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CellaVision® DM96 User`s Manual 3.0

1. 110 12 4 2 BUIDEXGNANGC s aca nus cox Pea ate Lee bor POET ee Rack RD ee eed 112 12 5 Database Performance 114 4 User s Manual CELLAVISION CellaVision DM96 12 5 1 Controlling the Database Size 114 13 TROUBLESHOOTING 115 13 1 Troubleshooting Steps 115 13 2 Troubleshooting Chart 115 13 2 1 General Startup Errors 115 13 2 2 Hardware Startup Errors 116 13 2 3 General Processing Problems 117 13 2 4 Hardware Errors During Processing 120 13 2 5 E SdEllOlS eee gtx eee ese Soares ee ee oe dee oat oe ee ee eee eS eedes 125 13 26 ATCAWING Em 234204665 2436405044 REX PRG ES ken RA RR een A 125 13 2 7 Cell Location Problems 126 132 8 Barc de T HODIGNISS cadena 6u mur on esa whe Rt dae dor Peach eee eed ed edo es 128 13 2 9 StainingProblems 129 13 2 10 Slide Transport Jam 0 0 0 cc eee 131 13 2 11 Magazine TransportJam 132 APPENDIX A SYSTEM SPECIFICATION 135 APPENDIX B STORAGE AND HANDLING 143 APPENDIX C BUTTONS AND I
2. 39 3 3 3 Excluding the Platelet Analysis 39 34A COMMEN oca 2 39 atiis t Gn ne CN on EA URBC ERROR OED OSS EDGR WHEE E de A 39 3 4 1 Adding Comments 40 2 5 Order Bald xui edes ped es eee tnd EXE eee hae E EUR Rol RENAE Eis ed WU E Re eee 41 9 5 MIOMING a SIGS IA IA ER RE Rud oa RUASEN EE Ped EE RENE VERS 42 3 6 1 White Blood Cells Red Blood Cells and Platelets 43 4 VERIFYING PROCESSED SLIDES BODY FLUIDS 44 4 1 Body Fluids Differential 44 4 1 1 Customizing VieWS 46 4 1 2 Reclassifying Cells 46 2 1 9 India ous no ans RE SALA a oe RE ye eee E EFRON o DH o Do UR 46 4 1 4 Copying Images to Disk 46 4 2 Body Fluids Overview Image 47 4 2 1 Navigating in the Overview Image 48 4 2 2 Tagging Regions of Interest 49 4 2 3 Copying Regions of Interest to Disk 50 4 3 COMME Suae gt AE V HC beak oho Nat duc eed ase eed feudi y b acabe oe Rd ER a 50 4 3 1 Adding Comments 50 44 Order Data
3. 65 6 2 2 Pending Orders Dialog for Body Fluid 66 6 3 ArchivingData 66 6 4 UsageLog 67 ERa ai AA E E E N E E aa 67 642 OPeCCINCAUON AAA II oe eugene E E e eee 67 6 5 Export LOQIFICS snes aos irass ae CX 3 973005 3 aride deed dog Sh ORO o8 2 NC dn RS e Cs 68 6 6 Backup and Recovery of the Database 68 6 6 1 System Backup amp xxu 3E EARRERSARHASC ETE E RESXSTed edel nic Wa 69 6 6 2 Online BACKUP uud nire ind IAEA IIIA One ed 69 6 6 3 Verify Backup 71 6 6 4 RHecovery llle hh 71 7 DIGITAL SLIDES 72 Fal SOCAN ONGC EPCETOERESTROTITTETILOTOTOOTTITITT eas San ee Wa aween 72 7 1 1 Slide and Magazine Reguirements 72 7 2 ScanOverviewlmage 79 Tel QVGWIOW socere rsr uua decd 3E pede bake Gere bee borne Edu dg 79 Fee NA vem ahi wow ee es Ree ed Vee oO EEA ee Ooo ew es 74 7 2 3 Tagging Regions of Interest 75 7 2 4 Copying Regions of Interest to Disk 76 7 2 5 AddingComments 76 12 5 Oder DAA oc ne 254 55 Gb aoe eee Seba ae seen Bion eS ees 76 7 3 Database VieW
4. 77 7 3 1 Processed Orders 77 T32 PEN OIdefS EIA KAA IIIA whee nb ER E owe 77 7 4 Customizing the System 79 7 4 1 Adjusting Database Users and Language 79 7 4 2 Adjusting Default ScanArea 79 7 4 3 AdjustingAnalysis 80 7 4 4 AdjustingAutodelete 81 User s Manual 3 CELLAVISION CellaVision DM96 8 SYSTEM INFORMATION 82 9 CELLAVISION REMOTE REVIEW MULTIPLE USERS 83 9 1 Working with Orders Slides 83 10 CUSTOMIZING THE SYSTEM 84 10 1 Adjusting Database Settings 85 10 1 1 CreatingaNewDatabase 86 10 1 2 DeletingaDatabase 87 10 1 3 Creating a New Database Connection 87 10 1 4 Deleting a Database Connection 87 10 1 5 CompressingaDatabase 87 10 1 6 Setting User Restrictions 88 10 2 Adjusting Users Settings 88 10 3 Adjusting Analysis Settings 90 10 4 Adjust
5. 9go o Fo 090 60 09999 ofo 9 009 0 8 o of 000 da a 99 o0 89 YA o a T 9 oo oop e o o See oo 000 209 oo o 00460 PR Fio o ee o So 9o9 o 3 0290 o 99993 0097 6 20 900089220 09 R o o 99 ho Sor POS 10 p 2020 90 09 e 096 0090 9 0 Qv X o 69 o6 o09 o oQ 09 o A 8 COQUE CAUCUS t o 0999 o o eg 96 e o0 OQ CG o toos Number of RBC s used for precharacterization fi 348 Reset to Precharacterizatibn Exclude RBC Analysis The RBC panel is used for characterization of the RBC morphology AII morphologies handled by the system are listed Morphologies precharacterized by the system are marked with a small dot Cont d 32 User s Manual CELLAVISION CellaVision DM96 Cont d The columns labeled 0 to 3 grade the morphology characteristics Normal Green dot in column 0 indicates a normal level Red dot in column 1 indicates that the morphology is present at a Slight low level WATIA 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 1s shown dimmed In the bottom right hand corner of the RBC image there is a cross shaped ruler tha
6. CellaVision DM96 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 CellaVision 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 username password and select the desired database The following icons indicate available database types Processing database g Export database L Scan database CellaVision Competency Software database CELLAVISION CO Username Password Database H YourD atabase Cancel 4 Click OK 16 User s Manual CELLAVISION CellaVision DM96 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 Appendix C Buttons and Indicators
7. Ordering Physician 560421 2234 Michelle Lawson 1956 04 21 2001 02 12 Dr Spoc 680124 2334 Margret Clark 1968 01 24 1997 10 30 Ester b 60121 2234 Eddie Levinson 1956 01 21 125 2001 02 12 Dr Spock 680224 2334 Mike Elson 1968 02 24 150 1994 10 30 Sister 480624 2234 Sid Fernwilter 1948 06 24 200 1999 12 31 Ester 560421 2234 Clara Spielberg 1956 04 21 2001 02 12 Dr Spock 680124 2334 Louise Clark 1968 01 24 1997 10 30 Ester 5601 21 2234 Billy Hutchinson 1956 01 21 100 2001 02 12 Dr Spock 680224 2334 Mike Carlson 1968 02 24 100 1994 10 30 Sister 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 BF 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 User s Manual CELLAVISION CellaVision DM96 6 2 1 Pending Orders Dialog for Peripheral Blood Order Data BEP MT Order 350 BB0427 2234 CNN mee oo m 1956 04 21 m m fea TT User s Manual 65 CELLAVISION CellaVision DM96 6 2 2 Pending Orders Dialog for Body Fluid Order Data o oa MT Order 380 POT 21 2234 fe bm o 2 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
8. WMWo Raion tn 3 TruColor Wright stain diluted 1 6 with phosphate 6 min 30 sec buffer pH 7 2 Wright stain alternative 2 can also be used for manual dip method 158 User s Manual CELLAVISION CellaVision DM96 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 1s 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 slides with c
9. 2 0 lt width lt 20 0 mm TE 2 0 2 height 2 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 User s Manual 19 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 Po default values Br default values d Brem of s Er Ear counti Humpe ar vv Eos bo count Ipe of order ype of order WBC I Diff ais z ETIEN PLT e ere Ts FE Bivereun TUA Add processed slide to worklist Enable LIS To adjust the analysis settings for individual slides click Database View and choose Pending Orders See 7 3 2 Pending Orders 80 User s Manual CELLAVISION CellaVision DM96 7 4 4 Adjusting Autodelete Autadelete Strategy Delete all images Start deleting after fao days It is not possible to archive the orders All orders will be autodeleted 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 ex
10. 50 4 5 SigningasSlide IIIA ee eee ee ee eee eee ENEAN 50 5 REPORTING RESULTS 51 5 1 Merging Slids sersan esea eek den Eus ba be poee nes eaa dite ba Ryo Pak Raps 51 5 2 Report PrevieW 54 5 3 Signing an Order result 54 5 4 SendinganOrertotheLIS 54 55 Cancelng an ONE esai AINA II AI KUALIKA TT ENTIER 55 6 DATABASE AND ARCHIVING DATA 56 6 1 Database Processed Orders 56 SAMEES OIN CETT 58 Ole Slde Eisla AI xa dac ER ou Id REPRE dordur anda d dw Bb ROIG dU D Sod d att 60 6 1 3 Opening an Order Slide 61 6 14 Protecting an Order 61 6 1 5 Searching for an Order Slide 62 2 User s Manual CELLAVISION CellaVision DM96 6 1 6 Deleting an Order Slide 62 6 1 7 ErportingOrders 62 6 1 8 Copying Images to Disk 63 6 1 9 Pining Orders c nonu ient tes Eun dos puro w Sere dabas ee ai Eun P ERE ce 63 6 1 10 The Worklist llle RR RR rns 63 6 2 Database Pending Orders 64 6 2 1 Pending Orders Dialog for Peripheral Blood
11. Cont d User s Manual 135 CELLAVISION 6 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 Basophils Band neutrophils Lymphocytes Limitations Distinctions between band and segmented neutrophils metamyelocytes and myelocytes myelocytes and promyelocytes lymphocyte and lymphocytes variant forms are subjects to variations among individual operators 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 156 samples based on NCCLS standard H 20A Cell class SD Cell class SD Neutrophils Macrophages The following fluid types were not included in the evaluation pericardial abdominal drain CAPD and bronchoalveolar lavage 136 User s Manual CELLAVISIO
12. 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 are currently logged on to User s Manual 87 CELLAVISION 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 Restricted user search options Allow restricted user to search by Patient ID C Order ID Both Patient ID and Order ID 10 2 Adjusting Users Settings Users Full Mame Access Level Email Observer ser Observer ser Observer Normal ser Normal ser User Restricted ser Restricted ser Restricted Authorized ser Authorized ser Authorized Administrator ser Administrator ser Administrator admin Administrator created by the system Administrator 4 Show inactive users Mew Delete E dit Show inactive users Activate this checkbox if inactive users shall be shown in the list New Add a new user see dialog below Edit Edit user information see dialog below Delete Delete selected users Cont d 88 User s Manual CELLAVISION CellaVision DM96 Cont d There are 5 levels of user authorization Observer Only al
13. CELLAVISION CellaVision DM96 1 TJ A catia Eo oo doo doo dX AA Analysis settings Default values Add processed slide to X X worklist Enable autostart autostart bacc MM reclassification settings RBC precharacterization settings PLT settings Use only manual PLT concentration estimation Defaults for PLT PLT estimate factor Intervals for average PLTs HPF a UA NS NND NINE Standard comments settings Reference cells settings DEBER bets Archivingsettings EK Users Manual 151 CELLAVISION CellaVision DM96 Appendix F Determining the Platelet Estimate Factor Follow the procedure below 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 152 User s Manual CELLAVISION CellaVision DM96 Appendix G Slide Preparation Guidelines Slide Preparation for Peripheral Blood WARNING Always use protective gloves when in contact with blood Sample
14. 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 CellaVision9 DM must be idle during export Otherwise the export will not be complete Export Log Files Export of all log Files in the program ir Export to CD C Export to LAN Export Burn Status 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 Two types of backup procedures are described below System backup and Online backup The main advantage of an online backup is that the database is backed up while the system can remain operational A disadvantage is that there must be enough disk space available to copy the complete database If the disk space is limited a system backup can be preferable For a system backup the database server must be stopped It is possible to configure the database so that no data will be lost in case of a hard disk crash but it is more complicated and requires at least two hard disks with separate disk controllers For more information about this contact your distributor 68 User s Ma
15. Image overview p Entry field Concentration level Increased 1 Use the entry fields to view all parts of the overview image 2 Select Concentration level 3 3 3 Excluding the Platelet Analysis Click Exclude 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 39 CELLAVISION CellaVision DM96 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 WBC comment These are my comments admin Comment added by hese are my comments author operator author Click Comments to add comments to WBC RBC and PLT WEC comment Comment H Erase Standard Comments lt lt Standard comments Comment types General 1 Hypersegmentation Iw WEL 2 Pelger form REC 3 Hyperaranulatian
16. System status is shown as a text dle Analyzing Stopped Paused or Error System status System indicators 18 x ioe Blood Differential Software DM96 File View Tools Help Ex Eti b a a CONI Analysis progress WBC Count x10e9 L e H Unidentified Cells counted 12 of total 100 Band neutrophil gt ON eer pees yen Segmented neutrophil 2 167 120 Eosinophil 0606201847 f 0506170369 Basophil B 5 3 0506170390 EE Lymphocyte 10 833 55 MEM H A 0601270204 Peripheral blood analysis started Monocyte 0606201842 Searching for monolayer FP 0506170387 Monolayer search completed romyelocyte 0606201841 Locating WBCs using low power magnification F Myelocyte Enough WBCs located Pre classifyingWBCs Metamyelocyte using high power magnification f Blast no lineage spec Lymphocyte variant form Plasma cell Other Total 12 100 740 eaog Non WBC Count PEER Enythroblast NRBC n Giantthrombocyte 2 167 euler i 5 Thrombocyte aggregation First name Robert i B Smudge cell b 41 7 ast name ourne gem 3 250 Gender Male Birthdate 1953 10 01 Ethnic origin Ward Comment RBC 0123 7 Polychromasia OOOO Side dam Hypochromasia TOTO Latest found cells ren Magazine ID 0606201844 EN S
17. 13 2 6 Archiving Errors 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 Message box There was a general error when accessing the recorder Check error logs 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 If a problem occurred previously while trying to archive it may be that the recorder has not been unlocked 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 toa transaction conflict when a CellaVision remote review opens an old order just as it is about to be deleted Restart the system computer and the program and try archiving again 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 requir
18. 4 Hypogranulatian PLI 5 Auer rods BF Append Cancel 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 40 User s Manual CELLAVISION CellaVision DM96 Cont d You may activate the Comment types you want to display 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 1s 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 41 CELLAVISION 6 CellaVision DM96 3 6 Signing a Slide A summary of the WBC RBC and PLT analyses is presented in the Sign Slide tab WH Sion Slide The signing procedure is as follows 1 Click Sign The
19. 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 analysed 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 WEBCs Found 100 Non WBCs Found 60 Ratio of WBECs Found 100 0 WEBCs 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 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 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 wit
20. E Mail Default recipient doctorShospital com Mail server mailserver hospital com E mail from Joperator 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 98 User s Manual CELLAVISION CellaVision DM96 Cont d Archiving utodelete Strategy warm when the following two conditions are met 1 The number of signed orders exceeds Autodelete 2 These orders are older than Archiving media 3 Path far archiving Network path or local drive E cb acuments and Settings vL sersDres Browse C CD archiving Images to archive Cell images PB overview images HBE 7PLT FB cell images 10 cells class C Mane fe All Normal V BCs Abnormal BCs Hon BCs BF overview images Overview images BF cell images C Mane 10s C 1e 5D WBLs Region of interest images Mon BCs Hane fe AJ 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 enabling each database
21. 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 1s 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 Disabled Send order to LIS when signed Enabled Review the cells in the WBC Galleries User s Manual 147 CELLAVISION CellaVision DM96 Workflow Single Slides Confirm Cell Counter Results Go to Database View Shift F1 Select orders Click Add to worklist Y Double click on the first slide in the Worklist Y Verify WBC Click RBC tab Perform RBC review 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 148 User s Manual CELLAVISION CellaVision DM96 Workflow Duplicate Slides Go to Database View Shift F1 Select orders Click 4 to worklist Click on the Slide A header in the Worklist Select all slides with a Select all sl
22. 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 text 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 52 User s Manual CELLAVISION CellaVision DM96 Cont d Comment Panel Comment MT Order 120 1 MT Order 120 2 Exclusion comment WEC comment WEC cell class comments Unidentified Band neutrophil Comment Comment to this cell class Segmented neutrophil Eosinophil Comment to this cell class Basophil Lymphocyte Comment to this cell class Monocyte Comment to this cell class Promyelacyte Hyelocyte Hetamyelocyte Immature eosinophil Immature basophil Promonocyte Prolymphocyte Blast na lineage spec Lymphocyte variant form Plasma cell Large granular lymphocyte Hairy cell Comment to this cell class S zary cell Comment to this cell class D ther Hon WEC cell class comments Erythroblast HRBC Giant thrombocyte Thrombocyte aggregation
23. restarted or if an error has occurred jj Start button i Autostart Replaces the Start button B Stop button Cont d 20 User s Manual CELLAVISION CellaVision DM96 Cont d The tree in the System Control panel displays a status log of processed magazines and slides System control Lb Mo magazine FID BBE3S3BBBBB55 ON d 12 51218538 EE 11 01818931 bif 10 31818533 4 8 71018531 Analysis failure Slide He B 01918331 Ed T 01310535 ET d b 11118531 QD 5 94119921 4 Empty Magazine mi 3 83118441 E T A 01144531 Default values hacg 1 01118531 rrr rir Fay 8088887788 Clear Log To empty the log from all information click Clear Log 2 5 3 Magazine Status The following information 1s available for each magazine Magazine status Magazine ID barcode 012345678912 Magazine Status b Analyzing w Finished The slide holder is processed and all slides have status OK Wamin A slide with status Warning Stopped Failed or Cancelled exists in the magazine E Failed The magazine has no magazine ID User s Manual 24 CELLAVISION CellaVision DM96 2 5 4 Slide Status The following information is available for each slide Elidestuue Senio oR barcode text A 7 012345678912 Default values Slide Status Processing wf OK Slide processed with no warning or error Warnin Slide processed with a warning see warning texts 8 bel
24. 5 Refit the screw cork 6 Close the main hatch Caution Use only immersion oil recommended by Cella Vision AB see Appendix A System Specification User s Manual 111 CELLAVISION 6 CellaVision DM96 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 Screws 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 112 User s Manual CELLAVISION CellaVision DM96 Cont d Lamp house screw a 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 p 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 User s Manual 113 CELLAVISION 6 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 the 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
25. CELLAVISION CellaVision DM96 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 User s Manual 35 CELLAVISION CellaVision DM96 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 22mm 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 of lines 1s drawn over the image to facilitate the counting of PLTS There are two ways or modes to perform the PLT esti
26. 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 13 Open the Output Drawer and remove the magazine 14 Gently pull the QS arm in the direction of the arrow until it stops 15 Close all the hatches and restart the system 134 User s Manual CELLAVISION CellaVision DM96 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 3A Current input for the slide scanning unit 2 1A Total current input for the system 8 4 A Voltage frequency 50 60 Hz 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
27. Collect blood from a vein or by skin puncture in an EDTA sample tube K2EDTA or K3EDTA 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 Use a clean dry microscope glass slide see 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 1n thickness ending in a squared or straight edge 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 User s Manual 153 CELLAVISION 6 CellaVisionP 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 image indicates the analysis starting point The analysis proceeds fr
28. 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 92 User s Manual CELLAVISION CellaVision DM96 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 for the grid size PLT count and PLT concentration result It is also possible to enable the option to use manual PLT concentration estimation uuuuununununuuunuuuuausas Use only manual PLT concentration estimation Humber of HPFs 8 per overview image FLT estimate Factor 0 0 Defaults For PLT tab Grid size 3 amp 3 0 83 HPF square PLT count Count PLT per grid square PLT concentration Calculated estimate Intervals for average PLTsZHPF value Significant decreased lt z Decreased g Hormal Ya Increased Use only manual PLT concentration estimation When this checkbox 1s 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
29. Megakaryacyte Smudge cell Artefact Not classed RBC comment Comment to this RBC admin PLT comment 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 User s Manual 53 CELLAVISION 6 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 Sign Slide Database YourDatabase Type Processing EH User name Fassword vw Sign order when signing slide Iv Send to LIS Print order Cancel 2 Type Username and Password if not prefilled 3 Select whether order shall be sent to 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 54 User s Manual CELLAVISION CellaVision DM96 5 5 Canceling an Order To cancel an order you sig
30. SSU and the system Critical internal error error computer Message box The oil canister is Refill oil canister An error occurred during empty oil dispensing Check the oil level The system must be restarted If the problem persists see troubleshooting section in the User s manual There are air bubbles Restart the SSU run a slide Repeat in the oil hose until there are no air bubbles in the oil hose 118 User s Manual CELLAVISION CellaVision DM96 Seemingly normal slides The barcode reader Check the cabling of the barcode reader get slide status is not connected Empty or no slide PID No barcode found Check positioning and size of the barcode see Appendix A System Specification The barcode could Clean the barcode printer head not be read due to bad print quality Replace the printer ribbon on the barcode printer Message box Connection with the Check network connection Critical error no database has been Restart the system computer or the connection with the lost computer on which the database database resides Message box At least the hatch Close all open hatches and click Retry Verify that the following specified in the hatches are closed message box is open Database access is The database server Restart the system computer or the slow needs to be computer on which the database restarted resides The database is too Keep the dat
31. Tagging Regions of Interest 49 75 Toolbar 17 Troubleshooting 115 U Usage Log 67 V Verification View 24 44 144 W Warning texts 22 WBC Attributes 30 WBC Galleries 27 WBC panel 24 44 Workflow 147 Worklist 24 44 63 Wright 158 X XY stage 15 170 User s Manual CELLAVISION CellaVision DM96 User s Manual 171 CELLAVISION CellaVision DM96 CellaVision AB Ideon Science Park SE 223 70 Lund Sweden C Phone 46 0 46 286 44 00 Fax 46 0 46 286 44 70 info cellavision com www cellavision com 172 User s Manual
32. The centrifuge choice provides a rough calibration of the sample position and size Typically the position 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 FAO 2 amp offset 2 5 0 mm 10 0 lt p affsetzz 10 0 mm 1 0 lt diameter lt 10 0 mmi The entire analysis area must also be contained within the following intervals 6 5 position lt 19 5 mm 6 5 lt p 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 Jools 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 104 Cont d User s Manual CELLAVISION CellaVision DM96 Cont d The Diameter setting was 8 mm in the example below In order to center the analysis are
33. This is done in the Archiving tab under Settings see 10 11 Adjusting Archiving Settings 66 User s Manual e CELLAVISION 6 4 Usage Log The system continuously saves data of processed slides and stores it in a Usage log To view this log select Tools View Log The log consists of two pages Statistics and Specification 6 4 1 Statistics xi Statistics Specification Installation 2006 08 09 10 30 01 File creation 2006 08 09 10 30 01 Last modified 2006 08 21 15 48 02 Seral number Prototup3 Nbr af analyses 135 135 Nbr af Failed analyses 18 18 Nbr af signed WBC 40 40 Nbr af signed RBC af 3r Nbr af signed PLT et ef Total analysis time 3 12 50 3 12 50 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 processing time The information can be selected for a specific month by entering Year and Month and clicking Update Year 2006 Month B Update Print 6 4 2 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 67 CELLAVISION CellaVision DM96 6 5 6 6
34. 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 162 User s Manual CELLAVISION CellaVision DM96 Cont d Total number of nucleated cells and non Total result O nucleated cells found in all the images WECs NBBCs found 21814 67 oth y eae DEOS Manual correction of nucleated cells found Manual corrector Total number of nucleated cells missed in all the WBCs NRBCs missed i d dan images Ratio ofw BCs WABCs found 99 5 Percentage of how many nucleated cells were found compared to the actual number of 8 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 older than five days are automatically deleted at program startup logon User s Manual 163 CELLAVISION
35. color in Order list and Slide list in the Database View see 6 1 Database Processed Orders A locked order slide can be opened but not modified 1 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 User s Manual 83 CELLAVISION CellaVision DM96 10 Customizing the System Settings are stored in either the system or CellaVision Remote Review or the database A setting that 1s 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 User settings Analysis default values Enable LIS Add processed slide to worklist e WBC reclassification settings e RBC precharacterization settings e PLT settings Active report template Report template contents Default settings for sign dialogs e Standard comments Custom reference cells e Autodelete Archiving settings The following settings are stored in the system Enable autostart Email settings Language Body fluid analysis ar
36. from order excluded Comments WBC My WBC remark NormalU ser RBC My RBC remark NormalU ser PLT My PLT remark NormalU ser Segmented neutrophil Remark on a cell class Add to Worklist Export Open Protect Unprotect Orders locked by another Slides in Selected slide marked user written in red text selected order blue or grey Data for selected slide An open order and slide is always written in blue text An order slide opened by another operator on a CellaVision Remote Review 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 Users Manual 57 CELLAVISION CellaVision DM96 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 E EH OrderiD PatienD FirstName LastName Signed by Analyzed 5 M e jEal MTOmer1i 7005241234 Anderson 2006 04 04 04 04 d MT Order 20 E50321 4321 Ben Benson 2006 09 04 05 04 TE uS iH MT Order 30 750211 4321 Claudia Crawford 2006 09 04 06 04 or H MT Order 40 450211 8888 Doris Davidson 2006 09 04 07 04 iH MT Order 50 b 611211 8888 Eric Ericson 2006 09 04 08 04 lt dw o E gH MT Order 60 511211 3
37. image click Tag region 2 Add a comment as an identifier for the region of interest and click OK User s Manual 49 CELLAVISION 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 4 Click OK Note The directory you specify in the destination path must exist 4 3 Comments Comments can be added to the Overview the 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 E 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 50 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 or
38. 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 166 User s Manual CELLAVISION CellaVision DM96 Appendix Glossary 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 estimate 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 Grunwald Giemsa a Romanowsky stain for blood smears Overview image of analysis area An order including more than one
39. objective see 12 2 Weekly Maintenance The microscope Replace the lamp see 12 4 2 Bulb lamp is defective Exchange User s Manual 117 CELLAVISION 6 CellaVision DM96 System needs Contact your local vendor s technical calibration or support alignment Slide status Oil on the slide Clean the oil off the slide and process it In 4 Incomplete ao analysis Could not find RBC monolayer Slide status No monolayer found Make sure that the slides are prepared according to the recommendations in Appendix G Oil on the slide Clean the oil off the slide and process it again Oil or dust on the low Perform weekly maintenance on the power objective current objective see 12 2 Weekly Analysis failure View the Slide Information dialog for more details Maintenance Slide status Light error when using 10x 50x 100x Dirty objective Perform weekly maintenance on the specified objective see 12 2 Weekly Maintenance magnification Too dark specimen Make sure that the slides are prepared according to the recommendations in Appendix G The microscope Replace the lamp see 12 4 2 Bulb lamp is defective Exchange High power images are not in focus Dust on the Perform weekly maintenance on the objective current objective see 12 2 Weekly Maintenance Incorrect objective Contact your local vendor s technical settings support Message box Temporary software Restart the
40. 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 114 User s Manual CELLAVISION CellaVision DM96 13 Troubleshooting 13 1 Troubleshooting Steps If a problem occurs follow these steps 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 13 2 1 General Startup Errors Problem Action You try to start the Previous Make sure the program is closed Wait program program has 10 seconds and try again Message box not closed The program has already been started and you cannot start another until the previous one is closed Message
41. 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 e Report a PLT concentration as described in 3 3 Estimating Platelets OR Click Exclude PLT Analysis User s Manual 43 CELLAVISION CellaVision DM96 4 Verifying Processed Slides Body Fluids Opening an unsigned slide leads directly to the Verification 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 9e F ois dit ovenien WBC RB Lymphocyte Unidentified Reference cells EJ Neutrophil Lymphocyte Eosinophil Macrophage Other Total Non WBC Count Smudge cell Artefact 4 E ORA SS ee c E pP pE aaa Da Open m Ww Remove E o P Patient data Order ID CP18B Last name ilk Lu m First name aa lek re e BF comment S A ISO Ready ladmin CsF CPH
42. to have its own archiving strategy Cont d User s Manual 99 CELLAVISION CellaVision DM96 Cont d 1 Autodelete Autodelete instead of archive activated Warn when the following two conditions are met 1 The number af signed orders exceeds 200 2 These orders are older than fao daps 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 1mages or no images at all from a group Cont d 100 User s Manual CELLAVISION CellaVision DM96 Cont d PB Cell images Overview images RBC and PLT Normal cells Segmented neutrophils Monocytes Lymphocytes Eosinophils Abnormal cells Basophils Prolymp
43. vendor s technical is not working support 116 User s Manual CELLAVISION CellaVision DM96 13 2 3 General Processing Problems Problem Start is deactivated No magazines on the Add magazines see 2 5 1 Adding conveyer Magazines One or more hatches Close all hatches See Appendix C are open indicated Buttons and Indicators for Hatch by Indicators An error has Restart the SSU and the program occurred during slide processing Slide process does not No magazines on the Add magazines see 2 5 1 Adding start even though conveyer Magazines Autostart is selected Close all hatches See Appendix C Buttons and Indicators for Hatch Indicators WBC images are not System needs Contact your local vendor s technical centered on the cell but calibration or support the cell can still be seen alignment Slide status Too small monolayer Prepare the slides with longer blood found films 4 Incomplete analysis Less than the ordered number of cells are collected Artefacts staining Make sure that the solutions are precipitates on the 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
44. 00 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 6mm the10x 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 78 more disk space for the overview images 102 User s Manual CELLAVISION CellaVision DM96 10 12 Adjusting Language Settings In the Language tab you set language for the user interface and manual Language Language for the user interface he change will take affect when the program is estarted Language for the online manual English User s Manual 103 CELLAVISION 6 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 Tools Settings BF Analysis Area Centrifuge Shandon Cytospin ir ibn 13 0 mm y position 25 0 mm Stat Spin Cytotuge Aw escor CyboPro 4 position 13 0 mm y position 38 5 mm diameter 7 0 mm offset 1 50 mr Y offset 1 50 cj imm Diameter 8 00 mm BF Analysis Area
45. 2 Starting the Slide Processing 20 25 0 Magazine StatUS us p 3 yen n our dou ees oon sous Er RU RUP So NUR Er REGE 21 2 544 Slide SIQUS o c 8656o440c84dhoetutencwad IAA x sg d 22 2 65 Ieclimg Madazlili6S u xa aos duds ane wt AI ew Ego de a X e aeos 23 2 7 Handling of STAT Slides 23 2 8 Shutting Down the System 23 3 VERIFYING PROCESSED SLIDES PERIPHERAL BLOOD 24 3 1 White Blood Cell Classification 24 3 1 1 Gustomizirig VIEWS e 02255 oe ORE EUR Eg IA cb e RR ERREUR PEU 27 3 1 2 Reclassifying White Blood Cells 29 XN E S UrMCTT V m 31 3 1 4 Copying Images to Disk 32 3 2 Red Blood Cell Characterization 32 3 2 1 Customizing the Red Blood Cell Overview Image 34 3 2 2 Characterizing Red Blood Cell Morphology 35 3 2 3 Excluding the Red Blood Cell Analysis 35 User s Manual 1 CELLAVISION CellaVision DM96 3 3 EstimatingPlatelets 36 3 3 1 Counting Platelets in the Overview Image 37 3 3 2 Estimating the Platelet Concentration Level
46. 3 2010 CellaVision AB All rights reserved CellaVision AB Ideon Science Park SE 223 70 Lund Sweden Phone 46 0 46 286 44 00 Fax 46 0 46 286 44 70 6 User s Manual CELLAVISION CellaVision DM96 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 e g Peripheral Blood and Body Fluid applications available for the CellaVision DM96 system The applicability of some sections in this User s manual may therefore depend on the applications installed on the system Contact your local distributor for more information 1 1 14 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 misleadi
47. 553 Felicia Faster 2006 09 04 09 04 4I qud MT Order r F LDB11 3553 Glen Gordon Authonz 2006 09 04 10 04 Order status J Empty field No slide is signed v At least one slide 1s signed 4 Order 1s signed Fi Order is cancelled STAT mark Empty field Not a STAT order Order is marked as a STAT order LIS status qu Empty field No data sent or received i Data received m Waiting to send result TET Result 1s sent Para Result 1s sent send failure qr Result 1s successfully sent Cont d 58 User s Manual CELLAVISION CellaVision DM96 Cont d Process status Empty field o T Archive status Empty field e e jr Comments Empty field BH Multi slide status Empty field C Order type Empty field BF 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 el Order is unprotected Order is protected Order and slides in this order cannot be deleted or archived Order 1s archived All images except Region of interest images have been deleted only applicable for scan databases Bi 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 Body fluid order User s Manual 59 CELLAVISION CellaVision DM96 6 1 2 Sl
48. 6 09 04 04 04 m Signed by None zl k a pus LIS status Data received Type of order WBC Search MV Show oy exact matches l Patient ID 700624 1234 Adam Anderson Gender Male Birth date 1970 06 24 AHHH Order ID PatientID FirstName LastName Signed by Analyzed Ethnic origin Asia vA j lea ill MT Odeio 700624 1234 Adam Anderson 2006 03 04 04 04 Ward Neuro clin v4 MT Order 20 650321 4321 Ben Benson 2006 09 04 05 04 Berl Connie 4 d MT Order 30 750211 4321 Claudia Crawford 2006 09 04 06 04 Migrane v H MT Order 40 450211 8888 Doris Davidson 2006 09 04 07 04 Orde gt rder comment v4 H MT Order 50 611211 8888 Eric Ericson 2006 09 04 08 04 My analysis remark NormalUser v lg 51211 3553 Felicia Foster 2006 09 04 09 04 A a 700611 3553 Glen Gordon Authoriz 2006 09 04 10 04 4 va A a 650611 3553 Henry Henryson Authoriz 2006 09 04 11 04 E 9 dj 710411 3553 Isac Irving Authoriz 2006 08 04 12 04 pen e W 50421 3553 John Doe 2006 09 04 13 04 Slide R H 580421 3535 Kent Kilroy 2006 09 04 14 04 Ame e WH 5806124092 Linda Lindford 2006 09 04 15 04 Em W B Kf MT Order 120 D 7907254092 John Ericson V MTOtder10 Slide ID MT Order 10 Slide Nbr 1 System Serial Nbr Unknown Magazine Batch ID Mag2 Slide pos 1 WBC count 2 34 x10e3 L RBC concentration Unknown Analysis completed 2003 04 02 00 01 Signed by AuthorizedU ser 2003 04 22 12 44 Excluded
49. Aa w Y e W AU e n gt a 2h Pa gt TL e 4 5 v e t 1 e 6 e i a a 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 1t 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 1mage Cont d User s Manual 165 CELLAVISION 6 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 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 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 Hon WwEcs Found 60 Ratio of WECs Found 100 0 WEBCs missed T Display Adjacent Areas Cell location percentage Number of missed nucleated cells in the analysis area PrinE Result The Result The result 1s automatically calculated The percentage indicates how
50. 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 Immature 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 of a 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 Howell Jolly bodies Pappenheimer bodies Basophilic stippling Parasites and 10 user defined characteristics
51. CellaVision DM96 USER S MANUAL 3 0 CELLAVISION CELLAVISION CellaVision DM96 1 INTRODUCTION 7 1 1 AboutthisUsersManual 7 1 1 4 Warnings and Precautions 7 1 2 Intended UseofCellaVisionDM96 9 1 2 1 Peripheral Blood Application 9 1 2 2 Body Fluid Application 9 1 8 General Description of CellaVisionDM96 10 1 3 1 Peripheral Blood Application 10 1 3 2 Body Fluid Application 12 1 3 8 CellaVision Remote Review 13 1 4 Components and Mechanical Operation 13 1 4 1 Major Parts of the System 13 2 OPERATING PROCEDURES 16 ZA Staring S yVSleWle cs 2yceseuseced peu cena nes a oa oe TUNE GE PEE ERR 16 2 2 System Control VieW 17 2 3 Slides and Magazines 18 2 51 BCO ereraa rarr UA IIIA IIIA 18 2 4 Loading SlidesintoaMagazine 19 2 5 Processing SA IIIA o AUC steeds HUE de He E o au 20 2 5 1 AGOMGIMAGAZINGSS dcm e aod a Eon dd KAA AUREUS EU seus m oe 20 2 5
52. Click Modify and the Standard Comments Editor appears 3 Edit Code Comment type and Comment 4 Click OK 96 User s Manual CELLAVISION CellaVision DM96 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 Band neutrophil Segmented neutrophil Eosinophil Bazophil Lymphocyte Monacute Framyelocute Myelocybe Metampelocyte Immature eosinophil Immature basophil Promonocyte Prolyrmphocyte eee Blast na lineage spec Preview Lymphocyte variant form Plasma cell Large granular lymphocyte Hairy cell S zar cell Other Ervthroblast MREBC Giant thrambacute Thrombacyte aggregation Megakarnocyte Smudge cell Artefact PB Reference Celle The reference cell gallery will be updated with an added or deleted cell only after the program has been restarted 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 97 CELLAVISION Ea CA DM96 10 10 Adjusting E mail Settings Enter Default recipient of e mail specify Mail server and E mail from i e sender of e mail
53. HE OOO00 Pea uo Microcytosis um COTS Slide position 1 e Macruertoeis OOOO Slide ID 6 4 e A 4 n Order E K Poikilocytosis COO Slide number 2 Sample date 2003 05 16 Lymphocyte Artefact Lymphocyte Ready ladmn YourDatabae NUM SCRL A start Ly German screendumps 2 2 System control view y 2 1 Logon dialog bmp P e Cella ision Blood Dif WI jJ 01 50PM User s Manual 17 CELLAVISION CellaVision DM96 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 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
54. N CellaVision DM96 Performance Specification Scan Throughput data and disk space requirements for the scanned slides 10x10 mm 10x 50x 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 500ml should be sufficient for approximately 10000 analyses Bulb OSRAM XENOPHOT HLX 64625 FCR 12 V 100 W halogen CellaVision slide magazines Stain May Gr nwald Giemsa or Wright Slide requirements mm glass 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 137 CELLAVISION 6 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 barcod
55. NDICATORS 144 APPENDIX D RECOMMENDED WORKFLOW 147 Workflow Single Slides Confirm Cell Counter Results 148 Workflow Duplicate Slides 149 APPENDIX E USER AUTHORIZATION LEVELS 150 APPENDIX F DETERMINING THE PLATELET ESTIMATE FACTOR 152 APPENDIX G SLIDE PREPARATION GUIDELINES 153 Slide Preparation for Peripheral Blood 153 EkampleSmears 155 Slide preparation for body fluid 159 APPENDIX H CELL LOCATION 160 Cell Location for Peripheral Blood 160 Cell location for Body Fluids 164 APPENDIX I GLOSSARY 167 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 Article No PM 10287 Revision 2010 01 11 Copyright 200
56. NUM Worklist Add BF comment Non WBCs panel Cont d 44 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 Green Contains WBC Count no reclassified Unidentified i 3008 cells or objects Preclassified by the Neutraphil n 08 system Lymphocyte fo 60 0 m Pen icon _ Eosinophil teste Cell class comments WBC panel Macrophage 5 0 BY Other Tick mark All Total images have been viewed Non WBOC Smudge cell Blue Contains at Non WBC panel r E least one reclassified cell or object Hat classed User s Manual 45 CELLAVISION CellaVision DM96 4 1 4 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 46 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 l
57. 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 CellaVision DM96 1 3 2 Body Fluid Application General Functionality 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 1s 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 cells or objects 100 WBC WBC Reclassification for Body Fluid Besides the cell classes mentioned above the operator can re
58. 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 User s Manual 93 CELLAVISION 6 CellaVision DM96 Cont d 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 10 7 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 Report Sign Report template Name Description m MINI MALG ermar Default report template created by the system MINIMAL talar Default report template created by the system gt Normal Default report template created by the system MarmalFrench Default repart template created by the system Marmallaerman Default report template created by the system Marmalltalian Default report template created by the system b al Set Active Add Delete Edit Default settings for Sign dialogs lw Prefill password v Sign order when signing slide Print order when signed Report All available templates are displayed in the list The currently used template 1s indicated with an arrow To change which template to use select a template in the list and click Set Active Default set
59. Sign Slide dialog appears EH User name my User ame Password W Sign order when signing slide Ii Send to LIS Print order Database YourDatabase Type Processing 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 signed 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 42 User s Manual CELLAVISION CellaVision DM96 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 1 e there should be tick marks after each cell class e No WBCs remain in Unidentified RBC An RBC characterization must be reported or excluded from the analysis Report a characterization by
60. Worklist Note BF slides are not automatically added to the worklist 90 User s Manual CELLAVISION CellaVision DM96 10 4 Adjusting Reclassification Settings m F m Ej m Forward preclassified cells Select your forwarding criteria using the checkboxes 91 Users Manual CELLAVISION 6 CellaVision DM96 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 Enable RBC precharacterization REC limits 5 1 Slight 2 Moderate 3 Marked 1 Slight 2 Moderate 3 Marked Polychromasta n5 P5 5 Anisacytosts B jis 0 Hypachromasia E f z 20 Microcphosis 6 jis 0 E 3 Macracutasis fe 3 20 Palkilacutasis 2 Anisocytosis sizes micrometers Microcytosis E 3 4 Normal Macrocytosis Reset RBC Limits and Anisocytosis size to their default values Fieset Mate Default values according ta O Connor Barbara H amp Color Atlas and Instruction Manual af Peripheral Blood Cell Morphology Lippincott Willams 5 Wilkin 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
61. a 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 negative y direction User s Manual 105 CELLAVISION CellaVision DM96 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 1mm 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 W Sian si puc ug E ed Duff x Overview Navigation 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 Tools Settings BF Analysis Area and adjust the Diameter setting Note Increasing the Diameter setting will increase the processing time 106 User s Manual CELLAVISION CellaVision DM96 11 Quality Control Self tests The system performs self tests during startup of the software and at certain points during the operation of the system When the software starts the system is checked before the operator can start analyses During this phase bo
62. abase size at the large recommended level see 12 5 Database Performance The database files Compress the database see 10 1 5 are fragmented Compressing a Database Body fluid sample spot is Incorrect Configure the BF analysis area settings not centered configuration of BF See 10 13 Adjusting BF Analysis Area analysis area The sample spot Make sure your sample preparation location varies too process produces slides where the much between sample spot is always in the same samples location The analysis area does Incorrect Configure the BF analysis area settings not cover the entire body configuration of BF See 10 13 Adjusting BF Analysis Area fluid sample spot analysis area Seemingly normal scan Too little specimen Prepare a slide with more specimen slides get slide status on the slides Analysis failure with the additional information No image data in scanned area Wrong area selected Select the correct area and process the slide again User s Manual 119 CELLAVISION CellaVision DM96 13 2 4 Hardware Errors During Processing Message box Critical jam error Message box Critical calibration error Message box Critical temperature error Message box Critical communication error 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 Message b
63. and the system computer Restart the program Make sure that the camera cable is connected to both the camera and the system computer Restart the program 123 CELLAVISION 6 CellaVision DM96 The camera cable is disconnected Message box Connection with the camera lost 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 Message box The Control unit has The configuration of the Control unit is incorrect Please contact support The File system or registry is corrupt Message box File system or registry error Restart the system If the error persists see troubleshooting section in the User s Manual lost its configuration Make sure that the camera cable is connected to both the camera and the system computer Restart the program Contact your local vendor s technical support Reinstall the program 124 User s Manual CellaVision DM96 CELLAVISION 13 2 5 LIS Errors Slide status da Default values The slides are analyzed with default values even though LIS is used for order information The orders are not in the LIS Make sure that orders for the slides that are to be processed are already available in the LIS The connection to the Make sure that the cable to the LIS is LIS is broken connected LIS status
64. blem Too many non Too many smudge Run another slide with less smudge WBCs cells cells Eo Verify sample preparation process pT Decrease centrifuge speed Teomanyarefacs _ Increase wash step po Rte 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 WBOs in sample Use a larger sample volume located Nearly all boxes are Stage or calibration Contact your local vendor s technical far from the cells error support Too many missed Too many WBOs in Do not process slides where the number cells the sample of WBCs exceeds the recommended amount Peorstening Verity staining procedure User s Manual 127 CELLAVISION CellaVision DM96 13 2 8 Barcode Problems The barcode could Blurry barcode Make sure the barcode is resistant to not be read caused by immersion oil immersion oil on the barcode Print the barcode as defined in Appendix 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 cells are missing Use slides with a white sm
65. box Wrong Enter correct username and password Could not log on to the username and Note that passwords are case system Make sure you or password sensitive a and A is not the same typed your username and password correctly Caps Lock is Deactivate Caps Lock activated Message box The database If the database is stored on the system Could not log on to the server could not computer restart the computer and the System Network be reached program Otherwise check the connection error network connection and that the computer that stores the database is turned on Message box The database is Move the database to the EA drive Disk space exhausted located on the C drive Logging on to the system The database Restart the system computer or the server needs to computer on which the database be restarted resides The database is Keep the database size at the too large recommended level see 12 5 Database Performance The database Compress the database see 10 1 5 files are Compressing a Database fragmented User s Manual 115 CELLAVISION CellaVision DM96 13 2 2 Hardware Startup Errors In startup test LIS cable is Make sure that the cable to the LIS is LIS Communication disconnected connected Server ERROR No Restart the program contact could be established with remote LIS server In startup test The camera cable is Make sure that the camera cable
66. 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 1s 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 User s Manual 161 CELLAVISION CellaVision DM96 Cont d c Looking at image X of a total of Y images Overview images mi Image v Step one image back or forth KERK Image 4 34 amp gt Number of nucleated cells in the image W BLs NABCs found 11 shown WBCs WABCs missed l Number of missed nucleated cells in the image shown number entered by the user Image status Empty Image has not been viewed m Image has been viewed and has no missed nucleated cells iut Image has been viewed but contains missed nucleated cells The Result When a slide has been examined a result 1s automatically calculated The percentage indicates how many nucleated cells the system found including the manually added number of missed cells It is possible to adjust the total number of found nucleated cells if it is determined that some found cells are neither WBC nor NRBC
67. cept the Region of interest and Mini map images are deleted when the time has expired User s Manual 81 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 e Serial number of your system e The type of Artificial Neural Network ANN used The computer name The computer s IP address Free disk space Free physical and virtual memory Total physical and virtual memory Licensed software e License expiry date 82 User s Manual CELLAVISION 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 E j Database The operating procedures in Database View Verification View and Report View are the same for CellaVision Remote Review as CellaVision DM It is not possible to process slides or archive data using CellaVision Remote Review 9 1 Working with Orders 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 DMs connected to the database this is indicated with red
68. classify 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 Limitations A significant number of samples have not been evaluated for the following fluid types pericardial abdominal drain CAPD and bronchoalveolar lavage Therefore they are not included in the statistical analysis 12 User s Manual CELLAVISION CellaVision DM96 1 3 3 CellaVision Remote Review CellaVision Remote Review is an additional software to CellaVision DM96 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 and vice versa CellaVision Remote Review 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 4 Major Parts of the System The system comprises the following major units Computer sys
69. der 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 MT Order 120 2 Reported Result WEC WEE Band neutrophil 42x A ote Segmented neutrophil 22 0 22 0 Eosinophil 15 3 15 3x B asophil 51x 51x Lymphocyte 16 1 16 1 Monocyte 14 4 14 4 Promyelocyte HM yelaocyte 1 72 Hetampelocpte 342 Immature eosinophil EA Immature basophil 1 JE Promonocyte Prolymphocyte Blast no lineage spec Lymphocyte variant form Plasma cell 2D 25x Large granular lymphocyte Hairy cell 1 7 YA Sezary cell YA As Other YA pa Hon BC Erythroblast NREC As 51x Giant thrombacyte Thrombocyte aggregation Megakaryocyte Smudge cell Artefact Hot 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 54 CELLAVISION 6 CellaVision DM96 Cont d Including Excluding Slides in from the Reported Result When a slide is signed it 1s 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
70. directly onto a slide it must be printed on a white smooth frosted area of the slide Barcode size The minimum supported barcode resolutions are listed in the table below Supported code resolution Code Cell size mil Code 39 7 Interleave 2 of 5 Cont d 140 User s Manual CELLAVISION CellaVision DM96 Cont d Quiet zone The recommended quiet zone is listed in the table below Vertical quiet zone cells Horizontal quiet zone cells Symbology Ro o j4 j4 E E QUIET ZONE QUIET ZONE Barcode position The barcode shall be positioned within the area as illustrated in the figure below E D eu Len 2 X 1 Where X1 2 mm X2 gt 6mm Y gt 4mm User s Manual 141 CELLAVISION ECA DM96 Firefighting Procedures Fire and explosion hazard Flash point 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 142 User s Manual CELLAVISION CellaVision DM96 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 Transporti
71. dled 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 WBC s 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 Users Manual 25 CELLAVISION CellaVision DM96 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 WBC class Unidentified SW iei Band neutrophil estination cell class l e segmented neutrophil bei Pen icon Indicates Cell class comments gt Eosinophil gt Basaphil Lymphocyte Tick mark All images Preclassitied by the Monacyte have been viewed system F Promyelocyte F Myelocyte Blue Contains at least one reclassified f Metamyelocyte y cyl cell or object Immature eosinophil Immature basophil WBC panel Fromonocyte Frolymphocyte Blast no lineage spec F Lymphocyte variant farm Flasma cell Large granular lymphocyte Hairy cell S zar cell Other Total Mon VVBC Erythroblast WRB Giant thrombocyte Green Contains no hrombacyte aggregation cyte ag
72. e The canister capacity is about 500 ml A sensor detects 1f 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 PC system 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 without any risk of personal injury User s Manual 15 CELLAVISION
73. e see 13 2 11 Magazine Transport Jam Restart the SSU and the program Remove the slide see 13 2 10 Slide Transport Jam Restart the SSU and the program User s Manual CELLAVISION CellaVision DM96 Message box The slide was stuck Remove the slide see 13 2 10 Slide Positioning error broken or fell out Transport Jam Restart the SSU and when moving the during transport to the program slide from the the slide holder magazine into the slide holder 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 Message box The slide was stuck Remove the slide see 13 2 10 Slide Positioning error broken or fell out Transport Jam Restart the SSU and when moving the during transport back the program slide from the slide into the magazine 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 Message box The magazine is Remove the magazine see 13 2 11 Magazine eject error stuck Magazine Transport Jam Restart the Remove the SSU and the program magazine if it is stuck or broken The system must be restarted If the problem persists see troubleshooting section in the User s manual Slides are not fully Push the slides back into the magazine inserted int
74. e 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 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 Slide Guides 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 User s Manual 109 CELLAVISION CellaVision DM96 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 canister Main hatch Service hatch 1 Open the main hatch 2 Remove the screw cork from the oil canister Cont d 110 User s Manual CELLAVISION CellaVision DM96 Cont d 3 Fill up with specified oil using a clean funnel Do not fill up above the black line We recommend not filling up more oil than will be used in 6 months A full oil canister of 500ml corresponds to about 10000 slides 4 Clean the system from immersion oil spillage with a lint free soft cloth
75. e 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 minimum barcode resolution shall be 7 mil Cont d 138 User s Manual CELLAVISION CellaVision DM96 Cont d The label should be positioned as shown in the figure below 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 2D D Barcode Scanner The following barcode formats are accepted by the system Linear codes CODE 39 CODABAR NW7 Code 128 Interleave 2 of 5 2D D codes DataMatrix QR Cont d Users Manual 139 CELLAVISION 6 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
76. ea Select Tools 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 84 User s Manual CELLAVISION 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 7 20030032 dm56im Processing Database fram installer O ScanDB Scan Used Beier User s Manual 85 CELLAVISION CellaVision DM96 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 e CellaVision9 Competency Software database a database for use with CellaVision Competency Software A CellaVision Competency Software database cannot be used for processing slides e Scan database a database for scanned slides 3 Click Create A new folder with the chosen Database name will be created 1n the specified Home directory Create a Database Database name Descriptions Home directory C Program Files CellaVi
77. ed 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 the database and try to delete them manually User s Manual 125 CELLAVISION CellaVision DM96 13 2 7 Cell Location Problems Cell Location Problems Peripheral Blood Too many non Too many smudge Run another slide with less smudge nucleated cells cells cells KA 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 Run another slide and if the problem non nucleated cells remains prepare new staining solutions Too few nucleated Low WBC count Prepare a new slide with a higher WBC cells located count a Too short smear Prepare longer smears ai Poor smear guality Verify smear preparation procedure Nearly all boxes are Stage or calibration Contact your local vendor s technical far from the cells error support Too many missed Too high WBC count Do not process slides with a WBC count cells that exceeds 100x10 l Peorstening Verify staining procedure Long processing Low WBC count Prepare a new slide with a higher WBC time count Poorstaining Verify staining procedure 126 User s Manual CELLAVISION CellaVision DM96 Cell Location Problems Body Fluids Pro
78. eld Cont d User s Manual 3 CELLAVISION 6 CellaVision DM96 Cont d PLT Result 1 Click Calculate PLT Result in the PLT Count panel PLT result PLT estimate factor iz Average PLTs HPF value 2 3 PLT concentration Calculated estimate 17 6 se 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 aNWaWaAa dada HH You have to determine 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 I decimal which means that the results may seem incorrect 38 User s Manual CELLAVISION CellaVision DM96 3 3 2 Estimating the Platelet Concentration Level The PLT concentration level can be estimated by setting it to four levels Significantly decreased Decreased Normal or Increased directly from viewing the image PLT count Grid size 3 x3 0 89 HPF square
79. ell It is now possible to split cells using the right click menu and select Split cell A dialog appears explaining the procedure Split cells are always moved to the bottom of the gallery The green square is never changed for split cells Instead 1f you click on Cell Marker a red cross marks the cell Note Cells created by splitting can always be removed using the right click menu WBC Attributes Each cell is associated with attributes aa yA 1 Reclassified cell forwarded from pes another cell class PD VE i yai Cell comments exist M ep E a ZA Indicates the order in the class Cell is selected for _ i e mail WBC attributes are shown by default Click WBC Attributes to show hide them 7 WBC Attributes Cont d 30 User s Manual CELLAVISION CellaVision DM96 Cont d 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 QN Un FW Ne Save cell as custom reference cell 7 Save images to disk 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 Number of cells included in e mail 1 E mail
80. evels Using both zoom levels will increase the processing time see 10 3 Adjusting Analysis Settings Mini map Trace Current position f Diff An Overview uL an Slide Navigation Zoom 10x E ee Bile Region of Interest Cell Location Region Comment Tag regpn Delete Edit Slide Comment F Pa Zoom panel Add slide comment Region of interest Navigation buttons panel User s Manual 47 CELLAVISION 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 as asl 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 scroll in any direction using the mouse Switch between the two zoom levels by right clicking in the overview image Adjust the zoom level by dragging the sliders 1n the Zoom panel Zoom 10x zx dl Bx L 48 User s Manual CELLAVISION 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 1 To save the current
81. fram CellaVisionBloodDitferentialS oftware Send e mail to doctor hospital Subject Mai from Cellavisioan DM System with cell images Message cm For default values see E mail tab in Settings 3 f 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 User s Manual 31 CELLAVISION CellaVision DM96 3 1 4 Copying Images to Disk You may copy selected 1mages 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 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 22mm ocular See 10 5 Adjusting RBC Precharacterization Settings gu YA nec s PLT M Sion Sie Og C Report all as 0 normal Use characterization o 090 o6 e o o Polychromasia Hypochromasia Anisocytosis Microcytosis Macrocytosis Poikilocytosis Target cells Schistocytosis Helmet cells Sickle cells Spherocytasis Elliptocytosis Ovalocytosis Tear drop cells Stomatocytosis Acanthocytosis Echinocytosis Howell Jolly Pappenheimer Basophilic stippling Parasites 009 o
82. fy 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 All 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 1n 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 63 CELLAVISION CellaVision DM96 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 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 E Processed Orders i Pending Orders MT Order 400 MT Order 390 MT Order 380 MT Order 370 MT Order 360 MT Order 350 MT Order 340 MT Order 330 MT Order 320 MT Order 310 OrderiD Patient ID itstName LastName Birthdate Nbr of cells Sample Date
83. ged 122 User s Manual CELLAVISION CellaVision DM96 User s Manual 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 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 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 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 Network cable between the system computer and the SSU is disconnected Network card in the SSU or system computer is broken Communication error between SSU and system computer The camera cable is disconnected The camera cable is disconnected Reconnect the network cable Restart the SSU and the program The network card has to be exchanged Restart the SSU and the program Make sure that the camera cable is connected to both the camera
84. greg reclassified cells or Megakaryocyte objects Non WBC panel smudge cell Artefact Not classed 26 User s Manual CELLAVISION CellaVision DM96 3 1 1 Customizing Views Galleries WBC s 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 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 logo 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 2nd gallery will display reference cells of the cell class selected 1n the main gallery amp 4 Indicates reference cell provided with the system You may expand this library by saving WBCs from processed slides as custom reference cells 1 Right c
85. he order 2 Click Protect Unprotect You may select multiple orders using Ctrl or Shift User s Manual 61 CELLAVISION CellaVision DM96 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 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 the database settings tab see 10 1 1 Creating a New Database a Exporting to an export database 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 o
86. hin acceptable limits Note It is recommended that you order 10x 50x overview images for cell location slides Note QC labels are not required for running cell location test on body fluid slides Cont d 164 User s Manual e CELLAVISION Cont d Examining a Cell Location Slide Open the slide in question from the database view Mini Map Analysis located area cells 2 Diff eon Overview Pont Mil Sion Side _ E Lh i to He Ee Navigation t a es on n 59s 7 ww e P Ju L ad n ss LI 2 Pas Ta L PU ie E e e iyis d Li Pu yrs e ave xe edi e P 7 e e 3 et Ge oe a 9 2 s f _ ele 4f i55 oie F a a tg m ar v 2d gt vy ZEN Yr i ya e we c qe P Zoom ot ee amp p LI 10x 5 s 42 s 9 gt af 9e a are 50 E e St m e WA e A m o AXIS TESI i 2 OA ITA gt Eae Nw 3 Ze c gt L P Region of Interest Cell Location ORE 4 2 7 p YA a as lt T e gt 9 tT h WBCs Found 200 s hs hd b aui om E pesi e J Non WBCs Found 36 25 UY eo gt E 3 vie IT s ii r La m Ratio of WECs found 100 0 TL 4 es ba t A 4 9 a WBCs missed 0 n ye 7s AI 4 E is oye a E je Ww e z a 9276 b gt Tue e 4 wa TA P Print Result e s P ce T1 N P 49 D T As f a
87. hocytes Large granular lymphocytes Hairy cells S zary cells User defined WBCs Smudge cell Band neutrophils Lymphocytes variant forms Promyelocytes Plasma cells Myelocytes Immature eosinophils Metamyelocytes Immature basophils Blast cells Promonocytes Non W BCs Other Giant thrombocyte Not classed Thrombocyte aggregation Artefacts Erythroblast NRBC Megakaryocyte BF Cell Images User defined Non WBCs Overview images 10x overview images and 50x overview images Region of interest images regions of interest tagged by the user WBCs Neutrophils Eosinophils Macrophages Other Non WBCs Smudge cell Artefacts Lymphocytes User defined WBCs User defined Non WBCs User s Manual 101 CELLAVISION CellaVision DM96 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 1 System Backup 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 MB A processed slide with 1
88. ide List Processing status Processing status Slide status Comments Slide P AE Slide ID Slide Nbr Analvzed Signed b 4M IB 1 2006 06 21 15 35 admin v b 2 006 08 21 15 35 d b 3 2006 08 21 15 38 vv H Ti b z 2006 08 21 16 42 pen Delete Process status We d Slide processing OK QD Slide processing stopped No result exists 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 e Processing error No result exists Slide status v Empty field Not signed i Signed Comments BJ Empty field No comments gH Comments exist 60 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 JI 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 Slide list you can open specific slides in the same way You may close the order and the slide using a toolbar button 2 Close Order and Slide un 6 1 4 Protecting an Order You may protect orders to prevent slides from being deleted or archived 1 Select t
89. ides with Slide BIDE ce MCE EOE ae Nbr 1 Click Remove Double click on the first slide in the Worklist Verify WBC Click RBC tab Perform RBC review Click PLT tab Perform PLT review Click Sign Slide tab Sign the slide 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 1n the worklist has been signed the Database View automatically opens Double click on the Order you would like to report If all 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 149 CELLAVISION CellaVision DM96 Appendix E User Authorization Levels Action Setting Observer Start slide processing User Restricted Authorized Administrator X Search in the database on Order ID and Patient ID Search in the database X X on other criteria Verify and comment X WBC RBC and PLT Edit Order data Add edit pending orders X Sign slides and reports Send results to the LIS Delete unsigned slides orders Delete signed orders Export orders Protect order from archiving Send images with e mail Export log files X X oL o d LL LLL SS LL LLL LL LLL 150 User s Manual
90. idual settings can also be switched using Toggle Color Brightness P Toggle Color Brightness h Adjusting Magnification Click Zoom In or Zoom Out to change the magnification in all galleries and in the WBC Full Screen View Zoom n Y Zoom Out Note You may also double click on a WBC to enlarge it and use the wheel button 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 appear 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 1s 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 6 CellaVision DM96 Cont d Splitting Cells If more than one cell is displayed in an image it can be difficult to determine which cell the system has actually identified Click Cell Marker and a green square appears marking the cell Cell Marker Sometimes the system fails to separate WBCs and the green square will cover more than one c
91. ine by moving the QS arm straight back If the slide does not move lies loose or is broken 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 131 CELLAVISION 6 CellaVision DM96 If the jammed slide is on the XY stage move the immersion oil arm out of the 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 132 User s Manual CELLAVISION CellaVision DM96 7 Gently pull the QS arm in the direction 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 133 CELLAVISION
92. ing Reclassification Settings 91 10 5 Adjusting RBC Precharacterization Settings 92 10 6 Adjusting PLT Settings 93 10 7 Adjusting Report Sign Settings 94 10 8 Adjusting Standard Comments Settings 95 10 9 Adjusting Reference Cells Settings 97 10 10 Adjusting E mail Settings 98 10 11 Adjusting Archiving Settings 98 10 12 Adjusting Language Settings 103 10 13 Adjusting BF AnalysisArea 104 10 13 1 Centering the AnalysisArea 104 10 13 2 Adjusting the Size of the Analysis Area 106 11 QUALITY CONTROL 107 12 MAINTENANCE 108 12 4 DailyMainmtenance 108 12 2 WeeklyMaintenance 108 12 2 1 Cleaning of Objectives 108 12 22 Side GUIES III III a a eee eee a ee 109 12 3 Preventive Maintenance 110 12 4 Remedial Maintenance 110 12 4 1 Immersion Oil Refill
93. ing to the instructions in this manual 3 Open the main hatch 4 Clean the XY stage from immersion oil with a lint free soft cloth 5 Close the main hatch 12 2 Weekly Maintenance 12 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 108 User s Manual CELLAVISION CellaVision DM96 Cont d 12 2 2 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 Mak
94. ion Test 1 Select a slide that meets the requirements and put a QC label on it Put the slide in a magazine place it in the DM and process the slide Go to the Cell Location tool when the slide has finished Select the new slide at the top of the slide list Go through all the images belonging to the slide and examine them for missed nucleated cells Enter the number of missed cells if any 1n the input field for each image nA d c N 6 When all images have been examined the result will appear at the end Check that it is within acceptable limits Cont d 160 User s Manual CELLAVISION 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 2006 05 22 08 30 2006 05 22 08 25 2006 08 22 08 16 2006 05 21 14 13 2006 05 21 08 22 Slide status v Empty Slide has no result not all images have been examined e Slide has a result and no missed nucleated cells all images have been examined ue Slide has a result but contains missed nucleated cells all images have been examined o 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 they contain any missed nucleated cells Green boxes mark the nucleated cells and blue boxes mark other found objects that are not nucleated
95. is Camera 1394 disconnected connected to both the camera and the Communication system computer Server Restart the program Could not initialize camera Please check camera cable In startup test No connection Check the connection between the SSU Instrument between the SSU and the system computer Restart the Communication and the system system and program Server computer SSU error No connection with the CCU ERROR Initialization failed The yellow status The status lamp is Contact your local vendor s technical lamp is not lit even not working support 30s after power on The yellow status The oil level is low Fill up the oil canister lamp is flashing but the startup test was successful The yellow status One of the hatches is Make sure all hatches are closed and lamp is flashing and not closed restart the program the startup test fails on System Control Server There was a jam Hemove 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 The output drawer is Check that no magazine is positioned to full and there is a the far right in the output drawer Restart magazine waiting to the SSU and the program be moved into the drawer The green power on The power is out for Connect the power cable and try again lamp is never lit the SSU The power on lamp Contact your local
96. lds 32 36 I Indicators 144 145 Inserting the slide holder 20 L LIS 54 LIS status 58 125 Loading Slides 19 Locked 83 M Magazine ID 18 Magazine Status 21 main gallery 27 Maintenance 108 May Gr nwald Giemsa 137 Merging Slides 51 Mini Map 47 73 74 Multiple Users 83 N Navigating 48 74 O Observer 89 Oil Refill 110 Opening an Order Slide 61 Order List 58 Order status 58 Overview Image 47 48 73 P PB 9 Pending Orders 64 PLT Count 37 PLT estimate factor 38 93 PLT Result 38 Printing Orders 63 Process status 60 Protecting an Order 61 Q Quality Control 107 R RBC characterization 92 RBC limits 92 RBC overview image 32 Reference Cells 27 97 Regions of Interest 50 76 Report 144 Report Preview 54 Report template 84 Report View 51 144 Reporting Results 51 Restricted user 84 Result Panel 51 User s Manual 169 CELLAVISION CellaVision DM96 Review Station 13 Review Stations 83 Right click Menu 31 S Scanning a Slide 72 Search criteria 56 Searching for an Order Slide 62 Settings 147 Shut down 23 Signing a Slide 42 50 Signing an Order 54 Single slide differentials 147 Slide ID 18 Slide Information Dialog 22 Slide Merge 51 Slide Preparation 153 Slide scanning unit 13 14 Slide Status 22 Splitting Cells 30 SSU 13 Staining Recipes 156 Standard Comment 96 Start 16 20 145 Statistics 67 Storage 143 System Control 17 System indicators 17 T
97. lick Order Data in the toolbar The Order Data dialog can also be accessed by right clicking on an order in the database view To edit order data click Order Data TH in the toolbar 76 User s Manual CELLAVISION CellaVision DM96 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 has manually been added to the database and has not yet been processed Pending Orders are useful when defining scan area for individual slides i Pending Orders Order ID _ Patient ID FirstName LastName Birth date Nbr of cells MT Order 310 Mike Lawson MT Order 320 Nicky Clark Add E dit Delete To add an order click Add To view or edit order data double click on an order or click Edit Cont d User s Manual 77 CELLAVISION 6 CellaVisionP DM96 Cont d Order Data Order ID MT Order 350 Patient ID Scan Area amp Magnification First name Magnification lines Last name C 10x Birth date f 10 50s Gender C Male C Female Ethnic origin Ward Patient comment Order comment Sample date Ordering physician required held Close To define scan area for the slide click Area Define the a
98. lick 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 CELLAVISION 6 CellaVision DM96 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 View 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 Color Brightness Color sliders I Reset Save Load Brightness Ll C im 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 Indiv
99. ll 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 User s Manual 23 CELLAVISION ECA DM96 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 DMConfiguration tool it is possible to add user defined WBC cell classes and RBC characteristics To do this contact your service personnel 3 1 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 En pilava loc EM Terenitial Software eT Fie View Took A ji 8 ES ree DE ML see ese S No Cot WS 1 gH Lymphacyta 1N Monocyte ED Framanpcyte Cc Lg ier E I lmphocyo venentiom PET BA META NE Worklist Non WBCs panel Add WBC 3rd gallery comment Cont d 24 User s Manual CELLAVISION CellaVision DM96 Cont d All cell classes han
100. lowed 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 User o Full Nama o Password PO Password again PO Email o Access level Observer l IW Account Active required field Lancel User Login 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 username 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 User s Manual 89 CELLAVISION 6 CellaVision DM96 10 3 Adjusting Analysis Settings Default values These values are used 1f 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 1f the LIS will be used Add processed slide to worklist If this checkbox is activated processed slides will automatically be added to the
101. mation 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 36 User s Manual CELLAVISION CellaVision DM96 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 arid size 4 x 4 0 50 HPF square Count PLT per grid square e Pp EP P 7 3 3 E Entry field P Ee E F r E NF C pprwmatePLTspergidsquae Calculate PLT Result a Counting PLTs per grid square 1 Select the Count PLT per grid square radio button 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 fi
102. mears Wright and MGG are examples of different Romanowsky stains Signing Finally confirming analysis results before locking and reporting them Slide ID The barcode number on the slide PID Same as Order ID Slide number A number that uniquely identifies slides within the same order Slide position The position of a slide in the magazine Unidentified Cells and objects which the system cannot preclassify Verification The operator s review of WBC RBC and PLT e g reclassification and confirmation of WBCs WBC White blood cell leukocyte Wright A Romanowsky stain for blood smears 168 User s Manual CELLAVISION CellaVision DM96 A Archive status 59 Archiving 66 98 Authorization Levels 150 Autostart 20 145 B Backup 68 Barcode 18 128 Batch Status 21 BF 9 Blood Films 153 Body Fluids Differential 44 Bulb Exchange 112 Buttons 144 C Canceling an Order 55 CellaVision Remote Review Station 13 Color and Brightness 28 Comment Panel 53 Comments 39 50 59 60 95 Creating a New Database 86 D Database 56 Database View 24 44 56 77 144 Default values 22 Deleting a Database 87 Deleting an Order Slide 62 Digital Slides 72 Disposal Information 143 Duplicate Slides 149 E E mail 31 46 entry fields 36 Error texts 22 Estimating 36 Excluding the Platelet Analysis 39 Excluding the Red Blood Cell Analysis 35 F Full Screen View 28 G Galleries 27 grid squares 36 H high power fie
103. n DM software It is important that slide preparation 1s performed according to standardized methods see Appendix G Slide Preparation Guidelines General Functionality of the System e Receives order information from and sends results to the LIS e ocates and presents images of every located cell or object found on the smear e Stores images and results in a database Presents an overview image of a user defined area on a slide 1 3 1 Peripheral Blood Application General Functionality Presents an image on a screen of every located cell or object e 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 preclassifies the following non WBCs Erythroblasts NRBC Giant thrombocytes Thrombocyte aggregations Smudge cells and
104. n the order with no included slides When the order is sent to the LIS the order will be reported as cancelled 1 Open the order in the Database View 2 Select the Slide Merge tab in the Report View 3 Make sure no slides are included 4 Click Sign Order The Sign Order dialog appears 5 Sign the order as described in 5 3 Signing an Order result User s Manual 55 CELLAVISION CellaVision DM96 6 Database and Archiving Data Click Database View 1n 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 panel Cont d 56 User s Manual CELLAVISION CellaVision DM96 Cont d Worklist Opened order and slide Selected order marked Data for selected order written in blue text blue or grey Worklist c Processed Orders i p Order ID S m MT Order 40 Search criteria Order data re Order ID MT Order 10 1 2 slide s in result View latest 2006 08 28 Ordered by Ester Analysis completed 200
105. nd prompt Start menu Run cmd 2 At the prompt type bsql mydatabase and press Enter to start the BSQL database tool 3 Log on as Administrator e g as admin 4 At the prompt type START BACKUP and press Enter to start the backup procedure 5 Type CREATE BACKUP IN c backupdir ciimg FOR DATABANK ciimg and press Enter 6 Type CREATE BACKUP IN c backupdir logdb FOR DATABANK logdb and press Enter Cont d User s Manual 69 CELLAVISION 6 CellaVision DM96 Cont d 7 Type CREATE BACKUP IN c backupdir sqldb FOR DATABANK sqldb and press Enter 8 Type CREATE BACKUP IN c backupdir sysdb9 FOR DATABANK sysdb and press Enter 9 Type CREATE BACKUP IN c backupdir transdb FOR DATABANK transdb and press Enter 10 Type COMMIT BACKUP and press Enter to complete the backup procedure 11 Type EXIT and press Enter to exit the BSQL tool 12 Type exit and press Enter to close the command prompt 13 Verify the backup files see 6 6 3 Verify Backup 14 Use e g Windows Explorer to copy the files in the backup directory to a backup location normally tape or network drive The name of the backup files should be the same as the original database files Note that the filename for the databank SYSDB may differ Note A more advanced but easier to use backup script is available through CellaVision or your local distributor 70 User s Manual CELLAVISION CellaVision DM96 6 6 3 Verif
106. ng results or even lead to injury Warning alerts appear in this manual as follows WARNING May cause injury Important May cause misleading results Cont d User s Manual 7 CELLAVISION 6 CellaVision DM96 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 Indicates that the surface becomes hot and should not be touched with bare hands Documentation needs to be consulted In vitro diagnostic medical device Temperature limitation This symbol is only valid in the European Community and indicates separate disposal of waste of electrical and electronic equipment On S
107. ng 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 143 CELLAVISION CellaVision DM96 Appendix C Buttons and Indicators If you place the mouse pointer 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 Enables help lines for PLT Help Lines P estimate Confirm Cell Counter Results Comments WBC Full Screen View WBC Galleries Zoom Mode Zoom In Zoom Out Scroll Mode 144 User s Manual CELLAVISION CellaVision DM96 Indicators ay Color Brightness Toggle Color Brightness Cell Marker WBC Attributes Entire RBC Image Start Stop Autostart Oil Level Indicators Output Drawer Indicators Hatch Indicators Adjusts image color and brightness Toggles between default color and lights settings and personal settings Shows Hides square for cell identification Shows Hides WBC attributes Shows the entire RBC image Automatic start of slide processing Indicates an empty oil caniste
108. nual CELLAVISION CellaVision DM96 6 6 1 System Backup System backup is a simple file copy process performed from the operating system The backup procedure must be performed by a Windows Administrator Before the file copying can start the database server must be stopped After the file copying the database server must be restarted 1 Start the program Mimer Administrator Start menu All Programs Mimer SQL Engine Mimer Administrator 2 Right click on the database name in the Local tab and select Stop Server Note that one column in the list specifies the home directory of the database 3 Verify the database files see 6 6 3 Verify Backup 4 Use e g Windows Explorer to copy the files dbf in the database home directory to a backup location normally tape or network drive 5 Right click on the database name again in the program Mimer Administrator and select Start Server 6 6 2 Online Backup An online backup is performed without stopping the database server The backup procedure uses SQL system management statements and must be performed by a CellaVision DM software Administrator but not necessarily a Windows Administrator First all data files called databanks 1n the database are backed up Then the backup files are copied to a backup location tape or network drive In the following example the database is called mydatabase and it is backed up into a directory called c backupdir 1 Start a comma
109. o the Restart the SSU and the program magazine since itis Discard the worn out magazine worn Out User s Manual 121 CELLAVISION 6 CellaVision DM96 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 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 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 Some object prevents changing of objectives Something prevents motor movement during calibration of motors The air filter is dirty The fan in the control unit does not function 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 Remove the obstacle that prevents motor movement Restart the SSU Check that the air filter on the back of the SSU is not dirty The fan has to be exchan
110. om the starting point towards the thinner part of the smear 154 User s Manual amp CellaVision DM96 Example Smears The line in the images indicates the analysis starting point Accepted These slides are all prepared according to the specifications and will be accepted in the DM8 DM96 Not Accepted IT AAA E ESSE au m g ul tee ret A QUK 3 ul M 24388550 P o ww koria BO E I B 5 These slides are not prepared according the specifications and will not be accepted in the DM8 DM96 Cont d User s Manual 155 CELLAVISION 6 CellaVision DM96 Cont d Recommended Staining Recipes CellaVision DM is optimized to analyze samples stained with May Gr nwald 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 May Gr nwald working solution b Every day Buffer working solution d Every day Giemsa working solution f Every day Buffer working solution d Every day Alternative 2 Buffer working solution d Quick rinsing Every day Giemsa working solution f Every day Buffer working solution d Every day Cont d 156 User s Manual CELLAVISION CellaVision DM96 Cont d a May Gr nwald stain stock solu
111. ooth frosted area Critical error inthe The Order ID Do not use an Order ID with more than database contains more than 24 characters 24 characters Could not find the Leading spaces in Remove leading spaces in the Order ID order in the LIS the Order ID JASO see section 12 2 5 for LIS errors 128 User s Manual CELLAVISION CellaVision DM96 13 2 9 Staining Problems The fixation and staining time may be increased The red cells appear Understaining bright red the white cells will appear indistinct with pale blue rather than purple nuclei and brilliant red eosinophilic granules will be seen microscopically Overwashing The washing technique may be corrected so that it is adequate but not excessive Use of stain buffer The pH of the buffer may be checked or wash water that with a pH meter and adjusted is too acidic The increased Use a new batch of stain or buffer acidity is due to exposure of the stain or buffer to acid fumes Pale inadequately Understaining The fixation and staining time may be stained red cells increased nuclei or eosinophilic granules Overwashing The washing technique may be corrected so that it is adequate but not excessive The erythrocytes Overstaining Decrease the fixation time appear blue or green the nuclear chromatin is deep blue or black and the granules of the neutrophilic granulocytes are deeply
112. over slip Stain the slide using the same staining recipe as for peripheral blood samples See Recommended Staining Recipes for staining recommendations User s Manual 159 CELLAVISION CellaVision DM96 Appendix H Cell Location Cell Location for Peripheral Blood 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 Running the test once or twice a day 1s a recommended interval at the high load laboratory The test establishes how many percent of the nucleated cells 1 e WBC and NRBC that are found on a slide The Cell Location tool may be accessed in the Tools menu Slide Requirements Use a 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 1 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 QC 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 Cell Location tool Pre printed QC labels are available from your local dealer Running a Cell Locat
113. overstained and appear large and prominent The granules of the eosinophils are blue or gray The amount of stain used may be decreased shorten the staining time and the amount of buffer increased increase the stain buffer time User s Manual 129 CELLAVISION 6 CellaVision DM96 Inadequate Increase the wash step washing Too high an The pH of the buffer may be checked alkalinity of stain or with a pH meter and readjusted to a buffer lower pH Thick blood smears Prepare a thinner blood smear Samples have dark Drying is occurring Ensure the adequate drying of samples areas of stain or during the period of previous to staining other artefacts staining EBENEN Unclean slides Use clean slides Inadequate washing Increase wash step not washing enough to remove the metallic scum A stain is forming Filter the stain precipitate in the solution Ensure that the stain has not exceeded the expiration date 130 User s Manual CELLAVISION CellaVision DM96 13 2 10 Slide Transport Jam WARNING 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 magaz
114. ow Results exist an Stopped Slide processing stopped by user No results exist o Error All ordered analyses failed see error texts below No results exist E Cancelled The slide was cancelled in the LIS Slide not processed Empty slide position in the magazine or no Empty Empty or no slide PID barcode on slide Warning Texts Default values The order was not found in the LIS The required number of WBCs were not found or one Incomplete analysis 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 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 1s displayed here 22 User s Manual CELLAVISION CellaVision DM96 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 1s ejected into the output drawer 2 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 leftmost magazine can be hard to pull out Open and close the input hatch and the conveyor wi
115. ox 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 120 At least the motor specified in the message box reported a jam error Magazine is broken and fragments are blocking the slide The barcode could not be read after the slide was processed At least the motor specified in the message box reported a jam error Critical temperature in the SSU No connection between the SSU and the system computer The magazine is stuck The slide is stuck or broken 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 Hemove 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 Wipe off oil from the barcode label Hemove 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 Shut down the SSU and contact your local vendor s technical support Check the connection between the SSU and the system computer Check power connection to the SSU Restart the system and the program Remove the magazin
116. p do as follows 1 Stop the database server using Mimer Administrator 1f necessary A program called Mimer Controller can also be used to stop and start the database server 2 Copy all database files dbf from the backup location c backupdir in the examples above to the home directory can be viewed in Mimer Administrator 3 Restart the database server User s Manual 71 CELLAVISION CellaVision DM96 7 7 1 7 1 1 Digital Slides With CellaVision DM96 it is possible to create digital slides Important The digitalized image generated provides a general overview of the prepared 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 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 Slide and Magazine Requirements Requirements for the slides used when scanning Glass e Size in mm 75 0 76 0 x 25 0 26 0 x 0 9 1 2 e Ground edges Clipped or round corners Barcode labeled e 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
117. 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 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
118. r Indicates need for refilling of oil Indicates a full oil canister Indicates room left 1n the output drawer Indicates a full output drawer Indicates all hatches closed Indicates an open hatch or oil immersion arm in Wrong position User s Manual 145 CELLAVISION 6 CellaVision DM96 Indicates the number of magazines in the system o Magazine Indicator 8 y except those in the output drawer Keyboard shortcuts Ctrl w Show hide Worklist 146 User s Manual CELLAVISION CellaVision 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 below 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
119. rders 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 autodeleted 1f autodelete 1s enabled Only peripheral blood orders can be exported to CellaVision Competency Software databases Orders residing in a Scan database cannot be exported 62 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 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 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 simpli
120. rea 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 dragaing in the slide image The Min Max following constraints apply x in mm 16 57 mm y 1 83 mm 28 83 mm 6 5 2 min mas lt 13 5 mm 6 5 2 r min max lt 50 0 mm The width and height af the scan area must also satisfy 2 0 lt width lt 20 0 mm TINI 2 0 2 height lt 20 0 mm Cancel Note If no scan area is defined the default scan area setting will be used 78 User s Manual CELLAVISION CellaVision DM96 7 4 Customizing the System To customize the system go to the Tools menu and select Settings 7 4 1 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 ar by clicking and dragging in the slide image The Mas i following constraints apply Min x 10 E mm esz mm lt I eal 6 5 2 min lt max lt 19 5 mm 6 5 lt ymin Y lt lt 50 0 ma X imm peed tne min lt mae mm The width and height of the scan area must also satisfy
121. sion BloodDitferentialy Type of database Processing database Normal C Scan database C Export database CellaVision Competency Software database Database aus 20000 MB Free disc space 58284 MB Note Creating a database can take up to 20 minutes oesi Creating a database requires that there 1s 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 Software database requires 100 MB Note Having many databases affects system performance negatively Note A database can be created only on your local computer 86 User s Manual CELLAVISION CellaVision DM96 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 1n 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
122. 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 72 User s Manual CELLAVISION CellaVision DM96 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 1 Overview The Mini Map shown 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 1mage 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 Overview Navigation Eu Es Zoom 10x JL 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 Users Manual 73 CELLAVISION CellaVision DM96 7 2 2 Navigating Move efficiently in the Mini Map by using
123. 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 predetermined factor to calculate the PLT estimate The system suggests RBC morphology characteristics The system suggests WBC classification The sequence of events from when the slide holder is put on the conveyer to when they are ejected to the output drawer Quickly scanned slides for cell counter verification The results are not sent to the LIS Red blood cell erythrocyte The operator changes the preclassification 167 CELLAVISION CellaVision DM96 Reference cells Cells with typical characteristics available in the 2nd and 3rd galleries Region of interest Part of the BF or Scan overview image tagged by the operator Romanowsky stain An eosin methylenblue solution for staining of blood s
124. 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 User s Manual 33 CELLAVISION CellaVision DM96 3 2 1 Customizing the Red Blood Cell Overview Image Change the magnification of the image by using these buttons Zoom In Zoom Out Entire RBC Image Shows the entire RBC image Navigate the 1mage by switching between different control modes The mouse pointer changes accordingly qt Zoom Mode Hold left mouse button down and zoom in out X by moving the mouse pointer up down i Scroll Mode Hold left mouse button down and scroll in any direction using the mouse Note You may also double click in the RBC image to enlarge a limited area and use the wheel button to zoom in out 34 User s Manual
125. tem e Slide scanning unit SSU Motorized microscope Digital color camera Immersion oil unit Slide feeder unit with barcode reader Magazine feeder unit Control unit Casing User s Manual 13 CELLAVISION CellaVision DM96 Slide Scanning Unit Control unit Digital color camera a Immersion 3 gt oil unit Status lamp Power on lamp Main switch pe Objective me di 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 CellaVision DM96 Motorized Microscope The motorized microscope is a fixed XY 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 immersion oil to a slide An optical drop counter controls the procedur
126. th 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 the 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 1s 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 1s 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 1s a recommended interval at the high load laboratory User s Manual 107 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 2 Shut down the system accord
127. the keyboard arrows or the Navigation Buttons asl 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 i Hold left mouse button down and scroll 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 1n the Zoom panel Zoom 10x e bs 74 User s Manual CELLAVISION CellaVision DM96 7 2 3 Tagging Regions of Interest To save an enlarged area as a region of interest for later reference click Tag region Region Comment re AA Identify your region of interest by adding a comment Tag Region E con E Lx ee User s Manual 15 CELLAVISION CellaVision DM96 7 2 4 7 2 5 7 2 6 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 4 Click OK Adding Comments To add a comment to the Overview click Scan comment Scan comment Order Data To view information about the order e g scanned area and comments c
128. tings for Sign dialogs Here you set the default values for the Sign Slide and Sign Order dialogs 94 User s Manual CELLAVISION CellaVision DM96 10 8 Adjusting Standard Comments Settings Standard Comments 1 Hypersegmentatian WEL 2 Felger form WEL 3 Huvpergranulatian WEL 4 Hipogranulatior WEL 5 Auer rads WEC b Doehlie bodies WEL 7 Prk notic nucleus WEL B Vacuolization WEL 4 Cleft nuclei WBC 10 General RBC slide comment HBL 11 General slide comment General Include code in comment Delete Modify Iw Always show expanded 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 User s Manual 95 CELLAVISION 6 CellaVisionP DM96 Cont d Adding a New Standard Comment 1 Click New 2 The Standard Comments Editor appears Standard Comment Editor Code Comment type z C General WBC C ABC PLT C BF Comment Auer rods Cancel 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 are always accessible 4 Click OK Deleting a Standard Comment Select the standard comment in the list 2 Click Delete Modifying a Standard Comment Select the standard comment in the list 2
129. tion 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 part buffer work solution Stable for 8 hours e Buffer stock solutions 1 and 2 1 9 07g KH2POA 0 067M ad 1000ml deionized water Store at 4 C to 8 C 2 9 45 g Na2HPO4 0 067M ad 1000ml deionized water Store at 4 C to 8 C d Buffer working solution pH 6 8 Combine 127 ml KH2POA stock solution with 123 ml Na2HPOA 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 ina dark boitle f Giemsa working solution Dilute 1 part Giemsa stock solution with 19 parts buffer work solution Stable for 8 hours Cont d User s Manual 157 CELLAVISION 6 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 Wright stain diluted 1 10 with phosphate buffer 7 min pH 6 8 Hinse in deionized water Alternative 2 Beckman Coulter GENS slide stainer
130. upply Off Supply 8 User s Manual CELLAVISION CellaVision DM96 1 2 Intended Use of CellaVision DM96 CellaVision DM96 is an automated system intended for in vitro diagnostic use CellaVision DM96 e Scans a user defined part of a microscope slide e Automatically locates and presents images of cells on smears from various specimens s intended to be used by skilled operators 1 2 1 Peripheral Blood Application The peripheral blood application PB 1s 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 1mages 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 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 referred to as a slide scanning unit and a computer system containing the acquisition and classification software CellaVisio
131. y Backup The databank check DBC program should be run before archiving the backup copies of the databank files e g copying them to tape or network to verify the physical integrity of the databank files A report file is created each time the DBC program is run In the following example the report file is given the same name as the databank but a different file extension 1 Start a command prompt 2 Type dbe c backupdir ciimg c backupdir ciimg and press Enter 3 Type dbc c backupdir logdb c backupdir logdb and press Enter 4 Type dbc c backupdir sqldb9 c backupdir sqldb9 and press Enter 5 Type dbc c backupdir sysdb c backupdir sysdb and press Enter 6 Type dbc c backupdir transdb c backupdir transdb and press Enter 7 Type exit and press Enter to close the command prompt If a databank file is corrupt in some way Errors are logged is shown The errors are logged in the report file Normally the message No errors found is shown If the DBC program reports that a databank file is corrupt the database backup procedure must be re run 6 6 4 Recovery If the hard disk crashes or the database files become corrupt because of some other reason an old backup can be used Always use the most recent backup Note All data stored in the database since the last database backup will be lost in case of a hard disk crash It is recommended to frequently backup the database To restore a database from a backu

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CellaVision® DM96 User`s Manual 3.0