oo Oe Ce d o o O99 3o O Gigs 1 000 u 0020 oo oof 02 ooo 9e Poe 00009 dbe 9oo09 odere o 000 45 ode Cer boe 90 00 Sc oto e oe 0 8 28900 2608 Microcytosis 0 45 Je o 0 Oo a o 8go 9 09 Macrooytsis 06000 as ed de es ov s eg oo 5 Mao ee R0 6 P Soo lee Poikilocytosis 06000 13 Og os o o Q9 o e o 999096 gee o 9 9099625 0 69 o e 0805 0 Qo O o Target cells OOOO 00 9 o oo es o Oaa o o 002 Schistacytosis DISCE 90909579 oec co 95 o o e0 e Tooo rd 9e So b o O o 0 0 60000 0 Helmet cell OOOO o 9 9 6 o o o o rus oeoo haoss as o so E o ERA RE GEL Spherocytosis OOOO Oo oe 99 o 99 6 ow Oo 009o o Elliptocytosis OOOO 959 090 0 6 000 o9 9950950 0 999 909 ot 0 99 90 09 Oo Qo od ooo oe N won Bodo Vete Doth Pda egeta Seco t is os ado o Slometacytosis OOOO ogg CS o So 09 age 233 FO de AO ooo 9 o 59 o Acanthacytosis OOOO o9 2544 ec 909909 o ee 9992 6e o rA e Echinocytosis OOOO 5 0 999 0 e856 o 0 amp 90 9 9 too o 00 o Howell Jolly OOOO JO S82 00 20 5 OS 00 cee 49999 009 9 059 59 9 Pappenheimer OOOO Ej 0 KO Bee o No 3 do e oo af oe e ilic suppli o Oo o NEER OR EDE 909o Goo Foe os o Oc0094 0007 02 Ot 590 08 S eq chee BETER UR GT 9 P Ed o P 20 098 998 ELI hy ig 0290009 Mo o 6 9 o 00999 oe o e goet ires Sas Peleas t hof Ree serit Ee 6 0
101. ood Smearing Instrument With HemaPrep the laboratory can standardize the smear quality irrespective of the staff experience By adjusting the speed of the spreader the operator is able to control smear length and thickness CellaVision Barcode Label Printer Kit The Barcode Label Printer Kit comes pre configured and ready for use to read and copy barcodes on vacutainer tubes and requisitions and it generates 2D barcode labels for microscope slides The printed labels have an excellent resistance against immersion oil and staining reagents CellaVision QC Labels Preprinted labels to verify the cell location performance of a CellaVision DM Analyzer CellaVision Magazine Pack Replacement magazines for clipped rounded beveled corner slides Peripheral Blood orange or Body Fluids blue CellaVision Immersion Oil Immersion oil for fine resolution and brightness optimized for CellaVision DM analyzers Products may not be available in all markets N EO CELLAVISION CellaVision DM96 Table of Contents 1 INTRODUCTION 7 1 1 About this Users Manual 22 222 tp Rosae Go Ea cp n C cand tgo 7 1 1 1 Warnings and Precautions 0 0 0 cee ees 7 1 2 Intended Use of CellaVision DM96 EE RE EE EE EE EE RA eee 9 1 2 1 Peripheral Blood Application EE cee 9 1 2 2 Body Fluid Application si ss EE EE Ee se ke ee eens 9 1 3 General Description of CellaVision DM96 SS EE
102. ou try to start the program Previous Make sure the program is closed Wait Message box program has 10 seconds and try again The program has already not closed been started and you cannot start another until the previous one is closed Message box Wrong user Enter correct user name and password Could not log on to the name and or Note that passwords are case sensitive system Make sure you password a and A is not the same typed your user name and Caps Lock is Deactivate Caps Lock password correctly activated Message box Could not log on to the system Network connection error Message box Disk space exhausted The database server could not be reached The database is located on the C drive If the database is stored on the system computer restart the computer and the program Otherwise check the network connection and that the computer that stores the database is turned on Move the database to the E drive Logging on to the system is slow The database server needs to be restarted Restart the system computer or the computer on which the database resides The database is too large Keep the database size at the recommended level see 12 5 Database Performance The database files are fragmented Compress the database see 10 1 5 Compressing a Database 114 User s Manual 13 2 2 Hardware Startup Errors CELLAVISION CellaV
103. out any risk of personal injury User s Manual 15 sense 2 Operating Procedures 2 1 Starting the System The CellaVision DM system computer is configured with a Windows policy restricting access to the operating system for the normal user When starting the PC the user will automatically be logged onto Windows and then the Cella Vision DM Software logon window will be displayed Start the system as follows 1 Switch on the slide scanning unit 2 Switch on the system computer Wait until the status lamp on the slide scanning unit is flashing or continuously lit see picture in 1 4 1 Major Parts of the System 3 In the Log On dialog type user name password and select the desired database The following icons indicate available database types E Processing database Bg Export database y Scan database r CellaVision Competency Software database CELLAVISION 6 Username Password Database EE YourDatabase gt twee 4 Click OK 16 User s Manual CELLAVISION EVAO no B VISTO 2 2 System Control View The System Control View shows the ongoing slide processing gives an overview of the preclassification and presents a log of processed slide holders The layout of the System Control View depends on the type of application Click System Control View in the toolbar Information in Toolbar System indicators show oil level number of magazines etc For a description of these indicators see
104. possible to adjust the total number of found nucleated cells if it is determined that some found cells are neither WBC nor NRBC cells For instance if the system identifies 187 nucleated cells but the user thinks 3 of them do not fall under this category he she can enter 184 in the Manual correction field and this number will be used in the calculation Cont d User s Manual 159 TIT iA CellaVision DM96 Cont d Total number of nucleated cells and non Total result Se nucleated cells found in all the images WBCs NRBCs found 218 B other Manual correction of nucleated cells found Manual correction mad WBCs NBBCs missed 1 Total number of nucleated cells missed in all the images Ratio of WBCs NRBCs found 99 5 ENS Percentage of how many nucleated cells were m found compared to the actual number of al nucleated cells on the images Messages about faulty slide analysis etc Print Result The result should be compared to the laboratory s own established limits Performance characteristics when using standardized staining and smear preparation procedures are presented in Appendix A System Specification If any of the requirements regarding the number of nucleated cells or non nucleated cells are not fulfilled an error message will be shown in the Total result panel The cell location results can be printed by clicking the Print Result button Deletion of Cell Location Slides Slides ol
105. r at the top of the gallery A cell class containing at least one reclassified cell is marked blue in the WBC and Non WBCs panels If a cell is reclassified to its own cell class it is considered reclassified and moved to the top of the gallery Note You can never reclassify WBCs on a signed slide Cont d User s Manual 29 CELLAVISION o EVAO D VISTO Cont d Cell Marker When the Cell Marker function is turned on a green square marking the cell the system has identified appears in every cell image The Cell Marker is used to split cells and identify duplicate cells Cell Marker La Splitting cells Occasionally the system fails to separate WBCs that are close to each other and more than one cell in an image will be outlined by the cell marker green square These cells should be split so that each can be identified by the operator With the cursor over the image use the right click menu and select Split cells A dialog appears explaining the procedure The appearance of the green square is not changed for split cells Instead a copy of the same image is created and a red cross will mark the cell which is to be identified Note Cells created by splitting can always be removed using the right click menu Identify duplicate cells If the green square outlines only part of a cell the system has only used this part for cell identification There is a risk that the system has identified the other part of the cell as
106. r the slide scanning unit 2 1 A Total current input for the system 8 4 A Voltage frequency 50 60 Hz Heat 3300 BTU h and 960W Sound level 45dBA 60dBA average peak Pollution degree 2 Installation category II Over voltage category II Mains supply voltage fluctuations not to exceed 10 percent of the nominal voltage WARNING Connect to ground sockets only WARNING The mains supply cord and plug of the equipment shall comply with any national regulations WARNING External computing devices connected to the communication connector LAN of the system have to comply with the standard UL 60950 Cont d User s Manual 133 CELLAVISION o CellaVision DM96 Cont d Performance Specification Peripheral blood Average WBC cell location and display of at least 97 with a standard deviation less than 2 Throughput Approximately 30 slides h for complete orders containing RBC PLT and 100 cell WBC Results of short term imprecision found in a clinical evaluation on 219 patient samples based on NCCLS standard H 20A Cell class SD Cell class SD Segmented neutrophils 4 7 Basophils 0 7 Band neutrophils 3 0 Lymphocytes 5 0 Eosinophils 1 2 Monocytes 2 0 Limitations Distinctions between band and segmented neutrophils metamyelocytes and myelocytes myelocytes and promyelocytes lymphocyte and lymphocytes variant forms are subjects to variations among individual ope
107. rators Performance Specification Body Fluid Average WBC cell location and display of at least 97 with a standard deviation less than 2 Throughput Approximately 20 slides h for orders containing only 10x overview images 6 mm analysis area Approximately 6 slides h for orders containing both 10x and 50 overview images 6 mm analysis area Results of short term imprecision found in a clinical evaluation on 182 samples based on NCCLS standard H 20A Cell class SD Cell class SD Neutrophils 3 3 Macrophages 7 3 Eosinophils 0 7 Other 4 3 Lymphocytes 5 9 ET EE EE T 134 User s Manual Performance Specification Scan Throughput data and disk space reguirements for the scanned slides CELLAVISION CellaVision DM96 Analysis area size Overview images Processing time Disk space 5x5 mm 10x 1 min 10 MB 5x5 mm 10x 50x 8 min 130 MB 10x10 mm 10x 2 min 45 MB 10x10 mm 10x 50x 30 min 500 MB The given values are approximate Processing time and required disk space vary depending on the sample Materials Specification Immersion oil Trak 300 Automated Differential System Immersion Oil Refractive index 1 5150 Viscosity 300 cSt PCB free 500 ml should be sufficient for approximately 10000 analyses Bulb OSRAM XENOPHOT HLX 64625 FCR 12 V 100 W halogen CellaVision slide magazines Stain May Griinwald Giemsa or Wright Slide requirements mm glass
108. re currently logged on to BET EE SSeS See 86 User s Manual CELLAVISION 6 CellaVision DM96 10 1 6 Setting User Restrictions Here you set the available database search criteria for the Restricted user Select the desired Restricted user search options 10 2 Adjusting Users Settings V ObserverUser ObserverUser Observer V NormalUser Normallser User RestrictedU ser RestrictedU ser Restricted V Authorizeduser Authorized ser Authorized Administratorll ser Administratorll ser Administrator 7 admin Administrator created by the system Administrator Show inactive users Activate this checkbox if inactive users shall be shown in the list New Add a new user see User Information dialog Edit Edit user information see User Information dialog Delete Delete selected users Cont d User s Manual 87 sees TENA er IE WATS enon B VISTO Cont d There are 5 levels of user authorization Observer Only allowed to view images and results User Can reclassify and recharacterize WBC RBC and PLT but not sign slides Authorized Same as User but can sign slides and orders Restricted Same as Authorized but with restricted database access Administrator Full access to the system The authorization level determines the different functions and features the operator can access see Appendix E User Authorization Levels User Information Observer User L
109. re database requires 100 MB Note Having many databases affects system performance negatively Note A database can be created only on your local computer pi M M User s Manual 85 CELLAVISION o 7 FE WATS enon D VISTO 10 1 2 Deleting a Database 1 Select the database in the list 2 Click Delete 10 1 3 Creating a New Database Connection 1 Click Connect A dialog appears where you may enter Database name Description and Remote computer 2 Click OK A new connection will be shown in the list Note On the remote computer select Help System Information to find out the name of the computer 10 1 4 Deleting a Database Connection 1 Select the connection in the list 2 Click Disconnect 10 1 5 Compressing a Database 1 Select the database in the list 2 Click Compress A dialog appears 3 Click Compress database 4 Click Close A compressed database will occupy less space on the hard disk The performance might also be improved Note It can take a long time to compress a database If the database is gt 10 GB in size it can take some hours The process requires free disk space twice the size of the database to be compressed Note During compression no client may be connected to the database This means that you cannot compress the database you a
110. rea setting will be used User s Manual 77 IT iA er TEER r2 D VISTO 7 4 Customizing the System To customize the system go to the Tools menu and select Settings 7 4 4 Adjusting Database Users and Language To adjust the settings for database users and language see 10 1 Adjusting Database Settings 10 2 Adjusting Users Settings and 10 12 Adjusting Language Settings 7 4 2 Adjusting Default Scan Area To adjust the default scan area go to Tools Settings Default Scan Area Default Scan Area The scan area can be selected either by using the edit boxes or by clicking and dragging in the slide image The following constraints apply Min Max x 10 m mm 16 67 mm v 17 83 mm 28 84 mm 6 5 lt min lt Xmax lt 19 5 mm 6 5 lt Y min lt Ymax lt 50 0 mm The width and height of the scan area must also satisfy 2 0 lt width lt 20 0 mm HUI 2 0 lt height lt 20 0 mm To adjust the scan area settings for individual slides click Database View and select Pending Orders See 7 3 2 Pending Orders Pam SS TA N 78 User s Manual CELLAVISION 6 CellaVision DM96 7 4 3 Adjusting Analysis To adjust the default analysis settings 10x or 10x and 50x magnification go to Tools Settings Analysis PB default values BE default values Number af WELS to count Number af WELS to
111. rection of the arrow until it stops 8 Move the lift down by turning the coupling to the drive screw 9 When the QS arm can clear the top of the magazine stop turning the coupling and gently push the QS arm in the direction of the arrow until it is in contact with the magazine 10 Continue turning the coupling until while looking through the Output Drawer the magazine is level with the floor User s Manual 131 me CellaVision DM96 11 Gently pull the QS arm in the direction indicated by the arrow until the magazine stops 12 Push the magazine onto the Output Drawer Note The next step is essential to avoid damage to the analyzer unit 13 Gently pull the QS arm in the direction of the arrow until it stops 14 Open the Output Drawer and remove the magazine 15 Close all the hatches and restart the system E eS SS TT N 132 User s Manual CELLAVISION Appendix A System Specification Climate Specification CellaVision DM96 is designed to be safely operated at 18 C to 31 C 64 F to 88 F at a maximum relative humidity of 90 with no condensation allowed indoor use and altitudes up to 2000 m Physical Specification Weight 60 kg excluding PC and monitor Size WxDxH 53x58x62 cm 20 9x23 6x24 8 inches Electric Specification monitor not included Voltage input 100 240 VAC Current input for the system computer 6 3 A Current input fo
112. repared sample within the intended use of the CellaVision DM96 applications All other use is for research use only and not for use in diagnostic procedures 7 1 Scanning a Slide Make sure that a Scan Database is available on your CellaVision DM To create a Scan Database see 10 1 1 Creating a New Database Log on to a Scan Database see 2 1 Starting the System To customize your system such as scan area and magnification see 7 4 Customizing the System 7 1 1 Slide and Magazine Requirements Requirements for the slides used when scanning Glass e Size in millimeter 75 0 76 0 x 25 0 26 0 x 0 9 1 2 Ground edges Clipped or round corners Barcode labeled Frosted end Note When using cover slips make sure the scanning area is within the cover slip area Note Coverslipped slides are supported as long as the total thickness of the slide is within the requirements Note CellaVision DM96 analyzers with a serial number higher than 31216 or systems that have been upgraded with the Stage Upgrade Kit CellaVision Part number XU 10043 support slides with the following dimensions mm 75 0 76 0 x 25 0 26 3 x 0 9 1 2 Note Any type of CellaVision magazines can be used for a scan analysis User s Manual 71 CELLAVISION o 97 FE WATS enon D VISTO 7 2 Scan Overview Image Opening a scanned slide leads directly to the Scan Verification View To open a slide see 6 1 3 Opening an Order Slide 7 2 4 Overview The Mini Map sho
113. rge granular lymphocyte Hairy cell S zary cell Other Total Non WBC Erythroblast NRBC Giantthrombocyte Thrombocyte aggregation Megakaryocyte Smudge cell j f dd EZ e i E x it di i s x L 76 TT v pti p ty L 3 Wc 9 EE 3 Wm ERG Not classed i wek c gt i 30 31 O S 9 WBC comment a r ra 3 a Vac Worklist Non WBCs panel Add WBC 3rd gallery comment Cont d 24 User s Manual CELLAVISION CellaVision DM96 Cont d All cell classes handled by the system are displayed in the figure on the following page WBCs and non WBCs automatically preclassified by the system are marked with a small dot or an arrow In settings see 10 4 Adjusting Reclassification Settings you may choose to auto forward preclassified WBCs to another cell class as follows Band neutrophil to Segmented neutrophil Metamyelocyte to Segmented neutrophil Lymphocyte variant form to Lymphocyte Plasma cell to Lymphocyte Blast cell Metamyelocyte Myelocyte and Promyelocyte to Other Cont d EE EE M EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE User s Manual 25 eene koe er IE VERE INER Cont d An arrow indicates an auto forwarded cell class Place the cursor over the arrow to see the destination cell class Arrow indicating an auto forwarded cell cla
114. rsion oil to a slide An optical drop counter controls the procedure The container capacity is about 500 ml A sensor detects if the oil level is below 100 ml Slide Feeder Unit with Barcode Reader The slide feeder transports slides from a magazine to the stage and back again after the slide has been processed It is equipped with a barcode reader which scans the barcode of both the slide and the magazine For maximum safety the barcode of the slide is scanned both before and after processing See Appendix A System Specification for more information about barcodes Magazine The magazine can be loaded with up to 12 slides clipped round corner slides Magazine Feeder Unit The unit moves magazines from the conveyer to the slide feeder unit and from the slide feeder unit to the output drawer It is equipped with a counter for the number of magazines in the conveyer and a sensor that warns if the output drawer is full Control Unit The control unit controls motors sensors oil applying and illumination It functions as a slave computer to the PC via an unshared 100 Mbit Ethernet connection Computer System A System Computer running Microsoft Windows XP and CellaVision DM software Casing The casing comprises a metal cabinet including 5 hatches drawers main hatch lamp hatch input hatch service hatch and output drawer WARNING Never tamper with sensors or other safety devices These make sure that the system can operate with
115. rt buffer work solution Stable for 8 hours C Buffer stock solutions 1 and 2 1 9 07 g KH5PO 0 067 M ad 1000 ml deionized water Store at 4 C to 8 C 2 9 45 g Na HPO 0 067M ad 1000 ml deionized water Store at 4 C to 8 C d Buffer working solution pH 6 8 Combine 127 ml KH2PO stock solution with 123 ml NagHPO stock solution ad 5000 ml deionized water Adjust to pH 6 8 Store at 4 C to 8 C Durable for a month at 4 C e Giemsa stain stock solution Merck M9204 Azur eosine methylenblue solution for microscopy contains methanol Store at 15 C to 25 C Durable for several months if kept in a dark bottle f Giemsa working solution Dilute 1 part Giemsa stock solution with 19 parts buffer work solution Stable for 8 hours Cont d 154 User s Manual CELLAVISION CellaVision DM96 Cont d Wright Stain Note Differences in staining results may be cause by alterations in pH reagents etc Local adjustments may be needed to achieve best results Be aware of pH variations in water Alternative 1 Sysmex SMS SP 100 slide stainer Solution Reaction time Wright stain 2 min 2 Wright stain diluted 1 10 with phosphate buffer 7 min pH 6 8 3 Rinse in deionized water 30 sec Alternative 2 Beckman Coulter GENS slide stainer Solution Reaction time Methanol 30 sec TruColor Wright stain 2 min 30 sec TruColor Wright stain diluted 1 6 with
116. s appear in this manual as follows Alert Explanation WARNING May cause injury Caution May cause damage to the system Important May cause misleading results Cont d User s Manual 7 CELLAVISION o 07 1 FE WATS enon D VISTO Cont d Place the system on a steady table Do not place it where it is exposed to bumps or vibrations excessive temperature variations or direct sunlight The system must be connected to grounded electrical sockets only Authorized personnel should do the initial installation and reinstallation after moving the system Do not install or run any software not supplied with the system To maintain electromagnetic compatibility use only original components Spillage of fluid on the surfaces of the system may cause malfunctions or deterioration Wipe off spilled fluids immediately with a soft tissue WARNING The system should be serviced by authorized personnel only WARNING If the equipment is used in a manner not specified by the manufacturer the protection provided by the equipment may be impaired The following symbols are found on the system Symbol Explanation Indicates that the surface becomes hot and should not be touched with bare hands Documentation needs to be consulted PP IVD In vitro diagnostic medical device 3 O Temperature limitation This symbol is only valid in the European
117. s manually been added to the database and has not yet been processed Pending Orders are useful when defining scan area for individual slides ft Pending Order MT Order 310 Mike Lawson MT Order 320 Nicky Clark Add Edit Delete To add an order click Add To view or edit order data double click on an order or click Edit Cont d BEUR EE EE DAT N 76 User s Manual CELLAVISION 6 er ENA ey noe B VISTO Cont d Order Data Order ID MT Order 350 Patient ID First name Last name Birth date Scan Area amp Magnification Magnification Area C 10x 10x 50x Gender C Male C Female Ethnic origin Ward Patient comment Order comment ici Sample date Ordering physician z required field Close To define scan area for the slide click Area Define the area that you want to scan on this particular slide Scan Area The scan area can be selected either by using the edit boxes or by clicking and dragging in the slide image The following constraints apply Min Max EE mm eer H mm 6 5 lt Xmin lt Xmax lt 19 5 mm 6 5 lt Ymin lt Ymax lt 50 0 mm v 17 83 mm 28 83 mm The width and height of the scan area must also satisfy 2 0 lt width lt 20 0 mm N 2 0 lt height lt 20 0 mm Note If no scan area is defined the default scan a
118. s or objects 100 WBC WBC Reclassification for Body Fluid Besides the cell classes mentioned above the operator can reclassify cells into the following cell classes Not classed and user defined cell classes Not classed should be used for cells and objects which the operator cannot identify and wants to exclude from the differential count Sample Preparation Body fluid samples are prepared by using a cytocentrifuge and a staining unit The sample is centrifuged onto a glass slide and stained with Romanovsky stain see Appendix G Slide Preparation Guidelines for recommended staining recipes 12 User s Manual CELLAVISION CellaVision DM96 1 3 3 CellaVision Remote Review Software CellaVision Remote Review Software is an additional software to CellaVision DM 96 The software gives remote users access to analyzed slides and the possibility to reclassify cells and sign slides from another location A slide being verified on CellaVision DM96 can simultaneously be opened on a CellaVision Remote Review Software and vice versa CellaVision Remote Review Software is intended to be used with the Peripheral Blood and the Body Fluid applications See 9 CellaVision Remote Review Multiple users for more information 1 4 Components and Mechanical Operation 1 4 1 Major Parts of the System The system comprises the following major units Computer system Slide scanning unit SSU Motorized microscope Digital color c
119. s presented in the same order as the system is working Cells marked with black boxes may occur in the middle of the test not only towards the end Note The last collected cell will be marked with both a black and a green or blue box Number of nucleated cells found in the sample Region of Interest Cell Location Number of non WBCs found in the WBCs Found 100 sample Non WBCs Found 60 Ratio of WBCs Found 100 0 Cell location percentage WBCs missed 0 I Display Adjacent Areas Number of missed nucleated cells in the analysis area Print Result The Result The result is automatically calculated The percentage indicates how many nucleated cells the system found including the manually added number of missed cells The result should be compared to the laboratory s own established limits Performance characteristics when using standardized staining and smear preparation procedures are presented in Appendix A System Specification The cell location results can be printed by clicking the Print Result button D EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE EE User s Manual 163 CELLAVISION 6 CellaVision DM96 Appendix Glossary Term Analysis Confirmation Duplicate slide differential Grid square In vitro LIS Magazine Magazine ID MGG Mini map Multi slide order Non WBCs Not classed Operator Order Order ID Other Patient ID Pending order PID PLT PLT estim
120. sion DM96 Appendix D Recommended Workflow Laboratories handle their peripheral blood differential counts in different ways making it hard to suggest one general workflow suitable for all laboratories See flowcharts of the three workflows Recommended Settings see 10 7 Adjusting Report Sign Settings 1 Single slide differentials Pre fill password Enabled Sign order when signing the slide Enabled Send order to LIS when signed Enabled Review the cells in the WBC Galleries 2 Confirmation of cell counter results Quickly scanned slides for verification of cell counter results Pre fill password Enabled Sign order when signing the slide Enabled Send order to LIS when signed Enabled Review the analysis type you want to confirm and then click Confirm Cell Counter Results Confirm Cell Counter Results When using the Confirm Cell Counter Result for any analysis type WBC RBC or PLT the normal sign slide checks cells in the Unidentified class all cells reviewed etc are disabled Note When using Confirm Cell Counter Results the results sent to the LIS are a WBC confirmation flag a RBC confirmation flag and or a PLT confirmation flag For a slide it is possible to report the WBC result and a RBC confirmation flag and a PLT result or any other combination 3 Duplicate slides An order consists of two slides Two persons sign one slide each Pre fill password Enabled Sign order when signing the slide D
121. slides To avoid the problem it is recommended to run two slides after weekly maintenance Delete these slides immediately to avoid the risk of result mix ups Caution Avoid alcohol on the oil level indicator 12 2 2 Slide Guides On systems with SN 31001 SN 31215 not upgraded with Stage Upgrade Kit CellaVision part number XU 10043 01 Clean the slide guides carefully to remove any glass shards or particles Apply one drop of stage oil at the two positions marked by red dots in the image below 12 2 3 Computer Turn of the computer completely Wait for 30 seconds and then start the computer again It is allowed to install an anti virus program but it is not recommended to scan the database files 108 User s Manual CELLAVISION 6 CellaVision DM96 12 2 4 Delete Unsigned Orders Delete unsigned and failed orders to minimize the size of the database 12 3 Preventive Maintenance No preventive maintenance by the user is necessary Preventive maintenance is to be performed by CellaVision authorized personnel 12 4 Remedial Maintenance 12 4 1 Immersion Oil Refill WARNING The oil may cause sensitization by skin contact We recommend using gloves Oil container Main hatch 1 Open the main hatch 2 Unscrew the oil refill cap from the oil container Cont d EE User s Manual 109 TIT io CellaVision DM96 Cont d 3 Fill up with specified oil using a clean funnel Do not fill up abo
122. slides with cover slip Stain the slide using the same staining recipe as for peripheral blood samples See Recommended Staining Recipes for staining recommendations 156 User s Manual CELLAVISION CellaVision DM96 Appendix H Cell Location Cell Location for Peripheral Blood The cell location performance shall be verified at regular intervals by running the Cell location test Running the test once or twice a day is a recommended interval at the high load laboratory The test establishes how many percent of the nucleated cells i e WBC and NRBC that are found on a slide The cell location performance shall also be verified after changes in staining procedure and after changes to staining solutions The Cell Location tool may be accessed in the Tools menu Slide Requirements Use a freshly stained blood sample with a WBC count in the normal WBC range To reduce processing time a WBC count above 7x10 1 is recommended If the system cannot locate at least 100 nucleated cells the result will be discarded The percentage of non nucleated cells i e all other object that are not identified as being a WBC or NRBC cell e g smudge cells must not exceed 30 of the total number of objects The slides must have a barcode label starting with the text OC AII slides with this kind of label are automatically treated as cell location test slides When the slide has been processed it will only be available in the
123. son 2011 04 11 14 57 Order status dz Empty field No slide is signed v At least one slide is signed A Order is signed a Order is cancelled STAT mark Empty field Not a STAT order Order is marked as a STAT order LIS status us Empty field No data sent or received Data received at Waiting to send result ad Result is sent g Result is sent send failure Fro Result is successfully sent Cont d 60 User s Manual CELLAVISION CellaVision DM96 Cont d Process status Empty field o D Archive status Empty field w 9 amp Comments Empty field Ei Multi slide status Empty field C Order type Empty field All slides in the order have process status OK Slide with process error in the order Stopped slide in the order Slide with process status in the order t Order is unprotected Order is protected Order and slides in this order cannot be deleted or archived Order is archived All images except Region of interest images have been deleted only applicable for scan databases BJ No comments Comments exist One slide in order More than one slide in order The order contains a cell counter confirmed result Peripheral blood order CellaVision Image Capture System order Body fluid order User s Manual 61 CELLAVISION 6 6 1 2 Slide List Processing status Processing status Slide status Comments
124. ss Destination cell class Preclassified by the system WBC panel WBC Unidentified F Band neutrophil Segmented neutrophil h phil Eosinophil Basophil Lymphocyte Monocyte Promyelocyte Myelocyte Metamyelocyte Immature eosinophil Immature basophil Promonocyte Prolymphocyte Blast no lineage spec Lymphocyte variant form Plasma cell Large granular lymphocyte Hairy cell Sezary cell Other Magnus celler Total Count 1 108 48 46 08 3 30m 1 108 42 42 08 4 408 L Pen icon Indicates Cell class comments Blue Contains at least one reclassified cell or object Tick mark All images have been viewed Non WBC panel Non WBC Erythroblast NRBC Giantthrombocyte Thrombocyte aggregation Megakaryocyte Smudge cell Artefact Count Green Contains no reclassified cells or objects Not classed 26 User s Manual CELLAVISION e7 LEVAT noe B VISTO 3 1 1 Customizing Views Galleries WBCS are presented by class in galleries The main gallery is always shown together with up to two additional galleries Click WBC Galleries to change the number of galleries WBC Galleries Left and right clicking in the WBC and Non WBCs panels also changes cell class in the main and the 2nd gallery respectively You can also select cell class in the drop down list The system keeps track of all WBCs viewed by the operator A tick mark appears when all WBCs of
125. t represents 14 um across As the image magnification is increased numbers will appear at the ends of the ruler to indicate the scale in micrometers The ruler can be moved around the RBC image by moving the mouse pointer in either zoom mode or scroll mode over the ruler depressing the left mouse button and then by dragging it to its desired placement The ruler will be placed back in the bottom right corner whenever the view is changed The ruler shape can be toggled between the default cross shape and a line shape by double clicking on it The shape will not change back to the cross when shifting views A thin window frame appears around the ruler when the mouse pointer is moved over it to indicate that the ruler can be moved or have its shape changed Note The RBC precharacterization is not available for images captured on a CellaVision Image Capture System 99 34 User s Manual CELLAVISION er LEVAT mE B VISTO 3 2 1 Customizing the Red Blood Cell Overview Image Change the magnification of the image by using these buttons sn b Entire RBC Image Shows the entire RBC image Navigate the image by switching between different control modes The mouse pointer changes accordingly Qt Zoom Mode Hold left mouse button down and zoom in out e by moving the mouse pointer up down y Scroll Mode Hold left mouse button down and pan in any e direction using the mouse Note You may also double click in t
126. t Jam WARNING m Always turn the system mains off before interacting with the interior of the system WARNING A broken slide can cause serious cuts and poses a danger of infection Always use protective gloves and tweezers when removing glass shards from the system 1 Turn off the power to the SSU 2 Open the Main hatch 3 Open the Service hatch 4 Gently pull the slide into the magazine by moving the QS arm straight back If the slide does not move lies loose or is broken then remove it by hand 5 Gently pull the QS arm all the way in the direction indicated by the arrow 6 Close all hatches and restart the system The magazine will be ejected into the output drawer User s Manual 129 EERS CellaVision DM96 If the jammed slide is on the XY stage move the immersion oil arm out of the way 13 2 11 Magazine Transport Jam 1 Turn off the power to the SSU 2 Open the Main hatch 3 Open the Service hatch 4 Look on the stage If the QS arm and the FPU are connected as shown in the picture proceed to step 5 Otherwise proceed to step 6 5 Place your hand as shown in the picture Push gently in the direction of the arrow until the FPU and the QS arm are disconnected 6 Gently slide the FPU fully onto the stage in the direction of the arrow 130 User s Manual CELLAVISION 6 CellaVision DM96 7 Gently pull the QS arm in the di
127. the database and try to delete them manually CELLAVISION o CellaVision DM96 13 2 7 Cell Location Problems Cell Location Problems Peripheral Blood Problem Cause Action Too many non nucleated cells Too many smudge cells Run another slide with less smudge cells Verify smear preparation process Too many artefacts Increase wash step Filter the stain Ensure that the stain has not exceeded the expiration date Cells misclassified as non nucleated cells Run another slide and if the problem remains prepare new staining solutions Too few nucleated cells located Low WBC count Prepare a new slide with a higher WBC count Too short smear Poor smear quality Prepare longer smears Verify smear preparation procedure Nearly all boxes are far from the cells Stage or calibration error Contact your local vendor s technical support Too many missed cells Too high WBC count Do not process slides with a WBC count that exceeds 100x10 l Poor staining Verify staining procedure Long processing time Low WBC count Prepare a new slide with a higher WBC count Poor staining Verify staining procedure Same cell counted more than once duplicate cell images are shown by the system Sample contains disintegrated cells or smudge cells and the system identifies different parts of a cell as
128. ton 2 Select the entry fields one by one count the PLTs in the image window and type the number in the entry field You can use tab and Shift Tab to move between entry fields b Specifying an approximate PLT count per grid square 1 Select the Approximate PLTs per grid square radio button 2 Use the entry fields to view different grid squares 3 Estimate the average PLT count per grid square and type this value in the field Note It is not possible use Count PLTs per grid square or Approximate PLT count per grid square for images captured on a Cella Vision Image Capture System Cont d 38 User s Manual CELLAVISION Cont d PLT Result 1 Click Calculate PLT Result in the PLT Count panel PLT result PLT estimate factor Fe Average PLTs HPF value 23 PLT concentration Calculated estimate fi 7 6 x10e9 L C Calculated level Increased C Manual level Increased 2 If you wish to report the PLT results calculated from the number of PLTs per HPF you have two choices Select Calculated estimate to report a concentration The estimate is calculated as Average PLTs HPF value x PLT estimate factor Select Calculated level to report one of four levels Significantly decreased Decreased Normal or Increased 3 If you wish to override the calculated PLT results select Manual level and choose one of the four levels Important You have to determ
129. ve the black line We recommend not filling up more oil than will be used in 6 months A full oil container of 500 ml corresponds to about 10000 slides 4 Clean the system from immersion oil spillage with a lint free soft cloth 5 Screw the oil refill cap back on 6 Close the main hatch Caution Use only immersion oil recommended by CellaVision AB see Appendix A System Specification 110 User s Manual CELLAVISION 6 12 4 2 Bulb Exchange WARNING When you exchange a bulb first switch off the SSU Wait for the lamp housing and lamp bulb to cool before touching Hatch 1 Loosen the 2 non detachable screws which hold the lamp hatch about half a turn counter clockwise using a 3 mm Allen key 2 Remove the hatch by pulling it outwards and then upwards Cont d User s Manual 111 VISION Cont d Lamp house screw 3 Loosen the non detachable screw of the lamp house cover using a 3 mm Allen key 4 Lift and remove the cover of the lamp house Bulb clamping levers Caution Do not touch the new bulb with bare hands If fingerprints are made on the bulb wipe it with a soft lint free cloth Cont d 112 User s Manual CELLAVISION CellaVision DM96 Cont d 5 Press the bulb clamping levers and gently withdraw the old bulb from the lamp housing 6 Press the bulb clamping levers and fully insert the bulb pins into the pin holes 7 Gently release th
130. ve y direction 104 User s Manual CELLAVISION e7 1E VATSTo n E VISTO 10 13 2 Adjusting the Size of the Analysis Area To adjust the size of the analysis area do as follows 1 Go to Tools Settings BF Analysis Area and select the desired setting for Diameter 2 Restart the program delete the order and rerun the slide to verify your new setting As a rule of thumb the analysis area diameter should be 1 mm larger than the sample spot diameter The slightly larger analysis area diameter will allow for variation in sample spot location between slides The image below shows an example where the analysis area covers the sample spot well Take the last analysis performed and check how well the analysis area covers the sample spot If the analysis area is too large or too small go to 7ools Settings BF Analysis Area and adjust the Diameter setting Note Increasing the Diameter setting will increase the processing time User s Manual 105 CELLAVISION o 11 Quality Control Self tests The system performs self tests during startup of the software and at certain points during the operation ofthe system When the software starts the system is checked before the operator can start analyses During this phase both the hardware and the software components are tested for anomalies as well as various requirements for the operation of the system If the LIS communication is enabled the program will also check th
131. w Click WBC Full Screen View to display all WBCS sorted by class WBC Full Screen View Note Cell classes that have been fully displayed in WBC Full Screen View will also be tick marked Adjusting Image Color and Brightness Click Color Brightness to display the Image adjustment dialog m Color Brightness Color sliders Image Adjustment E Reset IN ESSA LM L1 Sae p Load 9 G Brightness Color sliders Changes the color composition of the image Brightness Adjusts the brightness of the image Reset Restores original settings Save Stores individual settings Load Gets individual settings Cont d 28 User s Manual CELLAVISION CellaVision DM96 Cont d Individual settings can also be switched using Toggle Color Brightness Toggle Color Brightness Adjusting Magnification Click Zoom In or Zoom Out to change the magnification in all galleries and in the WBC Full Screen View Note You may also double click on a WBC to enlarge it and use the scroll wheel to zoom in out 3 1 2 Reclassifying White Blood Cells Reclassify WBCs by dragging and dropping them from one gallery to another 1 Place cursor over the cell image 2 Click and hold down left mouse button 3 Move cursor to the destination gallery then release button You may also drag and drop cells to the WBC and Non WBCs panels Press Ctrl or Shift to select multiple cells Reclassified cells always appea
132. wn in the Overview displays the entire sample area To enlarge a specific area of the sample click in the Mini Map The magnified area will be displayed in the large image on the screen On the Mini Map a red rectangle marks the area requested for enlargement A blue trace marks an already viewed area Mini Map Trace Current position EE verview Navigation Region of Interest Region Comment __ Tag Region Edit Scan comment Zoom panel Add scan comment Region of interest Navigation buttons panel The enlarged area can either have a 10x zoom or a combined 10x and 50x zoom Using both zoom levels will increase the processing time 72 User s Manual CELLAVISION e7 LEVAT mE B VISTO 7 2 2 Navigating Move efficiently in the Mini Map by using the keyboard arrows or the Navigation Buttons The image shown in the right part of the screen is an enlargement of the area inside the red rectangle shown in the Mini map Click on the Mini map to enlarge another part of the sample A blue trace in the Mini map indicates which parts of the overview image that have been viewed by the operator Hold left mouse button down and pan in any direction using the mouse Switch between 10x and 50x zoom levels by right clicking in the enlarged image Adjust the zoom level by dragging the sliders in the Zoom panel User s Manual 73 seksie 07 1 FE WATS enon D VISTO 7 2
133. xclude PLT Analysis to exclude PLT analysis results from the slide 3 4 Comments For each slide you can add comments to the WBC RBC and PLT results For WBC analyses you can also add comments to cell classes and individual cells WBC RBC and PLT comments are added in Verification View in each tab respectively Cell class and cell comments are added in the WBC tab in Verification View Note All comments except comments on individual cells are printed in the report User s Manual 41 E C 7 FE WATS enon D VISTO 3 4 1 Adding Comments The system records the author of each comment except for comments to cell classes and individual cells If another operator logs in each comment is tagged with the name of the operator who wrote it An operator can view all comments but can only edit his her own Comment added by operator admin omments Comment added by operator author Click Comments to add comments to WBC RBC and PLT WBC comment Hypersegmentation Pelger form Hypergranulation Hypogranulation Auer rods Append You may write edit comments in the Comment box Click Standard Comments to show hide standard comments Double click on a standard comment to add it to the Comment box You may also select a standard comment and click Append Cont d 42 User s Manual CELLAVISION CellaVision DM96 Cont d You may activate the Comment types you want to display
134. xt 1 Click on the result to change 2 Change the value in the dialog and click OK Note If you include or exclude a slide all manually changed values will be replaced by new automatically calculated values Cont d BEER EE EA 54 User s Manual CELLAVISION o CellaVision DM96 Cont d Comment Panel Comment Comment to this cell class Comment to this cell class Comment to this cell class Comment to this cell clas Comment to this cell cla Comment to this cell class Co Comment to this cell class ent to this cell clas Comment to this cell cla Comment to this cell cla Comment to this cell cla Comment to this cell class Comment to this cell class Comment to this RBC admin Comment to this PLT admin Here you see all comments associated with the order Only the beginning of the comment is shown in the table Click on a comment to view the whole comment text It is not possible to edit comments in this panel All comments in the Comment panel will be included in the report I User s Manual 55 EE o CellaVision DM96 5 2 Report Preview This tab contains a preview of the report The format of the report is based on templates and these can be selected in Settings see 10 7 Adjusting Report Sign Settings 5 3 Signing an Order result 1 Click Sign Order 2 Type User name and Password if not pre filled 3 Select whether order shall be sent t

CellaVision® DM96 User`s Manual 3.1-3.2

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CellaVision&reg; DM96 User`s Manual 3.1-3.2

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CellaVision® DM96 User`s Manual 3.1-3.2