Re: [Histonet] H.pylori question

[Kienitz, Kari via Histonet]

Local Coverage Determinations (LCD) from the website for the Centers for 
Medicare & Medicaid Services (CMS). Please use the link below to access this 
policy.

 you may find this information useful. Look at the GI section. It specifically 
calls out the use of special stains for H.pylori. Reimbursement may be an issue 
for you.

L35693 MolDX: Special Histochemical Stains and Immunohistochemical Stains   
 Palmetto GBA(11302)
http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=35693=6=229=1
N
 



Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Gareth Davis via Histonet [histonet@lists.utsouthwestern.edu]
Sent: Tuesday, September 27, 2016 10:45 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] H.pylori question

Okay, so I know I have heard rumors about the H.pylori testing being
affected by Medicare.  We currently do the H. pylori IHC stain on all
gastric biopsies.  Has anyone heard that Medicare will change, and we will
no longer be able to do it on all cases?  The last lab I worked in, in
Tennessee, stopped doing it all cases, because of the Medicare changes.
But, here in Arizona, they are still doing it.
What's the scoop?


--
Ms. Gareth B. Davis, HT, QIHC (ASCPcm)
Yuma Gastroenterology
Yuma, AZ 85364
928-248-5259
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[Histonet] patient identifiers

[Kienitz, Kari via Histonet]

Good morning everyone,

Along with an accession number, is a patients intitials an adequate identifier 
on a block/slide?




Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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[Histonet] productivity standards/slide

[Kienitz, Kari via Histonet]

Hi everyone,

What constitutes a slide? For volume purposes/tech productivity.

1 section on a slide= 1 slide
3 sections (levels) on a slide=1 slide or does it equal 3 slides?




Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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Re: [Histonet] Prefilled formalin containers

[Kienitz, Kari via Histonet]

I have had this annoying experience a few times over the last 20+ years.  It 
seems to me the breakdown is with quality control at the manufacturer.  Most 
recently, 1 out of 5 containers  came back to the lab leaking.  I put pressure 
on my vendor, who put pressure on his vendor.  Unfortunatly, his vendor really 
didn't take the situation seriously.  Even after explaining the dangers to lab 
personnel as well as patients being exposed to formalin they did nothing.

I feel fortunate the histology supply vendor I deal with values our business. 
He went and found a new vendor/manufacturer that has supplied us with 
containers that don't leak and so far they understand the health hazzard and 
the annoyance of what to many may seem trivial.



Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Vickroy, James via Histonet [histonet@lists.utsouthwestern.edu]
Sent: Monday, July 18, 2016 9:33 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Prefilled formalin containers

This is one of the things that comes up every couple of years.   Leaky 
prefilled formalin containers.   I know we have all dealt with nurses or 
physicians that can't put the lid on correctly or put the label on the threads 
of the containers.  Some of the new designs have a "clicking lid" when they are 
supposed to be sealed.   My experience with the "clicking lids" are that some 
vendors have lids that the "clicker" breaks off as soon as you unscrew it so 
obviously it doesn't help when putting the lid back on.   Another vendor that 
has the "clicking lid" does not have the "clicker" break off when you unscrew 
and screw but the containers still leak.

It seems to me that someone could come up with accost-effective prefilled 
formalin container that does not leak (of course provided the lids was put on 
straight).   I would be interested in other's experiences with this elemental 
yet extremely annoying issue. It seems like if we can make new automated 
electronic instruments someone might be able to make affordable container that 
doesn't leak.

Jim

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



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Re: [Histonet] Nuclear Bubbling

[Kienitz, Kari via Histonet]

incomplete deparafinization has my voteincrease times in xylene and I bet 
it goes away.  This happened to me when the paraffin that I had bought for 
years was slightly changed without notifying anyone.  If I remember right the 
polymer was increase resulting in xylene being less effective.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Hoekert, Willem via Histonet [histonet@lists.utsouthwestern.edu]
Sent: Wednesday, February 17, 2016 11:54 PM
To: Vickroy, James; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Nuclear Bubbling

Could it be due to incomplete deparaffinization?

Willem



Van: Vickroy, James via Histonet [histonet@lists.utsouthwestern.edu]
Verzonden: dinsdag 16 februari 2016 18:10
Aan: histonet@lists.utsouthwestern.edu
Onderwerp: [Histonet] Nuclear Bubbling

Struggling to find an answer.  We do a lot of GI biopsies in our lab.   
Sometimes they look wonderful without any nuclear bubbling, other times the 
bubbling is pretty intense.  Since nuclear bubbling is often attributed to 
incomplete fixation we of course have investigated the fixation times.  I do 
not find that the problem is fixation.  In fact some of the biopsies end up 
fixing for 48 hrs before processing. (weekend).  There was a suggestion last 
week or so that there might be water trapped under the slides after cutting and 
before staining.   I really thought that this might be the issue however I'm 
not sure at this point.  Extra drying seems to help but sometimes slides side 
by side are so variable, one with bubbles and one without.   I also don't 
believe the problem is in the processing schedule since the problem has shown 
up on both a rapid and a normal schedule. (therefore longer dehydration, 
clearing, etc.)

I am wondering if anyone else has worked with this issue.  Here are my 
questions:


1.Could it be something that is happening with the tissue before it 
gets to the lab?  Usually a delay if fixation  causes other artifacts but not 
bubbling.  Could it be heat from the GI procedure?

2.   We do use blue sponges for our biopsies.  I know some say get rid of 
the sponges but has anyone seen this problem caused by usage of sponges?

3.   What about the heat stage in our Prisma stainer?


I am really getting frustrated.  Pathologists never complain however I would 
rather all of the tissue did not have the "nuclear bubbling".   Again we only 
do biopsies so I really don't think the standard old " not enough time in 
formalin" is the issue.  I have even wondered about variables such as we use 
recycled formalin, recycled Clearite III.

Any suggestions?

Jim



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



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voorwaarden 

Re: [Histonet] TC labs

[Kienitz, Kari via Histonet]

The State is responsible for inspecting/upholding a TC lab to CLIA regulations, 
every two years.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Andy B via Histonet [histonet@lists.utsouthwestern.edu]
Sent: Monday, October 05, 2015 12:47 PM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] TC labs

Thank you. That is exactly what I would have given as an answer, but I have
yet to see any CLIA inspector or CLIA Operations manual that mentions any
of that, other than the vague statements about the Lab Director ultimately
being responsible. CLIA is not consistent with its rules and regulations
and interpretations. I would love for someone to prove me wrong!

When is the last time someone actually witnessed CLIA verifying a TC lab
other than maybe being shown some QC logs, etc? I have yet to see any
Testing Personnel verifications from CLIA for TC labs. It is hypocritical
for CLIA not to inspect TC- only operations. If there is a standard form or
regulation for this, please show me. I have never seen or heard of a PC
only lab director being asked for verification of testing personnel
qualifications from a TC lab.

Thanks in advance for everyone's input.

On Mon, Oct 5, 2015 at 3:42 PM, Andy B  wrote:

> Thank you. That is exactly what I would have given as an answer, but I
> have yet to see any CLIA inspector or CLIA Operations manual that mentions
> any of that, other than the vague statements about the Lab Director
> ultimately being responsible. CLIA is not consistent with its rules and
> regulations and interpretations. I would love for someone to prove me wrong!
>
> When is the last time someone actually witnessed CLIA verifying a TC lab
> other than maybe being shown some QC logs, etc? I have yet to see any
> Testing Personnel verifications from CLIA for TC labs. It is hypocritical
> for CLIA not to inspect TC- only operations. If there is a standard form or
> regulation for this, please show me. I have never seen or heard of a PC
> only lab director being asked for verification of testing personnel
> qualifications from a TC lab.
>
> Thanks in advance for everyone's input.
>
>
>
> On Mon, Oct 5, 2015 at 3:28 PM, Morken, Timothy 
> wrote:
>
>> What I believe happens is that the referring lab must do an
>> audit/inspection of the technical-only lab to be sure they are CLIA
>> compliant. For instance, check validation procedures for stains, equipment,
>> quality control. It's true CLIA itself does not inspect the Tech-only lab,
>> but the referring lab becomes the "technical supervisor" and must have
>> documentation to show they have inspected it and it is compliant. That is
>> how it works for vendors using other labs to do work for them under FDA
>> regulations.
>>
>>
>> Tim Morken
>> Pathology Site Manager, Parnassus
>> Supervisor, Electron Microscopy/Neuromuscular Special Studies
>> Department of Pathology
>> UC San Francisco Medical Center
>>
>>
>>
>> -Original Message-
>> From: Andy B via Histonet [mailto:histonet@lists.utsouthwestern.edu]
>> Sent: Monday, October 05, 2015 12:05 PM
>> To: histonet@lists.utsouthwestern.edu
>> Subject: [Histonet] TC labs
>>
>> Does CLIA inspect labs that only perform Technical Components on tissue?
>>
>> I know that CAP does so as part of its due diligence, however years ago a
>> CLIA inspector told me that CLIA doesnt inspect TC-only operations because
>> there is no report (PC) being rendered. How does this jive with grossing
>> and the new High Complexity Testing (HCT) paradigm?
>>
>> In other words, what is to prevent a pathologist (or non-pathologist)
>> from owning and operating a TC lab service that is remote from the PC
>> service location? How does CMS verify that TC labs are correctly and
>> compliantly performing grossing (HCT) and other TC lab evolutions if they
>> do not inspect such operations?
>>
>> I know of labs that are TC only and bill CMS for the Technical Components.
>> Has anyone else ever wondered about this? How is CMS assuring that TC
>> labs are compliantly staffed and managed if CMS only inspects labs that
>> issue reports?
>>
>> Does anyone wonder how CMS can get away with hammering some labs and
>> ignoring others?
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>>
>
>

Re: [Histonet] Manual Cassette Labelling

[Kienitz, Kari via Histonet]

Epic Scientific Super Moist Markers by Creative Waste Solutions
503-657-5711

They will not let you down :)


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Joanne Clark via Histonet [histonet@lists.utsouthwestern.edu]
Sent: Thursday, August 06, 2015 1:27 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Manual Cassette Labelling

Hi Histoland,

We have a satellite lab that manually prepares their cassettes.  We have had 
significant problems with the markers coming off after tissue processing.  We 
have tried StatLab markers, Leica Markers and the red AquaRellable pencils and 
continue to have issues.  Other than purchasing a cassette labeling system 
(their volumes are pretty low and there is limited bench space in the lab for a 
cassette labeler) does anyone have any suggestions or ideas on what might be 
causing this phenomenon or a really good permanent lab marker that has been 
successful for you?

Joanne Clark, BAAS, HT(ASCP)CM
Director of Histology

P.   (575) 622-5600
C.   (575) 317-6403
F.   (575) 622-3720
TF. (800) 753-7284

pcnm.com




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Re: [Histonet] Eosin

[Kienitz, Kari]

It's always kind of a stab in the dark to diagnose HE problems without a 
little more information.  One thing I would try if you don't feel its an actual 
Eosin problem is your alcohol prior to the eosin.  Slide volume and humidity 
can dilute your alcohol and cause lighter cytoplasmic staining.  The alcohol 
prior to eosin should be 95% and changed daily if need be.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Hannen, Valerie [valerie.han...@parrishmed.com]
Sent: Monday, July 13, 2015 8:05 AM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] Eosin

Good morning,

I once again am dealing with a my picky Pathologist!!  About a year ago, he 
started to complain about not having enough Eosin on his sections( first 
morning rack on Monday).. I went from changing the Eosin on Friday and stirring 
it on Monday to totally changing it  on Monday...it has all been good until the 
end of last week. The problem has started up again... little Eosin in the first 
rack of Monday morning.  Any suggestions??

Valerie Hannen,MLT(ASCP),HTL,SU (FL)
Section Chief, Histology
Parrish Medical Center
951 N. Washington Ave.
Titusville,Florida 32796
T: (321)268-6333 ext. 7506
F: (321) 268-6149
valerie.han...@parrishmed.commailto:valerie.han...@parrishmed.com
www.parrishmed.com

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Re: [Histonet] AFB contaminant

[Kienitz, Kari]

most likely a fungus ball, confirm with a PAS


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Abbott, Tanya [tanyaabb...@catholichealth.net]
Sent: Thursday, July 09, 2015 12:09 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] AFB contaminant

Has anyone ever had a problem with a possible contaminant in their AFB hand 
stain? If so, how did you deal with it? Any suggestions?
Ours actually looked like an AFB like organism, which we later determined to be 
negative.
Thanks!

Tanya G. Abbott
Manager Technologist
Histology/Cytology
St Joseph Medical Center
(phone) 610-378-2635

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Re: [Histonet] Histonet Digest, Vol 140, Issue 6 Specimen loss

[Kienitz, Kari]

whoa! 7% of specimens? Working in a high volume colonoscopy laboratory for 4 
years, I've only had two specimens that were so minute there was nothing at 
embedding.  Bio-wraps or lens paper is a must.  


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: Steve McClain [ste...@mcclainlab.com]
Sent: Wednesday, July 08, 2015 10:47 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Histonet Digest, Vol 140, Issue 6 Specimen loss

My goodness 7% tissue loss is ridiculous.
What fool published that?

A 0.8% loss of tissue is beyond me.
Would any one advertise in the local paper that your center of excellence lab 
loses nearly 1% of your specimens?

possibly too small to survive processing is in my opinion, a self-fulfilling 
prophesy,
one to be eschewed and denounced,
or beaten out of the grosser who dares use that description for it is an 
expectation of failure.
That grosser would not last a week around me.
I would walk them to the train station and ask them not to return.

I felt less cantankerous before I read that one.
Steve A. McClain, MD
631 361 4000


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RE: [Histonet] Nuclear Artifact

[Kienitz, Kari]

I have experience the over-cooked, dried out look a few times myself through 
the years and it can be baffeling especially when pathologists tell you things 
look dried out.  The first thing we think of it too much exposure to 
heat/chemical when its almost always not enough exposure to xylene at the 
deparaffinization stage or the tissue is underprocessed. Both of these 
scenarios can make tissue looked dried out. Make sure your protocols are 
adequate for processing thickness. Then there are the varying paraffin 
compounds.  the higher the polymer content the more time you need in 
xyleneI know it sounds crazy but increase your time in xylene prior to 
staining and you will see alot of your random staining issues disappear.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Patrick Laurie 
[foreig...@gmail.com]
Sent: Wednesday, April 22, 2015 9:10 AM
To: Michael Ann Jones
Cc: histonet@lists.utsouthwestern.edu; Lisa Roy
Subject: Re: [Histonet] Nuclear Artifact

At a previous job, we found (this was specific to prostate biopsies) that
one of our clients was taking the prostate biopsies out, lining them up on
a dry paper towel, doing the whole procedure, then putting them into the
formalin jars.  It can be some time between the start and finish of a
procedure, so the first couple were looking very dried out (paper towel
absorbed most of the moisture) with very pale hematoxylin staining.  The
pathologist found them almost uninterpretable. When this happened, the
first natural area we examined was processing, which in this case turned
out not to be the culprit.  Collection procedures are not usually done by
lab staff, a clinician or staff may have a great idea to make things easier
but not know the downstream effects.

Patrick Laurie(HT)ASCP QIHC

Histology Manager

Celligent Diagnostics, LLC

101 East W.T. Harris Blvd  | Suite 1212 | Charlotte, NC 28262

Work: 704-970-3300  Cell: 704-266-0869

On Wed, Apr 22, 2015 at 10:02 AM, Michael Ann Jones mjo...@metropath.com
wrote:

 Happy Lab Week!!
 We worked on our HE for almost two years. We were using Leica HE
 products and after 2 years of struggling, adjusting and analyzing
 everything in our lab - we switched to the Richard-Allen Scientific
 products. We were seeing variability between days of staining, tissues
 right next to each other, nuclear paleness, eosin uniformity instead of
 differentiated, etc. Switching reagents helped us tremendously - we have
 more consistent higher quality stains on a daily basis and within tissues.

 I you¹re struggling and have analyzed your processors, etc. to death -
 maybe try different reagents? (we even measured the tap water that we use
 on our stainer daily, the pH of reagents every other hour etc. and between
 5 experienced histotechs, we couldn¹t figure it out)
 Good luck! :)

 Michael Ann
 Michael Ann Jones, HT (ASCP)
 Histology Manager
 Metropath
 7444 W. Alaska Dr. #250
 Lakewood, CO 80226
 303.634.2511
 mjo...@metropath.com







 On 4/21/15, 5:55 PM, Sue suetp...@comcast.net wrote:

 OMG we are experiencing the same issue. At first it was just GI and now
 we are seeing it on prostate. One pathologist said it looks like the
 tissue has been cooked. The only issue is we can have two biopsies right
 next to one another in the basket one looks good and one looks bad. My
 director also thinks it is the processors. I had Thermo out and they
 could find nothing. We changed out all the reagents and the biopsies were
 fine than two days later we had some bad ones. I know in July Fisher had
 a formalin recall associated to the mixture of buffer, water and
 formalin. We thought that might be it but it is now almost a year later
 and all the bad formalin should be gone. The histotechs say the tissue is
 crunchy and they are right. I am running a test tonight of a small needle
 biopsy that I made from a colon. I placed it is straight formaldehyde
 overnight and am processing it on our biopsy cycle tonight. My director
 also wanted us to only put three levels on our Thermo, but he wanted the
 middle level to have empty baskets. I stopped that today because I think
 the other issue is that the poor biopsies may be on the top level and as
 the reagents are used the level changes, and also due to displacement
 with the middle level being empty the reagent 

[Histonet] RE: inconsistent HE staining

[Kienitz, Kari]

Hi Julie,
Try increasing your deparaffinization times, sometimes there is just not enough 
time in xylene so subsequent staining can be very inconsistent like described.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Gastroenterology-EAST
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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missive. If you have received this in error, please notify the sender 
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From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Julie Cohen 
[juc2...@med.cornell.edu]
Sent: Wednesday, April 01, 2015 9:06 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] inconsistent HE staining

Hi,

I made slides of paraffin-embedded mouse small intestine (Swiss rolls), and 
stained them with Hematoxylin and Eosin.  Parts of the tissue on the same slide 
are stained dark with good structure.  Other areas look washed out with poor 
structure.  We realize that some of this could be caused by the 
orientation/structures captured, but similar tissue type looks paler as well.

Has anyone had a similar experience, and could suggest an explanation for me to 
give to our client?  At first we thought it might be due to poor fixation, 
since the centers of tightly-wound rolls were affected, but we also observed 
this in the outer parts of loosely wound rolls.  I soak the blocks before 
sectioning; could non-uniform swelling result in variations of the section 
thickness?  (These are 7 microns thick.)

Apologies if this information is available somewhere else; I tried 
unsuccessfully searching the archives.

Thank you,

Julie Cohen

Research Lab Tech
EM Core Facility
Weill Cornell Medical College
1300 York Avenue, Room A-105
New York, NY 10021
lab: 212-746-6146
email: juc2...@med.cornell.edumailto:juc2...@med.cornell.edu

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RE: [Histonet] GI biopsy slides

[Kienitz, Kari]

My GI Pathologists require no more than 5 pieces of tissue per block; three 
levels on one slide; one section per level.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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missive. If you have received this in error, please notify the sender 
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From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert 
[lcolb...@pathmdlabs.com]
Sent: Tuesday, September 10, 2013 10:18 AM
To: Sheila Haas; Elizabeth Chatfield; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] GI biopsy slides

We cut exactly as Sheila does.

Laurie Colbert, HT (ASCP)

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sheila Haas
Sent: Tuesday, September 10, 2013 8:59 AM
To: Elizabeth Chatfield; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] GI biopsy slides

We cut 3 levels on one slide. Each level typically has two sections across the 
slide. If there are multiple pieces of tissue that need to be embedded in a 
little larger mold, we put 3 levels on 1 slide by breaking away the excess 
paraffin around the sections while they're on the waterbath. Then we can then 
fit 3  levels on 1 slide but each level will only have 1 section. Hope this 
makes sense.


Sheila Haas
Laboratory Manager
MicroPath Laboratories, Inc.



From: Elizabeth Chatfield epchatfi...@ihis.org
To: histonet@lists.utsouthwestern.edu
Sent: Tuesday, September 10, 2013 11:31 AM
Subject: [Histonet] GI biopsy slides


Hi folks,

We are re-thinking how we cut our GI biopsy slides. Currently we are cutting 3 
levels with 3 sections on each slide.  Is anyone out there putting all 3 levels 
on the same slide?  We are receiving cases with a large number of samples and 
some our pathologists would like to see fewer slides.


Thanks,
Elizabeth
Charlottetown, PE

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RE: [Histonet] GI biopsy slides

[Kienitz, Kari]

yesfor some cases there are many blocks and slides!

Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.commailto:kkien...@orclinic.com





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and confidential use of the intended recipient. If you are not the intended 
recipient, please do not read, distribute or take action in reliance upon this 
missive. If you have received this in error, please notify the sender 
immediately by reply e-mail and delete this message and its attachments from 
your computer system. Thank you



From: jeff lowen [lowenj...@hotmail.com]
Sent: Tuesday, September 10, 2013 10:57 AM
To: Kienitz, Kari; Laurie Colbert; Sheila Haas; Elizabeth Chatfield; 
histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] GI biopsy slides

That would make it easier to embed though don't u end up with multiple blocks 
and the additional slides that way at times?

 From: kkien...@orclinic.com
 To: lcolb...@pathmdlabs.com; micropathl...@yahoo.com; epchatfi...@ihis.org; 
 histonet@lists.utsouthwestern.edu
 Date: Tue, 10 Sep 2013 10:30:40 -0700
 Subject: RE: [Histonet] GI biopsy slides
 CC:

 My GI Pathologists require no more than 5 pieces of tissue per block; three 
 levels on one slide; one section per level.


 Kari Kienitz HT, (ASCP)
 Histology Laboratory
 Portland Gastroenterology
 The Oregon Clinic
  NE 99th Ave
 Portland, OR 97220
 503.935.8311
 kkien...@orclinic.com




 CONFIDENTIALITY WARNING: This e-mail and any attachments are for the 
 exclusive and confidential use of the intended recipient. If you are not the 
 intended recipient, please do not read, distribute or take action in reliance 
 upon this missive. If you have received this in error, please notify the 
 sender immediately by reply e-mail and delete this message and its 
 attachments from your computer system. Thank you
 
 From: histonet-boun...@lists.utsouthwestern.edu 
 [histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert 
 [lcolb...@pathmdlabs.com]
 Sent: Tuesday, September 10, 2013 10:18 AM
 To: Sheila Haas; Elizabeth Chatfield; histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] GI biopsy slides

 We cut exactly as Sheila does.

 Laurie Colbert, HT (ASCP)

 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sheila Haas
 Sent: Tuesday, September 10, 2013 8:59 AM
 To: Elizabeth Chatfield; histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] GI biopsy slides

 We cut 3 levels on one slide. Each level typically has two sections across 
 the slide. If there are multiple pieces of tissue that need to be embedded in 
 a little larger mold, we put 3 levels on 1 slide by breaking away the excess 
 paraffin around the sections while they're on the waterbath. Then we can then 
 fit 3 levels on 1 slide but each level will only have 1 section. Hope this 
 makes sense.


 Sheila Haas
 Laboratory Manager
 MicroPath Laboratories, Inc.


 
 From: Elizabeth Chatfield epchatfi...@ihis.org
 To: histonet@lists.utsouthwestern.edu
 Sent: Tuesday, September 10, 2013 11:31 AM
 Subject: [Histonet] GI biopsy slides


 Hi folks,

 We are re-thinking how we cut our GI biopsy slides. Currently we are cutting 
 3 levels with 3 sections on each slide. Is anyone out there putting all 3 
 levels on the same slide? We are receiving cases with a large number of 
 samples and some our pathologists would like to see fewer slides.


 Thanks,
 Elizabeth
 Charlottetown, PE

 -
 Statement of Confidentiality
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 information intended for a specific individual or organization. If you have 
 received this communication in error, please notify the sender immediately. 
 If you are not the intended recipient, you are not authorized to use, 
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 delete this email from your entire computer system.



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RE: [Histonet] linear stainer hematoxylin staining issues

[Kienitz, Kari]

If your acetic acid solution is made in-houseI would suggest remaking it, 
just in case it was accidently made stronger.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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and confidential use of the intended recipient. If you are not the intended 
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missive. If you have received this in error, please notify the sender 
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From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sophia Lin 
[lins0...@gmail.com]
Sent: Wednesday, March 27, 2013 9:26 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] linear stainer hematoxylin staining issues

We have the Hacker linear stainer, and for the past two weeks we had clean,
crisp HE staining. However, last Friday, something happened and our HE
stains no longer look crisp, but instead have a hazy, unreadable look.
Nothing different has been done, and we have troubleshot for every possible
scenario. After a clean set up, we noticed that the hematoxylin is not
staining very well. We have it set for 2 minutes with agitation for a
uniform staining. Hematoxylin is Harris Special (mercury free) from MCC and
the eosin is with phloxine b from AMT. After the hematoxylin (2 buckets for
total of 4.5 minutes), we use 1.5% acetic acid. It seems that the
hematoxylin is not staining well.

Any tips? We may need to consider increasing a bucket for hematoxylin?

Thanks,

Sophia
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[Histonet] RE: interview

[Kienitz, Kari]

Hi Gale,

In my career I have had the pleasure of hiring many OJT histotechs.  With 
varying degrees of education and  a whole range of personalities.  The things 
that tend to really stand out in the candidates who excelled are the ones who 
could follow direction, pay close attention to detail, and communicate well.  
Histology is a field where as many mundane tasks must be done as the 
complicated ones. 

For many years we would administer to all final candidates a simple aptitude 
test.  It was honestly something most 3rd graders could do.  Its was amazing 
how many people would get caught up following directions on where to place 
their name on the paper and simple math.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com




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recipient, please do not read, distribute or take action in reliance upon this 
missive. If you have received this in error, please notify the sender 
immediately by reply e-mail and delete this message and its attachments from 
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From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Gale Limron 
[ga...@unionhospital.org]
Sent: Tuesday, January 08, 2013 10:02 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] interview

Hello,
I just found out today I will be doing 2nd interviews for 3 candidates for a 
part time Histology position at our hospital on Friday of this week. These 
candidates are not histotechs but are willing to do online training and take 
ASCP board exam within 24 months. I would appreciate some help with what 
questions to ask. I did not attend the 1st interviews but these were done by 
our lab manager who does not know a lot about what we do I 
histology.
Thank you!

Gale Limron CT,HT (ASCP)
Histology Supervisor
Union Hospital
659 Boulevard
Dover, Ohio 44622
330-343-3311 ext 2562



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RE: [Histonet] Devasting news on 88305TC component

[Kienitz, Kari]

Actually, the global payment for this code is being reduced by 33% according to 
the announcement. Regardless of the establishment, small lab; large volume lab; 
POL lab everyone will be taking a hit on this.  Even if the POL labs all dried 
up and went away, the remaining labs may get the work but they will be doing it 
for a lot less reimbursement. 


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nails, Felton 
[flna...@texaschildrens.org]
Sent: Friday, November 02, 2012 10:01 AM
To: 'Jesus Ellin'; 'Cristi Rigazio'; Brendal Finlay
Cc: histonet@lists.utsouthwestern.edu; Webster, Thomas S.
Subject: RE: [Histonet] Devasting news on 88305TC component

Before you holler political and blame the candidates, ask yourself who was hurt 
most by POL's?
Large reference labs.
With this change they will get back the business because it will not be 
profitable to establish a POL.
Also they lobbied for and increase on the PC, reference have pathologist, most 
POL's don't.
Just my thought

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Jesus Ellin
Sent: Friday, November 02, 2012 11:52 AM
To: 'Cristi Rigazio'; Brendal Finlay
Cc: histonet@lists.utsouthwestern.edu; Webster, Thomas S.
Subject: RE: [Histonet] Devasting news on 88305TC component

AMEN

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cristi Rigazio
Sent: Friday, November 02, 2012 9:32 AM
To: Brendal Finlay
Cc: histonet@lists.utsouthwestern.edu; Webster, Thomas S.
Subject: Re: [Histonet] Devasting news on 88305TC component

Political yet?!  Seriously!  52%, while the PC is increased 2%... But in case 
anyone wondered both candidates for President are looking for the middle class! 
 Unbelievable!

Sent from my iPhone

On Nov 2, 2012, at 8:28 AM, Brendal Finlay 
brendal.fin...@medicalcenterclinic.com wrote:

 http://www.cap.org/apps/cap.portal?_nfpb=truecntvwrPtlt_actionOverrid
 e=%2Fportlets%2FcontentViewer%2Fshow_windowLabel=cntvwrPtltcntvwrPtl
 t%7BactionForm.contentReference%7D=statline%2Fspecial_report_final_201
 3_physician_fee_schedule.html_state=maximized_pageLabel=cntvwr


 Brendal Finlay, HT (ASCP)
 Medical Center Clinic
 brendal.fin...@medicalcenterclinic.com
 850.474.8758
 http://medicalcenterclinic.com
 -Original message-
 From: Davide Costanzo pathloc...@gmail.com
 Date: Fri, 02 Nov 2012 10:09:18 -0500
 To: Webster, Thomas S. twebs...@crh.org
 Subject: Re: [Histonet] Devasting news on 88305TCcomponent

 That is devastating! Do you have a link to this information?

 Sent from my iPhone

 On Nov 2, 2012, at 4:53 AM, Webster, Thomas S. wrote:

 Devastating I meant


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RE: [Histonet] POL labs

[Kienitz, Kari]

Hooray Nicole! Very well stated.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Nicole Tatum 
[nic...@dlcjax.com]
Sent: Wednesday, October 31, 2012 12:39 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] POL labs

Let me start by sharing this:

Definition of FREE ENTERPRISE
: freedom of private business to organize and operate for profit in a
competitive system without interference by government beyond regulation
necessary to protect public interest and keep the national economy in
balance.

Key Word being For Profit. Health care is a commodity that is bought and
sold and the medical industry is big bucks for our economy. So what if a
POL is for profit, so are some hospitals, pharmaceutical companies,
pharmacies, and the local gas station. My point being is, just because a
POL is for profit does not mean that the facility does not offer the same
quality of care as a national laboratory who is also seeking profit. So,
as far as Im concerned the Doctor, owner, or medical director is able to
bill for any test he performs in his facility that is currently licensed
and regulated. I really dont think the setting should be a factor. We all
will see changes and cuts. I do not believe this thread has any thing to
do specifically with the election. Besides it doesnt really matter what
side of the fence your on. Cuts are comming, dare I say rationing. Even
if socialized medicine does not get passed and Romney wins, Medicare will
have to decrease its allowable payouts each year.  I personally am more
worried about what that will mean for our payscale. For those of you who
dont know me, I DO work in a POL lab. Im not bias, but I don't think the
location of my lab is relative to the fact that it shouldn't be allowed to
exist because its for profit. Just my thought. Happy Halloween to all.

Nicole Tatum, HT ASCP



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[Histonet] RE: GMS on Toenail

[Kienitz, Kari]

After cutting, try putting the slide into a coplin jar of formalin.  Introduce 
to heat for about 30 minutes or so, remove and let air dry before staining.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kkien...@orclinic.com

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Scott, Allison D 
[allison_sc...@hchd.tmc.edu]
Sent: Thursday, April 19, 2012 12:22 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] GMS on Toenail

Hello to all in histoland.  We have a stubborn toenail that keeps coming off 
when we try to do a GMS stain on the ventana machine.  Any suggestions on how 
to keep the section on the slide during the staining procedure.

Allison Scott HT(ASCP)
Histology Supervisor
LBJ Hospital
Houston, Texas

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[Histonet] RE: Ventana XT/Ultra

[Kienitz, Kari]

Be careful assuming costs.  The cost of all consumables through Ventana is 
dependent of your instituitions volume and contractual agreement. The only way 
to have an accurate accounting is for Ventana to do a quote or go by list 
pricing.


Kari Kienitz HT, (ASCP)
Histology Laboratory
Portland Gastroenterology
The Oregon Clinic
 NE 99th Ave
Portland, OR  97220
503.935.8311
kbrads...@orclinic.com

From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Clare Thornton 
[cthorn...@dahlchase.com]
Sent: Wednesday, March 28, 2012 8:43 AM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] Ventana XT/Ultra

Has anyone ever worked up cost/slide for either the XT and/or Ultra as far as 
the bulk fluids are concerned?  Does anyone know how much bulk fluid (LCS, 
Reaction buffer, CC1) is used per slide during a typical run?

thanks!
Clare

Clare J. Thornton, HTL(ASCP), QIHC
Assistant Histology Supervisor
Dahl-Chase Diagnostic Services
417 State Street, Suite 540
Bangor, ME 04401
cthorn...@dahlchase.com

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[Histonet] RE: standard for sm bx microtomy

[Kienitz, Kari]

Do you have a maximum number of pieces of tissue per block? I work for a GI lab 
also.  My slides go out to a hospital path group who insist only 5 pieces of 
tissue per block.  Of course this adds a lot of extra work on  many 
cases...just wondering?

Kari Kienitz, HT(ASCP)
The Oregon Clinic - Portland GI



From: histonet-boun...@lists.utsouthwestern.edu 
[histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Amber McKenzie 
[amber.mcken...@gastrodocs.net]
Sent: Monday, January 09, 2012 1:44 PM
To: Sharon Allen; histonet@lists.utsouthwestern.edu
Cc: Lisa Manning
Subject: [Histonet] RE: standard for sm bx microtomy

We are a GI lab and I do 3 levels on each block, 3 sections on each slide

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sharon Allen
Sent: Monday, January 09, 2012 3:26 PM
To: histonet@lists.utsouthwestern.edu
Cc: Lisa Manning
Subject: [Histonet] FW: standard for sm bx microtomy

Hi,

Is there is a standard used for small biopsy Microtomy?  I am wondering how 
other sites cut their biopsies (ie the number of sections per slide and the 
amount of roughing in between sections)?  I am also curious about the number of 
slides per biopsy.

Thanks for your help,



Sharon Allen

Senior Medical Technologist

Neuropathology Lab-MS435U

Health Sciences Centre

820 Sherbrook Street

Winnipeg,MB, CA

R3A 1R9

e-mail: sal...@dsmanitoba.ca




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