I agree with Rene. To discredit the pathologist theory show if all of the
specimens from the run are not fixed properly. Then show if it is just the
LEEPs. Then show if it is that particular clients specimens? Then onto that
client's LEEPs.
That should prove your problem lies with the client handling and not the
fixation on your end. Cauterization can cause burning of the specimen, but not
look unfixed. If it was left out of formalin, autolysis can set in.
The situation shows the god-complex some physicians have and the lack of
respect they have for their techs.
This is why we should all be certified and keep up with continuing education,
so that these pathologists will respect us.
Ok, I'm going to get off my soapbox now, before I say something ugly.
Toysha Mayer
------------------------------
Message: 3
Date: Fri, 31 Mar 2017 12:50:37 +0000
From: T H <thiggin...@msn.com>
To: "histonet@lists.utsouthwestern.edu"
<histonet@lists.utsouthwestern.edu>
Subject: [Histonet] Tissue Fixation
Message-ID:
<sn1pr19mb060735d7b896c67b0223e098d8...@sn1pr19mb0607.namprd19.prod.outlook.com>
Content-Type: text/plain; charset="iso-8859-1"
Good Morning,
I have a pathologist that is not happy with the fixation on some of our LEEP
specimens. She swears its histology doing something to the specimen to cause
the tissue to look unfixed on only "part" of the LEEP specimens (all the same
client specimens). She claims we must be diluting our formalin to cause this
issue or "something". We mentioned maybe it was on the clients end not placing
them in 10% formalin right away, she wouldn't hear of it.
Let me give you some back ground on how our process works. Our clients send us
all our specimens to us via Overnight FedEx or UPS in 10% formalin they will
then they sit in 10% formalin in-house until the processors are started around
3pm and sits an additional 5 hours in 10% formalin on the processor before the
processor actually starts. That being said the fixation process has had a
pretty good start before we ever even touch it.
My question is, and I thought I had read this in the past is, when a specimen
is left out prior to fixation and lying on a absorbent surface such as a paper
towel, won't the area of the tissue touching the absorbent surface begin the
disintegration processes faster in that exact area then the rest of the
specimen? Or if you have any other suggestion on what might be happening to
only "certain" specimens would be great as well.
Thanks for your help!
Tim
------------------------------
Message: 4
Date: Fri, 31 Mar 2017 13:32:35 +0000 (UTC)
From: Rene J Buesa <rjbu...@yahoo.com>
To: T H <thiggin...@msn.com>, "histonet@lists.utsouthwestern.edu"
<histonet@lists.utsouthwestern.edu>
Subject: Re: [Histonet] Tissue Fixation
Message-ID: <1730848134.8065268.1490967155...@mail.yahoo.com>
Content-Type: text/plain; charset=UTF-8
What you describe as a possible scenario is absolutely possible.If your PT does
not "want to hear" about it, suggest she gets a "hearing aid" or to study
something about histotechnology or even better yet, pay attention to what a
professional on the subject (you) has to say about it. You would never dare to
question her diagnosis, why would she question yours on this subject?Ren?
On Friday, March 31, 2017 9:11 AM, T H via Histonet
<histonet@lists.utsouthwestern.edu> wrote:
Good Morning,
I have a pathologist that is not happy with the fixation on some of our LEEP
specimens.? She swears its histology doing something to the specimen to cause
the tissue to look unfixed on only "part" of the LEEP specimens (all the same
client specimens).? She claims we must be diluting our formalin to cause this
issue or "something".? We mentioned maybe it was on the clients end not placing
them in 10% formalin right away, she wouldn't hear of it.
Let me give you some back ground on how our process works.? Our clients send us
all our specimens to us via Overnight FedEx or UPS in 10% formalin they will
then they sit in 10% formalin in-house until the processors are started around
3pm and sits an additional 5 hours in 10% formalin on the processor before the
processor actually starts.? That being said the fixation process has had a
pretty good start before we ever even touch it.
My question is, and I thought I had read this in the past is, when a specimen
is left out prior to fixation and lying on a absorbent surface such as a paper
towel, won't the area of the tissue touching the absorbent surface begin the
disintegration processes faster in that exact area then the rest of the
specimen?? Or if you have any other suggestion on what might be happening to
only "certain" specimens would be great as well.
Thanks for your help!
Tim
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------------------------------
Message: 5
Date: Fri, 31 Mar 2017 13:57:30 +0000 (UTC)
From: Paula Keene Pierce <pa...@excaliburpathology.com>
To: Rene J Buesa <rjbu...@yahoo.com>, Histonet Histonet
<histonet@lists.utsouthwestern.edu>
Subject: Re: [Histonet] Tissue Fixation
Message-ID: <372734167.8016960.1490968650...@mail.yahoo.com>
Content-Type: text/plain; charset=UTF-8
Bravo Rene!?Paula Keene Pierce, BS, HTL(ASCP)HTPresidentExcalibur Pathology,
Inc.5830 N Blue Lake DriveNorman, OK 73069PH 405-759-3953FAX
405-759-7513www.excaliburpathology.com
From: Rene J Buesa via Histonet <histonet@lists.utsouthwestern.edu>
To: T H <thiggin...@msn.com>; "histonet@lists.utsouthwestern.edu"
<histonet@lists.utsouthwestern.edu>
Sent: Friday, March 31, 2017 8:44 AM
Subject: Re: [Histonet] Tissue Fixation
What you describe as a possible scenario is absolutely possible.If your PT does
not "want to hear" about it, suggest she gets a "hearing aid" or to study
something about histotechnology or even better yet, pay attention to what a
professional on the subject (you) has to say about it. You would never dare to
question her diagnosis, why would she question yours on this subject?Ren?
? ? On Friday, March 31, 2017 9:11 AM, T H via Histonet
<histonet@lists.utsouthwestern.edu> wrote:
Good Morning,
I have a pathologist that is not happy with the fixation on some of our LEEP
specimens.? She swears its histology doing something to the specimen to cause
the tissue to look unfixed on only "part" of the LEEP specimens (all the same
client specimens).? She claims we must be diluting our formalin to cause this
issue or "something".? We mentioned maybe it was on the clients end not placing
them in 10% formalin right away, she wouldn't hear of it.
Let me give you some back ground on how our process works.? Our clients send us
all our specimens to us via Overnight FedEx or UPS in 10% formalin they will
then they sit in 10% formalin in-house until the processors are started around
3pm and sits an additional 5 hours in 10% formalin on the processor before the
processor actually starts.? That being said the fixation process has had a
pretty good start before we ever even touch it.
My question is, and I thought I had read this in the past is, when a specimen
is left out prior to fixation and lying on a absorbent surface such as a paper
towel, won't the area of the tissue touching the absorbent surface begin the
disintegration processes faster in that exact area then the rest of the
specimen?? Or if you have any other suggestion on what might be happening to
only "certain" specimens would be great as well.
Thanks for your help!
Tim
Message: 6
Date: Fri, 31 Mar 2017 15:06:53 +0000
From: "Morken, Timothy" <timothy.mor...@ucsf.edu>
To: Rene J Buesa <rjbu...@yahoo.com>, T H <thiggin...@msn.com>
Cc: Histonet <histonet@lists.utsouthwestern.edu>
Subject: Re: [Histonet] Tissue Fixation
Message-ID:
<761e2b5697f795489c8710bcc72141ff8e5c6...@ex07.net.ucsf.edu>
Content-Type: text/plain; charset="utf-8"
Tim, I have to agree with Rene that the formalin or time in formalin is
obviously not the problem - it has plenty of time in formalin (and who would
dilute it anyway?). Handling before formalin must always be determined when
problems arise. If the sample sits on a paper towel, gauze etc it does not
really degrade faster, rather the tissue may dry out and so fixes by
dehydration rather than by formalin. It may be the formalin cannot get into the
tissue in those dried out portions of the tissue. However that is just
speculation. Since these all seem to be from one particular client, the client
is the place to start. The only way to determine the problem is to follow the
specimen from start to finish. Can you or someone you trust physically observe
the way samples are handled from the time they are taken to the time put in
formalin? One issue I always run up against is people saying they do one thing
but actually doing another. And they may realize during questioning that they
are not
doing it right but don't want to admit it. It wastes a lot of time. I've had
physicians tell me to ignore the part of the process they are responsible for
because they do it right. I just tell them that to be complete we need to
follow the process from start to finish, nothing personal, just business.
Leaving any part out may lead to not resolving the problem. Probably 99% of the
process is just fine, but that 1% is damaging the sample and needs to be
illuminated.
Tim Morken
Pathology Site Manager, Parnassus
Supervisor, Electron Microscopy/Neuromuscular Special Studies Department of
Pathology UC San Francisco Medical Center
Content-Type: text/plain; charset="utf-8"
Aren't LEEPS done with some sort of electric method that will damage the tissue
before it even reaches formalin. I'm not positive but Google it - I believe
that might be the problem. j
Joyce Weems
Pathology Manager
678-843-7376 Phone
678-843-7831 Fax
770-380-8099 Cell
joyce.we...@emoryhealthcare.org
www.saintjosephsatlanta.org
5665 Peachtree Dunwoody Road
Atlanta, GA 30342
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