I have worked in several HT labs and as expected most differ in individual 
technique.  Most are very good as far as work flow from grossing, processing, 
embedding and sectioning.  I work in a lab now where the grossing and 
processing of "like specimens" are in case order until there embedded.  
Embedded totally out of order, even within a case.  One person will rough cut 
the blocks on 1 microtome, approx 20 microns.  After all the embedding is done 
the  trimmed  blocks are put in order, placed  on ice in which about half are 
to be cut on another microtome.  Although the microtomes are adjusted close I 
have found that by the time I'm ready to section my blocks on the microtome not 
used for trimming I often have to go into the tissue 20-40microns,  5 microns 
at a time, to get a complete section.  This often makes it tough to get a good, 
rehydrated 2nd section not to mention often the 1st if the event the tissue is 
larger and or firm to start
 with.  Often I have to re-trim the blocks to match my microtome then rehydrate 
them again.  This all takes time and makes it impossible to section all my 
cases in order, waiting on blocks to rehydrate, hold slides sometimes leading 
to mistakes.

I have always, and in every lab I worked except this one, trimmed my own blocks 
for a specific microtome.  At the end of trimming, I always fine cut 4-5 
microns 2-5 times to deminish the artifact often caused by too aggressive 
initial trimming.  Then I rehydrate and ice the tissue..   With this technique 
I use less knifes also.

I temped in this lab about 1/1/2 years ago and was asked by the Pathologist and 
Lab Director to address these very issues and section quality.  Now that I'm 
back nothing has changed.  The pathologist still has section quality issues.  
What ever happen to the idea of Quality Improvement.  The works getting done I 
suppose, maybe thats all that matters these days.







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