[Histonet] Paraffin for Infiltration and Embedding Validation
Does anyone use the same paraffin for both tissue processing or infiltration and embedding? We do with quality results; but the company is no longer making that brand. Our brand before was a Fisher brand Paraplast Tissue Embedding Medium that worked well for both infiltration and embedding. Would like other suggestions. Per research, the other two alternative proposed and similar brands to what we have are: distributed by VWR and Fisher- a Leica brand. Any thoughts about them? There is a difference in price but quality is first then price. If we find a brand that is made by the same manufacturer as well as chemical composition and temp range, we feel a validation is not necessary. However, if not, we will do a validation. Thus, any suggestions on a method or template form concerning validation of a new paraffin for tissue processing and embedding. The more people respond the more references I have to make an informed decision as to choice and eventually quality. V/r Ian R. Bernard, MSHA, HT (ASCP) HTL (Pend-2014) USAF, MSgt (Retired) Air Force Red Cross Volunteer Histologist (since 1 June) Anatomic Patology Technical Supervisor (effective 22 Sep) Anatomic Pathology, 10th Medical Group 210-687-7540 Cell ian.bern...@comcast.netmailto:ian.bern...@comcast.net ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: processing biopsies on VIP
Check your protocol. Heat or temp is a factor and length of time in alcohol. We have P/V for the 10 % NBF and paraffin infiltration. IB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Algeo, Lacie A Sent: Thursday, August 28, 2014 4:21 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] processing biopsies on VIP Hi there, Does anyone use P/V on their biopsy runs on the Tissue-Tek VIP 5? We're having really dry biopsies, and I think this could be why Thanks, Lacie Lacie Algeo, HTL (ASCP) MBCM Histology Supervisor Providence Sacred Heart Medical Center Laboratory 101 W 8th Avenue L-2 Spokane, WA 99204 509-474-4418 FAX 509-474-2052 lacie.al...@providence.orgmailto:lacie.al...@providence.org This message is intended for the sole use of the addressee, and may contain information that is priviledged, confidential and exempt from disclosure under applicable law. If you are not the addressee, you are hereby notified that you may not use, copy, disclose or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply e-mail and delete this message. This message is intended for the sole use of the addressee, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the addressee you are hereby notified that you may not use, copy, disclose, or distribute to anyone the message or any information contained in the message. If you have received this message in error, please immediately advise the sender by reply email and delete this message. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Peggy Wenk's passing
On behalf of all military histologist who knew Peggy, please accept our condolences. I had the pleasure of attending her NSH seminars and seeking out questions from her as recently as a few months ago. Sorry to hear of her passing. She was a true champion in the field of Histology and now will be a legend. God Bless you and family Ian Bernard USAF Academy, Colorado. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Lee Peggy Wenk Sent: Monday, July 28, 2014 7:48 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Peggy Wenk's passing It is my sad duty to tell you that Peggy Wenk passed away peacefully Saturday morning. Her husband and companion of 37 years and her sister (from Bend,OR) were there. As you know Peggy had a large influence in the world of Histology. She also put herself into her church serving over the years as a nursery school director, Lay Eucharistic Minister and on the vestry. She sang enthusiastically in the choir and played in the newly formed bell choir. Because of our love of books, we both volunteered at the local library. We helped collect books, sort them and then helped to sell them; raising funds for the library's use. There will be two memorial services: one here in Michigan for all her local family and coworkers, the second in southern California (a burial at sea). We are asking that no flowers be sent; instead Peggy has specified (she and her sister planned the funeral several months ago) three different charitable organizations in lieu of flowers. St. Mary's-in-the-Hills Episcopal Church (Peggy's church) Shades of Pink Foundation (financial aid to local breast cancer patients) Peggy A. Wenk Endowed Scholarship for Histotechnology at Oakland University Please respond to this email if you'd like more information on the services or on giving (or to l...@lpwenk.net). Thanks Lee Wenk (Mr. Peggy Wenk;) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Template Special Stain validation Form or Sheet
Any suggestions or examples (from CAP, ASCP or NSH) on a template validation sheet that we could use for documentation and for CAP inspection purposes? Is there a recommended test or sample size. We have positive controls for all our test menu stains. Need a reference for all above. Ian Bernard ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Special stain control validation- CAP compliance
Documentation is a key aspect of lab work. It is almost like doing the practice without procedures. Its shows history, continuity and evidence that the work was methodical, approved and sound. Thus it provides evidence based substantiation. Put all you do in practice in written language and you will be sound with this requirement. My take IB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Stacy McLaughlin Sent: Wednesday, April 30, 2014 7:43 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Special stain control validation- CAP compliance Hello, We validate our control blocks prior to patient use. We label the slide with the stain, date, and results. We keep the slides in a file for reference. Our recent CAP inspection cited us on this because it was not documented on paper. I am considering challenging this, as I feel what we're doing meets the intent of the checklist question. What are your opinions? Thanks, Stacy **NEW** 07/29/2013 ANP.21460 Special Stain Controls Phase I Validated tissue controls are required for each special stain. NOTE: Positive tissue controls assess the performance of the special stain. Special stains are performed on sections of control tissue known to contain components specific to each special stain. Validation of tissue used as a positive control must be performed and documented before being used with clinical specimens. Evidence of Compliance: ✓ Written results of special stain control tissue validation [Cooley-Dickinson.org] ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] RE: competency form
There is a great need for standardization in histotechnology, from forms, policies, procedures/methods to controls processes and protocols. Hope NSH is working with ASCP and CAP to make this happen. MSgt Ian R Bernard, HT(ASCP), MSHA-UAB Anatomic Pathology Lab Manager USAF- Active Duty 210-687-7540 Cell ibern...@uab.edu ian.bern...@comcast.net -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of joelle weaver Sent: Wednesday, April 09, 2014 7:09 AM To: Rathborne, Toni; 'Sheila Haas'; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form True there is inspector variation. Maybe we should all pool our resources and see what we can come up with collaboratively? It is great to know what the CAP feedback has been so we can all fill in any gaps. Joelle Weaver MAOM, HTL (ASCP) QIHC From: trathbo...@somerset-healthcare.com To: sm...@msn.com; joellewea...@hotmail.com; amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: competency form Date: Wed, 9 Apr 2014 13:04:17 + CAP inspectors may have opinions which differ from our own, and their interpretation of standards may also be different. Have you challenged this deficiency with CAP? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sheila Haas Sent: Wednesday, April 09, 2014 8:52 AM To: joelle weaver; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form What we had here, which did not meet the CAP inspectors requirements apparently, were the procedure (of course); a form with each observation of each task documented along with any corrective action necessary; the correlation of proficiency tests, educational assessments and performance reviews for technical staff; daily evaluations from the pathologists concerning staining, microtomy and grossing; and educational training documentation. We had no idea with all pieces of this documentation that we were anticipated to have more. The form for DO of each task was not detailed enough (despite listing each task and proficiency or corrective action of each task) according to the inspectors. I was hoping someone could share a form so as to assist us in seeing what holes there are in our form. While this DO form is definitely not our only form, the inspectors specifically commented on this one. If anyone can assist, it would be helpful. Thank you, Sheila Haas MicroPath Laboratories, Inc. Quality Assurance Coordinator From: joellewea...@hotmail.com To: sm...@msn.com; amber.mcken...@gastrodocs.net; ronald.hous...@nationwidechildrens.org; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] RE: competency form Date: Wed, 9 Apr 2014 12:26:47 + Is the question that Ronnie posed yesterday requesting justification of the need and extent of competency documentation for histology, or is it just a form needed? The general checklist pretty much sums up the necessity for doing, and required elements to me- GEN. 55500 and CLIA. Maybe I am not understanding? As for a form, I would expect that the specific items on any forms will vary by your personnel and by the testing and processes you perform. What I did to document initial training and competency was a make a summary checklist for each bench with tasks and direct observations DO for initial training documentation of satisfactory performance before patient testing. I just put all those checklists together in a summary table for each person. High complexity; such as grossing, IHC, FISH scoring get more attention and documentation, the waived tests, you have more discretion,- but I thought it easier to do everything about the same. I have not been inspected on this document yet ( so can't say if CAP will have issues with it- but will know soon...) but here is basically what I did to meet GEN.55500 or the main parts; Defined how competency is monitored- method and frequency ( just included as part of the competency SOP) Orientation and initial training documentation in a checklist for general lab, safety Training checklist on each technical bench, instrument, major procedure PT records and performance/results DO- a practical assessment ( block, slides, stains), for the assessment of previously analyzed specimens, and a PI feedback checklist for the technical from this audit of issues- how/what to improve Check off in performing QC, calibration, patient ID procedures ( acceptable error rates), examples for file DO of grossing, other performance such as instrument programming/maintenance Written quiz, policies procedures, troubleshooting( problem solving documentation) Continuing education
RE: [Histonet] RE: competency form- Inspector Perspective.
I recently had the great honor to serve as a CAP inspector in Arizona. The lab we inspected will be accredited. Lest we forget as inspectors or future inspectors, I hope the below perspective illuminates the purpose of the CAP inspection and helps preserve the integrity of the program if adhered to. As inspectors, we are trained to be thorough but to simultaneously use objective judgment i.e. there may be several ways to meet the intent of the question and that we must review all pertinent documentation and then determine if the process meets the intent of the requirement. Keeping in mind that the purpose of CAP inspection is not punitive but quality laboratory improvement to fulfill the regulatory purpose of the inspection (CLIA). Our focus should be, in the interest of time and thoroughness major compliance issue rather than nitpick. This helps us maintain professionalism and preserve the peer-review nature of the program. So what is it that constitutes compliance? Per CAP: - One, that the laboratory has defined a policy, a procedure, or a plan of the three P's for how they are going to do things in the lab. - Secondly, actual practices that matches those three P's. - Finally, documentation to support the fact that practice has indeed matched policies and procedures. So what is a deficiency? Per CAP: A deficiency means that the lab did not meet the intent of the checklist item. It's not the wording; it's not the specifics. It is the intent. If any of the three above criteria are not yet met, we should cite a deficiency We are admonished to remember that there may be many ways to accomplish an objective. The lab may not do things exactly the way that your lab does, but may still be meeting the intent of the requirement(s). Citing a laboratory for not doing it the way we do it is a common inspector error. Per CAP, partial compliance is the following: If there is partial compliance (e.g., some records are inconsistent, one bottle of reagent was not labeled completely, a few temperatures were not recorded, etc.), you must judge whether the degree of non-compliance is likely to have adverse effects on test accuracy, patient care, or worker safety. Also, determine if the lab staff was aware of the inconsistency and if corrective actions were performed. If adverse effects are likely or if there are definite patterns (e.g., missing temperatures only on weekends) without corrective actions only then we must cite a deficiency. Bottom-line, If you feel you were incorrectly cited since you met the intent of the question, you should appeal to CAP. It is an inspected lab's right. If a phase 11 deficiency, submit your evidence of compliance and the Lab Accreditation Committee will either overrule or sustain. I suspect they will overrule. Just saying, but based upon just what you described, it sounds like you all met the intent of the question. MSgt Ian R Bernard, HT(ASCP), MSHA-UAB Anatomic Pathology Lab Manager USAF- Active Duty ibern...@uab.edu ian.bern...@comcast.net -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rathborne, Toni Sent: Wednesday, April 09, 2014 7:04 AM To: 'Sheila Haas'; joelle weaver; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form CAP inspectors may have opinions which differ from our own, and their interpretation of standards may also be different. Have you challenged this deficiency with CAP? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sheila Haas Sent: Wednesday, April 09, 2014 8:52 AM To: joelle weaver; Amber McKenzie; Houston, Ronald; Histonet Subject: RE: [Histonet] RE: competency form What we had here, which did not meet the CAP inspectors requirements apparently, were the procedure (of course); a form with each observation of each task documented along with any corrective action necessary; the correlation of proficiency tests, educational assessments and performance reviews for technical staff; daily evaluations from the pathologists concerning staining, microtomy and grossing; and educational training documentation. We had no idea with all pieces of this documentation that we were anticipated to have more. The form for DO of each task was not detailed enough (despite listing each task and proficiency or corrective action of each task) according to the inspectors. I was hoping someone could share a form so as to assist us in seeing what holes there are in our form. While this DO form is definitely not our only form, the inspectors specifically commented on this one. If anyone can assist, it would be helpful. Thank you, Sheila Haas MicroPath Laboratories, Inc. Quality Assurance Coordinator From: joellewea...@hotmail.com To: sm...@msn.com; amber.mcken...@gastrodocs.net
[Histonet] Best Study material for HTL
Fellow Histonetters. I will sit for the HTL exam over next three to four months. Per the ASCP suggested list, the following study materials were suggested as study for the HTL. Any thoughts on narrowing the list of study materials or are all materials indicted necessary? * Carson, F. Hladik, C. (2009). Histotechnology: A Self-Instructional Text (3rd ed.). Chicago: ASCP Press. * Kiernan, J. (2008). Histological and Histochemical Methods: Theory and Practice (4th ed.). Oxfordshire, England: Scion Publishing Ltd. * Kumar, G. Rudbeck, L. (2009). Dako Education Guide Special Stains and H E (2nd ed.). Carpinteria, CA: Dako North America. * Kumar, G. Rudbeck, L. (2009) Dako Immunohistochemical Staining Methods (5th ed.) Carpinteria, CA: Dako North America. * Harmening, D.M. (2012). Laboratory Management: Principles and Processes (3rd ed.). St. Petersburg: D.H. Pub. Consulting, Inc. Please advise. MSgt Ian R Bernard, HT(ASCP), MSHA-UAB Anatomic Pathology Lab Manager USAF- Active Duty 210-687-7540 Cell ibern...@uab.edu ian.bern...@comcast.net ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Rush Processing Protocol
Fellow Histonetters, our laboratory mostly processes small biopsy specimens such as GI, skins, vas deferens, ECCs, Cervical biopsies, EMBXs and breast core bxs with our largest routine specimen being gall bladders. We are seeking recommendations on a proven same-day or less than 8-hour processing program that would facilitate processing rush specimens only. Of course, we would validate this protocol with our processor and reagents. Any suggestions? Looking for total time and optimum time in each reagent. Our routine overnight is little over a 12 hour protocol. Please provide an evidence-based reference for optimum minimum processing time of biopsy tissues versus maximum time. Below are the reagents and amount of reagent containers we use. 10 % NBF- x 2 70% ALC- x 1 95% ALC- x 1 100% ALC- x 4 Clearing- X 2 Paraffin- X 4 Ian Bernard ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Ideal Workflow Lab Design for Histo/Cyto lab Processes
Histonetters, I'm looking for information or references concerning the ideal workflow design for a Histo/Cyto lab services. Need to consider ergonomics, work space, equipment, safety, etc. I know there are info. Just need source and experts to chime in. Journal of Histotechnology Advance article etc. Please reply to my work email as well. Ian Bernard ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Cytopathology Quest.
Thanks for your reference and input IB -Original Message- From: Fimbres, Amber [mailto:afimb...@uci.edu] Sent: Monday, October 14, 2013 11:58 AM To: Ian R Bernard; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Cytopathology Quest. According to Koss' Diagnostic Cytology and its Histopathologic Bases (1979), 100% methanol is equivalent to 95% ethanol which is equivalent to 95% reagent (denatured) alcohol which is equivalent to 80% propanol which is equivalent to 80% isopropanol. So in theory, if you ran out of 95% reagent alcohol and only had isopropanol on hand, as long as it was 80% it would be OK to use. Have I tried this? Honestly...no. Amber Fimbres, CT(ASCP)HTL -Original Message- From: Ian R Bernard [mailto:ibern...@uab.edu] Sent: Sunday, October 13, 2013 6:57 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Cytopathology Quest. Per text books, for cytology specimens, 95% Ethyl Alcohol is the fixative of choice. Are there any studies or references that approve 95% isopropyl or denatured alcohol as a suitable substitute? Ian Bernard This message contains confidential information and is intended only for the individual named. If you are not the named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system. E-mail transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Gastro Tissue for Validation of Processing Protocol
Our lab is looking to acquire actual (gastric) or alternate similar tissue to validate a gastro tissue processing protocol. Any suggestions on obtaining endoscopic biopsy specimens or alternate tissue types to validate the gastric biopsy protocol? Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) NCOIC-Manager, Anatomic Pathology Lab 10th Medical Group USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Retirement of Mr Bryan Haynes from Civil Service as Histologist- USAFA
Our USAF civilian histologist will be retiring from Civil Service, 31 Aug. Those of you who know him and wish to send me a few words of well wishing, please do so as I will present this at his retirement lunch. Mr. Haynes has 35 + years of experience as a histologist. He served in many capacities during his tenure as an USAF active duty person and as a DOD GS civilian in the histology career. Please send your quote about Mr. Haynes as a Friend, colleague, mentee or mentor, etc. Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) NCOIC-Manager, Anatomic Pathology Lab 10th Medical Group USAF Academy, CO 80840 Graduate Certificate In Gerontology Student-UAB 210-687-7540 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Biocare Decloaker Nx Gen
We recently bought this equipment and it works well. We are happy with it. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Blazek, Linda Sent: Thursday, March 28, 2013 1:52 PM To: Swartwood, Steven J; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Biocare Decloaker Nx Gen We have used the Decloaking Chamber for several years now and have had excellent results. The nicest thing is that there is consistency and reliability. Each run will be the same as the one previous and having the ability to use the USB stick for documentation of time, pressure and temperature makes record keeping really easy. We have had no complaints. The only con I can come up with is that it comes in a big box that is hard to store if you have to send it back for some reason. Linda Blazek HT (ASCP) Manager/Supervisor GI Pathology of Dayton Digestive Specialists, Inc Phone: (937) 396-2623 Email: lbla...@digestivespecialists.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Swartwood, Steven J Sent: Thursday, March 28, 2013 1:40 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Biocare Decloaker Nx Gen Has anyone ever used the Biocare Decloaking Chamber Nx Gen for epitope unmasking (heat retrieval)? Also does anyone have any personal pros/cons with this instrument? We are thinking about getting one because of inconsistencies with our current method using a vegetable steamer. We use many different tissue types both animal and human. Also we use many different antibodies. Currently with the vegetable steamer we've used Citrate, EDTA, and Tris-EDTA combinations. We've used times from 30-60 minutes, and even tried 30 minutes x 2 or 40 minutes x 2, but we still see some inconsistent staining. To make sure it wasn't due to fixation vimentin staining was performed and shows even staining. It's just certain antibodies that are giving us trouble even from multiple different companies. Any advice would be greatly appreciated and very beneficial to our work pertaining to the instrument. Thanks again everyone have a great end of the week, Steven Swartwood HT(ASCP) steven.swartw...@cshs.org IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED. If you have received this message in error, please notify us immediately by calling (310) 423-6428 and destroy the related message. Thank You for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Telepathology
We are a test site for the Aperio System. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Gloria Tharp Sent: Tuesday, June 11, 2013 9:09 AM To: Histonet@lists.utsouthwestern.edu Subject: [Histonet] Telepathology Does anyone have any recommendations for scanning equipment to have slides read off site from main lab. Thanks. Gloria Tharp, BA, HTL(ASCP) Director of Operations PCA Southeast gth...@pcasoutheast.com 931-490-1005 800-388-1294 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Happy Lab Week from Pam Barker and RELIA Solutions!!
- We are celebrating with sponsor breakfasts and lunches for lab personnel from local restaurants each day. - Different internal games. - Educational Lab Week information and mementos for patients and staff alike - And finally, two half days this week, some personnel will go hiking and others on another day horseback riding. That way our mission is staffed without negative impact to patient care V/r Ian R. Bernard, MSHA, HT (ASCP) NCOIC-Manager, Anatomic Pathology Lab 10th Medical Group USAF Academy, CO 80840 Graduate Certificate In Gerontology Student-UAB 210-687-7540 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Pam Barker Sent: Monday, April 22, 2013 11:49 AM To: Histonet Subject: [Histonet] Happy Lab Week from Pam Barker and RELIA Solutions!! Hi Histonetters. Happy Lab Week!! Wow this year is just flying by!! It was just Histotechnology Professionals Day a short time ago and here it is lab week already! So here is my question. How is your facility celebrating Lab Week? I hope you are gearing up for a fun week and if you need some ideas for lab week check out Advance Magazine, they have some fun ideas. I think we both know it wouldn't be an email from me if I didn't tell you about my current openings. Please take a second and check them out. Here Are My Spotlight Opportunities: Night Shift Histotech - Patterson, NJ Brand New Lab!! Day Shift Histotech - Salem, VA beautiful area and great Team HT/HTL Mohs Histotech - Long Beach, CA - Make it your own brand new in office lab! The rest of the histology positions that I am most excited about are located in these areas: Nashville, TN Waco, TX Tyler, TX -2 sites one at a hospital and one at a private dermpath lab Atlanta, GA Charlotte, NC Staunton, VA Louisville, KY Staunton, VA Remember if you refer someone to me and I place them now or in the future You will earn a 500 dollar referral fee!! If you think you or someone you know might be interested in any of these opportunities or would like to talk about a job search in another area, please contact me. I can be reached at 866-607-3542 or rel...@earthlink.net Thanks-Pam Thanks-Pam Right Place, Right Time, Right Move with RELIA! Thank You! Pam M. Barker Pam Barker President/Senior Recruiting Specialist-Histology RELIA Solutions Specialists in Allied Healthcare Recruiting 5703 Red Bug Lake Road #330 Winter Springs, FL 32708-4969 Phone: (407)657-2027 Cell: (407)353-5070 FAX: (407)678-2788 E-mail: rel...@earthlink.net www.facebook.com/PamBarkerRELIA www.linkedin.com/in/reliasolutions www.twitter.com/pamatrelia ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] 2013 CAP Inspection Success National Lab
Colleagues, thank you for your input with questions. Your input and our implementation have proved successful. Hard work towards alignment of policies, procedures and practices to standards (CAP) all proved successful. Thank you to my staff, in particular SRA George Williams, for their hard work in preparation. Yesterday, 18th April 13, we were inspected by CAP and we are glad to report that we had a very successful outcome: Our Anatomic Pathology department scored with: Zero Discrepancies and Recommendations. A very detailed inspection, in all aspects of our entire laboratory with 10 inspectors. Bottom-line: Our Lab is reaccredited another two years to serve our patient population. Also glad to report that prior to the inspection that our lab was selected as the 2013 Advance Magazine National Lab of the Year! Please see the April edition of Advance Magazine. Fellow Colorado Histo colleagues, I'll see you tomorrow for the Colorado Society of Histotechnology Meeting in Fort Collins. V/r Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP)- (Working on HTL) NCOIC-Manager, Anatomic Pathology Lab 10th Medical Group USAF Academy, CO 80840 Graduate Certificate In Gerontology Student-UAB 210-687-7540 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] FFPE for Immunohistochemistry.
Pretreatments are used to recover bonded antigen sites owing to formalin linkage. What is the optimum or maximum fixation time for tissues that may require Immunohistochemistry staining? IB ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Validation Method for Auto HE stainer
I'm looking for a benchmark or researched protocol. IB ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Biocare Decloaker Nx Gen
I would welcome input hear as well since we are looking at buying one as well. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Swartwood, Steven J Sent: Thursday, March 28, 2013 12:40 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Biocare Decloaker Nx Gen Has anyone ever used the Biocare Decloaking Chamber Nx Gen for epitope unmasking (heat retrieval)? Also does anyone have any personal pros/cons with this instrument? We are thinking about getting one because of inconsistencies with our current method using a vegetable steamer. We use many different tissue types both animal and human. Also we use many different antibodies. Currently with the vegetable steamer we've used Citrate, EDTA, and Tris-EDTA combinations. We've used times from 30-60 minutes, and even tried 30 minutes x 2 or 40 minutes x 2, but we still see some inconsistent staining. To make sure it wasn't due to fixation vimentin staining was performed and shows even staining. It's just certain antibodies that are giving us trouble even from multiple different companies. Any advice would be greatly appreciated and very beneficial to our work pertaining to the instrument. Thanks again everyone have a great end of the week, Steven Swartwood HT(ASCP) steven.swartw...@cshs.org IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed and may contain information that is privileged and confidential, the disclosure of which is governed by applicable law. If the reader of this message is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this information is STRICTLY PROHIBITED. If you have received this message in error, please notify us immediately by calling (310) 423-6428 and destroy the related message. Thank You for your cooperation. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Optimum room temperature for Histo Cyto Lab
Does anyone know about research or standards with this. Deg C or Deg F IB ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Quality In AP
Yes. Any more examples of near misses in histology and cytology? I will use these case studies and source of errors as examples. Although this may have been obvious human error with the wrong section on the slide, a systems approach to quality improvement could have prevented this incident. Building quality controls, assurances and improvement initiatives throughout the entire test cycle (pre analytical, analytical and post analytical) is key. We also need to be aware of latent systems errors that may or may not be in our control but must be considered as we try to improve quality and reduce errors for patient safety. IB -Original Message- From: Cristi Rigazio [mailto:cls71...@gmail.com] Sent: Sunday, March 24, 2013 9:58 AM To: Ian R Bernard Cc: histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Quality In AP During a tumor board conference, a pancreatic cancer case was being reviewed. The slide was shown and a pathologist pointed out the tissue was lung, not pancreas. The patient was scheduled for surgery the following day. It was promptly cancelled. This incident started in the lab when the wrong section was placed on the slide, how it got all the way to a final report and subsequent surgery scheduling, I can't answer. Is this the kind of example you are seeking? Kind regards, Cristi Sent from my iPhone On Mar 24, 2013, at 6:05 AM, Ian R Bernard ibern...@uab.edu wrote: I'm in the process of writing a comprehensive Quality Management Program for our AP department. I have references but would like some input from colleagues. - Sentinel event involves death or serious physical or psychological injury. - Near Miss fall short of that. Bottom-line, need some real life examples of near misses in Surgical pathology, Histopathology and Cytopathology. Send me you input IB ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Procedure manuals
Pre CAP every two years or as needed. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Gail Marcella Sent: Friday, February 01, 2013 11:59 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Procedure manuals Hi - Does anyone know if everyone that works in the lab has to sign off on every procedure in the manual, every single year??? ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: cytoprep
Our rehydration time is 30-45 secs. Then into 95% alcohol. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nancy Schmitt Sent: Wednesday, January 30, 2013 12:18 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] cytoprep Hi to all- I am continuing to have a problem with Pap stains done by hand: 1. We rehydrate 25 seconds in saline and straight into alcohol. Thicker areas are ok, but thinner areas appear to be air dried.. 2. Red cell ghosts are NOT clearing I believe there are quite a few Histology labs also performing cytoprep work and I will appreciate any thoughts you may have. Nancy Schmitt HT, MLT Dubuque, IA NOTICE: This email may contain legally privileged information. The information is for the use of only the intended recipient(s) even if addressed incorrectly. If you are not the intended recipient, please notify the sender that you have received it in error and then delete it along with any attachments. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] CSF GYN Testing
What is a perfect amt/size specimen for CSF for Cytology non gyn testing per the literature? Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) NCOIC-Manager, Anatomic Pathology Lab 10th Medical Group USAF Academy, CO 80840 Graduate Certificate In Gerontology Student-UAB 210-687-7540 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] CAP New requirement: Cytopathology Exclusions from Submissions
Fellow Laboratorians who process Cytopathology specimens, specifically, Non-Gyn specimens. A policy that list specimens that are excluded from routine submission to cytology for processing. Please share your facilities' approved examples on the types of specimens, and a justification and reference as to why this should be excluded. Thanks Ian Colorado ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] CAP New requirement: Cytopathology Exclusions from Submissions
Yes, This is a new checklist item as of 07/11/2011. Cytopathology Exclusion question: CYP.01650. Ian -Original Message- From: Oscar [mailto:omgwake...@gmail.com] Sent: Sunday, December 30, 2012 9:15 PM To: Ian R Bernard Subject: Re: [Histonet] CAP New requirement: Cytopathology Exclusions from Submissions Hi Neha. I was checking the Histonet, and found the question below. Is there a requirement for non-GYN specimens? There is one for Histo, but didn't know there was a Cyto... Sent from my iPad2 On Dec 30, 2012, at 10:01 PM, Ian R Bernard ibern...@uab.edu wrote: Fellow Laboratorians who process Cytopathology specimens, specifically, Non-Gyn specimens. A policy that list specimens that are excluded from routine submission to cytology for processing. Please share your facilities' approved examples on the types of specimens, and a justification and reference as to why this should be excluded. Thanks Ian Colorado ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] FNA procedure in Cytopathology
With HIPPA privacy rules, patient identifies should be carefully considered. For the time out procedure for patient safety, during the FNA process ,we ask the patient to provide DOB and name only. For the slide labeling part of the process, what two patient identifiers do you all annotate on the patient slides. The same aforementioned or something else. The impasse is space on the slide. is patient first initial of last name and last four acceptable? Or should we stick with name and DOB for consistency of policy. Or does it matter? Ian ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Re: Stain for HP
Also Alcian Yellow -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bob Richmond Sent: Friday, October 19, 2012 5:01 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Re: Stain for HP Staining gastric biopsy specimens for Helicobacter pylori: practice varies greatly in various labs I've worked in. One lab does a blue stain (generic equivalent of Diff-Quik II), while the other does immunohistochemistry, each of them on all specimens. I've also seen labs that did a full tissue Giemsa, and one that did a cresyl echt violet stain. Haven't seen a routine Warthin-Starry in many years. I think everyone bills every one of these stains they do. There are still a few hold-outs for real men can see 'em on the H E. As far as I know, no studies have been done comparing the sensitivity (we'll forget specificity) of the various methods. My personal opinion is that none of the dye or silver methods is conspicuously better than the others. Reading the blue stain is time-consuming; I use oil immersion magnification (which real men disdain) to confirm all positives (and confirm Helicobacter heilmannii, which I have seen once), and on all apparent negatives with acute inflammation. The IHC can be read rapidly with much less magnification. I note that many pathologists sign out any bacteria they see in a blue stain as Helicobacter, including the frequent bugs that get carried down from the oral cavity as the scope advances. These pathologists should definitely switch to IHC. So if I have one gastric biopsy case a day, I'm happy with the blue stain. If I have ten, I want IHC. If there is no inflammation, I can do without any stain. Bob Richmond Samurai Pathologist Maryville TN ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: H.Pylori
We do Alcian Yellow for HP. IB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Harrison, Sandra C. Sent: Wednesday, October 17, 2012 2:04 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] H.Pylori We do an H.P. routinely on stomach, body, fundus, antrum, pyloric, prepyloric, and gastric (Not on cardia area of stomach or GE jcn.) We use a kit from Newcomer Supply of a Steiner-Chapman modified Silver Stain. The pathologist's order an IHC for H.P. only about 5% of the time, if for example, they do not see H.P. from the silver stain, but the patient has a history of H.P. Sandy C. Harrison, HTL (ASCP) Histology Supervisor Minneapolis VA 612-467-2449 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Used Histology Equipment
IMEB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Best Sent: Friday, October 12, 2012 5:40 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Used Histology Equipment Does anyone have the contact information for the company that purchases used Histo equipment? I saw them at the NSH conference in Denver, but have misplaced their business card. Laurie Best Histology Supervisor Sunrise Medical Labs 250 Miller Place Hicksville, NY 11801 (631)435-1515x1018 This message contains privileged and confidential information intended only for the use of the addressee named above. If you are not the intended recipient of this message you must not disseminate, copy or take any action in reliance on it. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Are those sites using the Thermo Fisher SlideMateslide printer also using Thermo slides?
Encouraging information and thanks for the slides tibit. That has been an issue. IB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Best Sent: Friday, October 12, 2012 5:38 AM To: Beth Cox; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Are those sites using the Thermo Fisher SlideMateslide printer also using Thermo slides? We have been using the Thermo Printmate and the Slide Mates since 2009. There have been some issues, but eventually, they have been resolved and the system is working very well. We use Premier charged slides by Avantik after trying a broad range of slides, these are very economical and work well. We run about 100 slides per day through each slide printer. We also have them in place to print slides for Hologic Thin Preps and Surepath PAPs both systems use imagers and are ok most of the time despite a very high volume in that area. Hang in there be and persistent it will get better. Their tech support is pretty good. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Beth Cox Sent: Thursday, October 11, 2012 4:59 PM To: histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Are those sites using the Thermo Fisher SlideMateslide printer also using Thermo slides? We also installed 3 Thermo SlideMates in April 2012. They have had light use since then because Thermo could not get/install a PrintMate cassette printer to finish the project. We have found the best slide to use is the Colorfrost slides from Statlab. However our print quality is VERY inconsistent and still unsatisfactory. Right now, all three are in having their print heads replaced ($1,000 each) after only 5 months of light use. Like IB, we are also waiting for Thermo to fix the problems. We are definitely dissatisfied with the results and unhappy with the Slidemates. Beth Cox, HTL/SCT(ASCP)QIHC Histology Supervisor St Elizabeth Healthcare Edgewood, KY Subject: RE: [Histonet] Are those sites using the Thermo Fisher Slide Mateslide printer also using Thermo slides? To: Elizabeth Chlipalal...@premierlab.com, 'Harrison, Sandra C.' sandra.harris...@va.gov,histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Message-ID: d4f4c602b10b9f45b4e9271af6380e161418d...@uabexmb4.ad.uab.edu Content-Type: text/plain; charset=us-ascii We have also acquired a Thermo Fisher slide mate/micro writer in Mar/Apr of this year. We have yet to have them work and consistently. The printing quality despite the type slides used is inconsistent. Nevertheless, I am giving them opportunity to fix it since we have invested money. IB USAFA, Colorado Springs. -Original Message- From:histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Elizabeth Chlipala Sent: Wednesday, October 10, 2012 2:12 PM To: 'Harrison, Sandra C.';histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Are those sites using the Thermo Fisher Slide Mate slide printer also using Thermo slides? Sandra We had one slide mate that we purchased few years back, we had problems from the beginning with both fisher and other slides, right now the machine is sitting in a cabinet not being used. To me we found it very unreliable with respects to print quality. Liz Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC Manager Premier Laboratory, LLC PO Box 18592 Boulder, CO 80308-1592 (303) 682-3949 office (303) 682-9060 fax (303) 881-0763 cell www.premierlab.com Ship to address: 1567 Skyway Drive, Unit E Longmont, CO 80504 -Original Message- From:histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Harrison, Sandra C. Sent: Wednesday, October 10, 2012 1:00 PM To:histonet@lists.utsouthwestern.edu Subject: [Histonet] Are those sites using the Thermo Fisher Slide Mate slide printer also using Thermo slides? I just purchased 6 Slide Mates. We just began using them yesterday. Are any of you using slides that are NOT Fisher slides on your SlideMates? When you respond, could you answer the following questions? a) Is the print job consistently satisfactory? b) How long have had your SlideMate(s)? c) What difficulties did you have, getting it to consistently print well? d) Approximately how many slides per day you are printing on (each)SlideMate? Thanks, Sandy C. Harrison, HTL (ASCP) Histology Supervisor Minneapolis VA 612-467-2449 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Are those sites using the Thermo Fisher Slide Mate slide printer also using Thermo slides?
We have also acquired a Thermo Fisher slide mate/micro writer in Mar/Apr of this year. We have yet to have them work and consistently. The printing quality despite the type slides used is inconsistent. Nevertheless, I am giving them opportunity to fix it since we have invested money. IB USAFA, Colorado Springs. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Elizabeth Chlipala Sent: Wednesday, October 10, 2012 2:12 PM To: 'Harrison, Sandra C.'; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Are those sites using the Thermo Fisher Slide Mate slide printer also using Thermo slides? Sandra We had one slide mate that we purchased few years back, we had problems from the beginning with both fisher and other slides, right now the machine is sitting in a cabinet not being used. To me we found it very unreliable with respects to print quality. Liz Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC Manager Premier Laboratory, LLC PO Box 18592 Boulder, CO 80308-1592 (303) 682-3949 office (303) 682-9060 fax (303) 881-0763 cell www.premierlab.com Ship to address: 1567 Skyway Drive, Unit E Longmont, CO 80504 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Harrison, Sandra C. Sent: Wednesday, October 10, 2012 1:00 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Are those sites using the Thermo Fisher Slide Mate slide printer also using Thermo slides? I just purchased 6 Slide Mates. We just began using them yesterday. Are any of you using slides that are NOT Fisher slides on your SlideMates? When you respond, could you answer the following questions? a) Is the print job consistently satisfactory? b) How long have had your SlideMate(s)? c) What difficulties did you have, getting it to consistently print well? d) Approximately how many slides per day you are printing on (each) SlideMate? Thanks, Sandy C. Harrison, HTL (ASCP) Histology Supervisor Minneapolis VA 612-467-2449 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Breast processing
This suggestion may not apply to reference laboratories, since these labs tend to work over the weekend. However, in our case, at an ambulatory primary care and surgical specialty clinic, I was able to work with our Ultrasound (Diagnostic Imaging) and ENT departments to have the breast core biopsy procedures scheduled two days in the week. This ensures quality diagnostic products since specimens do not have to sit or come to us close to the weekend for ER/PR Her-2 Neu studies. This collaborative pre-analytic approach works for our patients, the clinics, the lab testing professionals(ER/PR Her-2 Neu) and our pathologists. Thanks Ian -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Martin, Gary Sent: Monday, October 08, 2012 1:52 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Breast processing We have someone come in over the weekend and embed the tissue. If we go over the time protocol for some reason, which is not often, we will evaluate the specimen by FISH. Once you take the bitter pill of someone coming over the weekend, it works very well. Gary -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of histonet-requ...@lists.utsouthwestern.edu Sent: Monday, October 08, 2012 10:02 AM To: histonet@lists.utsouthwestern.edu Subject: Histonet Digest, Vol 107, Issue 10 Send Histonet mailing list submissions to histonet@lists.utsouthwestern.edu To subscribe or unsubscribe via the World Wide Web, visit http://lists.utsouthwestern.edu/mailman/listinfo/histonet or, via email, send a message with subject or body 'help' to histonet-requ...@lists.utsouthwestern.edu You can reach the person managing the list at histonet-ow...@lists.utsouthwestern.edu When replying, please edit your Subject line so it is more specific than Re: Contents of Histonet digest... Today's Topics: 1. RE: Breast processing times (Weems, Joyce K.) 2. Brain - Question and advise (Histo Histo) 3. back online, please feel free to check it out (M. Kap) 4. Flourescent mounting medium- PLEASE HELP!!! (Candice Smoots) 5. RE: Flourescent mounting medium- PLEASE HELP!!! (Jonathan Cremer) 6. Re: Brain - Question and advise (Rene J Buesa) 7. RE: Brain - Question and advise (McMahon, Loralee A) 8. question about decalicification end-point checks (Thurby, Christina) 9. Re: Brain - Question and advise (Rene J Buesa) 10. Re: Flourescent mounting medium- PLEASE HELP!!! (Rene J Buesa) 11. SOX-10 (Houston, Ronald) 12. RE: SOX-10 (Della Speranza, Vinnie) 13. Re: question about decalicification end-point checks (Rene J Buesa) -- Message: 1 Date: Mon, 8 Oct 2012 00:33:13 + From: Weems, Joyce K. joyce.we...@emoryhealthcare.org Subject: [Histonet] RE: Breast processing times To: Rathborne, Toni trathbo...@somerset-healthcare.com, Diana McCaig dmcc...@ckha.on.ca, histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Message-ID: e3a4ebd57a691646bcced4aa5911a030667af...@e14mbx12n.enterprise.emory.net Content-Type: text/plain; charset=iso-8859-1 We have someone from the clinical lab drain the processor, remove the blocks and set them aside for us to complete on Monday morning. Has worked perfectly for us. j From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] on behalf of Rathborne, Toni [trathbo...@somerset-healthcare.com] Sent: Friday, October 05, 2012 11:18 AM To: Diana McCaig; histonet@lists.utsouthwestern.edu Subject: [Histonet] RE: Breast processing times We have someone come in on Sunday, and work with one less person on Monday. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Diana McCaig Sent: Friday, October 05, 2012 11:15 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Breast processing times Can you please give me your routine for processing breast cases over the weekend. Do you extend the time in alcohol to achieve the 48 hour maximum, call someone in over the weekend, or just indicate on the patient report that the fixation extended beyond the 48 hours limit for HER 2, 72 hours for ER and PR. Is the ischemic time recorded within the lab as well as on the patient report? Thanks Diana ___pHistonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This
[Histonet] RE: Negative Controls
This is the key. What is the evidence based research/studies to support this? I will continue with negative controls until I am able to get peer reviewed research to support this. Besides overkill maybe pricey ($$) at times or not (since it is just slides) but from what I learned this past week at NSH 2012 Vancouver workshop: There are other important costs for us to consider thus we need to count the cost of poor quality. We learned that there are three types of other costs to consider in the medical laboratory: prevention, appraisal and failure (internal and external) costs. According to our workshop presenter from Vancouver, his or the research shows that failure costs are a whole lot more than the cost of prevention and appraisal. Therefore a focus on things like time, patients, reputation and staff costs is necessary as well as money. IB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Pardue, Judith Sent: Friday, August 17, 2012 1:08 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Negative Controls Does anyone know of any articles talking about not using negative controls when using a polymer based detection system. Judith Pardue Memorial Hospital Chattanooga, Tn. judith_par...@memorial.org This electronic mail and any attached documents are intended solely for the named addressee(s) and contain confidential information. If you are not an addressee, or responsible for delivering this email to an addressee, you have received this email in error and are notified that reading, copying, or disclosing this email is prohibited. If you received this email in error, immediately reply to the sender and delete the message completely from your computer system. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Tissue grossing
Kristen hope this helps. See CAP requirement for other than a pathologist assistant or pathologist below. Our lab policy is to use the histotechnician certification HT(ASCP) or HTL (ASCP) as qualification to gross since there is an educational requirement for certification that is comparable or exceeds the CAP requirement. Ian **REVISED** 07/11/2011 ANP.11605 Gross Examination - Non-Pathologist Phase II When individuals other than a pathologist or pathology resident assist in gross examinations, the extent of their activities and the nature of supervision (direct vs. indirect) is defined in a documented protocol. NOTE: This protocol must list the specific types of specimens for which non-pathologists are permitted to assist in the gross examination. The nature of the supervision must be established individually, for each non-pathologist. The laboratory director is responsible for this protocol. REFERENCES 1) Department of Health and Human Services, Centers for Medicare and Medicaid Services. Clinical laboratory improvement amendments of 1988; final rule. Fed Register. 1992(Feb 28):7183 [42CFR493.1489(b)(6)] 2) Cibull ML. QA. Northfield, IL: College of American Pathologists CAP Today. 1997;11(7):112 3) Grzybicki DM, et al. National practice characteristics and utilization of pathologists' assistants. Arch Pathol Lab Med. 2001;125:905-912 **REVISED** 07/11/2011 ANP.11610 Gross Examination Qualifications Phase II If individuals other than a pathologist or pathology resident assist in gross examinations, such individuals qualify as high complexity testing personnel under CLIA regulations. NOTE: The laboratory director may delegate the dissection of specimens to non-pathologist individuals; these individuals must be qualified as high complexity testing personnel under CLIA regulations. The minimum training/experience required of such personnel is: 1. An earned associate degree in a laboratory science or medical laboratory technology, obtained from an accredited institution, OR 2. 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, NAACLA, 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. It is the responsibility of the laboratory director to determine whether an individual's education, training and experience satisfies the requirements of this checklist requirement. This checklist requirement applies only to laboratories subject to US regulations. Evidence of Compliance: ✓ Records of qualifications including degree or transcript and work history in related field OR documentation of grandfathered exception REFERENCES 1) Department of Health and Human Services, Centers for Medicare and Medicaid Services. Clinical laboratory improvement amendments of 1988; final rule. Fed Register. 2003(Oct 1):1070-1071 [42CFR493.1489], 1071-1072 [42CFR493.1491]. V/r Ian Bernard -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of kristen martin Sent: Saturday, September 15, 2012 3:27 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Tissue grossing Hi all, How does one become qualified to gross tissue? A lot of the jobs I have been looking at call for being qualified to gross tissue, where I work right now the residents and Pathology assistants are the ones who gross the tissue. Thanks in advance for any help! Kristen Martin Sent from my Verizon Wireless BlackBerry ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Let's Talk CAP Inspections
I trust all of us will hopefully benefit from this line of discussion: In 2013 our lab will undergo our 2013 CAP inspection. The Cyto (Non-Gyn)-pathology, and Anatomic(Surgical only) Pathology and now the new Commons checklist will be used. Over the next weeks, in an effort to prepare, and to get feedback to CAP questions that tend to be subject-to-interpretation or subjective (since inspectors are our peers) versus objective questions (that are straight forward (or elementary my dear friend), I will present questions with hopes of obtaining interpretations from you, my fellow subject matter experts and fellow inspectors. By the way, this will be my first CAP inspection as sole manager of our lab. I also think volunteering to serve as an inspector will help the process as well. Look out, I may be coming your way. IB -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tom McNemar Sent: Tuesday, August 28, 2012 4:37 AM To: 'angela smith'; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] Remote processor alarms We are tied into the main lab system. It is a wireless system from Rees Scientific. We have the VIP 5 and it monitors the voltage. I get a call if there is an error of any type. Tom McNemar, HT(ASCP) Histology Co-ordinator Licking Memorial Health Systems (740) 348-4163 (740) 348-4166 tmcne...@lmhealth.org www.LMHealth.org -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of angela smith Sent: Monday, August 27, 2012 4:53 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Remote processor alarms What kind of remote alarms do you all have on your various processors when something goes wrong when you are not open but have processors running. So far I found sensaphone for the Peloris. I am interested in all types. Thank you Angela Smith ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail, including attachments, is intended for the sole use of the individual and/or entity to whom it is addressed, and contains information from Licking Memorial Health Systems which is confidential or privileged. If you are not the intended recipient, nor authorized to receive for the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this e-mail and attachments is prohibited. If you have received this in error, please advise the sender by reply e-mail and delete the message immediately. You may also contact the LMH Process Improvement Center at 740-348-4641. E-mail transmissions cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. Thank you. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Microtome feedback
What is great about the Leica RM2255? -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Bea DeBrosse-Serra Sent: Friday, August 17, 2012 8:58 PM To: Fred Underwood; Histonet Subject: RE: [Histonet] Microtome feedback Fred, The Leica RM2255 all the way! Go Dayton! Bea From: histonet-boun...@lists.utsouthwestern.edu [histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Fred Underwood [funderw...@mcohio.org] Sent: Friday, August 17, 2012 12:48 PM To: Histonet Subject: [Histonet] Microtome feedback Hello and TGIF to everyone. I'm exploring getting a new microtome and would like to draw on the vast knowledge and experience out there in Histoland. The three I'm looking at are: the Zeiss Hyrax M55, Thermo Scientific ME+, and the Leica RM2255. Thanks, Fred Underwood Montgomery County Coroner's Office Dayton, OH ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Immuno Controls
Looking for the same Ian -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Carlos Hernandez Sent: Tuesday, July 03, 2012 11:34 PM To: Histonet Subject: [Histonet] Immuno Controls Hi All! I was wondering if there is anybody out there that has an over abundance of controls for mart/melan a, s100, hmb45, pan keratin, ki-67, and mitf that they are will to share or sell? Please let me know if you can help me out. Thanks, Carlos ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Muscle Biopisy Procedure
Our lab never had the opportunity to perform a muscle biopsy procedure until now: we have a request for one. Since we never did one, we don't have a written procedure. We are looking for a benchmark or proven written procedure to freeze and ship the specimen to the Joint Pathology Center in Washington DC for processing. We will not perform any other aspects of the procedure, just the freeze and ship. Hope to do this next week. Any assistance is greatly appreciated. Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Reagent rotation
We do it by number of blocks- At or after 350 blocks the processor is changed. Ian -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Stephenson, Sheryl Sent: Tuesday, June 05, 2012 2:03 PM To: 'Mark Perrin'; histonet@lists.utsouthwestern.edu Subject: [Histonet] Reagent rotation We do it by the number of Runs. About every 6 run for rotations and 12 runs for a full change out. But we also have another processor as well. Sheryl Stephenson | Histology Technician Main 908.947.1100 Fax908.947.1085 Direct: 908.947.1624 sstephen...@lifecell.com 732. 939. 3037 Cell www.lifecell.com LifeCell Corporation | One Millennium Way | Branchburg, NJ | 08876 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mark Perrin Sent: Tuesday, June 05, 2012 2:05 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Reagent rotation What is the normal procedure for changing the reagents in the tissue processor? We have a Sakura VIP6. Should the schedule of changing be based on number of runs vs. number of blocks processed? About 80% of our blocks are small GI biospies. Thanks in advance for your input. Toshia Perrin Medical Practice Coordinator Southern Pathology This message contains privileged and confidential information intended only for the use of the addressee named above. If you are not the intended recipient of this message you must not disseminate, copy, or take any action in reliance on it. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] certification of histotechnologists
1. The military (US Air Force) even followed this approach; maybe in alignment with the civilian sector, with a purpose of cost savings or efficiency (by eliminating the med-lab foundation before histology). However, I would like to think that they viewed histopathology as a stand-alone needed specialty that required more time to focus on skill development. For unlike med-lab, our profession is a truly an art and science. When I received my histopathology training via the military in 1994 at the AFIP at WRAMC, all future histotechnicians had to complete medical-laboratory school. Now there is no requirement to complete med-lab school. Nevertheless, I was grateful for the med-lab foundation. Although my passion is grand scale healthcare administration, I love this field and will always try to improve and maintain my SKA in it. Hence, is the reason why I'm studying for my HTL. This is more than a job, it is a profession and thus a career. In the military (also a profession and career), we learn that for a job to be a profession or career it has to have the following attributes: - High degree of generalized and systematic knowledge- from Fixation, Processing, Specials, Immuno, Ground Histology, etc. - Primary orientation to the community interest rather than to individual self interest- we are key to patient care; i.e. we produce a product that the pathologist relies on to make patient diagnosis. - A high degree of self control of behavior through codes of ethics and voluntary associations: Ours are establish like organization like NSH, ASCP, CLIA, FDA etc. - A system of rewards or a set of symbols of work achievement. Our HT, HTL certifications are part of this. Bottom-line: our profession has a body of theory and specialized knowledge; a service orientation and a distinct subculture. So be encouraged my colleagues, be proud and know that our profession is significant to the field of medicine. I would highly suggest if you ever have the chance at a state or national Histotechnology event to hear the lecture from a pathologistd about our professional culture and the history of our profession. It will instill major professional pride. V/r IRB Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Friday, May 25, 2012 10:56 AM To: Janet Keeping; histonet@lists.utsouthwestern.edu Subject: RE: [Histonet] certification of histotechnologists Janet brings up an interesting point. The rest of the world (ie, besides US) has histo as part of the med tech program and then they specialize in their final year. I have worked with techs from many other countries and in general are far more knowledgeable than the majority of even certified techs in the US. The US med tech programs dropped histo decades ago. I'm not sure why. Pathology labs certainly benefitted financially because it allowed them to hire literally anybody to do the work. But even in the US the med tech schools are declining due to lack of enrollment. Probably due to automation in laboratories they just don't need as many people. Tim Morken -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Janet Keeping Sent: Friday, May 25, 2012 4:38 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] certification of histotechnologists Just curious if any consideration has been given to including Histotechnology in your medical laboratory programs as we do in Canada? our graduates are certified for 5 different careers and shortages in one particular laboratory does not seem to be a problem. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Cytology in Histo Lab
Our histopathology lab does cytology processing of Non-Gyns samples. Looking for a good cytology spray fixative to fix nipple discharge slides or smears. Need name of product, catalog number and distributor of this product. Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Tissue Processing Protocol for Small iopsies
Fellow histonetters, I'm looking for evidence based or best practice/ benchmarked tissue processing protocols for the small biopsies listed below. Please provide a reference since our facility strives for evidence based procedures for our patients . I am processing a number of: - Endoscopic or gastroenterology biopsies - Breast Core Biopsies Currently, owing to one processor (Sakura, Tissue Tek- VIP-5), we put all tissues on our 12 hour processing run. As a result, the endoscopic tissue, owing to its size, tends to be more dehydrated. To avoid the chatter artifacts associated with over dehydration, we soak these specimen blocks, a minimum of 15 minutes before sectioning with minimal or no chatter. We are hoping to improving turnaround time( to the pathologist) by not having to soak so long. Thus, we feel that a tissue processing protocol of less time will make a difference. As we all know CAP and ASCO, have recommended breast core biopsies (the evidence based standard for determining breast cancer) be fixed at a minimum of 6 to 72 hrs before processing to accommodate accurate testing of immune stains ER. PR and Her2Neu for breast cancer determination. Our processor reagents are as follows: 10% Neutral Buffered Formalin x 2 changes; 70% isopropanol x 1; 95% isopropanol x 1; 100% isopropanol- x 3 changes; clearing reagent- x 3 changes; and paraffin- 4 changes. By the way, we are looking at purchasing another processor- my next communicated topic to accommodate processing of our small biopsies. Question: is it ok to mix endoscopic with other small tissues such as: cervical bxs, shaves, ECC or EMB specimens on the same endoscopic processing protocol? Again provide a reference as a matter of evidence based medicine. We do this to try and split cases to avoid cross contamination at the grossing, embedding and cutting. We consider this a QA mechanism for maintaining the integrity of the specimen cases. V/r Ian R. Bernard Ian R. Bernard, MSgt, USAF, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Can use some help with processing references
Rather than research literature (lit), may I refer you to the foremost authority on histotechnology procedures: Histotechonology- A Self Instructional Text, 3rd Edition by Frieda Carson and Christa Hladik, Chapter 2, page 38, paragraph 2: Tissue should remain in paraffin the shortest time necessary for good infiltration because exposure to prolonged heat causes shrinkage and hardening. I consider book the foremost (bible) reference on histotechnology. At least I hope so, since I'm studying for my HTL from this book. Note: There are lit at the end of this chapter that may go into more detail. The paragraph goes on to state that: ...melted paraffin should be kept 2 to 4 degrees Celsius above the melting point because tissues exposed to overheated paraffin during infiltration will over harden. Bottom-line, I would not leave tissues in paraffin over the weekend. If you are using an automatic-closed system processor, your equipment should be able to work on a delayed status, where the tissues will sit in 10 Neutral Buffered Formalin under vacuum (better for the tissue), all weekend, and start processing schedule on Sunday to come off on Monday morning. At least ours does. Hope this helps. Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jackie O'Connor Sent: Sunday, May 13, 2012 2:42 PM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Can use some help with processing references Hi Y'all - I'm kind of in a jam here - I'm looking for references on paraffin tissue processing - can someone point me towards any literature that says leaving tissues in molten paraffin over the weekend is a bad idea? I need to prove a point, and need something to back me up. I'm out of the US doing a consult, having trouble doing a lit search - I'm really not lazy. Thanks in advance. Jackie O' ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] RE: Tissue Processing Protocol for Small biopsies part 2
Regarding the fixation time for breast biopsies, after doing some more research, I stand corrected (not 72 but up to 18hrs.) with the maximum amount of time for fixation in order to preserve the ER antigen in immunohistochemistry. See this paragraph taken from CAP website: The type of fixative also has an impact on the results of estrogen receptor determination. Most labs use 10 percent buffered formalin. It's a great general fixative. It doesn't make the tissue too hard, and it fixes tissue reasonably quickly. Optimum fixation time for estrogen receptor activity is between six and 18 hours for buffered formalin. Less than that and more than that, you're going to get a diminution in estrogen receptor or even a false-negative. The optimum fixation time also includes processor time. Consider your tissue is sitting in a processor over the weekend in 10 percent buffered formalin for up to 48 hours. You may well end up with false-negative reactivity or at least lowered estrogen receptor reactivity in breast cancer. Too little fixation is also a problem. It is a problem that I encountered in testing for estrogen receptor on breast cores. Our breast cores on the biopsy processor were getting a total of eight to 10 hours of fixation. The laboratory changed its procedure and started processing immediately after loading biopsy tissue. All of a sudden my breast cores were getting only two to six hours of fixation. And there was a falloff in estrogen receptor activity. Though I'd double check myself. Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 From: Ian R Bernard Sent: Sunday, May 13, 2012 11:15 AM To: 'histonet@lists.utsouthwestern.edu' Cc: BERNARD, IAN R MSgt USAF USAFA 10 MDSS/SGSH Subject: Tissue Processing Protocol for Small iopsies Fellow histonetters, I'm looking for evidence based or best practice/ benchmarked tissue processing protocols for the small biopsies listed below. Please provide a reference since our facility strives for evidence based procedures for our patients . I am processing a number of: - Endoscopic or gastroenterology biopsies - Breast Core Biopsies Currently, owing to one processor (Sakura, Tissue Tek- VIP-5), we put all tissues on our 12 hour processing run. As a result, the endoscopic tissue, owing to its size, tends to be more dehydrated. To avoid the chatter artifacts associated with over dehydration, we soak these specimen blocks, a minimum of 15 minutes before sectioning with minimal or no chatter. We are hoping to improving turnaround time( to the pathologist) by not having to soak so long. Thus, we feel that a tissue processing protocol of less time will make a difference. As we all know CAP and ASCO, have recommended breast core biopsies (the evidence based standard for determining breast cancer) be fixed at a minimum of 6 to 72 hrs before processing to accommodate accurate testing of immune stains ER. PR and Her2Neu for breast cancer determination. Our processor reagents are as follows: 10% Neutral Buffered Formalin x 2 changes; 70% isopropanol x 1; 95% isopropanol x 1; 100% isopropanol- x 3 changes; clearing reagent- x 3 changes; and paraffin- 4 changes. By the way, we are looking at purchasing another processor- my next communicated topic to accommodate processing of our small biopsies. Question: is it ok to mix endoscopic with other small tissues such as: cervical bxs, shaves, ECC or EMB specimens on the same endoscopic processing protocol? Again provide a reference as a matter of evidence based medicine. We do this to try and split cases to avoid cross contamination at the grossing, embedding and cutting. We consider this a QA mechanism for maintaining the integrity of the specimen cases. V/r Ian R. Bernard Ian R. Bernard, MSgt, USAF, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] New Topic: New Tissue Processor
We are looking at purchasing the Leica ASP 300S tissue processor. Like I mentioned below, I have the Sakura Tissue Tek VIP 5. Thus for my purchase package, I'm looking for references (pros and cons), of your experiences with the Leica ASP 300s. So far, I've heard good things. In particular, if there are any military or Federal agencies out there with this processor, please respond. However, I will take all responses. Note: This is no Federal endorsement of the Leica or Sakura processors, just our lab's preference based upon experiences/feedback. Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 From: Ian R Bernard Sent: Sunday, May 13, 2012 11:15 AM To: 'histonet@lists.utsouthwestern.edu' Cc: BERNARD, IAN R MSgt USAF USAFA 10 MDSS/SGSH Subject: Tissue Processing Protocol for Small iopsies Fellow histonetters, I'm looking for evidence based or best practice/ benchmarked tissue processing protocols for the small biopsies listed below. Please provide a reference since our facility strives for evidence based procedures for our patients . I am processing a number of: - Endoscopic or gastroenterology biopsies - Breast Core Biopsies Currently, owing to one processor (Sakura, Tissue Tek- VIP-5), we put all tissues on our 12 hour processing run. As a result, the endoscopic tissue, owing to its size, tends to be more dehydrated. To avoid the chatter artifacts associated with over dehydration, we soak these specimen blocks, a minimum of 15 minutes before sectioning with minimal or no chatter. We are hoping to improving turnaround time( to the pathologist) by not having to soak so long. Thus, we feel that a tissue processing protocol of less time will make a difference. As we all know CAP and ASCO, have recommended breast core biopsies (the evidence based standard for determining breast cancer) be fixed at a minimum of 6 to 72 hrs before processing to accommodate accurate testing of immune stains ER. PR and Her2Neu for breast cancer determination. Our processor reagents are as follows: 10% Neutral Buffered Formalin x 2 changes; 70% isopropanol x 1; 95% isopropanol x 1; 100% isopropanol- x 3 changes; clearing reagent- x 3 changes; and paraffin- 4 changes. By the way, we are looking at purchasing another processor- my next communicated topic to accommodate processing of our small biopsies. Question: is it ok to mix endoscopic with other small tissues such as: cervical bxs, shaves, ECC or EMB specimens on the same endoscopic processing protocol? Again provide a reference as a matter of evidence based medicine. We do this to try and split cases to avoid cross contamination at the grossing, embedding and cutting. We consider this a QA mechanism for maintaining the integrity of the specimen cases. V/r Ian R. Bernard Ian R. Bernard, MSgt, USAF, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Tendon Tissue Specimens
Histonetters, our lab processes tendon tissue. After processing, embedding and at the microtome, the specimen tends to be hard (possible calcification) like bone. We get decent sections but not the best, consistently. To help get the decent sections, we soak longer than regular tissues (almost like the endoscopic tissues), and we do some surface decalcifying. Besides these two techniques, are there are other methods for obtaining optimum sections (I.e. full face and complete), e.g. processing protocol, soak in another reagent etc.? Ian R. Bernard Ian R. Bernard, MSHA, HT (ASCP) 10th Medical Group- Anatomic Pathology Lab USAF Academy, CO 80840 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
