Re: [Histonet] Tissue repository

[Curt Tague via Histonet]

Thanks Richard, that’s a concern too, hospitals are certainly going to avoid 
any exposure.

Thanks again!
Curt

Get Outlook for iOS<https://aka.ms/o0ukef>

From: richard cartun 
Sent: Wednesday, July 31, 2024 7:00:26 PM
To: Histonet@lists.utsouthwestern.edu ; Curt 
Tague 
Subject: Re: [Histonet] Tissue repository

Hi Curt,

Does your lab have an in-house legal department?  If so, have you consulted 
with them about this?  The attorneys for the hospital I worked in wanted 
nothing to do with providing patient tissue to outside interests who were 
willing to pay for it.

Richard Cartun

On Wednesday, July 31, 2024 at 05:02:57 PM EDT, Curt Tague via Histonet 
 wrote:


Hi all,

So running a ref lab for years I've acquired a rather large supply of old 
blocks of various tissues, I'm considering turning this into a tissue 
bank/repository with the purpose of selling blocks for research and control 
purposes... anyone have any experience, what are the requirements to be 
compliant??? I have zero experience with this. I'm guessing some release forms, 
maybe patient consent forms (IMPOSSIBLE TO GET THOSE FOR BLOCKS THAT ARE 10 YRS 
OLD)... release of liability forms... I'm starting at zero so any insight is 
appreciated!

Best!

Curt

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[Histonet] Tissue repository

[Curt Tague via Histonet]

Hi all,

So running a ref lab for years I've acquired a rather large supply of old 
blocks of various tissues, I'm considering turning this into a tissue 
bank/repository with the purpose of selling blocks for research and control 
purposes... anyone have any experience, what are the requirements to be 
compliant??? I have zero experience with this. I'm guessing some release forms, 
maybe patient consent forms (IMPOSSIBLE TO GET THOSE FOR BLOCKS THAT ARE 10 YRS 
OLD)... release of liability forms... I'm starting at zero so any insight is 
appreciated!

Best!

Curt

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Re: [Histonet] 100% ethanol in tissue processing

[Curt Tague via Histonet]

My mistake, it’s methanol….

No bueno for tissue?

Curt

Get Outlook for iOS<https://aka.ms/o0ukef>

From: Mac Donald, Jennifer 
Sent: Wednesday, May 29, 2024 3:50:05 PM
To: Curt Tague ; Histonet@lists.utsouthwestern.edu 

Subject: RE: 100% ethanol in tissue processing

Absolutely can be used on the tissue processor or for staining.

-Original Message-
From: Curt Tague via Histonet 
Sent: Wednesday, May 29, 2024 12:16 PM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] 100% ethanol in tissue processing

  EXTERNAL SENDER - Exercise caution with requests, links, and attachments.

Hi all, stupid question (despite what all the college professors said, yes, I 
think there are some stupid questions and this is one of them, I should know)!

Someone dropped off a bunch of pure ethanol, they don't need it, I said I'd 
help dispose it... can't be used for processing can it? I seem to recall 
damaging some tissue many years ago when using ethanol... your thoughts?

Maybe just clean cycles on the processors...

Thanks,

Curt

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[Histonet] 100% ethanol in tissue processing

[Curt Tague via Histonet]

Hi all, stupid question (despite what all the college professors said, yes, I 
think there are some stupid questions and this is one of them, I should know)!

Someone dropped off a bunch of pure ethanol, they don't need it, I said I'd 
help dispose it... can't be used for processing can it? I seem to recall 
damaging some tissue many years ago when using ethanol... your thoughts?

Maybe just clean cycles on the processors...

Thanks,

Curt

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[Histonet] Old blocks for IHC controls

[Curt Tague via Histonet]

Forgive me if this has already been discussed ad nauseum... what are your 
thoughts on using old blocks for IHC control, like normal breast for CK7 or 
AE1/AE3... if we test the tissue and it works is that sufficient or is there 
some added steps and requirements I should be aware of?

We have blocks up to 15 years old, looks like there is a lot of good tissue we 
can use if age isn't an issue.


Best and thanks!

Curt




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[Histonet] distilled water systems

[Curt Tague via Histonet]

Not sure what everyone else is doing but we're buying a TON of DI water for 
bulk IHC reagents... I'm looking at a system to install to produce our own. 
Anyone have any recommendations of a good, cost effective and efficient system?

Thanks!
Curt




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[Histonet] Ventana Special Stain Platform

[Curt Tague via Histonet]

Simple question for you all, is there a market for these machines, I have 2 
that we used for only a few months then shelved, I'd like to find a home for 
them. Before I go through the effort of searching for an aftermarket vendor I 
am really just curious if anyone uses these things?

Thanks,
Curt

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[Histonet] Miami histology on the job training question

[Curt Tague via Histonet]

Hi all, specifically in the Miami area...
I have a friend who is interested in learning more about being a histotech... 
unfortunately I'm across the country and can't help train. Do any of you know 
of a facility who might be looking for a tech and is willing to train, from 
scratch, zero experience?
Hospital, private lab, really anything to get the training and experience.

Thanks,
Curt




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Re: [Histonet] Formalin Neutralizer

[Curt Tague via Histonet]

I use neutralex from Scigen (www.scigenus.com)...

https://www.scigenus.com/product-page/neutralex





-Original Message-
From: Paula via Histonet  
Sent: Tuesday, April 5, 2022 10:56 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Formalin Neutralizer

Hello,

 

Can you recommend the easiest and most cost-effective product to neutralize the 
formalin waste from our tissue processors?

 

Thank you,

Paula Lucas

Bio-Path Medical Group

 

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Re: [Histonet] Flooring

[Curt Tague via Histonet]

We use some of this clear vinyl, like you'd see in a walk in fridge... get the 
wide stuff and cut it out to fit under a cutting station. It completely saves 
the floors and when it's trashed out we can just throw it away, get he floors 
cleaned and put some more down... works great for me.
https://www.marinevinylfabric.com/products/clear-marine-vinyl?variant=39274692935764¤cy=USD&utm_medium=product_sync&utm_source=google&utm_content=sag_organic&utm_campaign=sag_organic&gclid=Cj0KCQiAjJOQBhCkARIsAEKMtO10i6dntCGz7nN7NIKDOxpa2a9Lp3o7EsglXSl9Mh-3TdVmL1pm0ugaAlvhEALw_wcB

https://www.strip-curtains.com/proCat/bulkVinylRolls.php
we use the 48" roll here

I'm sure you can google other vendors too... 


best of luck!
Curt



-Original Message-
From: Normington, Lacy via Histonet  
Sent: Thursday, February 10, 2022 8:51 AM
To: 'histonet@lists.utsouthwestern.edu' 
Subject: [Histonet] Flooring

What does your institution do to mitigate paraffin collection on the floors? Do 
you strip the floors at defined periods of time? Do you use mats throughout 
entire laboratory, under microtomy stations? Currently our institution uses a 
sticky plastic green flooring, which is ripped up every quarter and replaced. 
However, during this time there are many spots which the plastic breaks down 
due to consistent activity over a spot. This requires the flooring to be 
scraped, stripped, etc.

Thanks
Lacy Normington
UW Health
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[Histonet] Peloris 3 question

[Curt Tague via Histonet]

I'm looking at this processor, can someone other than a Leica employee offer 
some feedback? I've heard good things about it but I've also read a little on 
the FDA website about some malfunctions... if anyone has any thoughts I'd 
really love to hear them before I commit to this large purchase...

Thanks in advance!

Curt

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[Histonet] need control tissue help

[Curt Tague via Histonet]

I'm hoping someone might have extra PCP control blocks... I'm pretty close to 
out, down to our last one... I'm happy to barter and even offer a gift card for 
the effort, I know we can't buy/sell tissue, just a gift card to say thank you 
if I may offer...

Best!

Curt

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[Histonet] software question

[Curt Tague via Histonet]

I've used several different popular programs over the years at our reference 
lab but they are all built for much more than we really need. As a reference 
lab, doing large numbers of block histo with specials and IHC, we really don't 
need so much in terms of report and results... we do need that and use it but 
these programs are not build to do what we need and it's frustrating. Does 
anyone have any recommendations for a good out of the box program or web based 
program that would work good for just simple databasing the blocks and stains 
we provide service on? We need to generate labels of course, deliver logs and 
records of blocks received... then monthly totals for billing... any input is 
greatly appreciated.

Best!

Curt

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[Histonet] reprocessing tissue

[Curt Tague via Histonet]

I have a problem... some tissue got processed very poorly, there was water in 
the system somewhere and a few blocks just look burnt.. the nuclei are faint 
and cloudy, no detail at all. I've tried the process of rehydrating with the 
30% formaldehyde, glycerol and sodium acetate solution but they still process 
poorly, come out very brittle and just don't look good under the scope.

Does anyone have a magic bullet to salvage these specimens? I can send a pic 
directly if it helps.

Thanks,
Curt

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[Histonet] Specimen tracking scenario, accountability

[Curt Tague via Histonet]

So we're in a reference lab setting here, it's a little different than the 
hospital environment... I've been in both.

We receive specimens from a variety of different hospitals, physician offices 
and even other labs for histology (TC), we send the slides back. What I'd like 
to do is implement some system for tracking blocks throughout the process but 
with so many different clients and number systems/prefixes, most of which are 
NOT barcoded, it can be a challenge tracking the blocks throughout the whole 
process... from receipt to embedding to microtomy...
Aside from manually documenting every blocks on a paper log sheet, would anyone 
have any suggestions on how to track these things?

My initial thought is a simple digital photo of the basket at embedding (when 
removed from the processor) then another photo of blocks you take to your 
microtome and perhaps one last photo when blocks are taken from your cutting 
station to be filed or returned... the simple issue is tracking who is in 
possession of what blocks at all times... accountability... but this seems to 
present challenges too...

Any thoughts are appreciated.

Curt
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[Histonet] CLIA license expiration

[Curt Tague via Histonet]

Looking for someone who might have experience with this already My CLIA and 
State license are going to expire soon and I've heard nothing from either the 
state or CLIA So I took the liberty of reaching out to them with no luck... 
I then called an inspector I know who suggested the main office might be 
willing or able to submit a letter indicating that things are still good, labs 
are permitted to continue until further notice as this COVID issue has put them 
further behind than they already usually are.
So, my simple question is this, has anyone had to deal with this issue yet and 
if so, how did you get it resolved?

Thanks!

Curt

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[Histonet] too much formalin time

[Curt Tague via Histonet]

Quick drive by question,

We have some tonsil that has been in formalin for about 2 months, to be 
disposed of, is that not recommended for use as control tissue now, too much 
formalin exposure?

Thanks for your input again,

Curt

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[Histonet] New processor and white paper, need pathologists to participate

[Curt Tague via Histonet]

Hello histo-world,

I've helped a company develop a new tissue processor, a rapid technology which 
does NOT utilize microwaves and process fresh, fatty, breast and colon type 
tissue, beautifully, in under 5 hrs. We are ready to put it in the market but 
first want to do some kind of official validation and publish a white paper on 
the process. We are considering pathologist's who might be interested in 
participating in this process and having their names included in the paper. 
Without disclosing any of the proprietary specifics of the technology at this 
point, would any of you know of a pathologist who might be interested in this 
project?

All the best!

Curt

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[Histonet] Tissue needed

[Curt Tague via Histonet]

This might be an unusual request and I think I may have already asked in the 
past too... but here goes...

I'm working with a company who is developing a new tissue processor which 
basically cuts processing time in half. We've run a number of parallel tests to 
demonstrate the results are equal to the traditional methods we've been  using 
forever but now we need some tumors too. We've run the normal H&E, special 
stains and a large number of IHC, what's missing is the molecular tests at this 
point. We have a few tumors but we are looking for more to provide a large 
enough data pool for the entities we present to. With that, I'm hoping someone 
might be able to assist us with tumors, when the tumor is large enough that not 
all is necessary for diagnosis. We have a proprietary fixative that we would 
send to ensure that the tissue is not in formalin for an extended period of 
time.


Also, some of you have experience with stuff like this... our pathologists do 
as well but I'm curious whom some of you would recommend submitting this data 
too when it's complete and if you know a pathologist who might be interested in 
participating in the review of the slides?

Please email me if you are able to help.
c.ta...@pathologyarts.com





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[Histonet] procuring fresh tumor tissue

[Curt Tague via Histonet]

Hello again histonet-ers-

I am working with a company do validate a new rapid (another new) tissue 
processor... we are currently in the process of submitting a proof of concept 
paper to CAP then will submit a formal white paper with  data. What I am 
curious about is locating tumor tissue that can be used to parallel this study, 
obviously one part processed with the standard process we are all accustomed to 
and the other piece processed with this new technology. We are running all the 
necessary tests to show consistency and comparable results, H&E, special 
stains, IHC, DNA and RNA extraction... what I could use a little help with is 
sourcing some tumor that has not been in formalin for weeks and weeks... 
specifically breast tumor and possibly lung tumor to demonstrate all the 
downstream tests are not compromised with this technology.
Is there any source out there someone could recommend and/or, if you are in a 
large hospital setting, is that something you might be able to assist with, 
when a tumor is identified and not entirely needed for diagnostics?

All the best to you all, thanks for your thoughts,

Curt




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[Histonet] hair analysis question

[Curt Tague via Histonet]

This isn't directly related to histology but I know many of you are involved in 
other studies as well so I thought I'd ask.

We're working with some physicians on a hair analysis project, looking at some 
genetics. Does anyone here have any background in hair analysis for more than 
the forensic or drug screening utility? Is there any other test that you are 
familiar with, done from hair, or the pulp, that offers some prognostic or 
diagnostic utility?

Thanks if you do!

Curt



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[Histonet] Pneumocystis IHC RED

[Curt Tague via Histonet]

Anyone out there running this ab with red vs dab? I have a client who used to 
like it but it seems to fall off the face of the earth, wondering if it's back 
on the market anywhere...

Curt

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[Histonet] CC1 vs Ultra CC1

[Curt Tague via Histonet]

I made the mistake of ordering CC1 instead of Ultra CC1 I guess that can't 
be used on the benchmark ultra It's an "ULTRA" thing I guess...

Anyway, anyone out there use regular CC1... want a couple bottles? Brand new, 
unopened...

Curt

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Re: [Histonet] Another Dispenser Failure

[Curt via Histonet]

It's the money they care about...



Sent from my Verizon, Samsung Galaxy smartphone


 Original message 
From: Mark Tarango via Histonet 
Date: 2/28/19 12:46 PM (GMT-08:00)
To: Terri Braud 
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Another Dispenser Failure

I hope everyone is using on-slide controls :-)

On Thu, Feb 28, 2019 at 11:52 AM Terri Braud via Histonet <
histonet@lists.utsouthwestern.edu> wrote:

> Another one!!!
> Our Her2 antibody dispenser failed, LOT #E22628
> This one "supposedly" FDA approved.
> Roche, why do you continue to lie to consumers of your product?  You claim
> you've "fixed" the problem but your Ventana dispensers DON'T WORK!
> This is patient care!  Why don't you care about the customers and patients
> you are supposed to be serving
> Shame on you.
>
> Terri L. Braud, HT(ASCP)
> Anatomic Pathology Supervisor
> Laboratory
> Holy Redeemer Hospital
> 1648 Huntingdon Pike
> Meadowbrook, PA 19046
> ph: 215-938-3689
> fax: 215-938-3874
> Care, Comfort, and Heal
>
> -Original Message-
> From: histonet-requ...@lists.utsouthwestern.edu [mailto:
> histonet-requ...@lists.utsouthwestern.edu]
> Sent: Thursday, February 28, 2019 1:00 PM
> To: histonet@lists.utsouthwestern.edu
> Subject: Histonet Digest, Vol 183, Issue 23
>
>
> Today's Topics:
>1. H&E Staining question (Charles Riley)
>2. Re: H&E Staining question (Jay Lundgren)
>3. FYI- Roche Ventana users (Cassie P. Davis)
> Message: 3
> Date: Thu, 28 Feb 2019 15:23:16 +
> From: "Cassie P. Davis" 
> To: histonet 
> Subject: [Histonet] FYI- Roche Ventana users
> Message-ID: 
> Content-Type: text/plain; charset="iso-8859-1"
>
> Hi Histoland,
> I am biting my tongue HARD and just letting you know so it doesn't
> happend to you. I just got off the phone with Roche here is the heads-up.
> If one of their anitbody dispensers fails DO NOT put the antibody in one
> of their prep kits, as soon as you do they consider it off label use.
> Call customer service immediately and have them overnight a replacement!
> Cassandra Davis
> Histology Technician
> AP Laboratory
> 302-575-8095
> Email:  cda...@che-east.org
>
>
>
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[Histonet] BRCA1 on Benchmark Ultra

[Curt via Histonet]

Anyone getting good results, I'm trying to determine which clone/vendor to 
use... better to ask before I waste a bunch of time and money... any 
suggestions or recommendations?


Curt



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[Histonet] Quality Manager

[Curt via Histonet]

I am looking for a part time person  to come in and evaluate our entire system 
from top to bottom, to get all our policies and procedures compliant if there 
is a deficiency. This position will require more time up front then, once 
systems are in place and everyone is satisfied it will likely require less 
time, perhaps once every other week or even once a month.

The focus is on quality, compliance, training and record keeping.

Please contact me directly.


Thanks,



Curt Tague | President/CEO
PATHOLOGY ARTS | 1159 Pomona Road, Suite E, Corona, CA 92882 | 951.270.0605 
Office
949.246.4402 Cell |http://www.pathologyarts.com/I  
c.ta...@pathologyarts.com<mailto:c.ta...@pathologyarts.com> |



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[Histonet] ASR validation

[Curt via Histonet]

Hello to all again!
Thank you for all your help and advice over the years... now I have 1 more 
question... recommended protocol for validating an ASR antibody? As a private 
lab, I'm assuming we are required to notify all clients that it was validated 
internally and that it is not IVD but rather ASR???

Thanks again!

Curt

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[Histonet] IHC-H&E-IHC HELP...

[Curt via Histonet]

Need help before I turn a mistake into an irreparable mistake...

We have some unstained slides that were supposed to get stained with H&E but my 
guy stained them with IHC. It's complicated, we received slides and a block, 
the block was for IHC, the unstained slides were for H&E, he inverted the 
process)
The point is, now the unstained slides are stained with IHC... I know we cannot 
destain the IHC but we can simply run and H&E over them... the real question I 
have is subsequent to the H&E... this pathologist generally likes to see the 
H&E then order IHC on them based on what he sees (we only have these few 
unstained slides, don't have blocks to recut)...

So the question is... if we've already run IHC, then followed that with and 
H&E, can we return to run IHC on the slides again? would you want to skip any 
pre-treatment, antigen retrieval

I don't see this working too well myself, if they're already stained with DAB, 
that would be present on the second stain...

Thoughts?

Thanks for your help.

Curt

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[Histonet] BRCA-1 on Benchmark Ultra

[Curt via Histonet]

I'm trying to get this marker dialed in with little success... would anyone be 
willing to share their protocol to save me a little time and money?
Biocare antibody... working with CC1 and primary AB times Any help is 
greatly appreciated.



Thanks,

Curt



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[Histonet] HP on Benchmark Ultra

[Curt via Histonet]

Any input is appreciated...
We're running HP with Biocares BC7 clone. The stain works well but maybe too 
well, it seems to stain a variety bacteria as opposed to just the HP rods... 
and sometimes it gets a little "dirty" with some staining in the mucus as 
well... I think the first thing we'll try to do is reduce some retrieval 
times... basically lighten things up but I really want to get other opinions... 
some of our pathologists think it's suboptimal with all the other staining but 
I want to hear what others see, are you all seeing other seemingly nonspecific 
staining too? Maybe it's just a bad control, suboptimal... maybe we can dilute 
it down an little, reduce times...

Really wish I could attach a picture, it's not terrible but not perfect.

Any thoughts?

Thanks,

Curt





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[Histonet] benchmark special stain free sol

[Curt via Histonet]

I have 1 bottle of LCS and 1.5 bottle of depar solution for the benchmark 
special stain platforms, send me a fedex or ups number if you want them.

Curt

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[Histonet] lieca bond stainers available

[Curt via Histonet]

I've got 2 stainers that have been shelved for a couple years, anyone 
interested in them?

Curt



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[Histonet] tissue blocks available for banking

[Curt via Histonet]

If anyone is looking for tissue for a bank, I have a boxes and boxes of derm 
specimens and GI specimens. I know they're probably not what everyone needs but 
if someone out there does need them, you can have them. figured I'd ask before 
I disposed of them... at the landfill next to the city water well... LOL, just 
kidding, I know someone out there will not think that's funny, it's just a joke.


Curt




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[Histonet] Type AB Thymoma

[Curt via Histonet]

Any thoughts on what this might be useful for in terms of controls and/or 
research? I just obtained a large specimen and wonder if there is any real need 
to process and store it...


Thanks,

Curt


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[Histonet] american master tech retic component

[Curt via Histonet]

So I know they won't disclose this information if I call but I'd like to find a 
work around for the little silver vials provided by American master tech. Not 
that there is a problem with the quality of their product, I just want to cut 
my costs a little. Does anyone know what is in that little vial they sell with 
their retic kit, the recipe?

If they see this, I think they'll probably be a little irritated... sorry.

Thanks ,

Curt


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Re: [Histonet] benchmark ultra bulks

[Curt via Histonet]

My service/field technician said the Ultra LCS is required for the IHC, not 
sure why but that’s what I was told.

Curt


From: Allan Wang [mailto:alla...@gmail.com]
Sent: Friday, November 03, 2017 9:21 AM
To: Curt
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] benchmark ultra bulks

The LCS is fairly cheap in comparison to some other bulks and 650-010 is half 
the price of 650-210. I don't know if there's actually any difference between 
them.

I think an alternate formulation for EZ Prep (or Discovery Wash), CC1 and 
especially CC2 would save more money.

Allan

On Fri, Nov 3, 2017 at 12:00 PM, Curt via Histonet 
mailto:histonet@lists.utsouthwestern.edu>> 
wrote:
So like everyone else, I'm always trying to find new ways to save a few 
dollars, technology and costs are always increasing while reimbursements are 
always decreasing...
With that, does anyone have any thoughts on alternative bulks to what Roche 
sells for the benchmark ultra, I'm thinking an alternative to their Ultra 
LCS... any thoughts?
So long as a customer meets their monthly obligation it should be ok...

Is it even possible...

Curt


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[Histonet] benchmark ultra bulks

[Curt via Histonet]

So like everyone else, I'm always trying to find new ways to save a few 
dollars, technology and costs are always increasing while reimbursements are 
always decreasing...
With that, does anyone have any thoughts on alternative bulks to what Roche 
sells for the benchmark ultra, I'm thinking an alternative to their Ultra 
LCS... any thoughts?
So long as a customer meets their monthly obligation it should be ok...

Is it even possible...

Curt


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[Histonet] changing carbon filters

[Curt via Histonet]

How often is everyone changing the carbon filters in their tissue processors 
and stainer, maybe even the thermo-shandon hood filters too?

Curt






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[Histonet] IHC counterstain offline

[Curt via Histonet]

We currently use the benchmark ultra and are, in an effort to save a little 
money, looking at running out counter stain offline. Anyone have any 
suggestions or thoughts they might offer? We currently run our H&E with Richard 
Allen Hematoxylin 7111. I am curious if that is suitable for use in your 
experience or if you recommend a different Hematoxylin for IHC counter stains. 
How much bluing time, etc.



Thanks,

Curt


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[Histonet] BRCA-1 validation

[Curt via Histonet]

Just looking for some recommendations on tissue for validating BRCA-1, IHC... 
before I get to the pathologists... any recommendations. What I'm reading so 
far is ovarian carcinoma (serous) and normal breast, is that what you all have 
used and/or recommend?

Thanks,
Curt




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[Histonet] Nexus stainers

[Curt via Histonet]

Anyone out there using the Nexus and need Trichrome kits? We ordered the wrong 
kits (2) and naturally Ventana will not let us return them...  if you are 
interested, let me know.

Curt


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Re: [Histonet] Ventana Retic problems

[Curt via Histonet]

We have had the same problem our solution was not the second but the wash, 
it for a bad too quickly so we don't make a full carboy and let it sit for a 
week, we make fresh wash almost daily, ESPECIALLY when we have a retic. Our 
stains look great daily with fresh wash solution.
You may try that,  hope it helps.

Curt



Sent from my Verizon, Samsung Galaxy smartphone


 Original message 
From: Jeffrey Robinson via Histonet 
Date: 6/14/17 4:01 PM (GMT-08:00)
To: donna mihalik rossi 
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Ventana Retic problems

Hi Donna-  I have been dealing with these same exact issues for 3 1/2 years now 
so I think I have achieved "expert status" in dealing with this problem.

First, I'll give you my current protocol.  When all things are working 
smoothly, it produces a nice stain.  But it is very frustrating when it starts 
to "fade."

We cut all retics at 5.  Thinner cuts will definitely look lighter.

Protocol:  warmup slide:  47 degrees C.
 Oxidizer:4 minutes
 Decolorizer: 4 minutes
 Sensitizer:  8 minutes
 Optimize Counterstain Intensity:  4 Minutes

I have gone around and around with Ventana on decontamination problems with 
this instrument.  I was performing full decontamination runs every month.  My 
rep finally said to just decon the bulk wash carboy and the wash bottle on the 
instrument when fading begins to show.  Ventana claims there will be a new wash 
out this year that will hopefully take care of the problem once and for all but 
no one at Ventana can give me a release date on that.
In the meantime, this is what I do:

Daily:  run the "Purge Wash" function test 3 times in the morning before 
running any slides.  Be sure to run the "Purge" function and not the "Prime" 
function.
When loading slides, put all of your retic slides on after everything else 
(after the GMS, etc., slides).

When staining starts to fade:  after ruling out "thin cuts" and other obvious 
problems it is time for decon.  The fading will show first on the patient 
tissue (the control may still look OK).
Here is my current decon protocol:  I use the Lysol IC decon solution. I have 
an extra 6 gallon carboy and I leave some made up (diluted) so that it is ready 
to go.  Put some decon solution on a 4X4 guaze and wipe the dispenser tip 
underneath the top (lift lid up for access).  Dump the wash solution in the 
wash bottle on the instrument.  Rinse out with DI water. Fill with decon 
solution.  Swish solution inside bottle.  Replace bottle (on instrument).  Run 
"Purge Wash" function test (3 times).  After Purge #3, let the solution sit in 
the lines for at least 15 minutes (the longer the better).  When you are ready 
to proceed, rinse bulk bottle well several times and replace with DI water.  
Run "Purge Wash" 3 more times.  Time is not a factor here so you can just run 
them one after another.  After the third purge, replace the DI with BM SS wash. 
 Run "Purge Wash" function test 3 more times.  That's it.  I find I need to run 
this procedure about once a month.
Additionally, I decon the 5 gallon bulk wash carboy EVERY TIME I make up a new 
batch.  It doesn't take long (I just let the decon solution sit for 15 minutes) 
and then when I do need to do the modified decon on the instrument I do not 
need to worry about the bulk carboy.

I hope this helps- it takes a little time but it does seems to help with the 
retic stain intensity.

Jeff Robinson, Senior Histotechnologist (HT, HTL), Sierra Pathology Lab, 
Clovis, CA.

-Original Message-
From: donna mihalik rossi via Histonet 
[mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, June 14, 2017 1:45 PM
To: histonet
Subject: [Histonet] Ventana Retic problems

Hi Histonetters!  We are experiencing sporadic staining of retic fibers from 
our Ventana Benchmark machines.  We have 2 machines and are having the same 
problem on both. The machines were both decontaminated 2 weeks ago with all new 
solutions  being made.  The fibers are not crisp and are disconnected.  Our 
control tissue is  at the top of the slide with the patient tissue at the 
bottom. It appears that the control is staining better than the patient tissue 
but still is  not crisp. We have tried different lots with the same result. Any 
comments before we consult Ventana? Your help would be appreciated.  Thanks, 
Donna  Rossi, PSU


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Re: [Histonet] Personel

[Curt via Histonet]

That is very helpful. The test is the rendering of an interpretation or 
diagnosis, not the mere operation of the machinery, correct?

Curt


-Original Message-
From: Morken, Timothy [mailto:timothy.mor...@ucsf.edu] 
Sent: Tuesday, November 22, 2016 11:41 AM
To: Curt; Jesus Ellin
Cc: histonet@lists.utsouthwestern.edu
Subject: RE: Personel

Curt, 

Yes, but that is the test, not the personnel, and specifically applies to the 
interpretation of the test, not the running of the machine. In AP the "testing 
personnel" is the pathologist, not the tech running the machine. Only the 
pathologist interprets the stains and reports a result. They also have final 
signoff on any QC. I have never seen an explicit explanation from CAP about how 
the CLIA regs fit with histology. CLIA was written for the clinical lab where 
the MT's report results directly. CLIA considers all histology personnel as 
"Processing Personnel" not testing personnel. CAP has taken it up a notch, 
which they are allowed to do, but they have not provided any explicit guidance 
as to how it applies in histology. For instance, why is IHC  high complexity 
but special stains are not? They are similar in complexity of processing. 

I give workshops on competency testing in histology. This question is the 
number one question. Where does high complexity apply? All I want is for CAP to 
produce a document explaining their rational so people don't have to call them 
to get answers, or, god forbid, depend on a CAP inspector for the answer, most 
of which are contradictory from one inspector to another.

Tim



-----Original Message-
From: Curt [mailto:c.ta...@pathologyarts.com] 
Sent: Tuesday, November 22, 2016 10:43 AM
To: Morken, Timothy; Jesus Ellin
Cc: histonet@lists.utsouthwestern.edu
Subject: RE: Personel

I recently had this same discussion with Jesus, please follow this link he gave 
me: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCLIA/Search.cfm

At the top, enter "Test System / Manufacturer" for example, we enter Ventana, 
it will list all tests that qualify as High Complexity. There are 4-5 different 
tab/pages... even operating something as basic as a DAB detection kit appears 
to qualify as High Complexity...if you enter Leica, then you get much less but 
the detection kit is listed as High Complexity still so it would serve to 
reason that someone not qualified for high complexity testing cannot even load 
slides... maybe they can if a qualified person is the one prepping the machine, 
loading detection kits and AB's???

High Complexity testing personnel requirements per CAP: 

1. MD or DO with a current medical license¹; OR 2. Doctoral degree in clinical 
laboratory science, chemical, physical or biological science; OR 3. Master's 
degree in medical technology, clinical laboratory, chemical, physical, or 
biological science; OR 4. Bachelor's degree in medical technology, clinical 
laboratory, chemical, physical or biological; OR 5. Associate degree in 
chemical, physical or biological science or medical laboratory or equivalent 
education and training (refer to 42CFR493.1489(b) for details on required 
courses and training); OR 6. Individuals performing high complexity testing on 
or before April 24, 1995 with a high school diploma or equivalent with 
documented training may continue to perform testing only on those tests for 
which training was documented prior to September 1, 1997 (refer to CLIA 
regulation 42CFR493.1489(b) for details on required training)

Curt

-Original Message-
From: Morken, Timothy via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, November 22, 2016 10:17 AM
To: Jesus Ellin
Cc: Histonet
Subject: Re: [Histonet] Personel

Jesus, that is very interesting information. 

Does anyone know of any CAP accreditation documents that state explicitly  that 
IHC slide staining is high complexity? I have not seen any. If anyone has those 
documents I'd like to see them. The only reference from CAP about that 
classification I have seen was in a Q&A session transcript from a CAP webinar 
on competency testing. The webinar had no information about IHC and complexity. 
However, a presenter answering a question about whether IHC staining at the 
bench is a high complexity "test," did state that IHC staining is high 
complexity so the techs doing the staining must have competency testing. Very 
strange!

That's not to say I don't think IHC is high complexity - I do, and so is every 
other test in histology. But under CLIA the testing personnel is the 
pathologist, not the bench tech. CAP can deem IHC bench testing as high 
complexity if it wishes (CLIA is a baseline and deemed accrediting agencies, 
and institutions, can have stricter requirements). But it seems the only way 
anyone can find out if CAP classifies IHC as high complexity is to call them 
and ask.

Your comment about new technology i

Re: [Histonet] Personel

[Curt via Histonet]

I recently had this same discussion with Jesus, please follow this link he gave 
me: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCLIA/Search.cfm

At the top, enter "Test System / Manufacturer" for example, we enter Ventana, 
it will list all tests that qualify as High Complexity. There are 4-5 different 
tab/pages... even operating something as basic as a DAB detection kit appears 
to qualify as High Complexity...if you enter Leica, then you get much less but 
the detection kit is listed as High Complexity still so it would serve to 
reason that someone not qualified for high complexity testing cannot even load 
slides... maybe they can if a qualified person is the one prepping the machine, 
loading detection kits and AB's???

High Complexity testing personnel requirements per CAP: 

1. MD or DO with a current medical license¹; OR
2. Doctoral degree in clinical laboratory science, chemical, physical or 
biological science; OR
3. Master's degree in medical technology, clinical laboratory, chemical, 
physical, or biological science; OR
4. Bachelor's degree in medical technology, clinical laboratory, chemical, 
physical or biological; OR
5. Associate degree in chemical, physical or biological science or medical 
laboratory or equivalent education and training (refer to 42CFR493.1489(b) for 
details on required courses and training); OR
6. Individuals performing high complexity testing on or before April 24, 1995 
with a high school diploma or equivalent with documented training may continue 
to perform testing only on those tests for which training was documented prior 
to September 1, 1997 (refer to CLIA regulation 42CFR493.1489(b) for details on 
required training)

Curt

-Original Message-
From: Morken, Timothy via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, November 22, 2016 10:17 AM
To: Jesus Ellin
Cc: Histonet
Subject: Re: [Histonet] Personel

Jesus, that is very interesting information. 

Does anyone know of any CAP accreditation documents that state explicitly  that 
IHC slide staining is high complexity? I have not seen any. If anyone has those 
documents I'd like to see them. The only reference from CAP about that 
classification I have seen was in a Q&A session transcript from a CAP webinar 
on competency testing. The webinar had no information about IHC and complexity. 
However, a presenter answering a question about whether IHC staining at the 
bench is a high complexity "test," did state that IHC staining is high 
complexity so the techs doing the staining must have competency testing. Very 
strange!

That's not to say I don't think IHC is high complexity - I do, and so is every 
other test in histology. But under CLIA the testing personnel is the 
pathologist, not the bench tech. CAP can deem IHC bench testing as high 
complexity if it wishes (CLIA is a baseline and deemed accrediting agencies, 
and institutions, can have stricter requirements). But it seems the only way 
anyone can find out if CAP classifies IHC as high complexity is to call them 
and ask.

Your comment about new technology is interesting. In a modern scenario, which 
tech is the person who is "staining" the slide? And which of these is the "high 
complexity" part of the process?
1) person collating slides to stain
2) Person who programs the stainer
3) Person who dilutes the antibodies (still done!)
4) person who loads reagents on the stainer
5) person who loads the slides on the stainer
6) person who starts the stainer
7) person who unloads the slides from the stainer
8) person who labels and distributes the slides.
9) Person who checks QC slides (BTW, not a "test,").

In our lab these tasks are traded off by many different people throughout the 
day 

How about the person doing the validation of the stain? They are not doing a 
"test" but they are making the test possible to do.

Just some questions to ponder over the holidays!



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



-Original Message-
From: Jesus Ellin via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, November 22, 2016 9:36 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Personel

So I know I am going to open Pandoras box,, but have people been paying 
attention to the Personal requirements from CAP.

I called the CAP and asked them about the criteria concerning Moderate or High 
complexity testing, after discussing with them the situations,   IF you have a 
tech that is Licensed and Also has a QIHC, but does not minimum requirement 
Defined by CLIA in education ,, they CAN NOT do any QA/OC of IHC and antibody 
work up,, as IHC is defined as High complexity testing.

I also asked about the test systems.  The grandfather clause is only good for 
test systems that occurr

Re: [Histonet] Ventana Ultra vs. Leica Bond Max

[Curt via Histonet]

Hello,
We had Leica Bond Max instruments (2 Bonds) for about 5 years and made the move 
over the Ventana Ultras (3 Ultras) a couple years ago. We made the move 
initially for the speed and menu benefits versus the Leica, (Ultra is about 2x 
faster) but also saw a quality improvement once we tweaked the protocols a bit. 
 I don't know about the difference between the XT and the Ultra because we 
never had the XT, but from the Leica to the Ultra the biggest improvement was 
speed.

We also saw dirty H. Pylori staining at first with both Leica and Ventana but 
have cleaned it up dramatically with some processing and fixation changes.  I 
don't know if the instrument has much to do with the staining quality as the 
changes in our process because the staining was improved using the same Ultra 
instrument.  If you like I would be willing stain your tissue on our 
instruments to see if you do in fact have a bad instrument??? I can also share 
with you our protocols to see if that helps your staining issues. 
 
Thanks,
 
Curt

-Original Message-
From: Gareth Davis via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, September 08, 2016 12:10 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Ventana Ultra vs. Leica Bond Max

I was interested in anyone's opinion on the new Ventana Benchmark Ultra and 
Leica's Bond Max.  I currently use the Ventana Benchmark XT.  Ventana wants us 
to upgrade to the Ultra.  Because our contract will be up in a year, my manager 
and lab owners want me to check out other options.  Hoping to get a better deal 
and a better instrument.  The Benchmark XT slide heaters keep going out and the 
H. pylori is awful, Ventana swears it's the instruments fault.
Thanks,

--
Ms. Gareth B. Davis, HT, QIHC (ASCPcm)
Yuma Gastroenterology
Yuma, AZ 85364
928-248-5259
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[Histonet] automated special stains and control tissue

[Curt via Histonet]

Re: automated special stainers, are you all running the patient tissue with a 
control on it, like IHC? we're wrestling with the idea of a control on each 
slide or a batch control... the pathologist wants a batch control, thinks the 
control may contaminate the patient tissue (PASF for example). My argument is 
that this process is different in that each slide is stained independently and 
should be treated as a separate stain, not like the old days running a bunch of 
slides in a Coplin jar... if there's a mechanical error and some reagent is 
dropped on a slide but the error didn't  occur on the control slide then the 
control would still stain properly but the patient tissue would be negative... 
we will never know if there isn't a control. I  think they should be treated 
like IHC...

Anyone else have this issue?
Thoughts?

Curt

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[Histonet] unsubscribe

[Curt via Histonet]

Thanks,



CURT TAGUE | President/CEO
PATHOLOGY ARTS | 1159 Pomona Road, Suite E, Corona, CA 92882 | 951.270.0605 
Office
949.616.9911 Cell |http://www.pathologyarts.com/I  
c.ta...@pathologyarts.com<mailto:c.ta...@pathologyarts.com> |


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[Histonet] embedding and microtomy "medical waste"

[Curt via Histonet]

So here's a good one for you all... we had the county health department come 
through the lab and ding us on medical waste... specifically the plastic 
disposable lids at embedding, the lens paper used for wrapping specimens such 
as ECC and EMB. Then they got us on the Kim Wipes used to clean the water bath 
at microtomy... those papers have human tissue on them so they need to be 
treated as medical waste... NOW we have to have red cans next to all microtomes 
and embedding stations. The obvious issue outside of cost and logic is that 
these medical waste cans all seem to have self closing lids which really 
interferes with the rhythm and pace of work when one needs to reach over with a 
food to open the lid after every block is embedded and when they water bath is 
cleaned after every block...

Simple question(s): 1)does anyone else have to do such things to contain the 
waste, 2) does anyone know of a source for medical waste cans that do not have 
these frustrating self closing lids... if we could simple remove the lid and 
replace it when done then we could deal with it, the cost is one thing but 
slowing down work flow is a problem.

And just for a little more humor, they actually wanted me to contain and 
dispose of the water runoff from our two automated slide stainers, we run about 
2200 slides a night... that would be many gallons of waste water every night 
and would not be within the budget We in turn ran a fish kill test which 
demonstrated that the water runoff which contain little Hematoxylin, bluing and 
clarifier do not pose any significant threat to the environment, not even in 
California

Bottom line to all this, I need some red trash cans with removable lids, if 
they're still out there somewhere Anywhere.


Thanks for your input,

Curt

Ps, I didn't proff read thie smail... if something is not spelt correctly, 
don't hold it against me

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[Histonet] hello histonetters, looking for a little control tissue help

[Curt via Histonet]

We are looking for some control tissue that we're having trouble finding. Would 
like to see if anyone is interested or able to barter some tissue...

Now this is going to be the fun part... they're all the hard ones to find..

AML
EBV
Hairy Cell Leukemia
Mantle Cell Lymphoma
Mesothelioma
Thymus

It's never easy asking for help, inconveniencing other people, hate to ask but 
we just can't find any from our local sources.

Best regards and thanks for any help,

Curt

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RE: [Histonet] Thrombomodulin positive controls

[Curt]

We have plenty, we just use placenta, I can send you a block or two if still 
needed. What's everyone else using?

Curt




-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of S hay
Sent: Tuesday, March 18, 2014 11:32 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Thrombomodulin positive controls

Hi histoland.anyone have any tissue control blocks positive for 
thrombomodulin that u can part with. We would appreciate it tremendously.

Susan
Memorial Hospital
Belleville.  Illinois.
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[Histonet] anyone need a glass cover slipper

[Curt]

We have on old Hacker glass cover slipper, I think it's  a Hacker The name 
plate on the front says Meisei but I'm told it's a Hacker. Anyway, the model 
number: RCM-3660 if that's helpful.

I'm not looking to make a bunch of money, so many people here have been helpful 
over the years from knowledge and advice to helping me out with control tissue.

If someone needs one, I'd be willing to help out a bit, just need to cover the 
expense of shipping and packing.

Let me know, I can snap a picture if desired. We recently had is serviced and 
it's said to be working fine by the technician.


Curt

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RE: [Histonet] Processing:

[Curt]

This gets me back to another recent topic, soaking the blocks.

I've seen this a little in the past, just soak them on an ice block,tray for a 
couple minutes and you'll be fine. To me, another indicator would be that if 
you're getting dry tissue when changed but not later could there be some kind 
of variation in results??? How often do you change the processors, all the 
tissue A complete change every other day would probably get you consistent 
results, at least, even if they are a little dry. 

Just my experience.

Curt


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jb
Sent: Monday, January 13, 2014 8:46 AM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] Processing:

I have one tech telling me that when the entire processor is changed the tissue 
is too dry. We run a lot of fatty tissues, breast, etc on this processor. (Our 
biopsies are run on a separate processor). Is this correct, or should we only 
rotate reagents?  No other techs complain. I have a hard time believing this, 
my experience is the opposite. Any input is appreciated.



Sent from my iPhone
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RE: [Histonet] The Biopsy Chip for high throughput pathology in prostate cancer (and other organs, the list is open..)

[Curt]

Interesting, are you having much success convincing the clinician to take the 
time to us the device? Looks like they might be required to be extremely 
careful as opposed to just shooting a core into a specimen jar. Also, how about 
specimen identy/location, are the rows numbered or something along those lines. 
Something unique about each row to differentiate one from the other?

Curt


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sorin Musat
Sent: Tuesday, January 07, 2014 10:38 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] The Biopsy Chip for high throughput pathology in prostate 
cancer (and other organs, the list is open..)

Dear Histoneters,


I am a new subscriber to Histonet,
albeit I've been following this great website for at least 10 years.


I would like to post some information about a new medical device I invented and 
patented (the Biopsy Chip).
This device was intended for increasing the efficiency of processing and 
sectioning prostate biopsies, but can be used for other organs that require 
multiple biopsies (breast, thyroid, skin, etc.,) as well as for friable tissues 
(bone marrow).


For a quick preview, I uploaded on
youtube a little movie clip we presented at The Romanian Annual Congress of 
Urology in 2011 (summarizing the results of our first pilot study):

"High Throughput Biopsy Chip for the detection of Prostate Cancer":

http://www.youtube.com/watch?v=zP1iiE3CEn0



After we patented and registered
the medical device under the authority of the Romanian Ministry of Health, this 
technique was employed for over 2000 patients so far in a number of Romanian 
hospitals. We had very good results (significant economies in time and 
consumables + higher yield of tissue on the slides + more tissue left within 
the block + increased accuracy of the diagnostic). We already presented a 
couple of abstracts at 3 Urology conferences and we will publish very soon a 
full-length paper discussing our results.

We believe that the Biopsy Chip is the first application of tissue microarrays 
in clinical diagnostic. Presently we are trying to find collaborators in order 
to test the Biopsy Chip for other organs/pathologies besides prostate cancer.

We welcome any comments and suggestions. If anyone wants more information about 
this device I will be very happy to answer your questions. If appropriate, I 
could also upload a presentation on Histonet server.

Sincerely

Sorin Musat, MD, PhD
THEMIS Pathology (formerly HistoBest Inc, Edmonton, AB, Canada) Bucharest, 
Romania
mobile: (4)0768 735 194 / 0725 653 551
email: s_mu...@yahoo.com
skype: sorin.musat2
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[Histonet] RE: slide labeling

[Curt]

To add clarity, there is a 2D barcode on the block, we scan at microtomy and 
then label the slide. The system is really idiot proof "ASSUMING" the techs cut 
and label one block at a time, which we strictly enforce. The error here 
occurred when writing the number on the slide, I think he looked at the wrong 
block here, so in effect he did label a number of slides at the same time but 
the slide label was already affixed to the slide. I guess the rule should be to 
write the number as it's seen on the slide.

Curt


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Curt
Sent: Tuesday, January 07, 2014 10:33 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] slide labeling

So we have a facility we do some work for that requires both the hand written 
number and the slide label be viewable, so we place the slide label a little 
lower and write the number on the top of the frosted end. Does CAP recognize 
both numbers as a legal record? The reason I ask is because there was a case 
that the hand written number was wrong but the slide label was correct. That 
being said, there's still a QA issue with the slide not being accurately 
labeled. Slides are labeled at microtomy too, the hand written number and the 
slide label. I contend internally that the slide WAS accurately labeled because 
the sticker number and block number correspond accurately, the discrepancy was 
in the hand written number.

Thoughts? Does CAP have any guidance on this?

Thanks,

Curt

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[Histonet] slide labeling

[Curt]

So we have a facility we do some work for that requires both the hand written 
number and the slide label be viewable, so we place the slide label a little 
lower and write the number on the top of the frosted end. Does CAP recognize 
both numbers as a legal record? The reason I ask is because there was a case 
that the hand written number was wrong but the slide label was correct. That 
being said, there's still a QA issue with the slide not being accurately 
labeled. Slides are labeled at microtomy too, the hand written number and the 
slide label. I contend internally that the slide WAS accurately labeled because 
the sticker number and block number correspond accurately, the discrepancy was 
in the hand written number.

Thoughts? Does CAP have any guidance on this?

Thanks,

Curt

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[Histonet] anyone able to help with some PCP control tissue

[Curt]

I'm about out and don't have any sources (hospitals) that either have any or 
are willing to release it. Will gladly offer anything I have in return if 
there's something you might be short on. Can also provide our fed-ex number for 
shipping.

Thanks for any help offered.

Curt

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RE: [Histonet] Blade Rationing Follow-up

[Curt]

I'd send an email to both of them, show's them that you're being proactive and 
taking the initiative to look out for patient care AND the best interests of 
the lab/hosp. Include the lab director to get credit for your high level of 
care, so the manager doesn't take all the credit. This is how you move up the 
food chain, prove you're more valuable then what they're currently using you 
for.

Curt


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa
Sent: Tuesday, June 18, 2013 12:38 PM
To: Teresa Moore; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Blade Rationing Follow-up

I understand your point about telling your manager where to cut costs, but that 
is YOUR MANAGER'S job for which s/he is for sure better paid than you are.
Let s/he figure that out! 
Just warn your manager about the loss of quality with a measure like the one 
you have been asked to comply with.
You are better off if you discuss this issue with the lab director.
René J.

From: Teresa Moore 
To: histonet@lists.utsouthwestern.edu 
Sent: Tuesday, June 18, 2013 2:22 PM
Subject: [Histonet] Blade Rationing Follow-up


I really appreciate everyone's constructive comments regarding my post on
blade rationing.  Lots of you said there are many other ways to cut costs
in the lab.  I would like to hear some of your suggestions so I can take
them back to my manager.  I'd like to give her some legitimate alternatives
to her proposal. Would like to contribute to solving the problem of cutting
costs.

Thanks again



Teresa Moore, HT
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RE: [Histonet] Blade Rationing Follow-up

[Curt]

Had a thought change in the middle of a sentence, forgive the grammatical 
error, we're 



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Curt
Sent: Tuesday, June 18, 2013 12:36 PM
To: Teresa Moore; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Blade Rationing Follow-up

You could suggest that she switch to part-time... :) 
 
That's probably not a good idea. How about recycling your alcohol and 
Xylene/Xylene substitute? Are you already doing that? 

I'm not sure what others are looking at as far as cost to process per block but 
we recycle all 100% and Xylene, change the processors 2x/wk and have a cost of 
about $0.11 per block. I think we're the biggest hit is the paraffin, about 1 
cs/wk. formalin is cheap, Xylene is all recycled and alcohol is all recycled 
but a couple gallons of the 100% which are obviously run virgin reagents. I've 
found significant savings. 

I'm curious if others are managing their costs at this level too, if so, what 
are your numbers looking like?

Curt Tague,
CEO, Pathology Arts



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Teresa Moore
Sent: Tuesday, June 18, 2013 11:23 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Blade Rationing Follow-up

I really appreciate everyone's constructive comments regarding my post on blade 
rationing.  Lots of you said there are many other ways to cut costs in the lab. 
 I would like to hear some of your suggestions so I can take them back to my 
manager.  I'd like to give her some legitimate alternatives to her proposal. 
Would like to contribute to solving the problem of cutting costs.

Thanks again



Teresa Moore, HT
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RE: [Histonet] Blade Rationing Follow-up

[Curt]

You could suggest that she switch to part-time... :) 
 
That's probably not a good idea. How about recycling your alcohol and 
Xylene/Xylene substitute? Are you already doing that? 

I'm not sure what others are looking at as far as cost to process per block but 
we recycle all 100% and Xylene, change the processors 2x/wk and have a cost of 
about $0.11 per block. I think we're the biggest hit is the paraffin, about 1 
cs/wk. formalin is cheap, Xylene is all recycled and alcohol is all recycled 
but a couple gallons of the 100% which are obviously run virgin reagents. I've 
found significant savings. 

I'm curious if others are managing their costs at this level too, if so, what 
are your numbers looking like?

Curt Tague,
CEO, Pathology Arts



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Teresa Moore
Sent: Tuesday, June 18, 2013 11:23 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Blade Rationing Follow-up

I really appreciate everyone's constructive comments regarding my post on blade 
rationing.  Lots of you said there are many other ways to cut costs in the lab. 
 I would like to hear some of your suggestions so I can take them back to my 
manager.  I'd like to give her some legitimate alternatives to her proposal. 
Would like to contribute to solving the problem of cutting costs.

Thanks again



Teresa Moore, HT
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RE: [Histonet] Blade Rationing

[Curt]

That's penny pinching right there. I'd say fine, you tell me when to change 
blades and then put through the crap slides they get. Just avoid the calculi 
and staples at all costs... sometimes these number crunchers don't think.

Curt


-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Teresa Moore
Sent: Monday, June 17, 2013 2:11 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Blade Rationing

I work in a hospital, there are three of us on this particular shift and we cut 
approx. 200 blocks, give or take a few.  Our histo lab manager is telling us we 
should only be using one pack of blades (50 per pack) a month.  I'm wondering 
what other techs think of this especially lab managers and supervisors.

tmoor...@gmail.com
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[Histonet] looking for an IHC tech

[Curt]

We're a southern CA lab looking for someone to help grow our IHC dept. as well 
as contribute with some routine bench work. I'm not going to go into great 
detail here, please contact if you're interested in exploring the opportunity.

PLEASE NO HEAD HUNTERS OR JOB PLACEMENT AGENTS.


Curt
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[Histonet] IHC verification forms

[Curt Tague]

Please help me understand, do we need to verify antibodies or validate them,
or is it essentially the same thing? Also, can I please get a couple
examples of the forms you might be using, perhaps email me a copy???

I'm still new to the IHC world and trying to get things inline as they need
to be.

 

Thanks,

curt

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RE: [Histonet] Fite control block

[Curt Tague]

They're hard to come by but I'm sure there is a few helpful and kind people
out here that will help you out. I've helped a few people out with other
stuff in the past and people have helped me. It's like we're all one big
happy family helping each other when in need.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Artim,
Kimberly
Sent: Monday, June 06, 2011 12:31 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Fite control block

Does anyone know where I can get a Fite control block?

Kimberly Artim, AST, HT (ASCP)
Technical Coordinator, Anatomic Pathology
St Lukes Hospital & Health Network
801 Ostrum Street
Bethlehem, PA 18015
610-954-4832


Confidentiality Notice: This e-mail message, including any attachments, is
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RE: [Histonet] MSDS info

[Curt Tague]

Call the vendors or check their websites.



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Dianne E.
Holmes
Sent: Friday, May 27, 2011 9:48 AM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] MSDS info

HELP !!!
I am having to list all my chemicals in the lab for the Safety dept.
Several have no MSDS sheet with them?  (been here longer than I have!)
Where can I obtain this info to put in my records?


Individuals who have received this information in error or are not
authorized to receive it must promptly return or dispose of the information
and notify the sender. Those individuals are hereby notified that they are
strictly prohibited from reviewing, forwarding, printing, copying,
distributing or using this information in any way.

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RE: [Histonet] NV HT Position

[Curt Tague]

Am I the only one who hates seeing posts about POL's. HOW ARE THESE NOT
STARK LAW VIOLATIONS? It's self referral, period! As a private lab owner,
I'd love to be able to take a few dr. partners, but n, that's self
referral and against the law. It's all bull, just matters who's contributing
more to the campaign funds!

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Hale,
Meredith
Sent: Thursday, May 26, 2011 8:53 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] NV HT Position 

Great opportunity for a Histotechnician in a brand new laboratory! We
are a 5 physician gastroenterology practice located in Las Vegas, NV
looking for a certified HT or HTL.  Candidate must meet CLIA grossing
requirements.  The candidate will be responsible for routine histology
duties.  This is a part-time position that offers a competitive salary
and flexible hours. Interested applicants should contact Meredith Hale,
phone (214)596-2219 or e-mail mh...@carisls.com

 

 

Meredith Hale HT (ASCP) CM

Operations Liaison Director and Education Coordinator 

 

Caris Life Sciences

6655 North MacArthur Blvd, Irving Texas 75039

direct: 214-596-2219

cell: 469-648-8253

fax: 214-596-7095

mh...@carisls.com   

 

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[Histonet] pathology software

[Curt Tague]

We are considering a change in software LIS. We are a typical small private
path lab, currently path and cyto only but are looking at adding clinical in
the future. Need to have the EMR update capability, I think it's an HL7
interface, to transfer results electronically and upload directly to a
clients EMR. 

What are you all using in your labs? I can't go with some of the big guys
like Cerner, though it is nice and top of the line, it's a little out of my
budget. I need to have the ability to have several different label formats,
some of our hospital clients like labels with little info, some like more
info. So I want to be able to modify a slide label based on each clients
desire and then save it to the database as specific for that dr.

Anyone out there have a product that you're just over the top impressed
with, produce and customer service combined?

 

Thanks, 

Curt 

 

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RE: [Histonet] Recycled Xylene

[Curt Tague]

We recycle it and have had no problems with processing, no complaints from
the docs.

Curt 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Marshall,
Kimberly K
Sent: Wednesday, May 25, 2011 6:21 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Recycled Xylene

Hello in Histo land.
 
  I know it is a subject brought up over and over again but I need to
get the opinion of my fellow Histo techs on processing tissue with
recycled Xylene.  Yes I know it saves money and is better for the earth,
but is the quality of the tissue the same??? Coverslipping and clearing
slides with it I can see being ok, but processing with it??? It is not
100% after recycling.  I could use any thought on the subject.  
 
Thanks in advance
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RE: [Histonet] IHC pos. & neg. control question

[Curt Tague]

"If an inspector saw that,  you would be on immediate suspension."

 

This was the last statement from the original post, I chose not to include
it initially but it's just too juicy to keep from everyone else. Having
forwarded several of the responses I think he has come to understand that
it's not necessarily a requirement that will have us on immediate suspension
but rather a preference that, being a private lab, I will gladly provide to
keep the business.

 

Thanks again everyone and have a good weekend.

 

Curt 

 

 

From: Jay Lundgren [mailto:jaylundg...@gmail.com] 
Sent: Friday, May 20, 2011 11:57 AM
To: Curt Tague
Cc: Ingles Claire; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] IHC pos. & neg. control question

 

Curt,

 

 Thank you.  I'm here all week, try the veal.

 

  Sincerely,

 

   Jay A. Lundgren, M.S., HTL (ASCP)




























 

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RE: [Histonet] IHC pos. & neg. control question

[Curt Tague]

All very insightful input. I took the liberty of forwarding some of the
comments to the client, I think I errantly sent some of the critical
comments about him too. I'll probably hear about it later, the best was the
clown residency, I was in tears laughing. i'll let you all know what he says
about CAPs protocol, don't exactly know how he can argue against that.

Thanks all,
Curt 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Ingles
Claire 
Sent: Friday, May 20, 2011 6:30 AM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] IHC pos. & neg. control question

 
And the block in question has already been proven positive using THAT
procedure and antibody during validation.
Claire



From: histonet-boun...@lists.utsouthwestern.edu on behalf of Thomas Jasper
Sent: Thu 5/19/2011 2:39 PM
To: pete.peder...@healthonecares.com; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] IHC pos. & neg. control question



Pete,

When you run a positive control.  The tissue is already a known positive
(or it should be) for whichever antibody you are running regardless of
prior handling.  It would be impossible for this not to be so.  However,
with a negative, the concern is seeing how the patient tissue turns out
when subjected to all the same conditions, minus the antibody. 
tj

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of
pete.peder...@healthonecares.com
Sent: Thursday, May 19, 2011 12:31 PM
To: gdaw...@dynacaremilwaukee.com; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] IHC pos. & neg. control question

Glen,

If I am to understand you correctly you are saying control tissue is not
treated the same as patient tissue, therefore is useless as a negative
control correct? Then inversely doesn't that mean the same thing towards
the use of a positive control? How can you guarantee the positive
control tissue was treated the same as the positive stained patient
tissue? According to your logic it cannot. Therefore, without the use of
a negative control how can you say the staining seen in the positive
control is truly positive and not artifact? Best practice says use
positive and negative patient and control tissue. Please enlighten me if
you know anything to the contrary?

Pete Pedersen   B.S. HTL (ASCP)
Anatomic Pathology Supervisor

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Dawson,
Glen
Sent: Thursday, May 19, 2011 12:32 PM
To: histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] IHC pos. & neg. control question

IMHO: Running any piece of tissue as a control that does not belong to
the patient being tested makes zero sense.  Because it would not be from
the patient tissue being tested, how do you know if it was handled the
same as the patient tissue?  For example:

1) Were they processed the same way?
2) Did the patient tissue dry out in the OR before it was delievered?
3) Was the patient tissue ever irradiated?
4) Does the patient tissue contain any of a number of substances that
could cause non-specific staining.
5) Was the patient abducted by aliens?

My point is that running a piece of tissue as a negative control that is
not even from the patient being tested throws all of the conditions that
the patient tissue was exposed to prior to and during processing out the
window.  This makes NO sense.

Glen Dawson  BS, HT(ASCP) & QIHC
IHC Manager
Milwaukee, WI



-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Curt
Tague
Sent: Thursday, May 19, 2011 11:04 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC pos. & neg. control question

I got this email from a pathologist today. we have always run a positive
with the patient tissue and a negative, the same patient tissue, and had
no
problems. Am I missing something. Is there any documented regulation
dictating what needs to be used for the controls. In some cases if we
get
one slide of patient tissue, then we will use the pos. and neg. cont.
from
the same block but typically it's the pt. tissue that is used for the
neg.
control. Thanks for your guidance.



Email:

"I received slides on sentinel lymph node biopsies with a positive
control
on the same slide as the breast tissue, but the negative control was
just
the patient's lymph node and did not have the corresponding section used
for
the positive control.  The patient's own tissue cannot be used as a
negative
control.  The tissue that stained positively must serve as the negative
control without the antibody.  This is critical and you need to correct
that
immediately."





Curt



_

RE: [Histonet] haz mat

[Curt Tague]

I think that depends on the state you're in and what the regs are. I'll
forward this to my vendor who makes our formalin neutralizer, He may be able
to help out. There are several different products I think but not all are
state approved. I had to find the one that is approved here, in cali.

Curt 

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sara
Baldwin/mhhcc.org
Sent: Thursday, May 19, 2011 10:11 AM
To: histo net
Subject: [Histonet] haz mat

Our municipality actually came here and told us not to put anything down the
drains.  We now have it all hauled off they told us we can't even put the
10%  when it has been treated down the drain. 
Thanks
Pathology Supervisor
Kathy Baldwin, SCT (ASCP)
Memorial Hospital and Health Care Center
sbald...@mhhcc.org
Ph 812-482-0210, 482-0216,  Fax 812-482-0232, 
Pager 812-481-0897
Confidential information, Authorized use only.
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[Histonet] IHC pos. & neg. control question

[Curt Tague]

I got this email from a pathologist today. we have always run a positive
with the patient tissue and a negative, the same patient tissue, and had no
problems. Am I missing something. Is there any documented regulation
dictating what needs to be used for the controls. In some cases if we get
one slide of patient tissue, then we will use the pos. and neg. cont. from
the same block but typically it's the pt. tissue that is used for the neg.
control. Thanks for your guidance. 

 

Email: 

"I received slides on sentinel lymph node biopsies with a positive control
on the same slide as the breast tissue, but the negative control was just
the patient's lymph node and did not have the corresponding section used for
the positive control.  The patient's own tissue cannot be used as a negative
control.  The tissue that stained positively must serve as the negative
control without the antibody.  This is critical and you need to correct that
immediately."

 

 

Curt 

 

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[Histonet] unsubscribe

[Curt Tague]

 

 

Curt Tague

CEO, Pathology Arts

951.270.0605 Bus.

951.270.0675 Fax

909.266.7552 Cell

 

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[Histonet] ventilation and exposure

[Curt Tague]

Yesterday I asked for some direction on ventilation firms to evaluate my lab
and the fumes. I think I've got some decent leads but I have another quick
question, does any change the processor bottles, formalin, alcohols,
xylem/subs, inside a ventilated hood?

 

Thank for your input,

 

Curt 

 

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[Histonet] proper ventilation

[Curt Tague]

I want to make some evaluations of my lab ventilation system and perhaps any
upgrades that might be necessary. Does anyone have any recommendations for
the Southern California area?

 

Thank,

Curt

 

 

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[Histonet] control block swap

[Curt Tague]

I have a few good WT-1 control blocks I'm willing to barter with, any
takers?

 

Curt Tague

CEO, Pathology Arts

 

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