Re: [Histonet] Weak DAB from frozen

[Terri Braud via Histonet]

I agree with Carl Hobbs: "Perhaps your H2O2 ( substrate) stock has 'gone off'? 
That will give you a weaker/negative DAB result."
If your frozen DAB aliquots keep the same color, I would be very suspect of the 
Hydrogen Peroxide.  It can become unstable very quickly.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
Honesty
AccouNtability
AgiLity
CoLlaboration
CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 

Today's Topics:
   1. Re: DAB freezing (Alonso Mart?nez Canabal) (Carl Hobbs)

--

Message: 1
From: Carl Hobbs 
Re: [Histonet] DAB freezing (Alonso Mart?nez Canabal)

I do manual IHC-DAB regularly
DAB shouldn't "go off" after freezing unless you have somehow oxidised it 
during mixing/aliquoting.
It would then show as a dark brown aliquot I state this because I still make up 
my own DAB from dry powder ( have been doing for > 20yrs) SIgma D5637 I 
dissolve, aliquot and freeze, as you do.
An aliquot may  be stored at -20C  for 2yrs before I defrost/use it If I run 
out of 50microL aliquots  I will defrost a 1ml aliquot, re-aliquot into 50 
microL ( when I am doing IHC on a few slides, I make up a small working DAB 
vol.)

Perhaps your H2O2 ( substrate) stock has "gone off"?
That will give you a weaker/negative DAB result

NB: left-over  working DAB solution can be stored at 4C for  at least 7 days 
and still be perfectly usable ( NOT re-usable) If I have only 5-10 slides I 
will do the DAB step in the humidity chamber, applying DAB  as I would antibody 
(only into the hydrophobic pen-ringed section)

Good luck and...please let us know the answer when you solve your problem

Carl Hobbs FIBMS
Histology and Imaging Manager
Wolfson SPaRC
Guys Campus, London Bridge
Kings College London
London
SE1 1UL
020 7848 6810


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Re: [Histonet] John Caggiano's passing

[Terri Braud via Histonet]

I just returned from a week off to see the notice of John Caggiano's passing.  
My deepest condolences to his family and friends.  His unwavering commitment 
and support to the field of Histotechnology can't be understated.  RIP, you 
will be missed. 
Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion




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or email the sender and delete this message and any attachment from your 
system; you must not copy or disclose the contents of this message or any 
attachment to any other person. Any views expressed in this message are those 
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Re: [Histonet] [EXTERNAL] Histonet Digest, Vol 238, Issue 13

[Terri Braud via Histonet]

We have something that is a bit of a hybrid that we call a "dummy" requisition. 
 
A person "orders" a "test" for pathology or cytology in the hospital 
information system.  The form they fill out has all of the information that 
would appear on a paper requisition.  When completed, it prints to a printer in 
Pathology and is matched to the specimens in the department (this could print 
to where the specimens are collected).  The printed copy becomes the 
requisition. The pathology dummy test is autoresulted as "see pathology 
report".  The actual accessioning of the specimen into the LIS creates the true 
pathology test with result(report) pending.  
Advantages:  One can make required fields (such as clinical history) so that 
they must be filled out, which captures information required by CAP.
Cons: A pain when something needs to be corrected.  We usually have them cancel 
the order and submit another order.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
-Original Message-

Today's Topics:

   1. Electronic requisitions (Jacque Sagasser)
From: Jacque Sagasser 
Subject: [Histonet] Electronic requisitions
Hello
Does anyone use electronic requisitions? If so, would you mind describing your 
system for staying compliant with CLIA? Is a paper requisition sent in addition 
to the electronic requisition? If not, how does that work with accessioning and 
matching the specimens and patient information?  We currently use a paper 
system and the requisitions are filed and kept for 10 years. We would like to 
move to an electronic system, but I am not sure how to implement it, while 
staying compliant and not complicating the process. We do not have a bar code 
system set up. I could scan the paper requestions into the patient file, but 
that would be more work than just continuing to file them. I am also running 
out of room to file the requisitions though, so I am trying to explore my 
options. Thank you in advance for your input.

Jacque R. Sagasser, HT (ASCP)cm
Gandhi GI Pathology, LLC
999 Brubaker Drive
Suite 1
Kettering OH 45429
jsagas...@gandhigi.com
937-795-1099 phone
937-519-1321 fax


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Re: [Histonet] Von Kossa light source

[Terri Braud via Histonet]

We've used the UV light for the hood disinfectant, as well as just taken a 
break out in the sunshine.  Both worked just fine

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

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Re: [Histonet] Logging everything you do.

[Terri Braud via Histonet]

As someone who has been a supervisor in 3 institutions for 35 years, this is 
not that way to improve productivity.  To log in every minute of activity feels 
very punitive and I can't imagine that it would be well received by staff.  The 
best way to improve productivity is to start by asking each tech on a daily 
basis what problems do they feel impacts productivity.  Some items already have 
general standard established such as embedding, cutting, staining.  Ask your 
techs for their ideas.  I'm sure they will have some valid ones.  Don't let the 
talks dissolve into complaining.  Ask for concrete ideas for improvement that 
can be tried. Look for duplicity in work, records, and labeling.  Make sure 
they have the right tools to do their job. Get on the bench and see it for 
yourself.  There is nothing like first had experience to find the weak spots. 
They worst way to improve productivity is to require such an onerous demand 
such as a task log.  All you are doing is slowing productivity, not improving. 
Respectfully, Terri 

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion


Message: 5
Date: Fri, 21 Jul 2023 21:42:20 -0400
From: Samantha Golden 
Subject: [Histonet] Productivity log
I have asked staff to start logging all the tasks they perform and the amount 
of time it is taking them to complete. We would like to identify pain points 
and waste in an effort to improve our overall productivity. Rather than 
reinventing the wheel, does someone have a form they?ve used in the past that 
they would be willing to share? 
Thank you for sharing your experience. 
Samantha

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Re: [Histonet] changing expiration dates once open

[Terri Braud via Histonet]

The inspector is wrong.  Sometimes there is an expiration upon opening, but the 
majority of reagents do not have this.  Just smile and say OK like you really 
mean it, then check your CLIA regulations and be prepared to back up your 
defense for the next inspector.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Saturday, July 22, 2023 1:00 PM


Today's Topics

1. Expiration date after opeing a reagent (Paula)
Date: Fri, 21 Jul 2023 13:08:33 -0700
From: "Paula" 
Hello,
We just got CLIA inspected and had no deficiencies. The inspector did say he 
wants to see us write down on any reagent containers when it was opened, and 
write down the new expiration date.
The containers have the expiration date on them from the manufacturer, but the 
inspector said when the container is opened, the expiration will change and we 
need to write the date on the container under the opened date.
I've never heard of this requirement and I would like to ask if you have.
He said if the vendor does not give us any written documentation of when a 
reagent would expire after it's opened, then we should seek an alternate vendor 
who can.
Any comments, etc. are greatly appreciated.
Paula Lucas
Bio-Path Medical Group

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Re: [Histonet] Losing sections

[Terri Braud via Histonet]

I may have an answer for you.  Your Prisma stainer only runs the heater when 
needed.  With full runs, the oven stays warm, but later stain runs allow for 
the heater to cool down.  When your rack goes into the dry station, the heat 
comes up from the bottom to start to dry the slide, thus the bottom sections 
have enough dry time, but the top don't, and they wash off.
We used to encounter the same problem and that is what we hypothesized was 
happening, because, when we ran a blank rack through 10 minutes before loading 
the late rack, we were fine. Or, when we dried in a 60'C oven for 15 minutes 
when loading that lone late rack, we were fine.  
Just an idea, but for us, no more wash offs of top sections.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021

Message: 4
Date: Fri, 16 Jun 2023 14:25:31 +
From: "Kolman, Kimberly D." 
Subject: [Histonet] losing sections

For your entertainment, I have a bizarre phenomenon to share with the group:
I am occasionally losing the TOP section on a deeper cut H slide.
Full run of daily slides do not show this issue.  A deeper slide cut later in 
the day might, or a deeper slide cut first thing in the morning may, when I've 
not run a full daily run.
I have switched to a different lot number of standard slides.  I have used 
adhesive slides. Distilled water for the water bath same as I have used for 20 
years. Using Sta-On adhesive in the water bath. H stain done on a Prisma Plus 
stainer, with no changes in staining procedure.  There have been NO changes to 
any of my procedures.
This is a very random happening that is boggling my mind! If any section was 
going to fall off, I'd think it would be the 2nd section - (last one picked up 
from the water bath).  I've tried to make sure the slide has thoroughly dried 
before putting it on the stainer.  Slides appear clean, and no greasy 
fingerprints on the slide.  The one I always lose is the TOP section/very first 
level taken.

Any ideas? Do I just have a Histo Gremlin here?
Thanks for your input.
Kim
Kimberly D. Kolman, HT (ASCP)
Eastern Kansas Health Care System
Eisenhower VA Medical Center - Histology 115
4101 S. 4th St. Trfwy.
Leavenworth, KS 66048
913-682-2000 x 62537
Fax: 913-758-4193

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Re: [Histonet] Peroxidase Stain

[Terri Braud via Histonet]

I have long used the kits from Sigma and found them to be extremely reliable.  
Call their tech helpline for advice, or reach out to your pathologist for their 
preference.  I know that "homemade" saves money over kits, but for me, my most 
costly and precious resource is my tech time.  Save yourself and your techs a 
headache and call Sigma-Aldrich.
My 2 cents, Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Tuesday, June 13, 2023 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 235, Issue 9

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Contents of Histonet digest..."


Today's Topics:

   1. Peroxidase stain on peripheral smears (Kendra Beechie ND-Bismarck)
   2. MOHS staining (Ken M)
   3. Re: Peroxidase stain on peripheral smears (John Kiernan)


--

Message: 1
Date: Mon, 12 Jun 2023 14:22:08 -0500
From: Kendra Beechie ND-Bismarck 
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Peroxidase stain on peripheral smears
Message-ID:

Content-Type: text/plain; charset="utf-8"

Hello,

I am seeking some guidance in regards to a peroxidase stain. We have always 
used the Kaplow Method to stain peripheral blood smears, and up until recently, 
we have had no issues with getting it to work.  However, no matter what we try 
in recent months, we have not been able to get it to work. Several different 
techs have tried it and we have ordered new reagents, but there are no granules 
to be seen

Does anyone have any experience with peroxidase kits? I can see that 
Sigma-Aldrich has several available but I'm not sure what to go with

Any and all help would be greatly appreciated!

Thank you,

Kendra Beechie
MLS/HTL (ASCP), Technical Consultant
CHI St. Alexius Health
Bismarck, ND

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Message: 2
Date: Mon, 12 Jun 2023 20:34:52 +
From: Ken M 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] MOHS staining
Message-ID:



Content-Type: text/plain; charset="iso-8859-1"

For those doing MOHS staining either manually or automatically. How many 
staining cups do you really use? Are six enough if there is a running water cup 
nearby or do you need more?

Ken


--

Message: 3
Date: Tue, 13 Jun 2023 04:46:26 +
From: John Kiernan 
To: "histonet@lists.utsouthwestern.edu"
,Kendra Beechie ND-Bismarck

Subject: Re: [Histonet] Peroxidase stain on peripheral smears
Message-ID:



Content-Type: text/plain; charset="iso-8859-1"

What is the Kaplow method? I can't find it in textbooks. A quick Google search 
brings up only junk papers indicating that a Kaplov method may use carcinogenic 
benzidine (with wrong spelling) as the chromogen.
There are simple, safe and inexpensive methods for histochemical localization 
of sites of peroxidase activity.in tissue sections or smears of cells. Buy a 
textbook for about $50, read it, and save your lab a fortune in buying special 
kits for very simple routine histochemical jobs.

My ten cents-worth. June 2023
John Kiernan
J. A. Kiernan MB, ChB, PhD, DSc
Professor Emeritus, Anatomy & Cell Biology University of Western Ontario, 
London, Canada 
https://www.schulich.uwo.ca/anatomy/people/bios/emeriti/kiernan_john.html
Also  Secretary, Biological Stain Commission, Inc.
https://biologicalstaincommission.org
= = =

From: Kendra Beechie ND-Bismarck via Histonet 

Sent: June 12, 2023 3:22 PM
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] Peroxidase stain on peripheral smears

Hello,

I am seeking some guidance in 

Re: [Histonet] Coverslip Instruments

[Terri Braud via Histonet]

We use the Tissue Tek Glas with our Ventana labeled slides with no problem.  
The key is to insure the label does not hang off the edge in the slightest. 
However, it does not put them in a tray, however, that function only takes 
about 10 seconds.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion


Message: 2
Date: Fri, 17 Mar 2023 21:11:20 +
From: "Dooley, Elaine O." 
Subject: [Histonet] coverslip machines
Hi everyone,
Does anyone know of a cover slipping machine other than the Roche HE 600, in 
which the slides are loaded in 20 folder type trays.  The slides are not picked 
up by the machine, rather the coverslip is applied to the slides in the folder.
Elaine Dooley
Shands Labs at Rocky Point
352-265-0111 ext 72117
Or does anyone have good luck putting slides from a Ventana ultra with clear 
plastic overlays on an automated coverslipper?  Our old coverslippers always 
had problems with the labels sticking to the robotic arm that lifts the slide.

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[Histonet] background staining Melan A

[Terri Braud via Histonet]

My first instinct is to ask what detection system you are using.  If you are 
using an Avidin-Biotin detection, kidney is notorious for having excess biotin 
that must be blocked, or better yet, use a polymer based detection system.
That needs to be answered before further trouble shooting.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion
Today's Topics:

   1. Problems with Melan A staining (Ken M)
--
Message: 1
Date: Wed, 15 Mar 2023 16:51:03 +
From: Ken M 
Subject: [Histonet] Problems with Melan A staining
One of my histotech friends is having issues with Melan A staining. Using 
MA5-27949 Melan A antibody from Thermofisher, the negative Kidney tissue 
control was stained strongly positive while the positive melanoma tissue 
control was stained weakly positive. He couldn?t figure out why after several 
tries to reduce background. Can someone give me some suggestions? Thank you 
very much!
Ken



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[Histonet] A question for my hospital lab peeps

[Terri Braud via Histonet]

I'd love to hear your input
On breast mastectomy cases with sentinel lymph nodes, what is your cutting 
protocol for sentinel lymph nodes sent for frozen section?
How many frozen levels?
How many permanent section Levels?
Any unstained ffpe sections saved or stained IHC?
I'm just trying to make sure that what we're doing is the norm.  Thanks in 
advance.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-2021
  Honesty
AccouNtability
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Re: [Histonet] Bone saw

[Terri Braud via Histonet]

We have used the IMEB band saw for years and love the results.  It has a 
similar footprint and will cut through anything, including a steel pin.  It 
also has a diamond blade and optional water cooling.  It does seem a little 
awkward to clean, and I wish the protective housing was a little better.  If 
our IMEB failed, I would certainly take a long hard look at the Exakt 302 
because it seems to address some of the cons of the IMEB.  I don't know about 
cost comparison.  Best of luck.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046

Today's Topics:

   1. Looking for Bone/Pathology saw recommendations (M.O.)
--
Message: 1
Date: Fri, 20 Jan 2023 10:53:59 -0800
From: "M.O." 
Subject: [Histonet] Looking for Bone/Pathology saw recommendations

Hello and Happy Friday!
I work in an arthritis research lab and we are looking into pathology saws like 
the Exakt 302. We study lumbar spine and knees. During our tissue harvesting 
procedure we take slabs of each vertebral disc unit, facet joints, and knee 
osteochondral samples. Does anyone have experience in cutting bone specimens 
with a saw like this? Do you have any recommendations on the brand you prefer?

Sincerely,
Merissa


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Re: [Histonet] Testing Skills

[Terri Braud via Histonet]

Aside from the terrible legal  liability that you would open your institution 
to by asking them to operate "dangerous" equipment when they are not in your 
employ, sitting at a strange microtome/waterbath set up with different knives, 
paraffins, processing, just would not be an accurate test.
I really liked Thomas Podawiltz's idea.  Usually I just ask leading questions 
and then evaluate during the probation period.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874


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Re: [Histonet] FNA collection

[Terri Braud via Histonet]

Here our Histology techs and tech assistants collect all FNAs.  We stopped 
making thyroid smears 2 years ago, preferring to collect 6 passes, 5 directly 
flushed into Cytolyte for CB and Thin Prep, and one pass into Affirma holding 
solutions for possible testing for equivocal samples.  Using this method, our 
positive adequacy for thyroids actually increased.
We seldom have actual "fluid aspirates" for other samples, preferring to take 
core biopsies, roll them on sterile slides - fix and stain, then place the core 
in Formalin or RPMI as needed. Our pathologists make the adequacy/diagnosis 
from the stained slides and we have more tissue material for special studies.
There is no specific requirement for the staff making the smears, other than 
training and documentation of training and competency.
I've worked where other non-lab staff made the preps, and with the same 
training, can be equally as competent.
Hope this helps. Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
    Honesty
AccouNtability
    AgiLity
    CoLlaboration
    CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Wednesday, November 9, 2022 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 228, Issue 5
Today's Topics:

   1. Thyroid FNA's and other FNA procedures (Piche, Jessica)
Date: Wed, 9 Nov 2022 14:32:54 +
From: "Piche, Jessica" 
Subject: [Histonet] Thyroid FNA's and other FNA procedures
Good Morning,
Who makes the slides for fine needle aspirates at your facility? What are the 
qualifications to make the slides? I apologize if this message posted twice.
Thank you,
Jessica
Jessica Piche, HT(ASCP)
Waterbury Hospital Histology Laboratory
Histology Team Leader
203-573-7167


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Re: [Histonet] Sentinel Lymph node microtomy

[Terri Braud via Histonet]

A very interesting question, and I suspect you will receive a wide range of 
answers.  I, too, was taught to cut the first level, then 3 unstained for 
possible IHC, then second and 3rd level.  However, further research has shown 
that micrometastisis has little effect on patient outcomes so in many labs, the 
IHC performed on sentinel lymph nodes went out of  "fashion". 
For those nodes that are frozen and show metastatic disease, there is little to 
gain from additional studies, other than one good H for permanent section.  
For other lymph nodes, we usually start with 3 levels for H, 40 microns 
apart, though I have worked before where the pathologists required 5 levels.  
It will be interesting to see the varied responses.
Thanks for posing this interesting question.  Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
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-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Monday, October 3, 2022 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 227, Issue 2

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Today's Topics:

   1. Sentinel lymph node microtomy (Samantha Golden)


--

Message: 1
Date: Sun, 2 Oct 2022 18:38:34 + (UTC)
From: Samantha Golden 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Sentinel lymph node microtomy
Message-ID: <2000942797.1958358.1664735914...@mail.yahoo.com>
Content-Type: text/plain; charset=UTF-8

I am certain this question has been asked before, but I could not find a clear, 
definitive answer; perhaps there isn't one but I'm going to ask anyway...

Is there any type of standard for cutting levels on tissue, this example 
referring to SLN. I was taught to get a representative section for H and IHC, 
go deeper into block for additional sections (50-100 um, using professional 
judgement), then repeating for the final level(s).?

This results in varying, representative levels throughout the block, plus it 
leaves tissue for additional studies if necessary. However I've realized that 
not everyone was taught this same way. I want to be certain I am teaching 
others a correct way, and would love to have something concrete to refer to for 
guidance.?

Thanks for any help!

--

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Re: [Histonet] Pathology Competency

[Terri Braud via Histonet]

Besides the GYN reviews, we use our CAP surveys and circulate the ER/PR, Her2, 
CD20, Ki-67, and MMR panel between all pathologists for a blind read.  The 
original survey is reported in rotation, then all other pathologists are given 
blank copies of the answer sheet and asked to fill it out.  Then a comparison 
is made and the results reported, reconciled, and discussed and through the 
quarterly departmental QA meeting.  This was suggested to me by CAP to meet 
their requirements.  Additionally, the pathologists participate in others such 
as PIP, Non-Gyn Cyt, FNA-G, and of course, MK. I hope that helps.  Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

Today's Topics:

   1. pathologist competency (Nancy Schmitt)
   2. Re: pathologist competency (Michelle Bell)


--

Message: 1
Date: Sun, 25 Sep 2022 20:55:27 +
From: Nancy Schmitt 
To: Histonet 
Subject: [Histonet] pathologist competency
Hello-
Working with our Paths to update their competency policy - including the usual 
Gyn and Non gyn and surgical surveys along with their interdepartmental 
documentation; what are other folks including in this?
Thank much,
Nancy
Pathology Support Services Supervisor


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Re: [Histonet] Clarapath SectionStar

[Terri Braud via Histonet]

I'm not holding my breath for this one.  Not to say it will never happen, but 
don't look for this one anytime in the foreseeable future.  Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
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Re: [Histonet] Slide Printer

[Terri Braud via Histonet]

We've been using our Leica IPS and IPC printers for over 15 years, first as 
stand-alone units, and now, integrated into CoPath.  What a workhorse these 
instruments this have been!  Their modern equivalent is almost identical, so 
parts are readily available.  My recommendation would be to repair or replace 
with the same. 

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Friday, August 5, 2022 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 225, Issue 4

CAUTION: This email originated from outside Redeemer Health. Do not click links 
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Today's Topics:

   1. slide printers (Colleen Forster)


--

Message: 1
Date: Thu, 4 Aug 2022 17:15:11 -0500
From: Colleen Forster 
To: histonet-request 
Subject: [Histonet] slide printers
Message-ID:

Content-Type: text/plain; charset="UTF-8"

HEllo Histonetters,

We are a research lab that has been using the Leica IPC/IPS printed for many 
years. Today the flash motor went out in the IPS. We are now looking into 
updating the slide printer.

We are research only and NOT hooked into any LIS system. It would be a stand 
alone process. Can some of you share what you have and the pros/cons?
I need to start the search for the replacement I would like.

Thank you in advance.

--
Colleen Forster HT(ASCP)QIHC
BLS Histology and IHC Laboratory
Jackson Hall, Room 2-155
321 Church St. SE
Minneapolis, MN 55455
612-626-1930


--

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End of Histonet Digest, Vol 225, Issue 4



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Re: [Histonet] Roll plate, Freeze spray in the Cryostat

[Terri Braud via Histonet]

Just a word of caution that unless you are quite sure of the cleanliness of 
your cryostat, or the infectious status of the specimens cut in your cryostat, 
freezing spray is the worst product to use in a cryostat.  It creates 
aerosolized particles that can linger, and infect, for hours.
At our lab, we long ago decided to forbid the use, and we have no problems 
cutting beautiful frozen sections without it.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
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Re: [Histonet] roll plate - using freezing spray in a cryostat

[Terri Braud via Histonet]

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
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You can reach the person managing the list at
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When replying, please edit your Subject line so it is more specific than "Re: 
Contents of Histonet digest..."


Today's Topics:

   1. Cryostat anti-roll plate (Ken Marzinsky)
   2. Re: Cryostat anti-roll plate (Keyser, Geri L)
   3. Re: Cryostat anti-roll plate (Anne Murvosh)
   4. Re: Cryostat anti-roll plate (Keyser, Geri L)
   5. Re: Cryostat anti-roll plate (Keyser, Geri L)


--

Message: 1
Date: Tue, 24 May 2022 20:16:10 +
From: Ken Marzinsky 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Cryostat anti-roll plate
Message-ID:



Content-Type: text/plain; charset="iso-8859-1"

Hi everyone. Does anyone regularly use the anti-roll plate on their cryostat? 
Does it work well on the Leicas and Microms, or do you have to figit with it a 
lot? Does anyone have any tricks they can share to get it to work all the time? 
 I found that a little spritz of freeze spray on the plate and the bottom of 
the roll glass helps, but it is still seems a lot easier for us to use a brush 
or a teasing needle.

Ken
Durham, NC


--

Message: 2
Date: Wed, 25 May 2022 12:15:06 +
From: "Keyser, Geri L" 
To: "histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] Cryostat anti-roll plate
Message-ID:



Content-Type: text/plain; charset="us-ascii"

I use roll plate. 

I don't like the roll plate on the Leica. The Leica design creeps... a lot. 

Also, with the leica, the contact point with the blade is a soft aluminum arm. 
If you make adjustments with the roll plate holder contacting the blade, it 
will damage the soft aluminum holder. 

I like the thermo design much better. It creeps a lot less. 

Here's a procedure for roll plate adjustment. 

1.  Mount block on specimen disc. 
2.  Place Specimen Disc in chuck, position Blade carrier, and face off.
3.  Turn knurling screw clockwise until sections do not pass under the 
Anti-roll plate.
4.  Turn knurling screw counter-clockwise by 20 degree increments until 
sections effortlessly pass under the Anti-Roll Plate WITHOUT hitting the block. 

*   If the block is hitting the anti-roll plate, it may cause damage to 
glass. 
*   Hard contact is visible and can be heard. 
*   Soft contact, which can also damage the Anti-roll plate, cannot be seen 
or heard. But, can be felt by gently placing finger on the anti-roll plate 
turning lever while taking a section.


Geri 


-Original Message-
From: Ken Marzinsky via Histonet 
Sent: Tuesday, May 24, 2022 3:16 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cryostat anti-roll plate

WARNING: This email appears to have originated outside of the UW Health email 
system.
DO NOT CLICK on links or attachments unless you recognize the sender and know 
the content is safe.

Hi everyone. Does anyone regularly use the anti-roll plate on their cryostat? 
Does it work well on the Leicas and Microms, or do you have to figit with it a 
lot? Does anyone have any tricks they can share to get it to work all the time? 
 I found that a little spritz of freeze spray on the plate and the bottom of 
the roll glass helps, but it is still seems a lot easier for us to use a brush 
or a teasing needle.

Ken
Durham, NC
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Message: 3
Date: Wed, 25 May 2022 13:32:12 +
From: Anne Murvosh 
To: Ken Marzinsky ,
"histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] Cryostat anti-roll plate
Message-ID:
< 
st them. They creep forward so much that I just automatically know to roll 
imw4pr15mb45615d24e17f493a42281080c6...@mw4pr15mb4561.namprd15.prod.outlook.com>

Content-Type: text/plain; charset="us-ascii"

We have 3 new leicas and we constantly have to adju t slightly back after every 
4 specimens or so. The new leica designs are just bad and customer service is 
even worse. We have to use the plate as we do Mohs specimens and the sections 
are just better with the glass plate. I want to look for a different machine 
next time. We did test the Avantik and it cut nice but the glass plate was on 
the front and got in the way. I wish they would talk to Mohs techs before they 
design these. Oh well. No tricks just constant adjusting. Thanks Anne

-Original Message-
From: Ken Marzinsky via Histonet 
Sent: Tuesday, May 24, 2022 1:16 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cryostat 

Re: [Histonet] Stability Guarantee vs Expiration date

[Terri Braud via Histonet]

Richard's suggestion is the most sensible suggestion that I've seen in a while, 
however, it means less money for reagent manufacturers, so I doubt we will ever 
see it come to pass. - Terri
--

Message: 2
Date: Thu, 17 Mar 2022 13:45:44 +
From: "Cartun, Richard" 

Well stated Tony, and thank for all this useful information.  I am hopeful that 
we can get expiration dates overturned here in the United States.  In the past, 
I have recommended a "Stability Guarantee" date to replace the "Expiration 
Date".  After that date passes it would be the responsibility of the performing 
laboratory to validate that the antibody is still working properly.  And, as 
you pointed out, this is easily accomplished with the positive control which is 
run in parallel.  Laboratories cannot no longer afford to discard expensive 
reagents, especially those that are not being produced any longer.  Also, with 
the current staffing crisis in Histology/IHC laboratories and supply-chain 
issues we need to simplify our work environment.

Richard

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



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Re: [Histonet] cold ischemic time

[Terri Braud via Histonet]

We average within 1 minute for needle core and small biopsies, within 15 for 
lumpectomy or mastectomy.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Tuesday, February 15, 2022 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 219, Issue 11
Today's Topics:

   1. Cold ischemic times (Greg Dobbin)
   2. Re: Cold ischemic times (E. Wayne Johnson)
--
Message: 1
Date: Tue, 15 Feb 2022 12:10:01 -0400
From: Greg Dobbin 
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cold ischemic times

This is more of a survey than a question:
For those of you tracking and documenting your cold ischemic times for breast 
tissue (ie time out of body to time sliced [as needed] and immersed in 
formalin), and I assume most of you are...*what is your average time?*
*Background:*
*I ask because my director was looking for suggestions for quality indicators 
to report and while I feel like our cold ischemic average time is impressive at 
~17 mins, she says that is pretty standard for everyone.*
Thanks,
Greg
*Greg Dobbin*
Chief Technologist - Anatomic Pathology
Queen Elizabeth Hospital
Charlottetown, PE
Canada   C1A 8T5
Ph: 902-894-2337
*Everything in moderation...even moderation itself**!*





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Re: [Histonet] paraffin on floors

[Terri Braud via Histonet]

After a ba-zillion years in Histology, I've found there is no substitution for 
having the floors stripped every 2 weeks.  The trick is NOT to apply floor wax 
after stripping.  We've also been currently using mats in key areas where the 
most traffic is.  This prevents wax from being ground into the floor and 
becoming slippery.  The mats are changed out every 2 weeks, too.  The techs are 
expected to scrape up excess floor paraffin at the end of their shift or at the 
end of daily cutting.  I hope this helps.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion


-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Thursday, February 10, 2022 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 219, Issue 8

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Today's Topics:

   1. Tiny folds in colon bx (Rinker,Jeffrey)
   2. Flooring (Normington, Lacy)
   3. Re: Flooring (Curt Tague)


--

Message: 1
Date: Thu, 10 Feb 2022 16:22:13 +
From: "Rinker,Jeffrey" 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Tiny folds in colon bx
Message-ID:



Content-Type: text/plain; charset="iso-8859-1"

I have been having a terrible time with small folds in my colon bxs. They tend 
to be perpendicular to the cutting edge and i have tried all the standard ways 
to get rid of them. My Dr says that the sections are fine and that they don't 
effect the diagnosis but i would really like to figure out why hey are there.
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Message: 2
Date: Thu, 10 Feb 2022 16:51:15 +
From: "Normington, Lacy" 
To: "'histonet@lists.utsouthwestern.edu'"

Subject: [Histonet] Flooring
Message-ID:



Content-Type: text/plain; charset="us-ascii"

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

Thanks
Lacy Normington
UW Health


--

Message: 3
Date: Thu, 10 Feb 2022 17:42:18 +
From: Curt Tague 
To: "Normington, Lacy" ,
"'histonet@lists.utsouthwestern.edu'"

Subject: Re: [Histonet] Flooring
Message-ID:



Content-Type: text/plain; charset="us-ascii"

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

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

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


best of luck!
Curt



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

What does your institution do to mitigate paraffin collection on the floors? Do 
you strip the 

Re: [Histonet] Dissect Aid - Histonet Digest, Vol 215, Issue 2

[Terri Braud via Histonet]

We do not re-use.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Monday, October 4, 2021 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 215, Issue 2

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Today's Topics:

   1. dissect aid (Nancy Schmitt)


--

Message: 1
Date: Mon, 4 Oct 2021 15:16:31 +
From: Nancy Schmitt 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] dissect aid
Message-ID:



Content-Type: text/plain; charset="us-ascii"

Happy Monday!
For those using Dissect Aid (Statlab) - are you re-using this product for 
multiple specimens?
Can you please share what your process is for this?
Much appreciated,
Nancy Schmitt MLT, HT(ASCP)
MercyOne Dubuque

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Re: [Histonet] Happy Retirement, Tim

[Terri Braud via Histonet]

Wishing  you all the best in your retirement, Tim.  In reading your history in 
Histology and EM, I can see how your experience has led to so many wise, 
educational posts on the Histonet.  As others have also expressed, I hope you 
will continue to be a contributing part of the Histology world.  Thank you for 
all the experiences you've shared and congratulations!  Sincerely, Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
Honesty
AccouNtability
AgiLity
CoLlaboration
CoMpassion


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Re: [Histonet] cutting protocols for gender dysphoria mastectomies

[Terri Braud via Histonet]

We use the breast reduction mammoplasty protocol, 4 blocks each breast, single 
level, each block, unless the gross dissection reveals an unexpected anomaly.

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
 
Sent: Friday, August 27, 2021 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 213, Issue 20

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Contents of Histonet digest..."


Today's Topics:

   1. Re: [EXTERNAL] Histonet Digest, Vol 213, Issue 19
  (Maimone-Schoen, Michele)
   2. Re: Cutting protocol for gender dysphoria (Bob Richmond)


--

Message: 1
Date: Thu, 26 Aug 2021 17:04:25 +
From: "Maimone-Schoen, Michele" 
To: "histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] [EXTERNAL] Histonet Digest, Vol 213, Issue 19
Message-ID: <7547feac18644586b3e06ffced581...@nyp.org>
Content-Type: text/plain; charset="us-ascii"

Open Positions - New York Presbyterian Hospital/Weill Cornell Division 
Histotechnologist - Nights 12 a - 8 a Histology Supervisor -  2 p - 10 p Thanks

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 

Sent: Thursday, August 26, 2021 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 213, Issue 19

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Today's Topics:

   1. Copy of an old EM resin paper? (Morken, Timothy)
   2. Histopeeps!! RELIA Histology Careers Newsletter - Check   out
  the Spotlight Positions. (Pam Barker)
   3. Cutting protocol for gender dysphoria (Spoon, Victoria)


--

Message: 1
Date: Wed, 25 Aug 2021 17:01:00 +
From: "Morken, Timothy" 
To: Histonet 
Subject: [Histonet] Copy of an old EM resin paper?
Message-ID:



Content-Type: text/plain; charset="us-ascii"

Can anyone supply me a copy of this paper on epoxy resins? I can't find it 
anywhere on line and our library does not have that journal.

Glauert AM: Epoxy Resins: An update on their selection and use.  Microscopy and 
Analysis 15-20 Sept 1991.




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



--

Message: 2
Date: Wed, 25 Aug 2021 13:48:34 -0400
From: "Pam Barker" 
To: "Histopeeps Histonet" 
Subject: [Histonet] Histopeeps!! RELIA Histology Careers Newsletter -
Check   out the Spotlight Positions.
Message-ID: <000701d799d9$7aa0f200$6fe2d600$@earthlink.net>
Content-Type: text/plain;   charset="iso-8859-1"

Hello Histopeeps,

I hope you are having a great week! It?s the end of the summer.  Can you 
believe it?

Next week is Labor Day weekend!

Any thoughts on making a move in the near future?

I am already talking to people who are looking at travel contracts ending and 
others who are planning for moves after Christmas.

 

I have great opportunities with some of the cream of the crop of employers 
Nationwide

I have opportunities in:

v Colorado, Illinois, Florida, California, Texas, Virginia, Tennessee and 
Maryland.

My clients are looking for:

v Managers, Supervisors, Quality Specialists, IHC Specialists, Histotechnicians 
and Histotechnologists.

I am Sooo excited about the opportunities I am working on and here?s why:

1.  My clients are excited to meet you and ready to make a decision
right away.
2. 

Re: [Histonet] Cryostat validation

[Terri Braud via Histonet]

Tony - We were on the same page.  We purchased fresh beef liver, sectioned and 
froze it, cut and stained duplicate blocks and had the pathologist sign off on 
the process.  We were also able to get some tonsils delivered fresh and did 
them, too.  Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
Today's Topics:

   
   2. Re: New cryostat validation procedure (Tony Henwood (SCHN))
Message: 2
Date: Mon, 23 Aug 2021 20:31:19 +
From: "Tony Henwood (SCHN)" 
To: Greg Dobbin 
Subject: Re: [Histonet] New cryostat validation procedure

Hi Greg,

I would just grab some kidneys from the butcher, freeze and section as usual. 
They should give equivalent results to the older unit.

Regards
Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC), FFSc(RCPA) Principal 
Scientist, the Children?s Hospital at Westmead Adjunct Fellow, School of 
Medicine, University of Western Sydney
Tel: 612 9845 3306
Fax: 612 9845 3318
Pathology Department
the children's hospital at westmead
Cnr Hawkesbury Road and Hainsworth Street, Westmead Locked Bag 4001, Westmead 
NSW 2145, AUSTRALIA



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Re: [Histonet] The LEGAL side of specimen ownership

[Terri Braud via Histonet]

Sorry, E. Wayne, but in the USA, according to December 2004 JAMA The Journal of 
the American Medical Association 292(20):2500-5, recent examination of these 
issues by a US federal court resulted in a ruling that individuals do not 
retain rights of ownership or control of biological materials.  It belongs to 
the receiving laboratory.
A small collection of case law has determined that samples are controlled and 
owned not by those who contributed them but by researchers or their 
institutions. Taken together, the cases do not offer clear guidance; they are 
consistent only in their denial of a right claimed by individuals who 
contributed samples. Genet Med. 2011 Jun; 13(6): 569-575.
It is not YOUR gallbladder if you go to a hospital to have it removed. It 
becomes the property of the hospital or where ever they chose to send it.
 DONG DONG
Terri L. Braud, HT(ASCP)
HNL Laboratories for Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874

6. Re: release of body parts (E. Wayne Johnson)
Message: 6
Date: Thu, 19 Aug 2021 23:32:13 +0800
From: "E. Wayne Johnson" 
Subject: Re: [Histonet] release of body parts
I will take the other side of this argument.

If you go to the Dentist and he extracts a tooth, it is the usual procedure 
that he gives it to you.
After all it is "your tooth".

Like wise, it's your gall bladder.? The legal department should understand that 
it is your personal property and the mining of it from your body gives the 
hospital no particular right to take control of it any more than they have the 
right to take control of a birthed infant.

E. Wayne Johnson DVM
Enable AgTech
Beijing




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Re: [Histonet] release of body parts

[Terri Braud via Histonet]

Our policy, and the policy at 2 other institutions that I've worked at, is a 
mirror of what Richard Cartun stated.  We don't release soft tissues to 
anything but a funeral home. 

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

Today's Topics:

   1. release of body parts (Nancy Schmitt)
   2. Re: release of body parts (Cartun, Richard)


--

Message: 1
Date: Wed, 18 Aug 2021 16:33:20 +
From: Nancy Schmitt 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] release of body parts
Hello-
We are seeing a bit more of patients that are requesting to take their body 
parts with them (uterus, POC, etc); I am talking home  - not the funeral home.
Are you using a release of body parts form to fill out with the patient?
Are you draining off the formalin, or sending in formalin with parafilm around 
the lid?
Thank you for your thoughts,
Nancy Schmitt MLT, HT(ASCP)
Pathology Support Services
Dubuque, IA  52001

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Re: [Histonet] Cryostat

[Terri Braud via Histonet]

I'm not sure I understand why you would want to replace your 1850s just because 
Leica is closing the support.  I have 2 and they are real workhorses.  There 
are 2 independent companies in the area that can repair and perform PMs.  One 
is Bel-Air and the other is Advantik.  I'm sure there are others, but I've used 
both companies and can highly recommend them.  If you like your Leica, keep it 
until parts are no longer available, which could be years.
I have two 1850s and I'm sure they will be here for a long time.  Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
Today's Topics:

   1. cryostat (Histology)

Date: Mon, 9 Aug 2021 13:00:30 +
Subject: [Histonet] cryostat
Hello,
Trying to get everyone's opinion on cryostats.  We have had the Leica CM1850 
forever and it is not being supported by Leica anymore.  Thinking of trying a 
different company maybe Tanner or Rankin.  What does everyone use and like.  We 
do not cut Mohs, only DIFs.  Maybe 1 a day.
Thanks to all,
Mehndi Helgren
Dominion Pathology Laboratories
733 Boush Street
Suite 200
Norfolk, VA 23510
757-664-7901



--

Message: 2
Date: Mon, 9 Aug 2021 13:56:42 +
From: "Morken, Timothy" 
To: Histology 
Cc: Histonet 
Subject: Re: [Histonet] cryostat
Message-ID:



Content-Type: text/plain; charset="us-ascii"

Mehndi, we also cut frozens for DIF on kidney and muscle histochem. We have two 
Epredia NX70 cryostats. We've used them for 8 years now and really like them. 

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


-Original Message-
From: Histology via Histonet 
Sent: Monday, August 09, 2021 6:01 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] cryostat

Hello,

Trying to get everyone's opinion on cryostats.  We have had the Leica CM1850 
forever and it is not being supported by Leica anymore.  Thinking of trying a 
different company maybe Tanner or Rankin.  What does everyone use and like.  We 
do not cut Mohs, only DIFs.  Maybe 1 a day.

Thanks to all,

Mehndi Helgren

Dominion Pathology Laboratories
733 Boush Street
Suite 200
Norfolk, VA 23510
757-664-7901

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Subject: Digest Footer

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End of Histonet Digest, Vol 213, Issue 6



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Re: [Histonet] Processing Protocols

[Terri Braud via Histonet]

We have encountered a similar problem with one of our two processors is down.  
Shortening the longer schedule produced underprocessed fatty tissues and over 
processed biopsies, so we run the biopsies on the short schedule overnight, run 
a quick clean cycle, then the larger tissues on the 10hr schedule on the same 
instrument, pull the them off and leave them in the embedding unit to embed in 
the afternoon, or next morning.  It does put the larger tissue a day behind, 
but does not sacrifice the quality of the processing.  It you shorten your 
large tissue processing run so that you can run small biopsies with the bigger 
stuff, you will have to revalidate your IHC, so maybe this might be a better 
alternative.  Good luck, Terri

Terri L. Braud, HT(ASCP)
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
  Honesty
AccouNtability
    AgiLity
    CoLlaboration
  CoMpassion

Message: 1
Date: Tue, 3 Aug 2021 10:34:11 +
From: "Piche, Jessica" 
Subject: [Histonet] Processing protocols

Good Morning Everyone,
Our pathologist wants us to shorten our large tissue processing run so that we 
can run small biopsies with the bigger stuff when one of our tissue processors 
are down. We have 2 Excelsiors. Would anyone like to share any protocols they 
might have for this purpose?
Thank you!
Jessica Piche, HT(ASCP}
Waterbury Hospital Histology Lab

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Re: [Histonet] brain freeze artifact

[Terri Braud via Histonet]

First of all, freezing spray should NEVER be used in a cryostat.  It produces 
dangerous aerosolized pathogens that linger in the air, just waiting to infect 
someone. There should be no exceptions.
As to the ice artifact problem,  not surprising to see this in brain since it 
is so fragile and often edematous.  Your best bet to eliminate freeze artifact 
is to "snap freeze" the tissue using the technique used in muscle biopsy 
samples.  A metal sample cup containing 2-Methyl Butane (Isopentane) is  
suspended in Liquid Nitrogen, stirring until it becomes a thickened, white 
slurry.  The mounted tissue sample is immersed in this slurry to freeze, then 
placed in the cryostat to come up to cryostat temps before cutting.  That is 
the short and sweet version, and there are many published versions of the 
technique.  It is cumbersome, but produces no freezing artifact.
Best of luck, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Laboratories for 
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
Ph: 215-938-3689
Fax: 215-938-3874
--

Message: 3
Date: Fri, 16 Jul 2021 15:25:08 +
From: Bonello Dorianne M at Health-MDH 
To: "histonet@lists.utsouthwestern.edu"
Subject: [Histonet] frozen section problem

Dear all,
We are experiencing freezing artifacts on our frozen sections. Basically, we 
are seeing cavity-like structures under the microscope, mostly elongated, 
especially when it's a frozen section on brain tissue. This is most probably 
happening due to ice crystal formation. We're not using cryospray, relying only 
on the cryobar boost function.
Does anyone has a solution to this problem please
Regards,
Dorianne Bonello
Allied Health Practitioner (MLS)
Histology Laboratory - Pathology
Health-Mater Dei Hospital



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Re: [Histonet] Microscope Calibration

[Terri Braud via Histonet]

A. USE EYEPIECE WITH OCULAR MICROMETER ALREADY IN PLACE. 
B. Place the stage micrometer on the stage and focus on some portion of the 
scale with the 10X objective.
C. Looking through the microscope, examine the ruling of the stage micrometer 
so that you can distinguish between
the large (0.1 mm.) and the small (0.01 mm.) divisions.
D. Adjust the field so that the 0 line on the ocular micrometer is exactly 
superimposed upon the 0 line on the stage
micrometer.
E. Without moving the stage micrometer find another point at the extreme right 
where two other lines are exactly
superimposed. The second set of superimposed lines should be as far as possible 
from the 0 lines, but the
distance will vary with the objective and microscope.
F. Knowing that each large division of the stage micrometer equals 0.1 mm. and 
each small division equals 0.01
mm., determine the total distance (in millimeters) between the two points of 
superimposition and the number of
small ocular units necessary to cover the same distance (Figure 1).
For example: Suppose 27 ocular units equal 2 large stage units or 0.2 mm.
G. Calculate the number of millimeters that is measured by one small ocular 
unit.
For example: Divide .2 mm.
27 = 0.0074
H. Since measurements of the protozoa and other small organisms or structures 
are usually given in microns rather
than millimeters, the above determine must be converted to microns. Since 1 
millimeter equals 1,000 microns,
the millimeter determination multiplied by 1,000 will give the number of 
microns measured by 1 small ocular
unit.
For example: 0.0074 mm. X 1,000 = 7.4 microns (u).
I. Record the calibrations of the ocular micrometer obtained with the 10X 
oculars combined with each of the
three objectives. The lines of the stage micrometer will increase in 
magnification while those of the ocular
micrometer will remain the same. With high and oil magnifications, the thinner 
ocular micrometer lined must be
centered on the broader stage micrometer line for more accurate measurement.
J. The size of any microscopic object can be quickly determined by measuring it 
with the ocular micrometer, noting
the particular lens combination, and referring to the record of the ocular 
micrometer calibrations.
RECORDING RESULTS: Record results of calibration on calibration card and is 
kept in the cabinet behind the scope in Special
Microbiology.
REFERENCES:
Clinical Microbiology Procedures Handbook, Third edition, Vol 2. Lynne S. 
Garcia, ASM Press 2010.
Date Approved by

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


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Re: [Histonet] New antibody diluent

[Terri Braud via Histonet]

CAP specifically addresses Scott's question in the checklist (see below, copied 
from the Checklist)
ANP.22780
Laboratories confirm assay performance when conditions change that may affect 
performance.
NOTE: A change in antibody clone requires full revalidation/verification of the 
assay (equivalent to initial analytic validation/verification - see ANP.22750).
Laboratories must confirm assay performance with at least when an existing 
validated/verified assay has changed in any of the following ways: antibody 
dilution, antibody vendor (same clone), or the incubation or retrieval times 
(same method).

So, according to CAP, each antibody with the new diluent would have to confirm 
with at least two known positive and two known negative cases.
What a pain! (IMHO)

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

   3. Re: Antibody diluent (Lindrud, Scott)

Message: 3
Date: Thu, 25 Mar 2021 12:30:25 +
From: "Lindrud, Scott" 
Subject: Re: [Histonet] Antibody diluent

What is everyone's take on what needs to be done from a verification/validation 
standpoint if you switch diluents for your concentrated antibodies?  The CAP 
summary of recommendations on the validation IHC antibodies doesn't 
specifically mention the changing of diluent as one of the variables.
If I change the diluent on my ER and Her2 concentrates, do I need to do a 
complete re-validation or just a quick verification using a few positive and 
negative cases?  I'm not really liking the idea of a complete re-validation!
Thanks for any info!
Scott
Scott A. Lindrud, MLSCM(ASCP)CTCM  | Histopathology Technical 
Specalist/Cytotechnologist
P: 320-231-4520
F: 320-231-4503
scott.lind...@carrishealth.com

Rice Memorial Hospital
301 Becker Ave SW
Willmar, MN 56201



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Re: [Histonet] My boss won't manage a terrible employee

[Terri Braud via Histonet]

As a long time supervisor, I wanted to respond to the article about handling a 
terrible employee and add a few observations.
Let me state, I am very process oriented, so I wanted to make a few 
observations.  I try not to see a "terrible employee".  To me, that adds a 
personal connotation that might make one less inclined to improve their 
performance.  Performance has to be a measurable event.  I would see an 
employee not meeting minimum standards of performance.
With that in mind, I would bring the employee in for counseling as part of a 
performance improvement with a conversation to go something like this.
"It has come to my attention that the date matching that you are responsible 
for, is not being done correctly, or in a timely fashion.  Can you tell me what 
is happening?"
Then LISTEN.  Sometimes the hardest part of a manager's job. 
"I want to try and help you succeed at this task, do you have any suggestions 
on how you might do this?"
Usually, they will respond somewhere along the lines of "try harder"
"I know that you are trying, but that doesn't seem to be working.  How about we 
change the process?  I was thinking along the lines of a notebook to write down 
the correct date for each case you check that you have to correct.  Once a 
week, we can meet to insure you have not missed any corrections until you have 
it down 100%.  Is this something you could do?
Then decide on a date and stick to it.
Let's say they fail miserably first week and have a failure rate of 20%.  At 
the weekly meeting, point out the percentage, ask if they have any ideas on how 
to improve that number and suggest a target goal of less than 3% errors for the 
next week and let them know the time frame that they need to reach that goal.  
Let's say 4 weeks.
Each week, point out the target goal, and their achievement, recognize 
improvements, but always ask for more until you get where you need to be.  
There are the cases where that won't happen. So after 3 weeks of failing to 
reach goal, the conversation should be something like this.  
"I'm concerned that you are not close to reaching goal and if you don't show 
major improvement, I will have to escalate this to the manager.  Is there 
anything that I can do to help you achieve this goal?"
Then if the goal is still not met, make an appointment with the manager, point 
out your written performance improvement and the employee's performance.  If 
your manager is derelict and refuses to do anything, then you will have to 
stand up for yourself and say that you can't be responsible for someone's 
performance without the authority for a failure of performance to have 
consequences.  
The entire time, keep up your weekly meetings, encourage the employee, try 
different approaches to help them achieve a better performance. And document, 
document, document.  Every meeting, every goal and every measurable 
performance.  Keep it non-personal, performance based.
Just my 2 cents - Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
--

Message: 1
Date: Mon, 8 Mar 2021 11:13:55 -0500
From: "Pam Barker" 
To: "Histopeeps Histonet" 

And That's not all!
Here is a great article that I found online!  If you have time to read it I
would love to know what you think!
https://www.askamanager.org/2021/02/my-boss-wont-manage-a-terrible-employee-
my-coworker-scream-yawns-and-more.html 

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[Histonet] Xray machines for Histology

[Terri Braud via Histonet]

Everyone here LOVES our Hologic Faxitron.  A self-contained unit, so simple to 
operate.  We can instantly x ray anything, including sometimes, the paraffin 
blocks, to see the microcalcifications to be sure we get them on a slide if 
they are there.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

--

Message: 3
Date: Fri, 12 Feb 2021 20:39:40 +
From: "Lima, Teresa" 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] X-ray machines for the lab
Hello all,
We are having issues with microcalcifications in breast tissue not being 
present in the H slides of breast biopsies. The pathologists would like to 
get an x-ray machine for the grossing room. Does anyone know where we can 
purchase a small, portable x-ray machine?
Thanks,
Terri


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Re: [Histonet] Dragon

[Terri Braud via Histonet]

We were using mModal and are in transition to Voicebrook which uses Dragon as a 
speech recognition set up with SQ CoPath for both grossing and microscopic 
dictations. We have mixed user feelings, too.  Our PA who does the majority of 
the gross, uses it and has lots of templates preset to simplify the gross. She 
uses voice commands to navigate through CoPath.  She is very fast and seldom 
has an error.  With the pathologists, it's a bit of a mixed bag, somewhat 
dependent on how they embrace the technology change.  Proper installation and 
set up, complete with templates is key.  The use of a headset with mic seems to 
produce the best results as opposed to a gooseneck microphone.  I hope this 
helps.  Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Message: 5
Date: Tue, 9 Feb 2021 16:48:30 -0500
From: Amanda Coscetti 
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Dragon
Message-ID: <3d4a88a7-181e-47b2-b830-64437cae1...@gmail.com>
Content-Type: text/plain; charset=us-ascii

Does anyone use Dragon while grossing? We are looking at switching to Dragon 
and wanted some feedback for use in pathology.  
Currently, we use M*Modal for dictations and then have transcriptionists type 
all of the information in Cerner reports. 
Thanks!! 
Amanda 
--
Message: 6
Date: Tue, 9 Feb 2021 17:01:54 -0500
From: Cristi Rigazio 
To: Amanda Coscetti 
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Dragon
Message-ID: <232b1a9f-8471-48f6-ae43-67b05f97c...@gmail.com>
Content-Type: text/plain; charset=utf-8

I used it exclusively in GI lab for years and loved it but we only did small 
biopsies, so it was super simple.  We use it now throughout the system I work 
in and there are a variety of opinions.  Some of the PAs love it and some 
really struggle.  Same with the pathologists.  So we live in dual worlds with 
both Dragon and MModal.  If you would like to contact me separately I am happy 
to discuss! Thanks Cristi



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Re: [Histonet] Bouin's in a spray bottle

[Terri Braud via Histonet]

I have to agree with Bob.  Bouin's should not be used as an ink fixative, 
especially in a spray bottle.  We use 5% Vinegar, or glacial acetic acid, and 
it works just fine.
Just my 2 cents - T

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Sunday, February 07, 2021 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: [EXTERNAL] Histonet Digest, Vol 207, Issue 5

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Today's Topics:

   1. Re: Bouin's fixative (Bob Richmond)


--

Message: 1
Date: Sat, 6 Feb 2021 13:22:22 -0500
From: Bob Richmond 
To: "Histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] Bouin's fixative
Message-ID:

Content-Type: text/plain; charset="UTF-8"

>
> Bouin's fixative has no business being used in a spray bottle. It's a very
> toxic material that shouldn't be aerosolized.
>

As Dr. Steve McClain suggests, dilute acetic acid - 3 to 5%, white vinegar,
is quite sufficient for preparing tissue for inking, and isn't toxic and
messy like Bouin's fixative, or flammable like acetone.

Bob Richmond
Samurai Pathologist
Maryville TN


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Re: [Histonet] Ouside Consults

[Terri Braud via Histonet]

Interesting question - Here, as previous places I've worked, we accession 
outside surgical consults with one of our routine Surgical numbers, and outside 
Cytological consults with a routine Cytology accession number.  If we receive 
multiple mixed cases, they are all reported as a Surgical Consult.


Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
Today's Topics:

   1. Question about accessioning outside consult cases
  (Martha Ward-Pathology)
   


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Re: [Histonet] Floaters

[Terri Braud via Histonet]

60% of floaters from the water bath?  I find that really hard to believe.  
The  Gephardt and Zarbo CAP study from 1996 showed reported the results of a 
Q-Probes study of 275 laboratories and documented a frequency of contamination 
of between 0.6% and 2.9%, depending on the study method. Their study 
demonstrated the rate of extraneous tissue contamination was higher for blocks 
than for slides and higher in a retrospective review than in a prospective 
study.  So in other words, when people knew they were being studied, they were 
more careful and the contamination rate went down, but in retrospect, the 
majority of floaters occurred in the blocks, not the water bath.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
HNL Labs, Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
Today's Topics:

   1. "Floaters" in surgical or cytology specimens
  (Martha Ward-Pathology)
   2. Re: "Floaters" in surgical or cytology specimens
  (Joe W. Walker, Jr.)


--

Message: 1
Date: Fri, 4 Dec 2020 13:55:20 +
From: Martha Ward-Pathology 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] "Floaters" in surgical or cytology specimens
Message-ID:



Content-Type: text/plain; charset="us-ascii"

I am posting this question for a colleague in our Cytology department. How 
often do you see floaters on surgical or cytology specimens?Obviously we 
would never want to see any type of carryover but is there a standard rate 
published somewhere that he can reference?

Thanks in advance for your help.

Martha Ward, MT ASCP, QIHC
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center


--

Message: 2
Date: Fri, 4 Dec 2020 17:41:11 +
From: "Joe W. Walker, Jr." 
To: Martha Ward-Pathology 
Cc: "histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] "Floaters" in surgical or cytology specimens
Message-ID:



Content-Type: text/plain; charset="utf-8"

https://academic.oup.com/ajcp/article/136/5/767/1766314

"Floaters represent a potential source of diagnostic error and occur in 0.01% 
to 1.2% of slides. Pick up of floaters from the water bath appears most common 
(?60%). Floaters in only 1 level and mismatch with the specimen tissue type are 
clues to the extraneous nature of the floater."

Joe W. Walker, Jr. MS, SCT(ASCP)
Anatomical Pathology and Interim Phlebotomy Manager
Rutland Regional Medical Center
160 Allen Street, Rutland, VT 05701
P 802.747.1790  F 802.747.6525
joewal...@rrmc.org, www.rrmc.org

-Original Message-
From: Martha Ward-Pathology via Histonet 
Sent: Friday, December 4, 2020 8:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] "Floaters" in surgical or cytology specimens

[External Email] This email originated from outside of the organization. Think 
before you click: Don?t click on links, open attachments or respond to requests 
for sensitive information if the email looks suspicious or you don?t recognize 
the sender.


I am posting this question for a colleague in our Cytology department. How 
often do you see floaters on surgical or cytology specimens?Obviously we 
would never want to see any type of carryover but is there a standard rate 
published somewhere that he can reference?

Thanks in advance for your help.

Martha Ward, MT ASCP, QIHC
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center
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[Histonet] Crystals forming in Hematoxylin

[Terri Braud via Histonet]

Hello Histo Peeps - What are the clear crystals that form in Hematoxylin?  We 
use Richard-Allen 7211.  We love the stain, but occasionally, when a bottle has 
been previously opened, we find clear crystalline precipitate forming in the 
bottom.  Today, we had a huge one (over an 2" in greatest diameter) that was 
quite beautiful.  It had a few occlusions of purple streaks, but otherwise was 
clear.  Doesn't seem to affect the stain, so I was just curious.
Inquisitively yours, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] LIS Systems

[Terri Braud via Histonet]

I've had great personal experiences with Sunquest CoPath Plus.  It is very 
flexible for customization and at 3 differing institutions, has been extremely 
reliable.  This does, however, come at a rather expensive cost.  I think that 
in choosing a system, one needs to take into account connectivity to 
instrumentation, EMRs, billing, and if the system has to interface with another 
IS, or is stand alone.  I'm sure there are some other good systems out there.  
Best of luck, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Thursday, May 14, 2020 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 198, Issue 12

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Today's Topics:

   1. LIS System Recommendations: (J B)
   2. Re: Spectra Staining Kits (Greg Dobbin)


--

Message: 1
Date: Wed, 13 May 2020 14:24:23 -0700
From: J B 
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] LIS System Recommendations:
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Hi there, I am looking for a new LIS system. Can anyone recommend a good
product for a AP lab? We handle all specimen types.

Thank you,

Julie


--

Message: 2
Date: Thu, 14 May 2020 08:30:24 -0300
From: Greg Dobbin 
To: redrose...@gmail.com
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Spectra Staining Kits
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Hi Wanda,
If you have just purchased the Spectra stainer recently (ie still under the
first year warranty), demand that Leica send their Application Specialist
back on site. if they promised 2000 slides with no drop in quality over
that period (I believe it is 2000 slides or 7 days, whichever come
first)...then hold them to it! Make them work for you. You paid a lot of
money for that system. You should not need to be on here looking for help.
I have a Spectra and if you want to chat with me about our experience feel
free to call me. I'll send you my number in a separate email.
All the best,
Greg

-- 
*Greg Dobbin*
1205 Pleasant Grove Rd
RR#2 York,
PE  C0A 1P0


*Everything in moderation...even moderation itself**!*


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Re: [Histonet] grossing regulations

[Terri Braud via Histonet]

Actually, there is another route for some of us older techs.  You can be 
grandfathered in without a degree if you have a certain prerequisite number of 
hours in specific science courses and prior documented training in grossing.  
Of course, I'm so old, I don't remember the details. LOL

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Saturday, May 09, 2020 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 198, Issue 9

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Today's Topics:

   1. Re: Grossing regulations (Mark Pawlowski)


--

Message: 1
Date: Fri, 8 May 2020 17:17:14 +
From: Mark Pawlowski 
To: "histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] Grossing regulations
Message-ID: <3ea87019-5eaf-498b-b913-159af2695...@jefferson.edu>
Content-Type: text/plain; charset="utf-8"

Hello Kristy,
 The regulation say that you must have at least an Associates degree with a 
certain amount of credits in the sciences. And yes, it is considered high 
complexity.
 Sorry I don?t remember the amount of credits.

Mark

> On May 8, 2020, at 1:00 PM, "histonet-requ...@lists.utsouthwestern.edu" 
>  wrote:
>
> ?WARNING:  External Email - This email originated outside of Jefferson.
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>
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> Send Histonet mailing list submissions to
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> Today's Topics:
>
>   1. Regulation for grossing derms (Kristy Castillo)
>
>
> --
>
> Message: 1
> Date: Fri, 8 May 2020 05:41:23 -0700
> From: Kristy Castillo 
> To: histonet@lists.utsouthwestern.edu
> Subject: [Histonet] Regulation for grossing derms
> Message-ID:
>
> Content-Type: text/plain; charset="UTF-8"
>
> My question is:  What would be the regulation (CLIA) to gross dermatology
> specimens? Are they not considered high complexity?  Also, don't you have
> to have a HT to do this?   Someone is telling me they can gross as long as
> they have associates.  Is that correct?  Sorry, I am a little confused with
> this.  Thankful for all who answer this question.
>
> Kristy
> AZDermgroup, Histology Lab
>
>
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> End of Histonet Digest, Vol 198, Issue 8
> 


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Re: [Histonet] linear stainer protocol

[Terri Braud via Histonet]

We have the Leica linear stainer (Also sold by Avantik?) and have it set at 7 
second intervals. The stain takes about 100 seconds. 
Slides are fixed in the Coplin jar with 95% Alcohol then loaded:
The stations are in order:
1. Water wash
2. Hemotoxylin (Richard Allen 7211)
3. Hemotoxylin (Richard Allen 7211)
4. Hemotoxylin (Richard Allen 7211)
5. Water wash
6. Bluing (we use Surgipath SelecTech Blue Buffer 8 concentrate, diluted 
according to directions
7. Water wash
8. Eosin (1% Alcoholic)
9. 95% Alcohol
10. Absolute Alcohol
11. Absolute Alcohol
12. Absolute Alcohol
13. Xylene
14. Xylene

The slides are clean and consistent with great differentiation.  The Richard 
Allen 7211 Hematoxylin does not require filtering and seems to last forever.
I sincerely hope this helps.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:

   1. Routine H frozen section protocol (Raible, John C.)
   2. Re: Routine H frozen section protocol (Porter, Amy)
   3. FFPE PRC testing (Charles Riley)


--

Message: 1
Date: Fri, 24 Apr 2020 12:10:26 +
From: "Raible, John C." 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Routine H frozen section protocol
Message-ID:



Content-Type: text/plain; charset="us-ascii"

Hello Histonet,

My name is John Raible, and I work at the VA medical center in Minneapolis. I 
am trying to find routine H frozen section staining protocols for an 
automated linear stainer. My lab recently got one, and I was asked to research 
staining protocols Any help you could provide would be greatly appreciated.

Thank you all. Stay safe and healthy!

John


--

Message: 2
Date: Fri, 24 Apr 2020 12:26:28 +
From: "Porter, Amy" 
To: "histonet@lists.utsouthwestern.edu"
,"Raible, John C."

Subject: Re: [Histonet] Routine H frozen section protocol
Message-ID:



Content-Type: text/plain; charset="iso-8859-1"

Fix in 10% NBF - 10 minutes
Rinse in running tap water - 5 minute
Rinse in distilled water
Gill 2 Hematoxylin - 1 1/2 minutes
1% Glacial Acetic water - 3 dips
Running water - 2 minutes
(we do not need bluing agent - our water takes care of it)
95% Ethanol -2 minutes
1% Eosin/Phloxine - 2 minutes
95% Ethanol - 2 minutes
Remaining dehydration in absolute ethanol & xylene - 2 mintues rest of the way 
down




From: Raible, John C. via Histonet 
Sent: Friday, April 24, 2020 8:10 AM
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] Routine H frozen section protocol

Hello Histonet,

My name is John Raible, and I work at the VA medical center in Minneapolis. I 
am trying to find routine H frozen section staining protocols for an 
automated linear stainer. My lab recently got one, and I was asked to research 
staining protocols Any help you could provide would be greatly appreciated.

Thank you all. Stay safe and healthy!

John
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Message: 3
Date: Fri, 24 Apr 2020 12:13:58 -0400
From: Charles Riley 
To: Histo List 
Subject: [Histonet] FFPE PRC testing
Message-ID:

Content-Type: text/plain; charset="UTF-8"

What platform does everyone use to carry out FFPE PCR testing?

Seeking to bring in as many genetic mutation testing options as possible
(BRAF, KRAS, NRAS...etc.)



-- 

Charles Riley BS  HT, HTL(ASCP)CM

Histopathology Coordinator/ Mohs


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Re: [Histonet] Incomplete sectioning

[Terri Braud via Histonet]

A quality check can be accomplished in 2 places.  It can be done at cutting, 
but it should already be being done and it doesn't seem to be working.
Ideally, the stained H should be checked against the block face as it is 
pulled from the coverslipper to be given to the pathologist. Then it can be 
handed immediately to the tech that made the original error to  "do over"
Also, a common excuse will be "it was embedded poorly".  The answer to that is 
that it is the cutting tech's responsibility to hand back a poorly embedded 
block for it to be re-embedded if they feel that they can't get a 
representation section.
Remember, it could also be poorly cut gross, too.
Then you can nip it in the bud before the slide reaches the pathologist, and 
you can quickly identify who is turning out inferior sections and counsel them 
appropriately if needed.
Hope this helps. Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Tuesday, March 03, 2020 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 196, Issue 2

CAUTION: This is an EXTERNAL EMAIL. Stop and think before clicking links or 
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Today's Topics:

   1. Incomplete cross sections of all tissue in blocks (Amy Self)
   2. Re: Incomplete cross sections of all tissue in blocks
  (John Garratt)


--

Message: 1
Date: Tue, 3 Mar 2020 15:31:59 +
From: Amy Self 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Incomplete cross sections of all tissue in blocks
Message-ID:



Content-Type: text/plain; charset="utf-8"

Good Morning HistoNetters,

I am reaching out to the histonet in hopes to get some suggestions from you on 
how to handle incomplete cross-sections of tissue in blocks. We are a small lab 
so this has not been an issue in the past but now that we are growing and our 
staff has increased I am getting feed-back from pathologist that the sections 
of tissue are not complete. They are asking for too many deepers that possibly 
could be avoided if it was cut deep enough to begin with. I have been given 
some managerial type duties ? which I don?t like cause I know nothing about 
managing people and I need to approach this but I need to approach this issue 
correctly.  Do you have the histotech compare his/her cut slides to the block 
to make sure that a complete cross-section is obtained and is this documented 
somehow?  Any and all suggestions I need.

Thanks in advance for your help and as always you all rock.. ?

Amy Self
Histology Lab Senior Tech
Lab
Tidelands Georgetown Memorial Hospital
606 Black River Road
Georgetown, SC 29440
(843) 520-8711
as...@tidelandshealth.org
Our mission:  We help people live better lives through better health.


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Message: 2
Date: Tue, 03 Mar 2020 17:01:55 +
From: John Garratt 
To: Amy Self ,
"histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] Incomplete cross sections of all tissue in
blocks
Message-ID:



Content-Type: text/plain; charset=UTF-8

I suggest that each histotech is responsible for the blocks they cut and they 
cut the deepers on the their own blocks when they are requested. With feedback 
on the reason for the deeper from the pathologists they (the techs) will become 
more confident and learn how deep to cut.

John

On Tue, Mar 3, 2020 at 7:31 AM, Amy Self via Histonet 
 wrote:

> Good Morning HistoNetters,
>
> I am reaching out to the histonet in hopes to get some suggestions from you 
> on how to handle incomplete cross-sections of tissue in blocks. We 

Re: [Histonet] overstained Warthin starry

[Terri Braud via Histonet]

Any silver stains can be lightened or removed by the old method for removing 
mercury pigment.  This particular timing will remove it all so I would start 
the sequence of steps in 5 second increments, repeat or lengthen times as 
needed.
1. Hydrate to distilled water.
2.Place in Lugols iodine for 5 minutes.
3.Rinse in two changes of distilled water.
4.Place in 2% sodium thiosulfate for 1 minute.
5.Wash in running tap water and rinse in two changes of distilled water.


Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Message: 2
Date: Tue, 11 Feb 2020 10:33:12 -0500
From: Charles Riley 
To: Histo List 
Subject: [Histonet] Warthin starry
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Is there any way to lighten and over stainer WS stain?

Charles Riley BS  HT, HTL(ASCP)CM
Histopathology Coordinator/ Mohs


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[Histonet] Need a procedure

[Terri Braud via Histonet]

Hi fellow Histonetters - I'm in need of some help, please
Background - We currently use agar to capture our scant cell blocks for 
processing. I am unfamiliar with the Plasma/Thrombin method of cell block 
preparation and am interested in comparing it to our current method
Request - Could you please send me your procedures for this method, 
specifically where you purchase your plasma and thrombin and what species are 
used?
Thanks in advance. Histotechs rock!

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] pregnancy and chemical exposure

[Terri Braud via Histonet]

Hi Val - 
I'm sorry that you feel that your concerns are not being addressed.  I am the 
safety officer for our entire lab as well as the chair on our hospital's 
Environmental Safety and Hazardous Materials Committee.  I do think that Tim 
has a valid point that Xylene is detectable by smell long before it poses a 
danger.  It can be smelled at 0.8ppm to 40ppm and only becomes unacceptable at 
100ppm.
You should have access to your most recent exposure tests which should have 
been performed at the peak of your work exposure process (i.e. using a 
Short-term exposure value (STEL) measure while changing the processor, or 
stainer) This is the best look at your actual exposure.  If this STEL has not 
been done, ask for it to be repeated.  It is cheap and easy. Additionally, you 
should be provided with appropriate PPE which include NITRILE gloves that are 
approved for Chemical use (looks for the label to state "tested and approved 
for use with  Chemotherapy drugs.  Those should be sufficient.) The gloves 
should be changed every 30 minutes of exposure task time, or sooner if the 
gloves are compromised.  You should also have access to air flow studies for 
your fume hood that show it is performing according to specs.
There are no useful studies of xylene exposure and prenatal risk or 
developmental toxicity.  The best overall study can be found at the NIH, but 
the only ones that specifically address this had too many limitations to be 
considered useful and didn't even include exposure levels.
As a tech, I have been in the field for over 40 years, I can tell you that I 
can count over 20 pregnancies amongst me and my coworkers at 3 different 
institutions, with no problems whatsoever, and many of these were in a 
not-so-great  environment as the one I work in now.
As a manager, I would expect that if I gave you the provisions that I 
discussed, (within STEL, appropriate PPE with Nitrile gloves, and an the hood 
air flow check) that you should be able to perform your chemical related tasks 
with no problems. 
My personal advice is the stressing over this problem is not good for you or 
your baby either.  I wish you and your new baby only the best.  Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Message: 7
Date: Tue, 21 Jan 2020 16:23:15 +
From: "Morken, Timothy" 
To: Val L , "Eck, Allison" 
Cc: Histonet 
Subject: Re: [Histonet] Pregnant in histo lab. Am I safe?

The problem with xylene is that the acceptable air level in the lab is 100ppm 
but humans can detect it by smell at the 5 - 20ppm range. So it seems like it 
is "everywhere" but it could still be at a very low level. What level is safe 
for a pregnancy?  CDC has some info on this:
https://www.cdc.gov/niosh/topics/repro/solvents.html

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

-Original Message-
From: Val L via Histonet  

Sadly I have already been exposed to xylene several times as I cannot avoid the 
smell. It?s everywhere. There are not enough vents in the lab. I don?t know if 
it?s ignorance or malice but my manager and coworkers are not quite informed 
about the dangers that a pregnant woman face in a histology lab.
They feel that if the lab passed a xylene vapor tests and give me a general 
purpose respirator then that?s enough for me to be safe and I can do the same 
work as everybody else. There is a negligent attitude regarding safety in this 
laboratory. Also there has been a negative attitude towards pregnant women like 
if they were are a burden in the lab.  It makes me nervous to work here. I 
don?t think is a healthy work environment.

On Saturday, January 18, 2020, Eck, Allison  wrote:

> From: Valerie Laughlin via Histonet 
> [histonet@lists.utsouthwestern.edu]
> Sent: Saturday, January 18, 2020 7:21 AM
> To: histonet@lists.utsouthwestern.edu
> Subject: [Histonet] Pregnant in histo lab. Am I safe?
>
> Hello everyone. I am currently in the last weeks of my first trimester 
> of my pregnancy.
>> I have asked this question to my Ob-Gyn, family and general pregnancy 
> forums but I wanted to ask people who understand the field of 
> Histotechnology better.
> I have been very concerned about the side effects of the chemicals 
> that might have on my baby.  The lab works with the typical stuff 
> (formaldehyde, xylene, alcohol of different percentages, glacial 
> acetic acid, stains etc) They make the fixative from scratch.
> I had to inform my supervisor and manager. I didn?t get the most 
> positive reaction from them but I don?t care as this is my personal 
> business and I have rights like everybody else.
> I gave them a letter from my doctor informing my pregnancy and that I 
> should be kept away from the chemicals for my own safety.
> They acknowledged the letter but still 

Re: [Histonet] Slippery floors

[Terri Braud via Histonet]

Dear Dorianne - 
Over 40+ years, I've seen all sorts of attempts at solving the "slippery floor" 
issue; mats, special flooring, etc.  In my experience, there is no substitute 
for having the Environmental Services folks, strip the floors every 2 weeks.  I 
find that while applications of floor finish (wax)make the floors look nice and 
shiny, they only serve to exacerbate the slipperiness. Try it, you will like it!
Terri
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


Message: 6
Date: Fri, 10 Jan 2020 09:09:40 +
From: Bonello Dorianne M at Health-MDH 
Subject: [Histonet] slippery floors
Dear all,
we are currently experiencing problems due to our lab/corridor linoleum floors 
which have become too slippery.
Anyone experiencing the same problem? If so, can you please suggest any 
solutions/measures taken to make the floor less slippery.
Regards,
Dorianne


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Re: [Histonet] H protocols

[Terri Braud via Histonet]

We use the same protocol for all H 


Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Sent: Friday, January 03, 2020 1:00 PM
Subject: Histonet Digest, Vol 194, Issue 2
Today's Topics:

   1. H protocols (Charles Riley)
Date: Fri, 3 Jan 2020 12:42:40 -0500
From: Charles Riley 

Does everyone use the same protocol for routine H's as well as things
like Cell blocks and or lymph nodes?
If you use a different protocol how does it differ from your routine stain?
Charles Riley BS  HT, HTL(ASCP)CM
Histopathology Coordinator/ Mohs


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Re: [Histonet] Delay in embedding

[Terri Braud via Histonet]

We do it all the time.


Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Wednesday, December 18, 2019 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 193, Issue 12

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Today's Topics:

   1. Delay in embedding? (P Sicurello)
   2. Re: Delay in embedding? (Theresa Dalton)
   3. Re: Delay in embedding? (Tony Henwood (SCHN))
   4. Re: Delay in embedding? (Jennifer Saunders)
   5. Re: Delay in embedding? (Garrey Faller)
   6. Happy Holidays Histonetters! Here are the 12 days of
  Christmas for histotechs by Ashley Troutman. Enjoy! (Pam Barker)
   7. plural fluid prep (Michelle Jamison)


--

Message: 1
Date: Tue, 17 Dec 2019 11:30:58 -0800
From: P Sicurello 
To: HistoNet 
Subject: [Histonet] Delay in embedding?
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Good Morning Listers,



How many out there will process tissue and then leave the cassettes at room
temperature and embed it at a later time (hours or the next day)?



Please send me your opinions about doing this.  I think it?s a bad idea,
others I speak with disagree.

Sincerely,

Paula Sicurello, HTL (ASCP)CM

Histotechnology Specialist

UC San Diego Health

9300 Campus Point Drive

La Jolla, CA 92037
(P): 858-249-5610



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Message: 2
Date: Tue, 17 Dec 2019 15:33:43 -0500
From: Theresa Dalton 
To: P Sicurello 
Cc: HistoNet 
Subject: Re: [Histonet] Delay in embedding?
Message-ID: <693b4d62-df63-486c-9017-d24b9f190...@icloud.com>
Content-Type: text/plain; charset=utf-8

We have done this - only on an emergency basis. 

Sent from my iPhone

> On Dec 17, 2019, at 2:48 PM, P Sicurello via Histonet 
>  wrote:
> 
> ?Good Morning Listers,
> 
> 
> 
> How many out there will process tissue and then leave the cassettes at room
> temperature and embed it at a later time (hours or the next day)?
> 
> 
> 
> Please send me your opinions about doing this.  I think it?s a bad idea,
> others I speak with disagree.
> 
> Sincerely,
> 
> Paula Sicurello, HTL (ASCP)CM
> 
> Histotechnology Specialist
> 
> UC San Diego Health
> 
> 9300 Campus Point Drive
> 
> La Jolla, CA 92037
> (P): 858-249-5610
> 
> 
> 
> *Confidentiality Notice*: The information transmitted in this e-mail is
> intended only for the person or entity to which it is addressed and may
> contain confidential and/or privileged material.  Any review,
> retransmission, dissemination or other use of or taking of any action in
> reliance upon this information by persons or entities other than the
> intended recipient is prohibited.  If you received this e-mail in error,
> please contact the sender and delete the material from any computer.
> ___
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--

Message: 3
Date: Tue, 17 Dec 2019 22:28:13 +
From: "Tony Henwood (SCHN)" 
To: Theresa Dalton , P Sicurello

Cc: "'histonet@lists.utsouthwestern.edu'"

Subject: Re: [Histonet] Delay in embedding?
Message-ID:

Content-Type: text/plain; charset="utf-8"

Hi Paula,

We routinely do this, especially for our fetal autopsy blocks.
We are then able to process and let them set at room temp until we are able to 
embed and cut.
Some cases are more urgent than others so these can be expedited a lot easier 
since they will only need embedding, sectioning and staining. We also get best 
usage of our limited processing capabilities.
It is more efficient 

[Histonet] Processing descemet's membrane

[Terri Braud via Histonet]

Hello Histopeeps -
I need your help, please.  I need to improve our processing of Descemet's 
membrane, more specifically keeping track of that little wisp of clear 
colorless tissue?  Do you have any tricks to help keep track of it through 
processing?  Inks?  Embedding gel? Anything?
I'm open for any ideas to make this process easier.  Thanks in advance, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] weekends in the small lab

[Terri Braud via Histonet]

Garrey brings up an excellent point, cautioning carefulness when dealing with 
breast fixation times over the weekend. When we receive breast biopsies on 
Thursday, that do not have enough fixation time to load Thursday evening, we 
run them Friday morning as soon as a processor becomes available.  For breast 
cases received on Friday, they are processed as a routine specimen, coming off 
on Monday.  For the rare occasion that we have a Friday breast received before 
a 3 day weekend, we will ask for a volunteer to come in and remove it from a 
routine schedule before the 72 hour fixation time is exceeded. We just let the 
blocks sit at room temp in paraffin until embedded.  We have been operating 
this way for years with no problem.
Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


-Original Message-
From: Garrey Faller [mailto:garr...@gmail.com] 
Sent: Friday, December 06, 2019 7:02 PM
To: Terri Braud
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] weekends in the small lab

CAUTION: This is an EXTERNAL EMAIL. Stop and think before clicking links or 
opening attachments.

Agree. As a pathologist, I’ve benefited from weekend coverage at a much smaller 
Hospital  lab. Now am at a much busier lab and we don’t have weekend coverage . 
Would I like it? Yes. But we function fine without it. One thing to always 
consider is cap/Asco time fixation guidelines for breast biopsies. Having a 
weekend run gives you more flexibility.
G

Sent from my iPhone

> On Dec 5, 2019, at 1:40 PM, Terri Braud via Histonet 
>  wrote:
> 
> In my experience in 2 small hospital labs, weekend coverage is just not 
> worth it.  If it is a major surgery, then the patient will be recuperating 
> and if it is just a biopsy, the ordering physician is rarely available to 
> correlate the Pathology findings with the clinical findings.  Most tell the 
> patient that they will get their results in a week or two.
> The only exception that I have encountered was if you process non-gyn 
> cytology.  On rare occasions, we found the need to process a fluid in order 
> to look for organisms or to send for flow, though we seldom did more than one 
> per year.  For those occasions, we usually just had someone volunteer to come 
> in to process it in order to save our weekends free.
> Generally, at both hospital labs, we were closed when surgery was closed, 
> even on 3 day weekends and we've never had trouble or complaints. The weekend 
> cases you describe are not a rush.
> 
> Terri L. Braud, HT(ASCP)
> Anatomic Pathology Supervisor
> Laboratory
> Holy Redeemer Hospital
> 1648 Huntingdon Pike
> Meadowbrook, PA 19046
> ph: 215-938-3689
> fax: 215-938-3874
> Care, Comfort, and Heal
> 
> 
> Today's Topics:
>   1. Weekend Coverage for Small Pathology Labs (Lindrud, Scott)
> Message: 1
> Date: Thu, 5 Dec 2019 15:19:39 +
> From: "Lindrud, Scott" 
> Subject: [Histonet] Weekend Coverage for Small Pathology Labs
> 
> Hi Histonet,
> I apologize if this is being re-posted but I did not see this message on the 
> daily Histonet Digest so I'm not sure if it ever got posted.
> I was wondering if anyone would be willing to share their experience with 
> weekend Histology coverage for smaller Pathology labs?  When I say small, I'm 
> saying about 30,000-33,000 blocks per year (avg 130-140/day) with automated 
> IHC and special staining.  Our lab is in a rural area where all but one of 
> the histotechs live between 25-50 miles away.  Winter weather has played a 
> role in numerous instances of trying to get a histotech to the lab on a bad 
> weather Saturday.
> 
> Our lab currently has a histotech come in on Saturday morning to set up a 
> gross for about 16-20 cases which will be put on processing run to come off 
> on Monday morning.  The majority of the cases are from colonoscopies, 
> colposcopies, skin excisions, gallbladder/appendix, and placentas.
> 
> I'm asking this to see if there is a necessity for the Saturday coverage for 
> a lab our size.  If the industry standard is that most labs of smaller size 
> have some sort of Saturday histology coverage, then we're good to go.  But if 
> most smaller labs aren't providing some sort of weekend coverage, then I feel 
> more confident talking to management for our histotechs about the necessity 
> of providing the Saturday coverage.   I just don't know what other smaller 
> labs are doing.
> 
> Thanks for any opinions or information!
> 
> Scott A. Lindrud, MLSCM(ASCP)CTCM | Histopathology Technical Specialist
> Phone: 320-231-4406
> Fax: 320-231-4305
> scott.lind...@carrishealth.com<mailto:scott.lind...@carrisheal

[Histonet] weekends in the small lab

[Terri Braud via Histonet]

In my experience in 2 small hospital labs, weekend coverage is just not worth 
it.  If it is a major surgery, then the patient will be recuperating and if it 
is just a biopsy, the ordering physician is rarely available to correlate the 
Pathology findings with the clinical findings.  Most tell the patient that they 
will get their results in a week or two.
The only exception that I have encountered was if you process non-gyn cytology. 
 On rare occasions, we found the need to process a fluid in order to look for 
organisms or to send for flow, though we seldom did more than one per year.  
For those occasions, we usually just had someone volunteer to come in to 
process it in order to save our weekends free.
Generally, at both hospital labs, we were closed when surgery was closed, even 
on 3 day weekends and we've never had trouble or complaints. The weekend cases 
you describe are not a rush.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


Today's Topics:
   1. Weekend Coverage for Small Pathology Labs (Lindrud, Scott)
Message: 1
Date: Thu, 5 Dec 2019 15:19:39 +
From: "Lindrud, Scott" 
Subject: [Histonet] Weekend Coverage for Small Pathology Labs

Hi Histonet,
I apologize if this is being re-posted but I did not see this message on the 
daily Histonet Digest so I'm not sure if it ever got posted.
I was wondering if anyone would be willing to share their experience with 
weekend Histology coverage for smaller Pathology labs?  When I say small, I'm 
saying about 30,000-33,000 blocks per year (avg 130-140/day) with automated IHC 
and special staining.  Our lab is in a rural area where all but one of the 
histotechs live between 25-50 miles away.  Winter weather has played a role in 
numerous instances of trying to get a histotech to the lab on a bad weather 
Saturday.

Our lab currently has a histotech come in on Saturday morning to set up a gross 
for about 16-20 cases which will be put on processing run to come off on Monday 
morning.  The majority of the cases are from colonoscopies, colposcopies, skin 
excisions, gallbladder/appendix, and placentas.

I'm asking this to see if there is a necessity for the Saturday coverage for a 
lab our size.  If the industry standard is that most labs of smaller size have 
some sort of Saturday histology coverage, then we're good to go.  But if most 
smaller labs aren't providing some sort of weekend coverage, then I feel more 
confident talking to management for our histotechs about the necessity of 
providing the Saturday coverage.   I just don't know what other smaller labs 
are doing.

Thanks for any opinions or information!

Scott A. Lindrud, MLSCM(ASCP)CTCM | Histopathology Technical Specialist
Phone: 320-231-4406
Fax: 320-231-4305
scott.lind...@carrishealth.com



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End of Histonet Digest, Vol 193, Issue 3




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Re: [Histonet] Erroneous result

[Terri Braud via Histonet]

The report must be amended, not deleted.  The amended reason should state the 
reason for the amendment, and the correction. "This report is amended to 
correct the patient data to the correct patient"
All electronic reports that are downstream must show that correction.
You can never just delete an incorrect report. Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

   4. erroneous results (Nancy Schmitt)

Message: 4
Date: Wed, 6 Nov 2019 11:31:32 +
From: Nancy Schmitt 
Subject: [Histonet] erroneous results
Hello-
Could you please share your process for erroneous results?  Scenario:  Specimen 
received, processed and reported out.  Physician office calls to say that the 
specimen was labeled with incorrect patient information.  1. Do you remove the 
results? 2. do you amend the report? 3. do you leave any trace?  4. is your 
process the same for surgical specimens as it is for GYN paps?
Looking forward to the discussion,
Nancy Schmitt
Pathology Support Services Mgr.
Dubuque, IA


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Re: [Histonet] Cell block processing

[Terri Braud via Histonet]

We collect our FNAs in CytoLyt.  We also use it to wash all our non-gyn fluids, 
but then we fix the cell block "pellet" in formalin.
We have had no problems with immunos, and are able to lyse the RBCs to provide 
a nice, clear specimen.
Hope this helps.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal



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Re: [Histonet] Transporting large amputations and QA review of reports

[Terri Braud via Histonet]

1. Extremity carrier (Olszewski, Dawn)
I completely agree with Karen Bowden's response,
"I work in a research lab so this may not go over well.? How about using 
a cart and a child size body bag? You would not be able to see through 
the bag and there shouldn't be any smell and you most likely have a cart 
around the place"
This is exactly what we do.  The process is clean and neat and we also have to 
transport it through multiple patient areas.

4. Brandon Ward asked, "I'm wondering if any health systems have a quality 
program that includes a person(s) who audit final gross and final pathology 
reports?"
Our QA process reviews all of our reports that should contain synoptic reports. 
 These are reviewed by the Chief pathologist for the accuracy of the report 
information including the synoptic reports.

Just my 2 cents, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


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Re: [Histonet] Bone Marrow Assists

[Terri Braud via Histonet]

Our Histology Techs also assist with Bone Marrows in CT, though there is little 
to do.  We collect the aspirate in Heparin Tubes and the core in Bouins.  We 
bring it back to the lab and make our smears from one of the heparin tubes.  
The other tubes go for special studies.  I'd like to think our smears are 
better than many.  We pour the aspirate into a weigh boat and use a pipet to 
pick out the spicules for picture perfect smears. Much better results than the 
old method of making the smears at bedside.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Saturday, September 28, 2019 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 190, Issue 22
Today's Topics:

   1. Re: Histo techs assisting on BM Bx's (Webster, Thomas S.)
--
Message: 1
Date: Fri, 27 Sep 2019 17:13:29 +
From: "Webster, Thomas S." 
Subject: Re: [Histonet] Histo techs assisting on BM Bx's

Our histotechs assist bone marrows but it used to be Hematology's 
responsibility.  The bone marrows at my institution aren't very time consuming 
and are done in CT.


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Re: [Histonet] Freezing spray in cryostats

[Terri Braud via Histonet]

My question is why would you ever want to use an aerosol in the cryostat, 
taking a chance on aerosolizing some nasty bug?
Is the 30 seconds you save in using freezing spray worth the exposure to TB or 
goodness-knows-what?  
We use a simple metal heat extractor (comes standard in our Leicas) and place 
it on top of the freezing block to accelerate the process.  We never have 
issues with turn around times.
For me, no freezing spray.  Ever.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Wednesday, September 25, 2019 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 190, Issue 18

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Today's Topics:

   1. Flammable Sprays in Cryostats (Knutson, Deanne)
   2. Re: Flammable Sprays in Cryostats (Akemi)
   3. Re: Flammable Sprays in Cryostats (Hannen, Valerie)
   4. Re: Flammable Sprays in Cryostats (Ingles Claire)


--

Message: 1
Date: Wed, 25 Sep 2019 07:50:44 -0500
From: "Knutson, Deanne" 
To: "'histonet@lists.utsouthwestern.edu'"

Subject: [Histonet] Flammable Sprays in Cryostats
Message-ID:

<1e0e2b14c709174b8ac2be0ae7f768330159b5756...@exchange2k7.staprimecare.org>

Content-Type: text/plain; charset="us-ascii"

I just received a letter from Leica Biosystems where they are prohibiting the 
usage of flammable
freezing sprays in their cryostats.  What are others using in their cryostats 
to instantly freeze specimens?

Thank you.


Deanne Knutson
Supervisor
Anatomic Pathology
dknut...@primecare.org






  
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Message: 2
Date: Wed, 25 Sep 2019 09:05:20 -0500
From: Akemi 
To: "Knutson, Deanne" , Histonet

Subject: Re: [Histonet] Flammable Sprays in Cryostats
Message-ID: <19db25eb-9944-406b-917c-0878d6f15...@gmail.com>
Content-Type: text/plain;   charset=us-ascii

We are purchasing two of their newer UV cryostats and they were adamant that we 
use a non flammable freezing spray because it can damage the UV unit and have 
potential for exploding.

Akemi Allison

Sent from my iPhone

> On Sep 25, 2019, at 7:50 AM, Knutson, Deanne via Histonet 
>  wrote:
> 
> I just received a letter from Leica Biosystems where they are prohibiting the 
> usage of flammable
> freezing sprays in their cryostats.  What are others using in their cryostats 
> to instantly freeze specimens?
> 
> Thank you.
> 
> 
> Deanne Knutson
> Supervisor
> Anatomic Pathology
> dknut...@primecare.org
> 
> 
> 
> 
> 
> 
>  
> This email may include confidential and privileged information. If this is 
> not intended for your use, please destroy immediately and contact the sender 
> of the message.
> 
> This email and attachments contain information that may be confidential or 
> privileged. If you are not the intended recipient, notify the sender at once 
> and delete this message completely from your information system. Further use, 
> disclosure, or copying of information contained in this email is not 
> authorized, and any such action should not be construed as a waiver of 
> privilege or other confidentiality protections.
> ___
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> http://lists.utsouthwestern.edu/mailman/listinfo/histonet



--

Message: 3
Date: Wed, 25 Sep 2019 15:49:00 +
From: "Hannen, 

Re: [Histonet] Yearly Reviews

[Terri Braud via Histonet]

Hi Anne - Interesting question.  Our Human Resources department keeps records 
of annual reviews, which include annual competencies,  for 10 years following 
the separation of the employee from the system.
I'm curious what others are doing, and does it vary from state to state. Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Message: 2
Date: Thu, 19 Sep 2019 16:42:36 +
From: Anne Murvosh 
To: "histonet@lists.utsouthwestern.edu"
Subject: [Histonet] Yearly review
Hey everyone, does the yearly employee competency assessments need to be kept 
for just 2 years or for the entire time an employee is there. I have some old 
ones I want to toss, but I just wanted to be sure. Thanks Anne
--


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Re: [Histonet] Interview

[Terri Braud via Histonet]

Just a note: The liability of having a interviewee cut themselves operating an 
instrument that they have not been signed off as competent is HUGE.  I think 
your company/labs legal team would say absolutely not.
It would be nice to assess their cutting and other skills ahead of time, but 
that is what the probationary period is for.  Don't be afraid to let an 
underperformer go during probation.
More than likely, a good personality fit is the most important, anyway.
Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

   5. Help to interview new employees for the first time (Blanca Lopez)


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[Histonet] Ventana UltraView Contamination

[Terri Braud via Histonet]

Heads up, Histo peeps!
We have 2 ultraView kits, both from the same lot #F03020 that have extra plugs? 
Black things? Floating around in the Multimer reagent.
Please check your kits carefully.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] Tissue Adherence problem

[Terri Braud via Histonet]

Hi Deanne - 
Hope this will help
For our Ventana Ultra, we use Leica / Surgipath Apex Superior Adhesive slides.
We use de ionized water in our baths at 45C ish, no additives.
We never "double-dip" our slides (meaning that if we mount a control on the top 
of the slide, we turn the slide upside down to pick it up, only immersing the 
slide to pick up the intended tissue)
We pre-bake IHC slides in a hot air blower over at 65C, 10 min for small 
tissues, and 1 hr for large tissues, then load for IHC.

For special stains, we use the same slides, but they go directly on the Sakura 
Prisma stainer into the instrument oven at 65C for 15 minutes before staining
For H, we use the plain Surgipath Snowcoat  slides, no adhesive, directly on 
the Sakura Prisma stainer into the instrument oven at 65C for 15 minutes before 
staining.  They dry vertically in a rack as we cut, then we load as soon as the 
rack is full.

We once had an issue with tissue falling off and were able to trace it to a new 
tech's liberal use of Paraguard Spray. Stopped using it, wiped everything down 
with alcohol and our problem went away.
Also, many years ago, I had a problem with a bad lot of slides, but these were 
Cardinal's.
I sincerely hope you can get this straightened out.  I know how frustrating 
such a problem can be.
Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
   2. Tissue Adherence Issue (Knutson, Deanne)
Message: 2
Date: Wed, 17 Jul 2019 09:21:49 -0500
From: "Knutson, Deanne" 
Subject: [Histonet] Tissue Adherence Issue
Fellow Histonetters -

I would appreciate your feedback on an intermittent issue that has shown up in 
our lab.
All of a sudden, we are having difficulty with tissue specimens falling off of 
our slides on the IHC stains and special stains sporadically.
About a year ago, we switched instruments on the IHC bench from the Leica BOND 
to the ROCHE ULTRA, and we use the Ventana NexES special stainer.
No adherence issues with all of the validation slides that were run.
We have tried various types of slides recently as well, and the issue still 
prevails.

Would any of you mind telling me your slide workflow - type of slide used, 
gelatin or not used in flotation bath, how long slides are cooked, etc for 
your IHC slides, for your special stains slides, and even for your H slides.
I would welcome your suggestions and feedback.

Thank you so much!!!
Deanne Knutson
Supervisor
Anatomic Pathology
"Let All Be Received as Christ."


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Re: [Histonet] gross ventillation

[Terri Braud via Histonet]

Just a few words on gross ventilation.  To be really efficient, it should be 
downdraft ventilation with appropriate sink access.  Hoods with lowered sashes 
obscure working vision needed, are horrible to clean and disinfect.  There 
should be no excuse for not budgeting an appropriate downdraft gross 
workstation in a new gross workspace.  They cost 20% of what a good tissue 
processor costs.  If your budget allows for the purchase of a good downdraft 
hood (I am a big fan of LabConCo) it is probably not too much of a stretch to 
purchase a downdraft workstation. That way formalin capture and sink access are 
completely vented.  Either way, please stand up for safety.  Best of luck to 
you.  Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
   3. fume hoods for grossing (Histology)
--
Message: 3
Date: Thu, 6 Jun 2019 16:46:25 +
Subject: [Histonet] fume hoods for grossing
Hi Histonetters,
I'm trying to see what kind of exhaust/fume hoods people are using in small 
grossing labs.  We are moving into a new space and I want to make sure the 
ventilation at the gross board is adequate.  I don't think an actual grossing 
station is in the budget.
Thanks,
Mehndi Helgren
Dominion Pathology Laboratories
733 Boush St.
Suite 200
Norfolk, VA  23510
757-664-7901


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Re: [Histonet] Benchmarks for reprocessing

[Terri Braud via Histonet]

We are down to < 0.1%, but I think you have to take into account your grossing 
staff.  We are just medium sized and have an outstanding PA.  Our 2 new Leica 
6025 processors have also made a big difference.  I suspect if you are a 
teaching hospital with residents grossing, there would be a learning curve.  
When I was at UVA, our percentages were not so good until we hired a PA to 
oversee the gross room and to teach grossing skills.
Just my 2 cents.
Thx, T


Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Thursday, May 09, 2019 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 186, Issue 8

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Today's Topics:

   1. Benchmarks for Reprocessing (Cristi Rigazio)
   2. Re: Benchmarks for Reprocessing (Morken, Timothy)
   3. Part time histology in Phoenix area? (Jill Cox)


--

Message: 1
Date: Wed, 8 May 2019 16:20:24 -0400
From: Cristi Rigazio 
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Benchmarks for Reprocessing
Message-ID: <8c3b3b9e-6878-4932-9e20-4c1700840...@gmail.com>
Content-Type: text/plain;   charset=us-ascii


> Good afternoon Fellow histonetters!
> 
> I was wondering if there are any tertiary institutions out there that have 
> set a benchmark for reprocessing tissue?  We tend to be less than 1%, but 
> would love to see what others think is reasonable.
> 
> Thanks for the feedback and hope you all are having an excellent day!
> Cristi



--

Message: 2
Date: Wed, 8 May 2019 20:39:08 +
From: "Morken, Timothy" 
To: Cristi Rigazio 
Cc: Histonet 
Subject: Re: [Histonet] Benchmarks for Reprocessing
Message-ID:



Content-Type: text/plain; charset="us-ascii"

We try to be at 0.5% or less. We monitored as a quality indicator for several 
years and had to modify something to get to that point, but it is pretty steady 
now. We have new residents constantly rotating into pathology so it is a 
training issue every month. 



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

-Original Message-
From: Cristi Rigazio via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, May 08, 2019 1:20 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Benchmarks for Reprocessing


> Good afternoon Fellow histonetters!
> 
> I was wondering if there are any tertiary institutions out there that have 
> set a benchmark for reprocessing tissue?  We tend to be less than 1%, but 
> would love to see what others think is reasonable.
> 
> Thanks for the feedback and hope you all are having an excellent day!
> Cristi

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--

Message: 3
Date: Thu, 9 May 2019 07:43:24 -0700
From: Jill Cox 
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Part time histology in Phoenix area?
Message-ID: <3a38609b-e47e-44e7-a02d-5cc0157f2...@yahoo.com>
Content-Type: text/plain;   charset=us-ascii

Hello all,
Are there any part time or on call openings in the Phoenix area for histology? 
Thanks!!! 

Sent from my iPhone



--

Subject: Digest Footer

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End of Histonet Digest, Vol 186, Issue 8



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Re: [Histonet] Chromic Acid Disposal

[Terri Braud via Histonet]

The best thing to do would be to contact either your city chemist or the state 
EPA inspector to be sure to be in compliance with all local regulations. A 
reducing agent, such as sodium metabisulfite, sodium sulfite or sodium 
thiosulfate can be used to turn CrO3 into the less toxic Cr(III) oxide.
Alternatively, I would collect the waste and have a chemical waste disposal 
company dispose of it.  I'm not a big fan of the 
"flush-it-down-the-sink-with-water" method, unless we are talking minutes 
amounts.  If nothing else, it is about being a better steward of our planet.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Friday, April 12, 2019 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 185, Issue 6

CAUTION: This is an EXTERNAL EMAIL. Stop and think before clicking links or 
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Today's Topics:

   1. Re: 5% Chromic acid disposal (Bob Richmond)
   2. Re: 5% Chromic acid disposal (Bryan Llewellyn)


--

Message: 1
Date: Thu, 11 Apr 2019 13:29:09 -0400
From: Bob Richmond 
To: "Histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] 5% Chromic acid disposal
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Sharon at Celligent Diagnostics in Spartanburg SC asks:

>>We are changing our GMS stain over from a Periodic acid kit to a 5%
chromic acid kit. What do the labs that use chromic acid in special
staining do with the waste/ used chromic acid?<<

I hope someone can give an authoritative answer to this question, with
references. Chromic acid (chromium trioxide, CrO3) is a strong oxidant, and
chromium is toxic and an environmental hazard. I'd be comfortable with
pouring it down the drain with a LOT of water, but what do the authorities
want us to do?

Bob Richmond
Samurai Pathologist
Maryville TN


--

Message: 2
Date: Thu, 11 Apr 2019 11:26:01 -0700
From: Bryan Llewellyn 
To: Histonet 
Subject: Re: [Histonet] 5% Chromic acid disposal
Message-ID: <0cabb492-6985-4cb6-0783-172a98cdc...@shaw.ca>
Content-Type: text/plain; charset=UTF-8; format=flowed

I suspect disposal might vary depending on the State. I live in British 
Columbia and we had permission from out city (Prince George) to use a 
dribble tank with lots of water and flush them into the local river (The 
Fraser), but I opted to collect all the toxic chemicals and ship them 
periodically to a facility in our neighboring Province of Alberta for 
recovery and reuse. There must be facilities of that kind somewhere in 
the United States, I would think. That is probably the best option. We 
used the same procedure for mercury salts, osmium tetroxide, etc.

Bryan Llewellyn


Bob Richmond via Histonet wrote:
> Sharon at Celligent Diagnostics in Spartanburg SC asks:
>
>>> We are changing our GMS stain over from a Periodic acid kit to a 5%
> chromic acid kit. What do the labs that use chromic acid in special
> staining do with the waste/ used chromic acid?<<
>
> I hope someone can give an authoritative answer to this question, with
> references. Chromic acid (chromium trioxide, CrO3) is a strong oxidant, and
> chromium is toxic and an environmental hazard. I'd be comfortable with
> pouring it down the drain with a LOT of water, but what do the authorities
> want us to do?
>
> Bob Richmond
> Samurai Pathologist
> Maryville TN
> ___
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>



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Subject: Digest Footer

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End of Histonet Digest, Vol 185, Issue 6




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[Histonet] Stainer vs. Stainer

[Terri Braud via Histonet]

Hi Alison - 
I've used both stainers and like both of them a lot.  Both were super reliable 
and easy to use.  However, coverslipping is a different story.
I've used both film and glass.  About film - super quick, super easy, but - the 
purity of the xylene used to coverslip from film must be absolute. Anyone who 
has experienced film pulling off the slides in storage had a miniscule portion 
of water carried down the acohols and into the xylene. If it were glass, the 
process is a bit more forgiving of water contaminent. The absolute alcohols 
leading to the end xylenes must be kept very fresh.  I kept film slides for 
over 20 years, no problem.  If you are looking into digital pathology, I would 
check with vendors to see if film is acceptable.  I don't know.
As to coverslippers, we've been using the Sakura glass now for 10 years and 
love it.  I can't compare it to the newer Leica Glass, but 10 years ago my 
techs all preferred the Sakura because it had fewer moving parts and the 
maintenance was easier.  I hope this helps.  Good Luck, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

   6. stainer v. stainer (Perl , Alison)
   
Message: 6
Date: Wed, 13 Mar 2019 20:08:14 +
From: "Perl , Alison" 
To: "'histonet@lists.utsouthwestern.edu'"

Subject: [Histonet] stainer v. stainer


Hi all
We are getting ready to purchase a new H stainer/coverslipper, and are 
considering the Sakura Prisma Plus (tape) and the Leica Spectra (glass). Does 
anyone have good or bad feedback on either instrument, and/or tape v. glass? 
We've always had glass, but of course the coverslippers need more maintenance, 
take longer to dry, more expensive than tape, etc etc. So we are very 
interested in tape, but still a little hesitant about the old problems of 
yellowing and peeling after 10+ years. Since we're in NY, we have to keep all 
slides for 20 years

Any thoughts are appreciated!

Alison Perl, HTL(ASCP)CM
Anatomic Pathology Manager
CareMount Medical
110 South Bedford Rd
Mount Kisco, NY 10549
(914) 302-8424
ap...@cmmedical.com
www.caremountmedical.com



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Re: [Histonet] ER/PR Control

[Terri Braud via Histonet]

Hi Barbi - 
We are somewhere in-between with our ER/PR Controls.  When performing lot to 
lot validations, we use our in-house control, which only has a 0 and a 3+, BUT 
we also use a commercially prepared control that contains 4 cores, 0. 1+, 2+, 
3+.  Once the new lot of antibody has been validated against both controls, 
then we only use our inhouse control with the 0 and 3+.  It just saves on time 
and money.
Hope this helps, Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
   2. ER/PR controls (Moe, Barbi A)
   3. Re: ER/PR controls (Colleen Forster)
Message: 2
Date: Wed, 13 Mar 2019 17:43:51 +
From: "Moe, Barbi A" 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] ER/PR controls
For anyone making in-house ER/PR controls could you comment on what tissue you 
have in your control block -- one piece of positive tumor regardless of 
reactivity strength 1+, 2+, 3+ (weak, medium, strong) or multiple pieces to 
represent each level of reactivity?

Also, does anyone order commercially their ER/PR controls to achieve this level 
of representation in their control block?
Any thoughts are appreciated - thank you.

Barb Moe
Gundersen Health System
La Crosse WI
ba...@gundersenhealth.org


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[Histonet] Ventana dispensers - last word

[Terri Braud via Histonet]

To those of you who wrote in support of my comments, thank you sincerely.
To the Company's  credit, I did receive a call of apology and a listening ear 
concerning the ongoing problems associated with the dispensers.  I sincerely 
hope they understand the frustration that such a problem can cause.
I want to state that I really do like the Benchmark Ultra, but the instrument 
is only as good as the individual parts.  Based on many private responses that 
I received, I think that dispenser failure is probably being vastly 
underreported. I can only hope that a moment's indiscretion on their part will 
lead to a more open dialogue in their company concerning a true solution to 
this problem.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal



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Re: [Histonet] Roche "bashing"

[Terri Braud via Histonet]

Such a wonderful insight into the thought process of Roche.  Accused of bashing 
when I am telling the truth about failed lots when they claim the problem is 
fixed.
If only they would put that much effort into repairing the problem and 
fostering better customer relations, than how to market their product around 
this annoying truth.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:

   1. Re: Histonet Digest, Vol 184, Issue 1 (Jordan, Kelley)
Message: 1
Date: Fri, 1 Mar 2019 13:15:58 -0500
From: "Jordan, Kelley" 
Content-Type: text/plain; charset="UTF-8"
More bad press in histonet...not sure if we should pass it on to Marketing??
@Will, Who as Teri Blaud at   Holy Redeemer Hospital ? Teri is always
always bashing us.
Kelley Jordan
Strategic Account Manager - SC, NC, TN and KY
A Member of the Roche Group
Ventana Medical Systems
Mobile:  803.504.1135
Customer/Technical Support: 1.800.227.2155
kelley.jor...@roche.com
www.ventana.com

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Re: [Histonet] Another Dispenser Failure

[Terri Braud via Histonet]

Another one!!!  
Our Her2 antibody dispenser failed, LOT #E22628
This one "supposedly" FDA approved.
Roche, why do you continue to lie to consumers of your product?  You claim 
you've "fixed" the problem but your Ventana dispensers DON'T WORK! 
This is patient care!  Why don't you care about the customers and patients you 
are supposed to be serving
Shame on you.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Thursday, February 28, 2019 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 183, Issue 23


Today's Topics:
   1. H Staining question (Charles Riley)
   2. Re: H Staining question (Jay Lundgren)
   3. FYI- Roche Ventana users (Cassie P. Davis)
Message: 3
Date: Thu, 28 Feb 2019 15:23:16 +
From: "Cassie P. Davis" 
To: histonet 
Subject: [Histonet] FYI- Roche Ventana users
Message-ID: 
Content-Type: text/plain; charset="iso-8859-1"

Hi Histoland,
I am biting my tongue HARD and just letting you know so it doesn't 
happend to you. I just got off the phone with Roche here is the heads-up.
If one of their anitbody dispensers fails DO NOT put the antibody in one of 
their prep kits, as soon as you do they consider it off label use.
Call customer service immediately and have them overnight a replacement!
Cassandra Davis
Histology Technician
AP Laboratory
302-575-8095
Email:  cda...@che-east.org



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Re: [Histonet] bleach under the sink

[Terri Braud via Histonet]

Cleaning supplies may be stored under the sink, but since "things" have a way 
of migrating there as well, we just have a blanket rule, nothing under the 
sink.  Of course, this would never occur in the Histology Department, LOL. The 
space is actually locked off.
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:

   1. Histotechnologist Needed near Philly! (Kristyn Ferber)
   2. Bleach Regs (Maryann Deathridge)
   3. Re: Bleach Regs (Laurie Redmond)
   4. Re: Bleach Regs (Morken, Timothy)

Message: 2
Date: Thu, 31 Jan 2019 15:11:45 +
From: Maryann Deathridge 
Subject: [Histonet] Bleach Regs
Hello Histonetters!
Has anyone heard of a regulation by CAP, CLIA or OSHA regarding commercial 
bleach stored under the laboratory sink.  My lab routinely has a gallon 
container of dated/ bio-labeled commercial bleach stored under the sink for 
cleaning purposes. Daily use to clean special stain coplin jars,etc..  I had a 
suspicious med tech tell my pathologist that is was against regulations to have 
it in the lab anytime !
HUH
Responses welcomed.
Have an awesome Thursday!
Maryann  Deathridge, Lab Manager
Pathology Assoc. of  St. Thomas
4220 Harding  Pike
Bldg. SE,  Suite 504
Nashville, TN  37205
madeathri...@pastnashville.com


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[Histonet] another Ventana dispenser failure

[Terri Braud via Histonet]

We have another dispenser failure.  Ki-67, Cat# 790-4286, Lot# E17347, Failed 
on the 9th to last dispense.
The plunger was very "sticky" and difficult to depress.
Roche, are you listening???

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] sticking dispensers

[Terri Braud via Histonet]

We still have sticky issues, especially with the 250 HP dispenser, but there 
have been others.  I have given up on Ventana.  They don't fix it, don't care, 
and make you jump through hoops to get help.  I'm STILL waiting on my refund 3 
months ago from the HP recall where we had to repeat 78 HP tests. 
Why do we have to contact them and provide a short story's worth of info, only 
for them to NOT FIX the problem, and hang on to your money.  They should be 
beating down our doors to make their faulty dispensers right.
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874

   3. Ventana HP IHC dispensors (Cavett, Will)
   4. Re: Ventana HP IHC dispensors (Oler, April)
   5. Re: Ventana HP IHC dispensors (Baker, Tabari)


Message: 3
Date: Thu, 10 Jan 2019 21:21:35 +
From: "Cavett, Will" 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Ventana HP IHC dispensors
Message-ID: <28b18bd2aacb4659884bc5529d93f...@informdx.com>
Content-Type: text/plain; charset="us-ascii"

I just wanted to see if anyone is having any dispenser issues for your HP IHC 
from Ventana? This is greatly affecting our workflow across several of our 
entities. Thanks in advance for your help.
Will Cavett, II, MBA, SCT (ASCP)
Lab Operations Manager
--
Message: 4
Date: Thu, 10 Jan 2019 21:27:28 +
From: "Oler, April" 
To: "'Cavett, Will'" 
Cc: "'histonet@lists.utsouthwestern.edu'"

Subject: Re: [Histonet] Ventana HP IHC dispensors
Message-ID: <32adbb916e9c4cd19583c8af4b04a...@med.umich.edu>
Content-Type: text/plain; charset="us-ascii"
Hi Will,
I've been seeing sticking dispensers in several IView Blue ISH kits, an 
Ultraview Kit, and also a Calretinin. All within the last few weeks. I'm very 
interested to hear if others are having issues as well. 
April
Message: 5
Date: Thu, 10 Jan 2019 17:32:42 -0500
From: "Baker, Tabari" 
To: "Cavett, Will" 
Cc: "histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] Ventana HP IHC dispensors
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Hi Will and April,

My name is Tabari Baker and I am a Scientific Affairs Manager for Roche 
Diagnostics.  I am in a non-commercial, non-sales role.  I am interested in 
hearing more about your continued issues with sticking dispensers, and want to 
help get this resolved.  Please reach out to me directly so that I can assist 
you with quickly rectifying these issues.
Thanks in advance.
Best,
TB


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[Histonet] looking for a specific block storage cabinet

[Terri Braud via Histonet]

Hi Histo Peeps - I'm trying to find the brand of paraffin block storage 
cabinets that have a little more height clearance than the traditional 
Tissue-Tek block storage cabinets.  They were shown to me about 3-4 years ago, 
but I've misplaced the literature.  I think they were blue?  Vendors welcome to 
respond, but please, only if you have the product to which I'm referring.
Thanks, Terri
Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] Roche/Ventana rant

[Terri Braud via Histonet]

My sympathies.  I wish we had never bought the Ventana Ultra.  The constant 
failures of the dispensers has caused such a headache, and the documentation 
needed before they will even agree to replace one reagent, and then the fight 
to obtain a credit for the entire test, not to mention wasted tech time and 
valuable patient tissue.
Roche - I hope you are watching this.  Your customer service is terrible and 
you do nothing but try to cover up problems.  Still waiting on my refund from 
the H.Pylorii recall - 72 tests that had to be repeated!!!
Another unhappy customer.  Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Monday, December 24, 2018 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 181, Issue 12

CAUTION : External Email

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Today's Topics:

   1. Ventana BenchMark Special Stainer (P Sicurello)


--

Message: 1
Date: Mon, 24 Dec 2018 09:31:37 -0800
From: P Sicurello 
To: HistoNet 
Subject: [Histonet] Ventana BenchMark Special Stainer
Message-ID:

Content-Type: text/plain; charset="UTF-8"

Happy Christmas Eve,

I sit here reading several replies about the failure of GMS stains.  There is 
one theme that pretty much everyone has mentioned, and I can say we agree with 
them, Ventana/Roche blames the user and does nothing to help correct this 
problem.  We have heard the same as everyone else:  User error, blame the wash 
buffer - make fresh every day, etc, blame everyone and everything except 
themselves.  We have 3 of the Special Stainers, one of them we have used almost 
non-stop since November 2015.  It had a problem with Trichrome stains over two 
years ago, which was fixed by balancing the vortex mixers (they told us it was 
user error then too).  Now that the machine has been relocated and the software 
has been upgraded, a machine that rarely, if ever, had a GMS stain fail now 
fails with regularity.

Ventana/Roche needs to realize that they have a serious problem and not 
continue to sweep it under the rug.  It's not the wash buffer, it's not the 
user, it's something else and they do not want to own up to it or help come up 
with a solution (no pun intended).  We have spent a lot of money on these 
machines, all the kits they had us throw out because they blamed the kit, all 
the wash buffer we dumped because they told us we had to make fresh every day 
(we use these machines so much that the wash buffer does not sit around and get 
icky), and their response is silence.

Sorry about the rant, but this is bugging me and I had to vent.

Have a safe a wonderful Holiday Season- whatever you celebrate -or don't 
celebrate.

Sincerely,

Paula Sicurello, HTL (ASCP)CM

Histotechnology Specialist

UC San Diego Health

9300 Campus Point Drive

La Jolla, CA 92037
(P): 858-249-5610



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End of Histonet Digest, Vol 181, Issue 12
*


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[Histonet] LIS recommendations

[Terri Braud via Histonet]

LIS recommendations - I LOVE CoPath!  Either version, but I am currently using 
the SunQuest version 6.1.
Loads of flexibility.  You can use it at it's most simplest, or add in all the 
bells and whistles. Easy to build and maintain, with well-established 
instrument interfaces and voice recognition programs.
Not only am I the Supervisor, but I am also the CoPath Systems Manager.  

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


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Re: [Histonet] BioCare mart 1

[Terri Braud via Histonet]

Just call BioCare Technical service.  They have a complete procedure for hand 
staining.  I know because I used it in their facility when I went for training 
on their Flx.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
 3. MART-1 immunot procedure (Katie)


--
Message: 3
Date: Wed, 14 Nov 2018 09:16:58 -0800
From: "Katie" 
Subject: [Histonet] MART-1 immunot procedure
Hello all,
My dermpath lab is looking into adding a MART-1 immuno, as a hand stain.  The 
procedure that I received from BioCare for their cocktail kit is extremely 
minimal.  Do any of you have a more thorough and/or broken down hand stain SOP 
that I could please reference?
Thank you so much,
Katie Riley-Hamilton
Technical Supervisor of Dermatopathology
Puyallup Dermatology Clinic
ka...@puyallupderm.com



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Re: [Histonet] Cost per test averages

[Terri Braud via Histonet]

I find it very peculiar to be lectured by a Roche representative on including 
reagent management when calculating stain costs, considering Roche's yearlong 
ongoing issues with reagent supply problems and massive recalls.  I've yet to 
have one month with no reagent supply problems from Roche/Ventana.  Failed 
dispensers, multiple recalls, major delays in deliveries of supplies (the most 
recent was a TWO MONTH BACKORDER on a routinely run antibody) and the list goes 
on.
Roche needs to get their own house in order before they come on a technical 
list-serve to lecture.
Just saying...

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
Message: 2
Date: Sat, 10 Nov 2018 14:54:19 -0500
From: "Frazier, John" 
To: Charles Riley 
I?m a vendor that sells an H staining product, so I?m not going to attempt to 
give you what the average cost per of a H stained slide.
What I will tell you is that when looking at cost per slide you need to 
calculate more than your consumables. Those are going to be your capital cost. 
You also need to calculate in your labor cost. Those are gonna be your 
operational dollars.
The reason why I say that is that some strainers are more efficient than other 
stainer. Not just in the staining process itself but in the overall 
maintenance, reagent management and waste control cost.
Remember when using labor dollars you want to calculate that using fully 
burdens dollars.
Be complete in the way that you calculate your overall cost per slide

John Frazier, MBA, MT(ASCP)
Strategic Workflow Consulting
Roche Diagnostics



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Re: [Histonet] Instrument to instrument correlation

[Terri Braud via Histonet]

Hi Paula - 
I use duplicate microarrays (TMAs), each with at least 10 positive cases and 10 
negative cases, one TMA slide on each instrument for each antibody.
Passed CAP with no problems. Hope this helps. Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
  

 3. Instrument Correlation (Paula)
Date: Thu, 1 Nov 2018 08:01:32 -0700
From: "Paula" 
Hello everyone,
Could you recommend/suggest how the correlation between 2 IHC Bond instruments 
is performed and written out for them?
This has never been brought up before and I'm just starting my research.
Thank you in advance,
Paula


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Re: [Histonet] Repeats in IHC

[Terri Braud via Histonet]

Our repeat limits differ.  If it is due to tissue falling off, we will try at 
least 3 times 
If it is due to unexpected, but within control, we will repeat it 2 times
Then if it is still problematic for the above 2, we will send out the block for 
staining.
If it is due to technical error (wrong block, wrong stain) we will perform the 
stain until correct, and it better not be more than once, LOL

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
Today's Topics:

   1. Histotechs abroad? (Wellen, Terry :LLS Lab)
   2. Re: Frozen sections and cold acetone (Hobbs, Carl)
   3. REPEATS IN IHC (Kurth Virginia L.)
   4. Re: REPEATS IN IHC (Rene J Buesa)


Message: 3
Date: Fri, 26 Oct 2018 20:07:22 +
From: Kurth Virginia L. 
Subject: [Histonet] REPEATS IN IHC

Hello, I was wondering if anyone in the histology laboratory (IHC) has a limit 
on how many times one would repeat a stain; for example but not Limited too:  
The tissue fell off, negative control, wrong block,etc.. for IHC DAB and/or 
ISH.  Thanks Ginny


--

Message: 4
Date: Sat, 27 Oct 2018 13:48:06 + (UTC)
From: Rene J Buesa 
To: "Kurth Virginia L." ,
"histonet@lists.utsouthwestern.edu"

Subject: Re: [Histonet] REPEATS IN IHC
Message-ID: <1773692175.85882.1540648086...@mail.yahoo.com>
Content-Type: text/plain; charset=UTF-8

Ginny:It seems you are asking for a "problem" average and that will vary per 
laboratory and how the whole process is carried out.Section washed out from the 
slide usually is consequence of poor processing or sectioning and has nothing 
to do with IHC, although, perhaps, a wrongly performed HIER can cause it.Wrong 
block is a mistake also having nothing to do with IHC and is always caused by 
an inattentive HT not paying attention to the process.My point is that, 
essentially, the lab should try to get to "0" mistakes and any one has to be 
documented in the QC record but it will be interesting to find out the 
"mistakes rate" you find and I think you should share it with all.Ren? 

On Friday, October 26, 2018 4:41 PM, Kurth Virginia L. via Histonet 
 wrote:
 
 Hello, I was wondering if anyone in the histology laboratory (IHC) has a limit 
on how many times one would repeat a stain; for example but not Limited too:? 
The tissue fell off, negative control, wrong block,etc.. for IHC DAB and/or 
ISH.? Thanks Ginny ___
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Re: [Histonet] dishwasing

[Terri Braud via Histonet]

We wash by hand, but do use some disposables (pipets, etc). We make one final 
DI wash, then check the pH for residual detergent.  Record pH per batch washed.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Thursday, September 27, 2018 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 178, Issue 20

CAUTION : External Email

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Today's Topics:

   1. Glass wash question (Richardson, Pam K)


--

Message: 1
Date: Thu, 27 Sep 2018 15:14:45 +
From: "Richardson, Pam K" 
To: "'histonet@lists.utsouthwestern.edu'"

Subject: [Histonet] Glass wash question
Message-ID:
<998284c32f61104ca0becf6f90fde514f...@lxexmb01.gundluth.org>
Content-Type: text/plain; charset="us-ascii"

I am curious as to how you manage washing your glass ware. Are you using a 
dishwasher? Washing by hand? Sending to CS? If you wash by hand or use a 
dishwasher do you use DI water? Do you use contrad 70? Do you use mostly 
disposable?

I appreciate any feedback.

Cordially,

Pam ~
National Histology Professionals Day 3/10/19 Pathologist Assistant Day 
4/14/2019 Medical Laboratory Professionals Week April 21-27, 2019 National 
Cytotechnology Day 5/13/2019
+++
Pam Richardson
Clinical Manager
Gundersen Health System Laboratory Services
Email: pkric...@gundersenhealth.org
Phone: 608 775-4133
Fax: 608 775-6136
Interdepartmental Mail Stop: H04-007
E-visit us at: http://www.gundersenhealth.org



--

Subject: Digest Footer

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End of Histonet Digest, Vol 178, Issue 20
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Re: [Histonet] Ultra Clean Diluent for IHC (Jennifer Kempf)

[Terri Braud via Histonet]

I agree with Jennifer - Just another recommendation for BioCare and their 
reagents.  They are a super company to work with and have excellent quality and 
quality control on their reagents.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


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Re: [Histonet] Pregnancy guide

[Terri Braud via Histonet]

Remember that contamination can also be by skin absorption.  With that in mind, 
we provide thick Nitrile gloves with instruction to change them at least every 
30 minutes, or less if they show any signs of deterioration.  We have great 
ventilation and beyond that, when we wear our fume badges, we perform the worst 
exposure tasks, so when calculated, the exposure shows what it would be like if 
we did that task for 8 hours a day - and we STILL are way under the limit. The 
result: No restrictions of duties - 5 babies born to employees here without a 
single problem in 12 years.
However, with that said, I would never ask a pregnant technician to hand 
coverslip more than the occasional slide.
Just my 2cents - T

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
  

 2. Pregnancy guide for working in histology (Carol Torrence)
Message: 2
Date: Thu, 6 Sep 2018 16:43:47 +
From: Carol Torrence 
To: "histonet@lists.utsouthwestern.edu"

Subject: [Histonet] Pregnancy guide for working in histology
Message-ID:

Content-Type: text/plain; charset="us-ascii"

Good morning!

Could some of you chime in on guidelines you go by for those employee that are 
expecting a baby.  I have removed employee from xylene exposure during staining 
and cover slipping but am on the fence about grossing.  At this time the 
employee has been removed from grossing.  All grossing is done under an exhaust 
hood.  Our exposure badges have always read well below limits.  Thanks in 
advance!

Carol M. Torrence, HT(ASCP)



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Re: [Histonet] LTP fluid with Phenol

[Terri Braud via Histonet]

Here is the approximate chemical make-up of LTP with Phenol.  (LTP stands for 
Long Term Preservation)
Ethanol  48.%
Formaldehyde 20.%
Ethylene Glycol 4.%
Phenol 11.%
Glutaraldehyde 4.%

Due to the presence of Ethylene Glycol, I would let the tissue set in a 
separate container of 10% Neutral Buffered Formalin for 24 hours before 
processing as usual.
I hope this helps. Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

 4. cadaver tissue processing for histology (Preiszner, Johanna)

Message: 4
Date: Wed, 22 Aug 2018 18:59:44 +
From: "Preiszner, Johanna" 
Subject: [Histonet] cadaver tissue processing for histology
Hi,
I got some cadaver tissue floating in "LTP embalming fluid w/ phenol".
Can I put those straight into the processor? Or has to be rinsed/soaked before? 
If so what should I use?
My Internet searches did not bring up anything useful.
Thank you!
Hanna Preiszner
ETSU/QCOM Dept of Pathology


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Re: [Histonet] special Stains under a hood

[Terri Braud via Histonet]

I have never (3 different places, 30+ years) heard of requiring special stains 
to be performed under a hood.  Certainly, there are a few reagents that might 
need benefit from a hood (concentrated Ammonium Hydroxide) but generally, they 
are performed on an open counter next to a sink.  If you are getting pushback, 
check to see if Micro is doing their gram stain under a hood? 

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


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Re: [Histonet] Unstained slides

[Terri Braud via Histonet]

I'm with Tim Morken on this one. The variability of antigenicity in storage is 
so wide open, and there really is no recent data, so we just make a point of 
educating our techs on not wasting tissue/levels during sectioning.  If the 
techs feel that the residual tissue in the block is in danger of being 
exhausted, we communicate with our pathologists on how best to handle any 
requests.  Unstained slides was time, money, and storage and we are better off 
without them.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
   7. Re: Unstained slides - how long are they good for?
  (Morken, Timothy)

Message: 7
Date: Fri, 17 Aug 2018 15:16:00 +
From: "Morken, Timothy" 
To: P Sicurello 
Subject: Re: [Histonet] Unstained slides - how long are they good for?


Paula, since it is variable we strive to not have unstained slides. We had kept 
them indefinitely, then when storage was overwhelming us we reduced it to 2 
months maximum. Now we require request for unstained to be ordered in the 
system and delivered to the pathologist. We do not hold any in the lab. We 
recut when new stains are ordered. In the past we had routinely cut extras 
"just in case" but ended up with thousands of unstained slides that were never 
used. Instead we trained everyone to reduce wastage and get good sections from 
a cut block with minimal facing. We have not stored unstained sections for many 
years and they do not seem to be missed. 

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


-Original Message-
From: P Sicurello via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, August 16, 2018 4:49 PM
To: HistoNet
Subject: [Histonet] Unstained slides - how long are they good for?

Hello My Fellow Histologists,

Happy Friday Eve.

The question has come up..  How long are *unstained* slides good for?
Not for H but tests like IHC and molecular testing.  These slides have
been cut, stored at room temperature, not sealed in anyway, and kept in a
cardboard box.

Please let me know what your opinions are and what your retention policy is
concerning *unstained* slides.

Thanks oodles.

Sincerely,

Paula Sicurello, HTL (ASCP)CM

Histotechnology Specialist

UC San Diego Health

200 Arbor Drive

San Diego, CA 92103

(P): 619-543-2872



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Re: [Histonet] detection of ganglion cells and nerve fibers

[Terri Braud via Histonet]

In the past, I've used a rapid acetylcholinesterase on frozen material, but we 
never used Osmium to enhance staining.  I've also used IHC on FFPE sections 
using s-100 and peripherin.  Works great, but it's been awhile, so I don't know 
if there is something better/easier out there now.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

--

Message: 3
Date: Mon, 13 Aug 2018 19:11:34 +
From: "Hobbs, Carl" 
When I was doing them biopsies (  pre-operative) to establish status, we used a 
std histochemical method on frozen sections of biopsy material ( visualising 
acetylcholinesterase activity).
It used Osmium to enhance /darken positivity so, NOT recommended these days.
I recall somebody leaving the lid off the Osmium ( stored at 4C)?..the fridge 
plastic lining was BLACK the next day!
So, any antibody that identifies nerve fibres and ganglion cells should be 
equally effective, using IHC/IF?
Sure, interpretation is critical ( identifying presence/absence of ganglion 
cells and "significant" increase in lamina propria of nerve fibres as 
compensatory mechanism)
There must be an internationally recognised/accepted protocol?
Which technique does Great Ormond Street Hospital/St Thomas' Hospital  use, 
these days?
Curious-illy
Carl
 Carl Hobbs FIBMS
Histology and Imaging Manager
Wolfson CARD
Guys Campus, London Bridge? 
Kings College London
London
SE1 1UL
? 
020 7848 6813




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Re: [Histonet] TMAs for MMR validation

[Terri Braud via Histonet]

We used US Biomax TMA CO804A to validate our MMR antibodies.  We sent one set 
to the reference lab where ours were currently being stained, and then stained 
the other set with the 4 Antibodies.  Compared the staining of the 2 and done!  
I had also called CAP in insure that this method would be acceptable.  I hope 
this helps.  Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
   2. TMA for MMR panel validation (Cassie P. Davis)

Message: 2
Date: Mon, 13 Aug 2018 15:30:49 +
From: "Cassie P. Davis" 
Subject: [Histonet] TMA for MMR panel validation
Happy Monday Histonet,
  I need your help with finding an appropriate TMA to use to validate 
the MMR panel. The stains are optimized, we just need an good TMA to validate 
it with. Thank you in advance for any help in this matter!
Cassandra Davis
Histology Technician
AP Laboratory
302-575-8095
Email:  cda...@che-east.org


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Re: [Histonet] Paperwork / tracking batch controls

[Terri Braud via Histonet]

There is an easy method to track batch controls using a blank slide. For each 
case stained, file a blank slide that has been labeled with the actual case 
number, the stain, and also the date of the control slide.  Easy peasy.  I 
published this method in Histologic in Aug. 1995 and it has stood the test of 
CAP and time.
As far as recording blocks and slides, if your new computer software system 
keeps those records and they can be retrieved easily, then you don't need to 
keep paper anymore. Happy Histo-ing!  Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Today's Topics:
   6. Paperwork (Campbell, Tasha M.)
Message: 6
Date: Fri, 27 Jul 2018 15:16:26 +
From: "Campbell, Tasha M." 
Hi everyone,
I have 2 questions:
  1.  Could someone please share some ways to keep track of the control that 
goes with the slides that it was used for?  So I am a small GI lab and there is 
a pathologist here a couple days a week.  We do trichrome on Microscopic 
colitis cases and so I have been batching the trichromes because it's a long 
stain to do by hand and it's a lot easier to do it that way. But my slides are 
automatically printed for me and they have the date on them that the specimen 
was entered into the system.  I cut the slide but then hold it until I am ready 
to do the stain.  I put a date on the trichrome control slide but it of course 
does not match the date on the patient slides because they have been held for a 
few days.  Is this something I even need to worry about?  So far I have just 
been writing down the date that I stain the patient slide on a log sheet but I 
am trying to minimize the amount of paperwork/manual logging.
  1.  We recently got a accessioning system and I can now pull the number of 
blocks and stains done each day.  Do I need to still keep writing down in my 
log sheet the number of blocks and stains?  Do I need to print out the report 
that has the numbers and file it or since I have the ability to pull it from 
the system, I don't need to have physical logs.
I am just trying to minimize as much manual logging and paperwork as possible!  
Thanks in Advance!!!
Tasha Campbell, B.S.,HTL(ASCP)
Frederick Gastroenterology Associates
310 W. 9th St.
Frederick, MD 21701
301-695-6800 ext. 144



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Re: [Histonet] HELP Path requesting +PAP stain control

[Terri Braud via Histonet]

On Date: Mon, 23 Jul 2018 18:31:48 -0400
From: Mary Ann 
Subject: [Histonet] Positive PAP
Mary Ann wrote "Help! My pathologist has asked that a positive patient be run 
down with our PAP stain for QC.
Point me to a reference to counter this request."

Hi Mary Ann - First of all, my sympathies.  This is the kind of craziness that 
can give a pathologist a bad name.  Secondly, what does he call a patient 
positive?  Positive for what?  LOL, JK.  In response to your question, here are 
the ONLY 2 requirements for Cytology stain QC, straight from the latest CAP 
list.  See below.  As one can see, nowhere does it require any type of patient 
control, only a documented assessment of the stain quality, on "actual case 
material"  CAPs words, not mine. Good Luck! Terri
__

**REVISED**   08/21/2017
CYP.03925   Stain AssessmentPhase I
Cytology stains are assessed at least annually to ensure their proper 
storage and acceptable quality.
NOTE: Cytology stains undergoing a daily technical quality review are exempt 
from an annual assessment.
Most stains used in the cytology laboratory are not subject to outdating, so 
that assignment of expiration dates may have no meaning.  The acceptable 
performance of such stains must be confirmed at least annually by technical 
assessment on actual case material, and as part of the evaluation of 
cytopathology cases. Where applicable, expiration dates assigned by a 
manufacturer must be observed.
Evidence of Compliance:
✓   Written procedure for stain assessment AND
✓   Records of assessment of appropriate quality of each cytology stain in 
use

CYP.04300   Daily QCPhase II
Daily QCPhase II
There are records of daily review of the technical quality of cytologic 
preparations by the pathologist or supervisory-level cytotechnologist.
NOTE:  The technical quality of cytologic preparations must be checked daily 
(on days processing occurs). This includes checking all stains for predicted 
staining characteristics each day of use. This check must include all of the 
types of preparations seen that day such as cytospins, cell blocks, and liquid 
based preparations.
If preparation and staining is performed by a different laboratory, there must 
be a procedure for the laboratory performing the preparation and staining to 
verify the acceptability of the quality of preparations and the acceptability 
of controls (if needed) before transfer.  Records of this verification must be 
readily available to the laboratory performing interpretations.  There should 
also be a mechanism for feedback from the interpreting laboratory to the 
laboratory that prepared the slides of any issues with the preparations.
_

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

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Re: [Histonet] New Microtome

[Terri Braud via Histonet]

We are using a Leica 2235 and love it.  Manual or Auto mode, the control panel 
is on a moveable pad, so can be used anywhere.  It has a foot pedal if you like 
that too!  The techs took to it like a duck to water and it cuts like butter!

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal



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Re: [Histonet] pap control

[Terri Braud via Histonet]

Are you referring to a Pap stain control?  If so, we run a self made buccal 
smear every day to check for stain quality.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

-Original Message-
From: histonet-requ...@lists.utsouthwestern.edu 
[mailto:histonet-requ...@lists.utsouthwestern.edu] 
Sent: Monday, July 16, 2018 1:00 PM
To: histonet@lists.utsouthwestern.edu
Subject: Histonet Digest, Vol 176, Issue 9

Today's Topics:
   1. Cap PAP Smears Controls (Mary Ann)
Message: 1
Date: Mon, 16 Jul 2018 12:51:53 -0400
From: Mary Ann 
Subject: [Histonet] Cap PAP Smears Controls
Hello,
In preparing for CAP I have a question:
Does anyone run a positive PAP control with their run?


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Re: [Histonet] broken screw in MMA

[Terri Braud via Histonet]

Just an idea.  Why not use SEM?  It seems like it would be so much easier.

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

   2. MMA or Epoxy Embedding (Jessica Riggleman)

Date: Thu, 21 Jun 2018 18:59:47 +
From: Jessica Riggleman 
Subject: [Histonet] MMA or Epoxy Embedding
Hi Everyone,
I am trying to embed screws in plastic (in the hopes to see breakage in the 
screw, etc). Right now I use specifically a mixture of methyl methacrylate, 
poly methyl methacrylate, and benzoyl peroxide. However this usually takes a 
few weeks to embed/dry. I am looking for something a little faster (perhaps a 
week max?).

Thank You,
Jessica
Jessica Riggleman | Research Associate
Globus Medical, Inc.
Valley Forge Business Center
2560 General Armistead Avenue | Audubon, PA 19403
Ph: (610) 930-1800 ext. 2583 | Fax:



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Re: [Histonet] CAP control revision

[Terri Braud via Histonet]

For all stains, we report the control verification on the patient report when 
reporting the stain results, and we run negative tissue controls for our 
organism stains, AFB and GMS

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal
 

  2. revised Cap regulation ANP .21395  ?? (Roy, Ryan)
Message: 2
Date: Thu, 14 Jun 2018 12:18:32 +
From: "Roy, Ryan" 
Subject: [Histonet] revised Cap regulation ANP .21395  ??
Hello Histonetters,
What is the take home message of this revision? How are other labs complying 
with respect to Special staining?  Do you keep records of individual case 
control verification or just individual block verification? Does anyone run NEG 
controls for Special staining? Is this regulation requiring Neg Controls for 
special stains? Any thoughts are appreciated.
" **revised** 08/17/2016
ANP .21395
Special Stains/Studies
For special stains, including histochemical stains, and studies using 
immunologic and ISH methodology, positive and negative controls are verified 
and recorded as acceptable prior to or concurrent with the reporting of patient 
results and records maintained. "

Thanks you,
Ryan Roy BS,  HTL (ASCP)CM
Laboratory: Histology Department
Manchester VA Medical Center
Manchester NH
603 -624-4366 extension 6640


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Re: [Histonet] QM Dashboard

[Terri Braud via Histonet]

We use: 
1.  Report TAT
2.  Discrepant pathology reports
a.  Internal vs External report correlation
b.  Frozen section vs Final diagnosis correlation
c.  Amended reports
I liked the idea of piece count discrepancy or even poorly processed blocks.  I 
never recommend using "recuts" as a QM because that is more often a product of 
the pathologists' preference or desire to see more tissue and does not reflect 
the quality of the sections (unless it is an incomplete facing issue).  This 
can quickly become punitive for your department because this information is not 
presented to people who understand pathology.
My 2 cents. Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal



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[Histonet] Ventana dispenser issues - AGAIN

[Terri Braud via Histonet]

When will this company ever learn? I'm at my wit's end with failed dispensers 
from Roche Ventana.  The volume of time I've wasted on this issue with this 
company is monumental.  They refuse to give true tracking information on the 
dispensers.  We have a relatively new Ultra.  The instrument is lovely, but the 
stains completely unreliable because of the dispenser failure.  Worse yet, one 
can never tell when the dispenser will fail.  It might fail right out of the 
box, or work fine for 30 tests and fail on 31.  This problem has been going on 
since the end of 2017 and still is continuing.  I know I'm not alone because of 
the recalls and most recently, the Medical Device Ongoing Action published 
5/11/2018. Reaching out to the company is like trying to talk to a politician 
who talks in circles.  I'm truly at a loss and would welcome any suggestions 
from non-Roche employees.
Frustrated, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor

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Re: [Histonet] Downtime

[Terri Braud via Histonet]

Hi Nancy - Please see my answers filled in below.  I hope that helps.  
Sincerely, Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

Message: 1
Date: Sun, 29 Apr 2018 20:57:29 +
From: Nancy Schmitt 
Subject: [Histonet] Downtime

Hello All-
We recently experienced some downtime with our computer systems - more than the 
usual 1-2 hours for maintenance.  Some was isolated to our Anatomic Pathology 
system, and some of the downtime was organization wide.  We are an independent 
laboratory system that operates with Cerner CoPath for Anatomic Pathology, MLab 
from McKesson for LIS and we then interface with Powerchart and EPIC at our 
hospitals.  There is nothing like a little downtime to make you take another 
look at your processes.  My questions:

1.   What computer product are you currently using for Anatomic Pathology?
Answer: Sunquest CoPath Plus

2.   Are you satisfied?
Answer: Extremely

3.   Do you have your own IT group or is it maintained by outside resources?
Answer: There is an IT group for the hospital, but both myself and the office 
supervisor have full system manager access to CoPath as well as the servers.  
With little exception, all modifications or enhancements to CoPath are made by 
myself or the office supervisor.  Occasionally, we need IT help when dealing 
with interfaces.

4.   Are you interfaced with hospital or other?
Answer: We are interfaced with Soarian Clinical and Mobile MD for reporting and 
Soarian Financial for billing.  All of our patient data comes from Soarian 
Financial, through Sunquest Clinicals to CoPath.  We also have a slide engraver 
interfaced. Cytology orders are entered through Soarian Clinical, but Surgical 
Orders are still submitted on a manual requisition.  

5.   What critical functions do you provide during downtime?  Are you 
giving verbal reports?  Are you typing reports on a backup laptop?
I appreciate any input you are willing to share and I am sure there will be 
others taking note of this valuable conversation!
Answer: During a Soarian/Sunquest/CoPath downtime, we immediately switch to a 
manual log for specimens, and a WORD format for our reports. Our personal PCs 
almost never go down together so we type on them in WORD.  Reports are manually 
signed by the pathologist and faxed by the office staff.  Stat procedures such 
as FNAs and Frozens and all report notifications are called into the physicians 
and documented and signed.  All of this is entered into the down system once it 
returns to normal.



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[Histonet] Power outage effects

[Terri Braud via Histonet]

We use a backup generator for power outages, and also, all critical instruments 
are plugged into an appropriate sized UPS (Uninterrupted Power Supply) to hold 
them for about 2 hours of uninterrupted power until the generators kick in. 
Basically what Allan Wang said in his reply.
Just remember that your backup generator has to be outside to avoid nasty fumes.
Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal

   5. effect of power outage on tissue processor (Matthew Fleming)
   6. Re: effect of power outage on tissue processor (Allan Wang)

Message: 5
Date: Fri, 20 Apr 2018 08:02:47 -0500
From: Matthew Fleming 
Subject: effect of power outage on tissue processor
Folks,

I'm just wondering about the effects of a power outage on the tissue in a 
tissue processor. I have a small dermatopathology lab, which moved about a year 
ago to a location more prone to power outages. Last weekend the power was out 
for about 7 hours, which meant that the tissue was in 100% alcohol for about 5 
hours, when it is programmed for 2, I believe. The tech who cut the tissue said 
it seemed a little dehydrated, but the slides looked fine.

After that, I got a quote for an automatic backup generator for the building, 
but it came in at $20,000, which was much more than I was expecting and an 
expense I'd certainly like to avoid if possible. I spoke to the guy who 
maintains my equipment, who said our tissue processor (a Sakura E300) should 
not be harmed by a power outage and would pick up where it left off once the 
power returns. He also said that it can sense when the paraffin in the supply 
bins is melted and wouldn't try to use any wax that isn't.

But still, a power outage could certainly mean that the tissue remains in a 
solution longer than programmed, as happened last weekend. My question is, how 
much of a risk does this pose? Could it damage the tissue so much as to make 
the ultimate sections uninterpretable?

I should mention that I know when the power goes out, because the building has 
a fire alarm connected to a monitoring service that calls when the power goes 
out. So, as an alternative to spending $20K, I could get a manual generator and 
just go in and plug it in when the power goes out, or if it is out for more 
than an hour or two.

Thanks in advance for your advice.

Matthew Fleming, MD
Fleming Dermatopathology
Brown Deer, WI


--

Message: 6
Date: Fri, 20 Apr 2018 12:45:07 -0400
From: Allan Wang 
To: Matthew Fleming 
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] effect of power outage on tissue processor
Message-ID:

Content-Type: text/plain; charset="UTF-8"

A generator is probably the cheapest option if you can go manually start it 
after a few hours.

I purchased a UPS for a DNA sequencer which shouldn't lose power when in use. 
You may also want one to add a few hours of leeway before the generator is 
needed.
You should measure the tissue processor's power consumption during usage with 
something like a Kill-A-Watt or cheaper ones to help you choose the right size 
of UPS.
The E300 manual says it draws 10.5 A at 110 V which is 1200 W, but actual usage 
could be significantly less if you aren't processing 300 samples.

I use this UPS and external battery:
https://www.amazon.com/TRIPP-SU2200XLCD-2200VA-1800W-Online/dp/B00CBQNBYI
https://www.amazon.com/BP48V27-2US-External-Battery-Select-
Online/dp/B00I3RROT2

This battery is also an option:
http://www.provantage.com/tripp-lite-bp48v60rt3u~7TRPL1CE.htm

It has a chart for runtimes with external batteries:
https://assets.tripplite.com/ups-runtime-chart/su2200xlcd-ru
ntime-chart-en.pdf

Allan Wang
Lab Manager
US Biomax

On Fri, Apr 20, 2018 at 9:02 AM, Matthew Fleming via Histonet < 
histonet@lists.utsouthwestern.edu> wrote:

> Folks,
>
> I'm just wondering about the effects of a power outage on the tissue 
> in a tissue processor. I have a small dermatopathology lab, which 
> moved about a year ago to a location more prone to power outages. Last 
> weekend the power was out for about 7 hours, which meant that the 
> tissue was in 100% alcohol for about 5 hours, when it is programmed 
> for 2, I believe. The tech who cut the tissue said it seemed a little 
> dehydrated, but the slides looked fine.
>
> After that, I got a quote for an automatic backup generator for the 
> building, but it came in at $20,000, which was much more than I was 
> expecting and an expense I'd certainly like to avoid if possible. I 
> spoke to the guy who maintains my equipment, who said our tissue 
> processor (a Sakura E300) should not be harmed by a power outage and 
> would pick up where it left off once the power returns. He also said 
> that it can sense 

Re: [Histonet] Attwood tip

[Terri Braud via Histonet]

Have you tried Polyphenyl Yellow 8G instead of Tartrazine?  Just a suggestion

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874
Care, Comfort, and Heal


Today's Topics:
   1. Attwood's tips please (Finlay Finlay)

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Message: 1
Date: Mon, 9 Apr 2018 12:40:45 +
From: Finlay Finlay 
Subject: [Histonet] Attwood's tips please
Hello,
I'm trying to work up an Attwood's  method but would be keen to get a guide on 
time for the differentiation step in tartrazine solution. The method I'm using 
suggests 20 minutes at the longest with regular microscope checks. I'm 
currently at about 4 hours with only slight loss of colour in the RBC's. I know 
that the tartrazine solution will work eventually as the slides I left in over 
the weekend became fully decolourised but those time scales are unworkable.
Thanks,

Finlay Finlay

Senior Histology Technician
Forensic Medicine and Science
School of Medicine
College of Medical, Veterinary and Life Sciences University of Glasgow Joseph 
Black building

Direct Line: +44 (0) 141 3303443
E-mail: finlay.fin...@glasgow.ac.uk

The University of Glasgow Charity Number SC004401

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End of Histonet Digest, Vol 173, Issue 7



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