Re: [Histonet] Do I have to destabilize MMA?
Dorothy, There are some that completely believe that it is necessary to destabilize MMA prior to use and they are not necessarily wrong as the protocol has worked for them without issue..so I assume. I personally have NEVER had to or tried this destabilization method, quite frankly because I have NEVER had a problem creating an acrylic resin embedded block, regardless of the tissue or size of the tissue, when simply combining monomer (MMA) with softener (DBP) and catalyst (Perkadox 16) in my almost 15 years of exclusively working with this resin for demonstrating bone, biomaterials and medical device implants. Again, I am not saying that the protocol given to you does not work, but rather it is my personal experience that this destabilizing method is an unnecessary step and a waste of time and expense. Hope this helps and please feel free to contact me if you have any additional questions or concerns. Best Regards, Jack Ratliff On Jan 15, 2014, at 10:02 PM, abt...@gmail.com wrote: I am new to MMA plastic bone technique. Some one gave me his protocol, in which has NaOH and d-water to wash MMA mixture before drying it in CaCl2. But others told me I don't need to do the destabilization step. Could any expert in this area to tell me if this step is necessary? And why have to do? Sent from my iPad ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: error rate for sectioning
My current QA monitors Not more than 0.17% slides mislabeledNot more than 1.0% of tissue blocks-reoriented ( embedding errors)Not more than 1.0% of tissue blocks reprocessed ( gross problem)Not more than 1% of specials and IHC stain slides repeated ( technical issues-not DX)Not more than 0.1% of slides, with documented evidence of cross contamination, requires RCA Based mostly on CAP- HQUIP, but some literature. Use LIS and HC1 to track in addition to manual methods for reporting, repeats etc. The medical director (pathologist) supervises , provides oversight for the quality issues and resulting corrective actions. Joelle Weaver MAOM, HTL (ASCP) QIHC From: michael.lafrini...@ccplab.com To: zerf...@ors.od.nih.gov; histonet@lists.utsouthwestern.edu Date: Tue, 14 Jan 2014 19:32:56 + CC: Subject: [Histonet] RE: error rate for sectioning Hi Patricia, Error rates should not be set by employers. You should have an effective QA management program and committee even in small practices with the Medical Director as the Chair. The committee sets and establishes error rate thresholds with monthly monitors in place to seek opportunities of improvement should error rates exceed below the set threshold. Hope this helps! Michael Michael R. LaFriniere, HT (ASCP) Executive Director Capital Choice Pathology Laboratory 12041 Bournefield Way, Suite A * Silver Spring, MD 20904 P: 240.471.3427 * F: 240.471.3401 * Cell 410-940-8844 michael.lafrini...@ccplab.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Zerfas, Patricia (NIH/OD/ORS) [E] Sent: Saturday, January 11, 2014 4:25 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] error rate for sectioning Hi All, What is the error rate set by you or your employer for paraffin sectioning? These are slides that are found to be unacceptable due to wrinkling, folding etc either by a pathologist or another reviewer. I was found to have 6 slides out of approx 1500 that I have sectioned to date to be unacceptable. I only perform this duty when I have completed all of my other work so this is not one of my regular duties. At times I have gone several months without sectioning and utilize a microtome that is approx. 26 years old. Since this was brought to my attention I have been given more up to date equipment which I have yet to utilize. Thanks in advance for your feedback. Patricia Zerfas ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Re: Do I have to destabilize MMA?
Thanks Jack's answer. I though I shouldn't to destabilization step as well. But my boss wants to do it. Is there a chemical theory behind this? Why previous protocol has this step (it must be reason)? And why the step is skipped now? I wish I know before approaching my boss. Additionally, there is a problem always bothering me in plastic sectioning. I often get cortical bone shattering ( crumbly) in the midshaft of long bone. Cortical bone and marrow are operate in the midshaft. I don't know why is that. It's not happen in the two ends of tibia and femur bone. And doesn't happen on ankle bones. Is that because the bone was stored in 70% EtOH too long (~one year)? I think infiltration is good since I did three times, 2 days each infiltration under vacuum condition in 4oC. If I use 40% EtOH to fix and store the bones will help? One more question. What is advantage if I use perkadox 16 to replace BP as catalyst? Do I have to dry MMA//DBP/perkadox 16 mixture through CaCl2? Thanks in advance for your help. Dorothy MGH endocrine histocore On Wed, Jan 15, 2014 at 11:02 PM, abt...@gmail.com wrote: I am new to MMA plastic bone technique. Some one gave me his protocol, in which has NaOH and d-water to wash MMA mixture before drying it in CaCl2. But others told me I don't need to do the destabilization step. Could any expert in this area to tell me if this step is necessary? And why have to do? Sent from my iPad ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Re: Do I have to destabilize MMA?
Methacrylate monomers are sold with added hydroquinone to inhibit spontaneous polymerization. The NaOH treatment to remove hydroquinone dates from the earliest years of plastic embedding (Newman et al. 1949 Science 110: 66-68). The NaOH treatment is not necessary, however, because the stabilizing action of hydroquinone can be overcome by simply using a larger amount of the polymerization catalyst. About 2% of either benzoyl peroxide or 1,2-dichlorobenzoyl peroxide will catalyze the polymerization of stabilized methacrylate monomer. See Hayat, MA 1981 Principles and Techniques of Electron Microscopy Vol 1. Baltimore: University Park Press, pp. 167-168. See Baker, JR 1960 Cytological Technique, 4th ed. London: Methuen, pp.77-84 for a thorough but simple explanation of the chemistry of methacrylate embedding. The whole book (which is a classic) is available, free, at http://archive.org. John Kiernan Anatomy Cell Biology University of Western Ontario London, Canada = = = On 16/01/14, Dorothy Hu abt...@gmail.com wrote: Thanks Jack's answer. I though I shouldn't to destabilization step as well. But my boss wants to do it. Is there a chemical theory behind this? Why previous protocol has this step (it must be reason)? And why the step is skipped now? I wish I know before approaching my boss. Additionally, there is a problem always bothering me in plastic sectioning. I often get cortical bone shattering ( crumbly) in the midshaft of long bone. Cortical bone and marrow are operate in the midshaft. I don't know why is that. It's not happen in the two ends of tibia and femur bone. And doesn't happen on ankle bones. Is that because the bone was stored in 70% EtOH too long (~one year)? I think infiltration is good since I did three times, 2 days each infiltration under vacuum condition in 4oC. If I use 40% EtOH to fix and store the bones will help? One more question. What is advantage if I use perkadox 16 to replace BP as catalyst? Do I have to dry MMA//DBP/perkadox 16 mixture through CaCl2? Thanks in advance for your help. Dorothy MGH endocrine histocore On Wed, Jan 15, 2014 at 11:02 PM, abt...@gmail.com wrote: I am new to MMA plastic bone technique. Some one gave me his protocol, in which has NaOH and d-water to wash MMA mixture before drying it in CaCl2. But others told me I don't need to do the destabilization step. Could any expert in this area to tell me if this step is necessary? And why have to do? Sent from my iPad ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Cryostat
I use to decon my cryostat with 100% Alco this keeps it from freezing up and it clean it. best of luck. Madeline Rotger Milanese H.T. BSHCS 500 New Hempstead Rd. New City N.Y. 10965 845-362-3200 Ext 129 madelin...@yahoo.com On Wednesday, January 15, 2014 2:52 PM, Abbott, Tanya tanyaabb...@catholichealth.net wrote: Need to decon my cryostat Tanya G. Abbott RT (CSMLS) Manager Technologist, Histology/Cytology St. Joseph Medical Center Reading, PA 19603-0316 ph 610-378-2635 fax 610-898-5871 email: tanyaabb...@catholichealth.net This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. If you are not an addressee, or responsible for delivering this email to an addressee, you have received this email in error and are notified that reading, copying, or disclosing this email is prohibited. If you received this email in error, immediately reply to the sender and delete the message completely from your computer system. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] 2014 CPT Changes
So elegant in its simplicity, I think I'll borrow it. Looks right to me. Ed Gray | Clinical Application Coordinator | Phone: 304-293-2945 | Fax: 304-293-1627 | WVU Healthcare l eg...@wvuhealthcare.com Message: 4 Date: Wed, 15 Jan 2014 19:02:46 + From: Susie Hargrove shargr...@unitedregional.org Subject: [Histonet] 2014 CPT Changes To: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Message-ID: A35DA58C5D75BB41A6877BC03166AFEA4371ECDD@UREXCHGP01.urhcs.local Content-Type: text/plain; charset=iso-8859-1 Hello, I know this subject had been looked at many times. I just want to see if I am correct before I start doing anything different. 1. 88342 , not much change . We can still just bill once per site, per case. This is per single antibody per Specimen. If I have a case with two parts and each part has 3 immuno's ordered I will bill them all 88342, Even if I do it on multiple blocks of the same specimen, I will still charge once. If one of these antibodies is a cocktail, I will bill 88342 for the first and 88343 for subsequent parts of that cocktail, and I can do this per specimen. So the only change I see here is the breakdown of the cocktail charges into 88343. 2. Medicare codes, GO461 is ordered for the first antibody , per specimen site per case, all additional antibodies, including cocktails , if any, are billed GO462. As before only 1 antibody can be billed by site/source. Now just to work out how the billing will flip over once the charges go across. Is anybody doing it differently? Susie Hargrove HT (ASCP) Histology Technical Specialist United Regional Health Care Wichita Falls, Texas 76301 Ph 940-764-3881 Fax-940-764-3129 CONFIDENTIALITY NOTICE: This e-mail, and any attachment, may contain identifiable health information that is subject to protection under state and federal law. This information is intended only for the person or entity to which it is addressed. If you are not the intended recipient, be aware that any review, re-transmission, copying, dissemination or other use of this information by persons or entities other than the intended recipient is prohibited and may be punishable by law. If you received this in error, please return it to the sender by electronic mail (reply) and delete the material from any computer or server on which it resides due to your receipt. -- Message: 5 Date: Wed, 15 Jan 2014 19:51:13 + From: Abbott, Tanya tanyaabb...@catholichealth.net Subject: [Histonet] Cryostat To: Histonet@lists.utsouthwestern.edu Histonet@lists.utsouthwestern.edu Message-ID: 852f7d2c14fb464d80e182b15db138af1fe72...@chiex005.chi.catholichealth.net Content-Type: text/plain; charset=us-ascii Need to decon my cryostat Tanya G. Abbott RT (CSMLS) Manager Technologist, Histology/Cytology St. Joseph Medical Center Reading, PA 19603-0316 ph 610-378-2635 fax 610-898-5871 email: tanyaabb...@catholichealth.net This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. If you are not an addressee, or responsible for delivering this email to an addressee, you have received this email in error and are notified that reading, copying, or disclosing this email is prohibited. If you received this email in error, immediately reply to the sender and delete the message completely from your computer system. -- Message: 6 Date: Wed, 15 Jan 2014 23:02:18 -0500 From: abt...@gmail.com Subject: [Histonet] Do I have to destabilize MMA? To: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Message-ID: 275d41a2-62a7-4b73-a627-a2a9de530...@gmail.com Content-Type: text/plain; charset=us-ascii I am new to MMA plastic bone technique. Some one gave me his protocol, in which has NaOH and d-water to wash MMA mixture before drying it in CaCl2. But others told me I don't need to do the destabilization step. Could any expert in this area to tell me if this step is necessary? And why have to do? Sent from my iPad -- Message: 7 Date: Thu, 16 Jan 2014 04:50:21 -0600 From: Jack Ratliff ratliffj...@hotmail.com Subject: Re: [Histonet] Do I have to destabilize MMA? To: abt...@gmail.com abt...@gmail.com Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Message-ID: blu0-smtp1759356a8873b92e3df8f4eae...@phx.gbl Content-Type: text/plain; charset=us-ascii Dorothy, There are some that completely believe that it is necessary to destabilize MMA prior to use and they are not necessarily wrong as the protocol has worked for them without issue..so I assume. I personally have NEVER had to or tried this destabilization method, quite frankly because I have NEVER had a problem creating an acrylic resin
[Histonet] Arkansas Society for Histotechnology Spring Meeting in Hot Springs AR
The Arkansas Society for Histotechnolgy is holding it's 40th Anniversay Meeting in Hot Springs, AR The program is listed and if you wish a registration packet with full program/abstracts and information please send an email and we will be happy to send it and update you for your trip to Hot Springs. The e-mail can be replied to through HistoNet or to ashn...@comcast.net Please note we are having a full HT Registry Course on Saturday March 1st with Shane Jones!! February 28th FRIDAY MORNING WORKSHOPS 8:00AM to 11:30AM IHC from the Beginning Bonnie Whitaker, Anatomic Pathology Operations Director Speaker: To Be Announced. Speaker withdrew We will update ASAP! 90 Minute Talk Integrating Mobile Technology With Anatomic Pathology 90 Minute Talk Dr Shree Sharma Pathology Department of UAMS February 28th AFTERNOON WORKSHOPS 1:00PM to 4:30PM I Have No Idea What I Am Looking At!! (Tissue Identification) Shane Jones BS, HT (ASCP) School of Histotechnology Program Director What’s New in HER2 Treatment, Testing and Regulation? Lynn Charpentier, Marketing Product Manager March 1 st - SATURDAY MORNING 8:00AM TO 11:30AM Hazard Communication Standard/GHS Awareness and Formaldehyde Training Part One: 90 MINUTES These are new regulations for waste handling today in Part 1 and Part 2 Part Two: 90 MINUTES Basic Microtomy Mari Ann Mailhiot, Technical Specialist MARCH 1 - SATURDAY AFTERNOON 1:00PM TO 4:30PM Basic IHC and Troubleshooting Workshop Matthew Pardilla, Technical Consultant Unraveling the Mysteries of Histotechnology Debbie Siena Histology Product Manger MARCH 1ST SATURDAY – CLASS BEGINS AT 8:00AM AND ENDS AT 4:30PM SPECIAL CLASS ALL FOR HISTOLOGY REGISTRY COURSE I HAVE TO KNOW ALL OF THAT FOR THE EXAM??? Shane Jones BS, HT (ASCP) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] 2014 billing changes
Hi Susie and fellow Histonetters : Susie - I am hoping to bill as you describe. To clarify - I will only use the 88343 when billing additional antibodies in a cocktails that can be separately visualized on one slide, identified with different chromogens, such as PIN-4. I will not use it for antibody cocktails, such as AE1/AE3, both stained with DAB. How I'm going to have our LIS translate the billing for CMS patients is another store. I'm having a similar issue with the changes in prostate biopsy billing for CMS patients. Arrghh! Terri L. Braud, HT(ASCP) Anatomic Pathology Supervisor Holy Redeemer Hospital Laboratory 1648 Huntingdon Pike Meadowbrook, PA 19046 Ph: 215-938-3676 Fax: 215-938-3874 4. 2014 CPT Changes (Susie Hargrove) Message: 4 Date: Wed, 15 Jan 2014 19:02:46 + From: Susie Hargrove shargr...@unitedregional.org Subject: [Histonet] 2014 CPT Changes Hello, I know this subject had been looked at many times. I just want to see if I am correct before I start doing anything different. 1. 88342 , not much change . We can still just bill once per site, per case. This is per single antibody per Specimen. If I have a case with two parts and each part has 3 immuno's ordered I will bill them all 88342, Even if I do it on multiple blocks of the same specimen, I will still charge once. If one of these antibodies is a cocktail, I will bill 88342 for the first and 88343 for subsequent parts of that cocktail, and I can do this per specimen. So the only change I see here is the breakdown of the cocktail charges into 88343. 2. Medicare codes, GO461 is ordered for the first antibody , per specimen site per case, all additional antibodies, including cocktails , if any, are billed GO462. As before only 1 antibody can be billed by site/source. Now just to work out how the billing will flip over once the charges go across. Is anybody doing it differently? Susie Hargrove HT (ASCP) Histology Technical Specialist United Regional Health Care Wichita Falls, Texas 76301 Ph 940-764-3881 Fax-940-764-3129 - CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it was sent. It may contain information that is privileged and/or confidential, and the use or disclosure of such information may also be restricted under applicable federal and state law. If you received this communication in error, please do not distribute any part of it or retain any copies, and delete the original E-Mail. Please notify the sender of any error by E-Mail. Thank you for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Leica TP1020 tissue processor comments?
Hello, Our lab is considering purchasing a new tissue processor. We have an IMS LX-120 benchtop processor and would like another benchtop model, if possible. I'd appreciate any comments you may have regarding the Leica TP1020 processor. Thanks very much! Carla **Please note new phone number** Carla Conway Histology Technician Western Fisheries Research Center, USGS 6505 N.E. 65th Street Seattle, WA 98115-5016 USA Phone: 206-526-2042 Fax: 206-526-6654 E-mail: cmcon...@usgs.gov ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Human bone and soft tissue processing issues
Hello Histonet! I am hoping that someone could shed some light on some issues I am having with some human knee tissues embedded in paraffin. About one year ago, we started having some issues with the established protocol and decided to increase the processing times. Issues we are seeing: Once processed, the stained ligaments (MCL, LCL, ACL, etc) appear to have brittle tissue (sort of wavy looking) toward the middle of the sample in stained sections. The block itself has white brittle areas that flake off. Regarding bone slabs, we find that the junction between the cartilage and bone is where the tissues are the hardest after decal and the color is different in this area. We think that the fixation may be a problem because of penetration. If you have any suggestions for ensuring complete fixation, that would be very helpful! The processor run does not include a fixative station. Soft Tissues and Ligaments: All tissues are trimmed down to about 4mm in thickness and put into Anatech’s Z-fix for 5 days with one change of Z-fix. Washed and put into 70% EtOH. Bone: Slabs are 6-9mm thick (we ideally aim for 7mm) across the tibial plateau and along the medial and lateral femoral condyles – with cartilage and about 1cm of subchondral bone. The slabs are individually fixed with Z-fix for 1 week, with one change of Z-fix and excess bone trimmed after the first 3 days. Then the samples are put into TBD-2 (formic acid decal) for up to 2 weeks depending on the end point, with a change of decal. Once decalcified, the samples are cut into 20mm X 4mm X 7mm pieces and washed and put into 70% EtOH. The processor completes all steps under vacuum. Older Protocol with another processor: 70%, 80%, 2X95%, 3X100%, 3XPropar, 3XParaffin All reagents are 2 hours. Old Protocol with Thermo Scientific Excelsior Processor: 70%, 80%, 2X95%, 3X100%, 3XPropar, 3XParaffin All reagents are 4 hours. Recent Protocol (past year) Thermo Scientific Excelsior Processor: 70% 1hr 85% - 4hrs 95% - 4hrs 2X100% - 4hrs 100% - 5hrs 2XPropar - 4hrs Propar - 5hrs 2XParaffin - 4hrs Paraffin - 5hrs The main questions are: 1) How can we ensure complete fixation? 2) What is causing these brittle/hard areas in our tissues, even for soft tissues? 3) What does over-processing look like in samples? 4) Is our recent protocol okay or does it need adjustments? Thank you in advance for any help or suggestions! Sincerely, Merissa ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Re: Do I have to destabilize MMA?
Thank John very much. I will check out your references. Hope we are not only be able to follow the protocol, but fully understand it. Dorothy Sent from my iPad On Jan 16, 2014, at 1:37 PM, John Kiernan jkier...@uwo.ca wrote: Methacrylate monomers are sold with added hydroquinone to inhibit spontaneous polymerization. The NaOH treatment to remove hydroquinone dates from the earliest years of plastic embedding (Newman et al. 1949 Science 110: 66-68). The NaOH treatment is not necessary, however, because the stabilizing action of hydroquinone can be overcome by simply using a larger amount of the polymerization catalyst. About 2% of either benzoyl peroxide or 1,2-dichlorobenzoyl peroxide will catalyze the polymerization of stabilized methacrylate monomer. See Hayat, MA 1981 Principles and Techniques of Electron Microscopy Vol 1. Baltimore: University Park Press, pp. 167-168. See Baker, JR 1960 Cytological Technique, 4th ed. London: Methuen, pp.77-84 for a thorough but simple explanation of the chemistry of methacrylate embedding. The whole book (which is a classic) is available, free, at http://archive.org. John Kiernan Anatomy Cell Biology University of Western Ontario London, Canada = = = On 16/01/14, Dorothy Hu abt...@gmail.com wrote: Thanks Jack's answer. I though I shouldn't to destabilization step as well. But my boss wants to do it. Is there a chemical theory behind this? Why previous protocol has this step (it must be reason)? And why the step is skipped now? I wish I know before approaching my boss. Additionally, there is a problem always bothering me in plastic sectioning. I often get cortical bone shattering ( crumbly) in the midshaft of long bone. Cortical bone and marrow are operate in the midshaft. I don't know why is that. It's not happen in the two ends of tibia and femur bone. And doesn't happen on ankle bones. Is that because the bone was stored in 70% EtOH too long (~one year)? I think infiltration is good since I did three times, 2 days each infiltration under vacuum condition in 4oC. If I use 40% EtOH to fix and store the bones will help? One more question. What is advantage if I use perkadox 16 to replace BP as catalyst? Do I have to dry MMA//DBP/perkadox 16 mixture through CaCl2? Thanks in advance for your help. Dorothy MGH endocrine histocore On Wed, Jan 15, 2014 at 11:02 PM, abt...@gmail.com wrote: I am new to MMA plastic bone technique. Some one gave me his protocol, in which has NaOH and d-water to wash MMA mixture before drying it in CaCl2. But others told me I don't need to do the destabilization step. Could any expert in this area to tell me if this step is necessary? And why have to do? Sent from my iPad ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
