Re: [Histonet] Blog Post Not lab related

[Caroline Miller via Histonet]

Lester, I do believe this is the second 'non lab related' blog post this
week. As we have spoken about before I do not think histonet is an
appropriate place for your blog posts. I, personally, was totally OK with
you co-posting with other lab related topics. However you are now pushing
it and I respectfully ask that you refrain from sending out your blog posts
to the whole list, let people sign up if they are interested.

The issue is that this is a histology related list, if everyone posted
non-lab stuff here it would soon be chaos!

Respectfully yours,
mills

On Wed, Apr 13, 2016 at 11:38 AM, Lester Raff MD via Histonet <
histonet@lists.utsouthwestern.edu> wrote:

> Just some philosophy towards the end of a long day.
>
>
> http://www.chicagonow.com/downsize-maybe/2016/04/kitten-power-can-get-things-done/
>
>
>
> Just a reminder-I try to limit my blog invitations here. If you enjoy the
> blog, remember to subscribe (no charge, no spam) on the ChicagoNow blog
> site.
>
> Thanks for your readership.
>
> Lester J. Raff, MD MBA
> UroPartners
> Medical Director Of Laboratory
> 2225 Enterprise Dr. Suite 2511
> Westchester, Il 60154
> Tel: 708-486-0076
> Fax: 708-492-0203
>
> ___
> Histonet mailing list
> Histonet@lists.utsouthwestern.edu
> http://lists.utsouthwestern.edu/mailman/listinfo/histonet
>



-- 
Caroline Miller (mills)
Director of Histology
3Scan.com
415 2187297
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[Histonet] Blog Post Not lab related

[Lester Raff MD via Histonet]

Just some philosophy towards the end of a long day.

http://www.chicagonow.com/downsize-maybe/2016/04/kitten-power-can-get-things-done/



Just a reminder-I try to limit my blog invitations here. If you enjoy the blog, 
remember to subscribe (no charge, no spam) on the ChicagoNow blog site.

Thanks for your readership.

Lester J. Raff, MD MBA
UroPartners
Medical Director Of Laboratory
2225 Enterprise Dr. Suite 2511
Westchester, Il 60154
Tel: 708-486-0076
Fax: 708-492-0203

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[Histonet] Frozen tissues

[Fatima Formadi via Histonet]

Hi Everyone,
I am new to the net and this is my first post.  I am a fairly new lab tech
who will soon start working in the histology department of our hospital and
I was wondering if you veterans can give me some heads up.  I will be
working mainly with frozen tissues.
1.  Are the main stains for frozen tissues the following: rapid H, PAS,
and methylene blue?
2. Does anyone have a protocol for collecting and disposing of reagents
(stains, acids, alcohols etc.) that they might share with me?
3. After preparing the slides for the pathologist, is the remaining tissue
always frozen in liquid nitrogen?

Thanks for any input.

Fatima
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Re: [Histonet] GLOMERULI ADEQUACY

[Jeffrey Robinson via Histonet]

Hi Melissa-  when Tim Morken taught me to be an EM tech many moons ago we would 
take a small dissecting microscope to the CT room.  We would have the 
radiologist place the first core on a sterile tongue depressor and then we 
would check it in some saline on a dental wax square under the scope.  The 
viable gloms were quite easy to see.  We could ask for an additional core or 
two right then if we felt it was needed.  We would then place the cores in a 
saline vial and take them back to our lab to split up the cores into the 
appropriate fixatives.  It really was quite valuable to have that interaction 
with the radiologists and to have the ability to ensure that we were obtaining 
adequate samples with the dual goals of giving ourselves enough tissue to 
perform the EM workup as well as avoiding any repeat biopsies due to inadequate 
sampling.

Jeff Robinson, Senior Histotechnologist, EM Tech Emeritus, Sierra Pathology 
Lab, Clovis, CA.

-Original Message-
From: Melissa Likens via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, April 13, 2016 7:22 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] GLOMERULI ADEQUACY

I have a question about how other institutions handle microscopic evaluation of 
glomeruli adequacy in renal specimens?  Specifically, who at you looks at the 
cores to determine if glomeruli are present before submitting specimens for 
further testing?  Do the pathologists look at them? Radiologists performing the 
cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies 
for glomeruli would be appreciated.
Thanks, Melissa
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Re: [Histonet] GLOMERULI ADEQUACY

[Cartun, Richard via Histonet]

We provide on-site assessment of the renal tissue obtained in Ultrasound, both 
at our main hospital and at our Children's hospital across the street.  I 
handle probably 95% of the biopsies; I have two pathology colleagues (MDs) that 
handle the other 5% when I am not here.  Occasionally, a resident or fellow 
(trained by me) will handle a biopsy after-hours.  We place the core(s) on a 
glass slide with a few drops of saline or RPMI and then examine it under a 
microscope using 4x and 10x objectives in Ultrasound.  We tell the 
interventional radiologist/PA or the nephrologist performing the procedure when 
the specimen is adequate.  We usually obtain adequate tissue with 2, 18-gauge 
needle cores in more than 90% of the procedures; sometimes we need to ask for a 
3rd core.  On the other hand, I can make one core work when it's more than 2.0 
cm long if there's cortex at both ends.  However, I don't recommend obtaining 
cores this long.  We have not had to repeat a biopsy over the last 25 years
 .

Richard

Richard W. Cartun, MS, PhD
Director, Histology & The Martin M. Berman, MD Immunopathology & Morphologic 
Proteomics Laboratory
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596
(860) 545-2204 Fax

-Original Message-
From: Melissa Likens via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, April 13, 2016 10:22 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] GLOMERULI ADEQUACY

I have a question about how other institutions handle microscopic evaluation of 
glomeruli adequacy in renal specimens?  Specifically, who at you looks at the 
cores to determine if glomeruli are present before submitting specimens for 
further testing?  Do the pathologists look at them? Radiologists performing the 
cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies 
for glomeruli would be appreciated.
Thanks, Melissa
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Re: [Histonet] GLOMERULI ADEQUACY

[Normington Lacy via Histonet]

We have our histology technicians attend all native and transplant renal biopsy 
procedures.  Our institution has stereo scopes (dissecting scope) located in 
ultrasound, transplant clinic and an additional one on a mobile cart for cases 
that might occur in Pediatric sedation, ICU, or bedside biopsies.  The core 
biopsy is handed to the histology technician who then looks under the scope to 
look for glomeruli.  Some of our clinicians like an approximate glomeruli 
count, although, most just want to know if they have cortical tissue.  In each 
of our reports we place the following comment per CAP regulations regarding 
adequacy (see below).  If a sample is difficult to determine adequacy, we 
always leave it up to the Nephrologist discretion.  We have a lead technician 
in the renal laboratory.  This individual trains all new employees on adequacy 
assessment.  Modern Pathology has an excellent photo of the difference between 
cortex and medullary tissue.  Search google images for dissecting sc
 ope renal biopsy.
 
At the time of sample collection, this sample visibly contains cortical 
tissue and is Satisfactory for Evaluation.
At the time of sample collection, cortical tissue is not identifiable 
and is Unsatisfactory for Evaluation.

Lacy

-Original Message-
From: Melissa Likens via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 9:22 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] GLOMERULI ADEQUACY

I have a question about how other institutions handle microscopic evaluation of 
glomeruli adequacy in renal specimens?  Specifically, who at you looks at the 
cores to determine if glomeruli are present before submitting specimens for 
further testing?  Do the pathologists look at them? Radiologists performing the 
cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies 
for glomeruli would be appreciated.
Thanks, Melissa
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Re: [Histonet] GLOMERULI ADEQUACY

[Morken, Timothy via Histonet]

Melissa, our PA's look at them when received in the grossing lab, and if they 
aren't sure they bring them down the hall to the EM lab and we confirm. Our 
clinicians seem to be pretty good at getting a good bx without examining them 
in radiology so this works for us.


Tim Morken
Pathology Site Manager, Parnassus 
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center




-Original Message-
From: Melissa Likens via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 7:22 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] GLOMERULI ADEQUACY

I have a question about how other institutions handle microscopic evaluation of 
glomeruli adequacy in renal specimens?  Specifically, who at you looks at the 
cores to determine if glomeruli are present before submitting specimens for 
further testing?  Do the pathologists look at them? Radiologists performing the 
cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies 
for glomeruli would be appreciated.
Thanks, Melissa
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Re: [Histonet] Grossing tech qualifications

[Rachel Pinch via Histonet]

I've had trouble understanding that as well.
Can an employee have 24 semester hours of biology and chemistry combined
with an associate's degree in science, and it be sufficient for CLIA?
Does the person have to have an associates in laboratory science?

Rachel

-Original Message-
From: Normington Lacy via Histonet
[mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, April 13, 2016 8:37 AM
To: 'Vickroy, James' ;
histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Grossing tech qualifications

James,
We base all of our high complexity testing on the semester hours as listed
in "c."  If an individual has completed an associate degree in a laboratory
science, they should meet the educational requirements as stated previously.
I would recommend obtaining a transcript from the applicants.  Our
institution then will keep that in their personnel file.  As part of our
policy for non-PA grossing, I have a form that I complete stating I reviewed
the employee's educational requirements.  I have copied and pasted my
document below.  If you are interested in receiving the entire procedure and
attachments, please let me know and I can email them to you directly.

Employee Name:__

A review of this employee’s educational records was completed on
___(date).

This employee has been   □approved □not approved   to perform high
complexity testing based on CLIA requirements as listed in the Federal
Register 493.1489 and 1491.

493.1489 states the following education requirements:

Each individual performing high complexity testing must--
(b) Meet one of the following requirements:
(1) Be a doctor of medicine, doctor of osteopathy, or doctor
of
podiatric medicine licensed to practice medicine, osteopathy, or
podiatry in the State in which the laboratory is located or have
earned a doctoral, master's or bachelor's degree in a chemical, physical,
biological or clinical laboratory science, or medical technology from an
accredited institution; OR
(2)(i) Have earned an associate degree in a laboratory science, or
medical laboratory technology from an accredited institution or?
   (ii) Have education and training equivalent to that specified in
paragraph (b)(2)(i) of this section that includes--
(A) At least 60 semester hours, or equivalent, from an
accredited institution that, at a minimum, include either-
(1) 24 semester hours of medical laboratory
technology courses; or
(2) 24 semester hours of science courses that
include--
(i) Six semester hours of chemistry;
(ii) Six semester hours of biology; and
(iii) Twelve semester hours of chemistry,
biology, or medical laboratory technology in any combination


Full text on Federal Register qualifications can be viewed at:
http://wwwn.cdc.gov/clia/regs/toc.aspx




Review completed by: __ (printed name)

__ (signature)

-Original Message-
From: Vickroy, James via Histonet [mailto:histonet@lists.utsouthwestern.edu]

Sent: Wednesday, April 13, 2016 8:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Grossing tech qualifications


a.   We are experiencing trouble finding another tech that will meet
CLIA high complexity testing standards as well as has histotechnician
training.   Also the qualifications for who can gross is a little vague so I
wanted to see if anyone has any information that would help me.  A summary
of the grossing qualifications are listed below.   In the past we have hired
applicants with bachelor's degrees in biology and then trained them in
histotechnology.   We also went through the 90 day inhouse training for
grossing.   My questions have to do with a clarification regarding those
with an associate's degree. I have an applicant that has an associate's
degree in science with an emphasis on microbiology. My question has to
do with the language  "An earned associate degree in a laboratory science or
medical laboratory technology" .   How can I determine what that exactly
means?   Would a person with an associate's degree in science with an
emphasis in microbiology qualify?  I'm not sure she has the sixty hours
total.

Qualifications of a technician for performing gross descriptions and
preparation for tissue processing under the direct or indirect supervision
of a pathologist include:

b.   An earned associate degree in a laboratory science or medical
laboratory technology,
Obtained from an accredited institution, OR

c.   Education/training equivalent to the above that includes at least
60 semester hours or equivalent from an accredited institution.  This
education must include 24 semester hours of medical laboratory technology
courses, or 24 semester hours of science courses that includes 

[Histonet] GLOMERULI ADEQUACY

[Melissa Likens via Histonet]

I have a question about how other institutions handle microscopic evaluation of 
glomeruli adequacy in renal specimens?  Specifically, who at you looks at the 
cores to determine if glomeruli are present before submitting specimens for 
further testing?  Do the pathologists look at them? Radiologists performing the 
cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies 
for glomeruli would be appreciated.
Thanks, Melissa
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Re: [Histonet] Grossing tech qualifications

[Normington Lacy via Histonet]

Essentially, an associates degree totals 60-80 semester hours depending on the 
program.  As long as 24 of those hours are in science or medical laboratory 
technology, they would qualify.  I think the confusion in "c." comes in when a 
student starts towards a bachelors degree, but then stops the program.  As long 
as they have 60 semester hours with 24 being in science, they too would qualify 
even though they have no degree.  Hope this helps.

Lacy

-Original Message-
From: Rachel Pinch [mailto:supervi...@galahistolab.com] 
Sent: Wednesday, April 13, 2016 9:15 AM
To: Normington Lacy; 'Vickroy, James'; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Grossing tech qualifications

I've had trouble understanding that as well.
Can an employee have 24 semester hours of biology and chemistry combined with 
an associate's degree in science, and it be sufficient for CLIA?
Does the person have to have an associates in laboratory science?

Rachel

-Original Message-
From: Normington Lacy via Histonet
[mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, April 13, 2016 8:37 AM
To: 'Vickroy, James' ; 
histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Grossing tech qualifications

James,
We base all of our high complexity testing on the semester hours as listed in 
"c."  If an individual has completed an associate degree in a laboratory 
science, they should meet the educational requirements as stated previously.
I would recommend obtaining a transcript from the applicants.  Our institution 
then will keep that in their personnel file.  As part of our policy for non-PA 
grossing, I have a form that I complete stating I reviewed the employee's 
educational requirements.  I have copied and pasted my document below.  If you 
are interested in receiving the entire procedure and attachments, please let me 
know and I can email them to you directly.

Employee Name:__

A review of this employee’s educational records was completed on 
___(date).

This employee has been   □approved □not approved   to perform high
complexity testing based on CLIA requirements as listed in the Federal Register 
493.1489 and 1491.

493.1489 states the following education requirements:

Each individual performing high complexity testing must--
(b) Meet one of the following requirements:
(1) Be a doctor of medicine, doctor of osteopathy, or doctor of
podiatric medicine licensed to practice medicine, osteopathy, or
podiatry in the State in which the laboratory is located or have earned 
a doctoral, master's or bachelor's degree in a chemical, physical, biological 
or clinical laboratory science, or medical technology from an accredited 
institution; OR
(2)(i) Have earned an associate degree in a laboratory science, or 
medical laboratory technology from an accredited institution or?
   (ii) Have education and training equivalent to that specified in 
paragraph (b)(2)(i) of this section that includes--
(A) At least 60 semester hours, or equivalent, from an 
accredited institution that, at a minimum, include either-
(1) 24 semester hours of medical laboratory technology 
courses; or
(2) 24 semester hours of science courses that
include--
(i) Six semester hours of chemistry;
(ii) Six semester hours of biology; and
(iii) Twelve semester hours of chemistry, 
biology, or medical laboratory technology in any combination


Full text on Federal Register qualifications can be viewed at:
http://wwwn.cdc.gov/clia/regs/toc.aspx




Review completed by: __ (printed name)

__ (signature)

-Original Message-
From: Vickroy, James via Histonet [mailto:histonet@lists.utsouthwestern.edu]

Sent: Wednesday, April 13, 2016 8:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Grossing tech qualifications


a.   We are experiencing trouble finding another tech that will meet
CLIA high complexity testing standards as well as has histotechnician
training.   Also the qualifications for who can gross is a little vague so I
wanted to see if anyone has any information that would help me.  A summary
of the grossing qualifications are listed below.   In the past we have hired
applicants with bachelor's degrees in biology and then trained them in
histotechnology.   We also went through the 90 day inhouse training for
grossing.   My questions have to do with a clarification regarding those
with an associate's degree. I have an applicant that has an associate's
degree in science with an emphasis on microbiology. My question has to
do with the language  "An earned associate degree in a laboratory science or
medical laboratory technology" .   How can I determine what that exactly
means?   Would 

Re: [Histonet] Grossing tech qualifications

[Normington Lacy via Histonet]

James,
We base all of our high complexity testing on the semester hours as listed in 
"c."  If an individual has completed an associate degree in a laboratory 
science, they should meet the educational requirements as stated previously.  I 
would recommend obtaining a transcript from the applicants.  Our institution 
then will keep that in their personnel file.  As part of our policy for non-PA 
grossing, I have a form that I complete stating I reviewed the employee's 
educational requirements.  I have copied and pasted my document below.  If you 
are interested in receiving the entire procedure and attachments, please let me 
know and I can email them to you directly.

Employee Name:__

A review of this employee’s educational records was completed on 
___(date).

This employee has been   □approved □not approved   to perform high 
complexity testing based on CLIA requirements as listed in the Federal Register 
493.1489 and 1491.

493.1489 states the following education requirements:

Each individual performing high complexity testing must--
(b) Meet one of the following requirements:
(1) Be a doctor of medicine, doctor of osteopathy, or doctor of
podiatric medicine licensed to practice medicine, osteopathy, or
podiatry in the State in which the laboratory is located or have earned 
a doctoral, master's or bachelor's degree in a chemical, physical, biological 
or clinical laboratory science, or medical technology from an accredited 
institution; OR
(2)(i) Have earned an associate degree in a laboratory science, or 
medical laboratory technology from an accredited institution or?
   (ii) Have education and training equivalent to that specified in 
paragraph (b)(2)(i) of this section that includes--
(A) At least 60 semester hours, or equivalent, from an 
accredited institution that, at a minimum, include either-
(1) 24 semester hours of medical laboratory technology 
courses; or
(2) 24 semester hours of science courses that include--
(i) Six semester hours of chemistry;
(ii) Six semester hours of biology; and
(iii) Twelve semester hours of chemistry, 
biology, or medical laboratory technology in any combination


Full text on Federal Register qualifications can be viewed at: 
http://wwwn.cdc.gov/clia/regs/toc.aspx 




Review completed by: __ (printed name)
   
__ (signature)

-Original Message-
From: Vickroy, James via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 8:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Grossing tech qualifications


a.   We are experiencing trouble finding another tech that will meet CLIA 
high complexity testing standards as well as has histotechnician training.   
Also the qualifications for who can gross is a little vague so I wanted to see 
if anyone has any information that would help me.  A summary of the grossing 
qualifications are listed below.   In the past we have hired applicants with 
bachelor's degrees in biology and then trained them in histotechnology.   We 
also went through the 90 day inhouse training for grossing.   My questions have 
to do with a clarification regarding those with an associate's degree. I 
have an applicant that has an associate's degree in science with an emphasis on 
microbiology. My question has to do with the language  "An earned associate 
degree in a laboratory science or medical laboratory technology" .   How can I 
determine what that exactly means?   Would a person with an associate's degree 
in science with an emphasis in microbiology qualify?  I'm 
 not sure she has the sixty hours total.

Qualifications of a technician for performing gross descriptions and 
preparation for tissue processing under the direct or indirect supervision of a 
pathologist include:

b.   An earned associate degree in a laboratory science or medical 
laboratory technology,
Obtained from an accredited institution, OR

c.   Education/training equivalent to the above that includes at least 60 
semester hours or equivalent from an accredited institution.  This education 
must include 24 semester hours of medical laboratory technology courses, or 24 
semester hours of science courses that includes 6 semester hours of chemistry, 
6 semester hours of biology, and 12 semester hours of chemistry, biology or 
medical laboratory technology in any combination. In addition, the individual 
must have laboratory training including either completion of a clinical 
laboratory training program approved or accredited by the ABHES, the CAHEA, or 
other organization approved by HHS (note that this training may be included in 
the 60 semester hours listed above), OR at least 3 months 

[Histonet] Grossing tech qualifications

[Vickroy, James via Histonet]

a.   We are experiencing trouble finding another tech that will meet CLIA 
high complexity testing standards as well as has histotechnician training.   
Also the qualifications for who can gross is a little vague so I wanted to see 
if anyone has any information that would help me.  A summary of the grossing 
qualifications are listed below.   In the past we have hired applicants with 
bachelor's degrees in biology and then trained them in histotechnology.   We 
also went through the 90 day inhouse training for grossing.   My questions have 
to do with a clarification regarding those with an associate's degree. I 
have an applicant that has an associate's degree in science with an emphasis on 
microbiology. My question has to do with the language  "An earned associate 
degree in a laboratory science or medical laboratory technology" .   How can I 
determine what that exactly means?   Would a person with an associate's degree 
in science with an emphasis in microbiology qualify?  I'm 
 not sure she has the sixty hours total.

Qualifications of a technician for performing gross descriptions and 
preparation for tissue processing under the direct or indirect supervision of a 
pathologist include:

b.   An earned associate degree in a laboratory science or medical 
laboratory technology,
Obtained from an accredited institution, OR

c.   Education/training equivalent to the above that includes at least 60 
semester hours or equivalent from an accredited institution.  This education 
must include 24 semester hours of medical laboratory technology courses, or 24 
semester hours of science courses that includes 6 semester hours of chemistry, 
6 semester hours of biology, and 12 semester hours of chemistry, biology or 
medical laboratory technology in any combination. In addition, the individual 
must have laboratory training including either completion of a clinical 
laboratory training program approved or accredited by the ABHES, the CAHEA, or 
other organization approved by HHS (note that this training may be included in 
the 60 semester hours listed above), OR at least 3 months documented laboratory 
training in each specialty in which the individual performs high complexity 
testing.

I would appreciate any understanding that others might have.

Jim



Jim Vickroy
Histology Manager
Springfield Clinic, Main Campus, East Building
1025 South 6th Street
Springfield, Illinois  62703
Office:  217-528-7541, Ext. 15121
Email:  jvick...@springfieldclinic.com



This electronic message contains information from Springfield Clinic, LLP that 
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