Re: [Histonet] Productivity Tracking

[WILLIAM DESALVO via Histonet]

I think there is a MOST important aspect left out of this discussion. . . 
QUALITY. The point is never how fast you can perform a task, but rather at what 
pace can you consistently produce quality work. Inferior or unacceptable slides 
will increase cost, in time and money, 4 to 10 times. Quality and productivity 
goals MUST be strongly linked or the patient suffers!!!

William DeSalvo

From: Jay Lundgren 
Sent: Sunday, July 7, 2019 1:20:56 PM
To: jasonhause...@gmail.com
Cc: WILLIAM DESALVO; Pairan, Kelly; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Productivity Tracking

As I pointed out, management can incentivize this any way they want.  You could 
give raises, or you could say a tech is not eligible for a raise until they can 
cut at a certain rate. The idea is to bring the slower cutters up to speed, not 
get rid of them.  Based on my experience, if you isolate and identify the 
malingerers, they will most likely speed up of their own accord.  Most people 
will stop their BS once they realize everyone is on to them.  The majority of 
people like to belong to a group, and don't like to be thought of as being bad 
at their job.

Only if they absolutely refuse to try to speed up would you start the process 
of getting rid of them, and only in certain situations.  We're talking the 
truly toxic employee.

At least this way, the slower cutters don't slow down your whole workflow, and 
it attempts to ensure some fairness in the amount of cutting each tech does.  
Also, you don't have to burden the faster cutters with more paperwork for 
productivity reporting, not to mention the hours it will take for management to 
collate and interpret the data.  It just takes someone counting the slides 
daily, which takes a couple of minutes tops.

But your comment is a good example.  Eventually, if everyone is not pulling 
together, the faster techs will start feeling taken advantage of, and change 
their own attitude towards work as well.

Why would you feel that you are "getting saddled" with critical work, rather 
than feeling proud that management has recognized your talent and is utilizing 
it efficiently to improve patient care?   Do you feel like its more work to cut 
60 slides of bxs, specials, and IHCs (say, 10 blocks) than 60 slides of routine 
surgicals (60 blocks)? Personally, I'd rather cut the bxs.

On Sun, Jul 7, 2019 at 2:02 PM 
jasonhause...@gmail.com<mailto:jasonhause...@gmail.com> 
mailto:jasonhause...@gmail.com>> wrote:
Really? If I am the faster cutter getting saddled with the more critical work, 
I would expect better pay than the slower cutter relegated to routine work.
 If one managesfrom the standpoint of individual productivity- one will never 
be satisfied. The slowest and least produ tive can be fired or laid off...that 
just means there is a new victim


Jason Hauser
Sr. Histology Tecnician, MLT
The South Bend Clinic
South Bend Indiana

-- Original message--
From: Jay Lundgren
Date: Sat, Jul 6, 2019 2:12 PM
To: WILLIAM DESALVO;
Cc: Pairan, 
Kelly;histonet@lists.utsouthwestern.edu<mailto:;histonet@lists.utsouthwestern.edu>;
Subject:Re: [Histonet] Productivity Tracking


By the way, the standard for graduation from AFIP was 30 blocks/hr.

Don't count blocks, count *slides*.

If you have people slacking, you really need to start action to get rid of
them.  One rotten apple ruins the whole bunch.  Google the new research on
toxic personalities in the workplace.

But if you want to try to bring them up to speed, try this: (Assuming one
processing run, but the principle still applies.)

1)Someone takes the day's worksheet, and counts the number of slides to be
cut, including recuts, special stains, IHC's and everything.   So,
according to your protocol, (numbers made up for example) 1 GI block=3
slides, an IHC panel= 10 slides, a routine tonsil block=1 slide, a bone
marrow block, with specials and unstained slides=20 slides

2)Divide the number of slides to be cut by the number of cutters.

3)Distribute the blocks equally based on number of *slides *to be cut per
tech.  Now obviously, you're going to want to give your biopsies, recuts,
specials and IHCs to your quickest cutters, and on down the line, in order
of priority, to the slower cutters.  If you only have 2 cutters, one person
is going to cut all the bxs and specials and a few routines, and the other
person will cut the bulk of the routines.

This daily routine achieves 3 things.

 1) It keeps the slower cutters from slowing down your more critical
workflow.
 2) It removes any benefit from slacking, because it attempts to ensure
that everyone is doing the same amount of work, at least as far as cutting
goes.
3) Most importantly, it identifies and isolates anyone who is cutting
slower, because they will still be sitting there cutting while everyone
else is done.

While this might seem cruel, most humans are very group oriented.  If the
slower cutter

Re: [Histonet] Productivity Tracking

[WILLIAM DESALVO via Histonet]

I suggest you use slides created for the microtomy minimum standard. Not all 
blocks are created equal. A good target is 30 slides per hour, for mixed 
specimens. If all specialty, then adjust from the 30.

William DeSalvo

From: Pairan, Kelly via Histonet 
Sent: Friday, July 5, 2019 8:41:28 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Productivity Tracking

Good Morning Histoland,
How are you tracking your histotechs productivity when it comes to cutting?  We 
recently have implemented a 25 block per hour goal for all of our histotechs 
and are receiving some push back.  I made 25 block per hour the goal based on 
the following article that has been circulating for many years 
(https://www.researchgate.net/publication/41942535_Productivity_standards_for_histology_laboratories).
  While I do not want to compromise quality, we do have turnaround times to 
meet and I have experienced techs who are cutting less than 20 blocks per hour. 
 I understand that some tissues and protocols take longer so this is an average 
not something that has to be hit every shift.

Thanks,
Kelly

Kelly Pairan,  HT (ASCP)CM, QIHC (ASCP)
Histology Supervisor-Anatomic Pathology
Department of Pathology and Laboratory Medicine
Email:  kelly.pai...@nationwidechildrens.org
ph: 614-722-5414
fx: 614-722-3033

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Re: [Histonet] Histonet - Molecular Biology ASCP

[WILLIAM DESALVO via Histonet]

If you have the HTL, you are eligible to take the MB. You can also track with 
education and OJT for one year in molecular lab.

William DeSalvo

From: Joe Myers via Histonet 
Sent: Friday, May 31, 2019 4:15:01 PM
To: HistoNet
Subject: Re: [Histonet] Histonet - Molecular Biology ASCP

Diana:
Unfortunately, there’s no such certification for “molecular biology in 
histology” per se; the MB certification offered by the ASCP is generally 
pursued by individuals who are already certified as an MT or MLT since these 
types of procedures are usually performed in the ‘main lab’ (rather than in the 
histology section).  That’s not to say that folks with HT/HTL/CT certification 
shouldn’t consider pursuing the MB as well if they’d like.  As Mark indicated 
in his response, doing so usually involves taking several courses relating to 
MB techniques/instrumentation, and although you will occasionally see an MB 
‘overview’ course offered at a histology-society meeting, one would likely need 
a great deal more classroom/self-paced education and hands-on training to 
successfully pass the MB exam.
Cheers,
Joe Myers, M.S., CT(ASCP)QIHC



> Message: 1
> Date: Thu, 30 May 2019 18:13:11 +
> From: Diana Martinez-Longoria 
> To: "Histonet@lists.utsouthwestern.edu"
> Subject: [Histonet] Molecular Biology ASCP
> From: Diana Martinez-Longoria
> Sent: Thursday, May 30, 2019 11:09 AM
>
> Subject: Molecular Biology ASCP
>
>
>
> Good day,
>
>
> I don't know if anyone can help me regarding how does someone become ASCP 
> certified for Molecular Biology in Histopathology? Does anyone know how one 
> can study or take a program that can prepare you to take the ASCP Molecular 
> Biology Exam? Thank you !
>
>
> Diana Martinez-Longoria
>
> Bachelors of Science in Biology
>
> Histotechnician (ASCP)cm
>
> El Centro Regional Medical Center
>
> Phone: 760-339-7267
>
> Fax: 760-339-4570
>
> Email:dmlongo...@ecrmc.org
>


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Re: [Histonet] Tissue Tek TEC 6 Embedding Centre

[WILLIAM DESALVO via Histonet]

Check with the manufacturer as many in the pathology space are moving to 
placing 10 use and no longer supporting. As this continues to become more 
prevalent, the refurbish companies will continue to support. This is similar to 
the support of some clinical instruments.

William DeSalvo

From: E. Wayne Johnson via Histonet 
Sent: Thursday, May 30, 2019 7:13:02 PM
To: Etheridge, Sandra AGRI:EX; 'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] Tissue Tek TEC 6 Embedding Centre

I am skeptical that parts are not available for these relatively new
(fifteen years old) machines...

Of course reliability is a serious concern in any case.

E. Wayne Johnson DVM
Enable AgTech
Beijing

Etheridge, Sandra AGRI:EX via Histonet wrote:
> Hi everyone,
>
> We are looking to purchase a new embedding centre and was wondering if anyone 
> has the new Tissue Tek TEC 6?  Our current Tissue Tek TEC is 15 years old and 
> parts are no longer available for repair.
>
> We are comparing the TEC 6 to the Leica HistoCore Arcadia system.  Just 
> wondering if anyone can give some feedback with regard to pro and cons of 
> either unit.
> Much appreciated!
>
> Sandra Etheridge
>
> BC Ministry of Agriculture
> Plant and Animal Health Centre
> Histology/IHC
> 1767 Angus Campbell Road
> Abbotsford, BC V3G 2M3
> # (604) 556-3120
>
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Re: [Histonet] Suggestions on a used microtome

[WILLIAM DESALVO via Histonet]

Contact Rankin for reliable refurbished instruments. I am partial to retracting 
microtones. Best to work with a company that provides quality

William DeSalvo

From: Craig via Histonet 
Sent: Tuesday, April 23, 2019 12:27:22 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Suggestions on a used microtome

Hi everyone!

Starting a new lab Texas and was looking at getting a used microtome and
wanted to see if any of you had suggestions on the best model to get used
and where?

Any suggestion will be greatly appreciated!

Best,
Craig
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Re: [Histonet] Fridge temp

[WILLIAM DESALVO via Histonet]

Simple, revalidate or pitch

William DeSalvo

From: MARY ANN via Histonet 
Sent: Tuesday, March 26, 2019 4:09:01 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Fridge temp

Let's say, hypotheticaly, if you discover your fridge with all you antibodies 
and detection kits were discovered to have been at 19c. for an undisclosed 
amout of time. 12 24 48 hours due tona power surge..south Florida weather.

Let's also propose your lab CFO/Owner dosent think its a big deal.

First how would you handle the issue given the frisge has been restored ?




Sent from Xfinity Connect Application
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Re: [Histonet] AB

[WILLIAM DESALVO via Histonet]

Helen, I have experience with both. Feel free to contact me directly with 
questions or we can arrange a call. More than happy to help

William DeSalvo
wdesalvo.cac@outlook. Com
480-622-1337

William DeSalvo


From: Helen via Histonet 
Sent: Thursday, November 29, 2018 9:10 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] AB


Hi there

I would like to know a Histology laboratory user experience of Tracking 
systems. Specifically vantage versus AB?
Any advice would be great.

Thanks
Helen



Helen Hegarty
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Re: [Histonet] AFB STAIN

[WILLIAM DESALVO via Histonet]

I completely agree with Tony. Not likely to see any sloughing off (shedding) of 
organisms from FFPE tissue blocks.

William DeSalvo


From: Tony Henwood (SCHN) via Histonet 
Sent: Thursday, October 4, 2018 1:54 PM
To: adesupo2...@hotmail.com; Laurie Colbert
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] AFB STAIN

Cross-contamination has not been proven in FFPE tissues.

I have not seen it in nearly 40 years of practice

Do you have any evidence of cross-contamination in FFPE?

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


From: Laurie Colbert via Histonet 
Sent: Thursday, October 4, 2018 10:36 PM
To: adesupo2...@hotmail.com; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] AFB STAIN

You should put the AFB control on a separate slide to prevent 
cross-contamination.

Laurie Redmond


-Original Message-
From: ADESUPO ADESUYI via Histonet 
To: histonet 
Sent: Wed, Oct 3, 2018 7:58 pm
Subject: [Histonet] AFB STAIN

Hello,
I have a question please. For the AFB Stain, do we put both the control tissue 
and the patient on the same slide?

Thanks,
Ade
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This message is intended for the addressee named and may contain confidential 
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Re: [Histonet] Temperature for Storing Slides and Blocks

[WILLIAM DESALVO via Histonet]

I do not know of a standard, but you should make sure the storage temp is 5-10 
degrees lower(maybe more depending on fluctuations in temp for the area). That 
would be < 120F degrees. Request the location Facilities department understands 
you need temperature control

William DeSalvo


From: Dessasau III, Evan via Histonet 
Sent: Wednesday, September 5, 2018 11:52 AM
To: Blake Taylor
Cc: 'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] Temperature for Storing Slides and Blocks

When we had our structure built we had cooling/heating units(2) put in a 
structure that is about 818sqft. 70F summer and 65 to 68F winter is what we aim 
for. Not sure if that is ideal but it keeps the blocks cool in the summer and 
the slides from sticking in the winter.
Thank you,
E-van
Histology Lab, Yerkes
Rm. 2122
7-7744 Lab
7-7902 office



-Original Message-
From: Blake Taylor via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Wednesday, September 5, 2018 1:53 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Temperature for Storing Slides and Blocks

Is there a good reference or standard on what the room temperature should be 
for storing slides and blocks? We have moved our long term storage out to our 
hospitals warehouse and I believe the building is getting much too hot. What 
temperature range is everyone using?

Thanks so much

Blake Taylor
Surgical Pathology Supervisor
Lexington Medical Center
803-936-8214
bcdu...@lexhealth.org

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Re: [Histonet] Davidson

[WILLIAM DESALVO via Histonet]

Davidson’s fixative is suggested to for use to fix in up to 24 hours. The small 
nodes should be at least halved and larger nodes cut no more than 2-3 mm thick. 
There are a few papers that state “small biopsies can be fixed rapidly”. I 
suggest < 6 hours for small biopsies. I would do, minimally, a quick 
verification study on multiple tissue samples before risking diagnostic 
samples. Hope that helps.
William

William DeSalvo


From: Azam, Muhammad via Histonet 
Sent: Monday, July 30, 2018 10:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Davidson

Hi;

I am wondering what is the optimal time for Davidson's fixative (range). This 
is in regards to a sectioned lymph node.

Thanks;

Muhammad Azam, MD
Staff Pathologist
VHAMOU

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Re: [Histonet] Paperwork

[WILLIAM DESALVO via Histonet]

I am not a a big supporter of batch controls and managing that process.

Place a control section above patient sample, choosing 1 slide/case, prior to 
moving slides to stain. Control always gets to pathologist that is reading 
patient slides, assuming patient slides always get to pathologist and control 
is filed with the case.

Think through what are the opportunities for error and develop a change to 
either eliminate or reduce the opportunity.

There are multiple solutions to your problem and you will need to decide what 
process change gives you the results you desire. There should be multiple 
responses to facilitate your change.

William

William DeSalvo


From: Campbell, Tasha M. 
Sent: Friday, July 27, 2018 11:00 AM
To: WILLIAM DESALVO; histonet@lists.utsouthwestern.edu
Subject: RE: [Histonet] Paperwork

I am a little confused about your batch control explanation.  Do you mean to 
put a piece of control tissue on every case slide?




Tasha Campbell, B.S.,HTL(ASCP)
Frederick Gastroenterology Associates
310 W. 9th St.
Frederick, MD 21701
301-695-6800 ext. 144

From: WILLIAM DESALVO [mailto:wdesalvo@outlook.com]
Sent: Friday, July 27, 2018 1:20 PM
To: Campbell, Tasha M.; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Paperwork

I have a few suggestions:

Batch control - you do need to continue documentation of which cases/slides 
corresponds to the one control and be able to provide for inspection or 
re-review of a case. I suggest you consider taking pre-cut slide, add a new cut 
control section (1 per case if there are multiple slides) before staining. This 
conserves control tissue and removes some of the logistics of locating and 
matching batch control. I believe this will be a quality improvement without 
high cost.

Accessioning/ LIS - Ditch the log sheets and do not print, unless there is a 
specific need. All of your manual tracking process is now electronic. Do update 
all SOP’s and note date of change in process.

William

William DeSalvo


From: Campbell, Tasha M. via Histonet 
Sent: Friday, July 27, 2018 8:41 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Paperwork

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] Paperwork

[WILLIAM DESALVO via Histonet]

I have a few suggestions:

Batch control - you do need to continue documentation of which cases/slides 
corresponds to the one control and be able to provide for inspection or 
re-review of a case. I suggest you consider taking pre-cut slide, add a new cut 
control section (1 per case if there are multiple slides) before staining. This 
conserves control tissue and removes some of the logistics of locating and 
matching batch control. I believe this will be a quality improvement without 
high cost.

Accessioning/ LIS - Ditch the log sheets and do not print, unless there is a 
specific need. All of your manual tracking process is now electronic. Do update 
all SOP’s and note date of change in process.

William

William DeSalvo


From: Campbell, Tasha M. via Histonet 
Sent: Friday, July 27, 2018 8:41 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Paperwork

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] Coronary or Muscular Artery Histology Textbooks

[WILLIAM DESALVO via Histonet]

Stevens and Lowe, Histology, 4th edition, 2015. Good human anatomy  and 
descriptive

William DeSalvo


From: Vivian Hou via Histonet 
Sent: Thursday, July 26, 2018 11:40 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Coronary or Muscular Artery Histology Textbooks

Dear all,

I am searching for textbooks (not journal papers) focused more towards
coronary or muscular artery histology (or just vascular anatomy overall),
any suggestions you may have will be greatly appreciated!

Thank you all for your time,
Vivian

--
-
V Hou
Research Scientist | Engineer III
Center for CardioVascular Innovation
e: ho...@uw.edu | p: 206-221-3053
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Re: [Histonet] Water for H Stainers?

[WILLIAM DESALVO via Histonet]

Tap water is most often used in H staining for rinsing and sometimes blueing 
and can be very cost effective. I do suggest you use a filter prior to the 
water entering the instrument. The filter can eleviate one of the key concerns, 
contaminates. 
The typical contaminates/compounds can be: 
Inorganic ions: chlorides, nitrates, sulfates, sodium, calcium, iron
Organic molecules: humic acids, phenols, tannins, pesticide residues
Particles and colloids
Microorganisms and their by-products
Dissolved gases
 
The other key concern is that the pH of the tap water may vary by location and 
even season. To change the color of hematoxylin stained nuclei from redish to 
blue, the pH should be 7 or higher. Most tap water is typically slightly acidic 
(pH of around 6.0 to 6.8), but this is much more alkaline than the pH of the 
haematoxylin, around pH 2.7. Rinsing for two to five minutes in running tap 
water will remove most of the excess mordant giving sharp blue nuclear 
staining. If you want sharper and better defined
 
As my good friend Skip Brown states, a good H stain is "balance of 
coloration". Understand the chemistry and you control the balance. 
 
William DeSalvo, BS HTL(ASCP)
 
> Date: Tue, 27 Sep 2016 14:17:08 -0700
> To: l...@premierlab.com; pat...@gmail.com; histonet@lists.utsouthwestern.edu
> Subject: Re: [Histonet] Water for H Stainers?
> From: histonet@lists.utsouthwestern.edu
> 
> Our Prisma is connected to tap water with a prefilter that we change weekly. 
> CathyBritish Columbia 
> 
> 
> Sent from my Samsung Galaxy smartphone.
>  Original message From: Elizabeth Chlipala via Histonet 
> <histonet@lists.utsouthwestern.edu> Date: 2016-09-27  9:54 AM  (GMT-08:00) 
> To: P Sicurello <pat...@gmail.com>, "'histonet@lists.utsouthwestern.edu'   
> (histonet@lists.utsouthwestern.edu)" <histonet@lists.utsouthwestern.edu> 
> Subject: Re: [Histonet] Water for H Stainers? 
> Paula
> 
> We have ours hooked up to tap water.
> 
> Liz
> 
> Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC
> Premier Laboratory, LLC
> PO Box 18592
> Boulder, CO 80308
> (303) 682-3949 office
> (303) 682-9060 fax
> (303) 881-0763 cell
> l...@premierlab.com
> www.premierlab.com
> 
> Ship to Address:
> 
> Premier Laboratory, LLC
> 1567 Skyway Drive, Unit E
> Longmont, CO 80504
> 
> -Original Message-
> From: P Sicurello via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
> Sent: Tuesday, September 27, 2016 10:28 AM
> To: HistoNet
> Subject: [Histonet] Water for H Stainers?
> 
> Good Morning Everyone,
> 
> 
> 
> What type of water do you use with your automated H stainers?  House or 
> deionized/distilled?
> 
> 
> 
> We cannot buy one of the waterless, fancy schmancy H stainers at this time. 
>  L Thank you in advance.
> 
> Sincerely,
> 
> 
> 
> Paula
> 
> 
> 
> Paula Sicurello, HTL (ASCP)CM
> 
> Histotechnology Specialist
> 
> UC San Diego Health
> 
> 200 Arbor Drive
> 
> San Diego, CA 92103
> 
> (P): 619-543-2872
> 
> 
> 
> *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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Re: [Histonet] No More Blog Posts -- Over and Out!

[WILLIAM DESALVO via Histonet]

Another personal e-mail from you that is unwanted. I am feeling like I have my 
own stalker. You are one of the reasons that individuals will not post or 
comment, personal and ugly. I cannot imagine why your workplace (LUMC.edu) 
chose you to represent them. I request that you no longer contact me and make 
personal attacks. I know nothing of you and you certainly do not know anything 
about me. If you have something to say, post to the listserve, not me.

> From: spinhe...@lumc.edu
> To: wdesalvo@outlook.com
> Subject: RE: [Histonet] No More Blog Posts --  Over and Out!
> Date: Mon, 2 May 2016 20:15:38 +
> 
> As is yours. Just can't keep that dictatorial aspect out of your charming 
> consultant two cents worth.
> 
> Steve Pinheiro
> 
> 
> -Original Message-
> From: WILLIAM DESALVO via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
> Sent: Monday, May 02, 2016 2:11 PM
> To: Manfre, Philip; Rene J Buesa
> Cc: 'histonet@lists.utsouthwestern.edu'
> Subject: Re: [Histonet] No More Blog Posts -- Over and Out!
> 
> Your response is WAY out of line. Keep it professional.
> 
> Sent from my Windows Phone
> 
> From: Manfre, Philip via Histonet<mailto:histonet@lists.utsouthwestern.edu>
> Sent: ‎5/‎2/‎2016 12:08 PM
> To: Rene J Buesa<mailto:rjbu...@yahoo.com>
> Cc: 
> 'histonet@lists.utsouthwestern.edu'<mailto:histonet@lists.utsouthwestern.edu>
> Subject: Re: [Histonet] No More Blog Posts --  Over and Out!
> 
> Delete button broken, huh.  I suppose it was necessary to attack a colleague 
> to feel puffed up about yourself.  Bully for you!
> 
> -Original Message-
> From: Rene J Buesa via Histonet [mailto:histonet@lists.utsouthwestern.edu]
> Sent: Monday, May 02, 2016 2:23 PM
> To: Lester Raff MD; 'histonet@lists.utsouthwestern.edu'
> Subject: Re: [Histonet] No More Blog Posts -- Over and Out!
> 
> Thank you VERY MUCH!René
> 
> On Monday, May 2, 2016 1:54 PM, Lester Raff MD via Histonet 
> <histonet@lists.utsouthwestern.edu> wrote:
> 
> 
>  To My Lab Colleagues:
> 
> As my intent has never been to sow discontent or rancor, I think it is for 
> the best if I no longer post links to my blog, lab related or otherwise.  Of 
> course the blogs go on, and if anyone is interested in being added to my 
> mailing list for future notifications, just drop me a line at 
> les.r...@post.com<mailto:les.r...@post.com>  The mailing list is never used 
> for any purpose other than announcing a new blog post. Be sure to let me know 
> you are from the Histonet list!
> 
> I will continue to participate in any histology/pathologist discussions here 
> as I have for many years.
> 
> Cheers,
> 
> Lester J. Raff, MD MBA
> UroPartners
> Medical Director Of Laboratory
> 2225 Enterprise Dr. Suite 2511
> Westchester, Il 60154
> Tel: 708-486-0076
> Fax: 708-492-0203
> 
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> 
> 
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Re: [Histonet] No More Blog Posts -- Over and Out!

[WILLIAM DESALVO via Histonet]

Your response is WAY out of line. Keep it professional.

Sent from my Windows Phone

From: Manfre, Philip via Histonet
Sent: ‎5/‎2/‎2016 12:08 PM
To: Rene J Buesa
Cc: 
'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] No More Blog Posts --  Over and Out!

Delete button broken, huh.  I suppose it was necessary to attack a colleague to 
feel puffed up about yourself.  Bully for you!

-Original Message-
From: Rene J Buesa via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Monday, May 02, 2016 2:23 PM
To: Lester Raff MD; 'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] No More Blog Posts -- Over and Out!

Thank you VERY MUCH!René

On Monday, May 2, 2016 1:54 PM, Lester Raff MD via Histonet 
 wrote:


 To My Lab Colleagues:

As my intent has never been to sow discontent or rancor, I think it is for the 
best if I no longer post links to my blog, lab related or otherwise.  Of course 
the blogs go on, and if anyone is interested in being added to my mailing list 
for future notifications, just drop me a line at 
les.r...@post.com  The mailing list is never used for 
any purpose other than announcing a new blog post. Be sure to let me know you 
are from the Histonet list!

I will continue to participate in any histology/pathologist discussions here as 
I have for many years.

Cheers,

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

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proprietary copyrighted and/or legally privileged. It is intended solely
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please notify us immediately by reply e-mail and then delete it from
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Re: [Histonet] Medical/health related post

[WILLIAM DESALVO via Histonet]

Again, why the non-Histo post. Take this to another source. I do not understand 
why Dr. Raff has not been removed from this list serve. This is a valuable site 
for histotechnolgy related issues, please let us keep it that way.

Sent from my Windows Phone

From: Lester Raff MD via Histonet
Sent: ‎4/‎28/‎2016 6:59 AM
To: 
'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] Medical/health related post

http://www.chicagonow.com/downsize-maybe/2016/04/running-mates-and-other-mates-fighting-trump-fighting-cancer/

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

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Re: [Histonet] Passing the HTL

[WILLIAM DESALVO via Histonet]

Congratulations! Well done and now the fun begins.

Sent from my Windows Phone

From: Terri Braud via Histonet
Sent: ‎4/‎26/‎2016 10:58 AM
To: 
'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] Passing the HTL

BIG Congratulations! To Patrick Lewis on passing your HTL

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

7. I did it  I am now a certified HTL (Lewis, Patrick)
Message: 7
Date: Tue, 26 Apr 2016 16:30:28 +
From: "Lewis, Patrick" 
Subject: [Histonet] I did it  I am now a certified HTL
Hi Everyone
After years of putting it off, I finally took my ASCP HTL  exam and passed it.
Huzzah!
Patrick.
Patrick Lewis
Research Associate II Bench
Seattle Childrens Research Institute
206-884-1115



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Re: [Histonet] Blog Post Not lab related

[WILLIAM DESALVO via Histonet]

IMO, this is a list serve not an advertising space. Keep blog posts and other 
advertising off the list. Keep the exchange about histotechnology. Plenty of 
interweb space for other communication. Dr. Raff and everyone is always welcome 
to be part of the discussion and help get answers to those that need.

Sent from my Windows Phone

From: Megan Dishop via Histonet
Sent: ‎4/‎14/‎2016 2:01 PM
To: 
histonet@lists.utsouthwestern.edu; 
heather.brow...@us.af.mil
Subject: Re: [Histonet] Blog Post Not lab related



Thank you for bringing attention to this, Heather. This has been my
observation also, and I couldn't agree more. Let's keep it professional.


Sent from my Sprint Samsung Galaxy® Note 4.

 Original message 
From: "BROWN, HEATHER L GS-07 USAF AETC 59 CRD/SGVUO via Histonet"

Date: 4/14/16  1:02 PM  (GMT-06:00)
To: histonet@lists.utsouthwestern.edu, HEATHER L GS-07 USAF AETC 59
CRD/SGVUO BROWN 
Subject: Re: [Histonet] Blog Post Not lab related


>>> "BROWN, HEATHER L GS-07 USAF AETC 59 CRD/SGVUO via Histonet"
 2016-04-14T13:02:26.146402 >>>
I am new to the Histonet, not to histology though.  There have been 2
great question and answer sessions since I've been on here.  The way
some of you guys talk to each other is so disrespectful.  I went through
AFIP as a civilian years ago and I thought the histo world was a small
society of people who shared a common, if not morbid, curiosity of the
human anatomy, how it works and how can we do the best we can do to help
our patient.  I will read all the submissions, because there may
actually be a good answer to a question.  I will have to really weigh my
options with asking a question...cruelty and ridicule or the possibility
of a good answer?  If you don't like histo, then don't do histo.  If you
can't be nice, then say nothing at all.  Life is a beat down everyday, I
darn sure wouldn't need if from my peers too.

Heather L. Brown, HT, ASCP
JBSA-Lackland, Texas



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Re: [Histonet] Processing issues

[WILLIAM DESALVO via Histonet]

Not knowing what issues you have, I suggest you look to your samples for 
processing. Reduce thickness and the shorter times will work. 2-2.5 mm thick. 
Standardize fixation before placing in tissue processor. What time is the 
processor started and what time does the tech remove? You may be able to reduce 
delay and increase alcohols. Specimen thickness will reduce the the time for 
solution to move through the tissue sample and allow exchange of solution. 
There are many options, but be more specific about the problem and you can 
narrow the changes

Sent from my Windows Phone

From: Charles Riley via Histonet
Sent: ‎3/‎22/‎2016 8:57 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Processing issues

We are having issues with our tissue processing. We use the thermo shandon
excelsior processor. All steps have agitation and under vacuum. Our routine
process is  as follows

1. Formalin   1hr
2. Formalin   1hr
3. 75% alcohol 30 mins
4.85% alcohol 30 mins
5. 95% alcohol 30 mins
6.95% alcohol 30 mins
7. 100% alcohol 30 mins
8. 100% alcohol 30 mins
9 xylene 30 mins
10. xylene 30 mins
11 xylene 30 mins
12. Wax for 30 mins
13. Wax 30 mins
14. Wax 30 minutes.

Can anyone give any suggestions for altering this process to work better? I
know the process should probably be longer however medical director does
not want to delay turn around time. If possible keep the process to under 9
hours. If this isn't conducive to consistent processing please explain why
so  I can show my superiors to give myself some leverage to change things
--

Charles Riley HT(ASCP)CM

Histopathology Coordinator/ Mohs

Doctors Pathology Services, Dover DE
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Re: [Histonet] automatic stainers and tissue processors

[WILLIAM DESALVO via Histonet]

I suggest you take the opportunity to find the instruments that fit your needs. 
Are going to rapid process, what types of tissue samples do you have, what do 
you want to improve? The histology lab is changing and you should look 5+ years 
down the road. I would not want you to be pigeon holed into a set of 
instruments. Drive quality, patient experience and flexibility. I am a wrong 
proponent of rapid processing, fix appropriately and do not use xylene or over 
process. For staining, Prisms and film are my choices. You need to find the 
instrumentation that works best for you. Good luck in your search, there are 
many options and great products to evaluate.

Sent from my Windows Phone

-Original Message-
From: "Silvia Bonner via Histonet" 
Sent: ‎2/‎29/‎2016 1:19 PM
To: "histonet@lists.utsouthwestern.edu" 
Subject: [Histonet] automatic stainers and tissue processors


Hello,
We are looking into purchasing new automatic H strainers and new tissue 
processors.  Any helpful advice?  I know this may have been discussed before 
but I an new to histonet.
Thanks for your help!
Silvia Bonner, HT(ASCP) CM
Histology Supervisor

sbon...@pathregional.com
Pathologists' Regional Laboratory
1225 Highland Ave
Clarkston, WA 99403
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Re: [Histonet] Bar Code and Tracking

[WILLIAM DESALVO via Histonet]

I believe it will be difficult to afford the cost of Co-Path in your small lab 
area, unless you can attach to a bigger hospital information system contract. I 
suggest you look to companies that have developed products for the small to 
medium sized histology labs.

Sent from my Windows Phone

From: Abbott, Tanya via Histonet
Sent: ‎2/‎17/‎2016 11:48 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Bar Code and Tracking

Hello,
I manage a small Pathology lab where we generate approx. 80-140 blocks for 
Histo and 5-6 Cytology fluids a day. I have 2 Histotechs that swap doing 
grossing monthly. I have 1 full time and 1 part time Cytotech and a Cyto 
assistant. I am curious if there are any smaller labs out there that have gone 
to a Bar Code and Tracking system and can offer any input. I came from a much 
larger lab that used CoPath from accessioning to sign-out, so that is the kind 
of system I am used to. It is certainly a system I wish to integrate in to my 
lab on a much smaller level, we currently have a very manual process, other 
than some entry/labeling in our LIS.
Any input is appreciated! Tanya

Tanya G. Abbott
Pathology Manager
Penn State Health St. Joseph
Pathology Department
(o) 610-378-2635
(f) 670-898-5871
tabb...@pennstatehealth.psu.edu
Penn State Health St. Joseph | The Future of 
Healthcare

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Re: [Histonet] Storage of Unstained Slides

[WILLIAM DESALVO via Histonet]

I would not heat dry unstained as heat drying removes the paraffin and 
cells/tissue in no longer protected by the paraffin. Drying slides is a process 
to remove the sate trapped between the section and glass. Heat drying can speed 
that process and is also helpful in "baking" tissue to slide to assist in 
tissue adherence. Air dry until staining is requested, is my advice.

Sent from my Windows Phone

From: T Williams via Histonet
Sent: ‎2/‎1/‎2016 5:31 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Storage of Unstained Slides

Does anyone have any suggestions as to how unstained slides with patient
tissue should be stored?  Or could anyone recommend a product for
storage?   Also - is it preferable that these slides not be placed in the
dryer until they are intended to be stained?  If so, what is the problem
with baking them as soon as they're cut and dried at room temperature?

I apologize for all the questions but I do  appreciate the guidance.

T. Williams
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Re: [Histonet] changing tissue processors

[WILLIAM DESALVO via Histonet]

I would suggest by cassette numbers. It will take some data collection, but 
once you settle on the number of cassettes, then you will have the process in 
control. The actual number will depend on the tissue types placed in the 
cassettes and the amount of blood, lipids and other elements extracted. Start 
with a minimum of 600 cassettes and see see what additional cassettes can be 
processed without losing quality.

Sent from my Windows Phone

From: Nirmala Srishan via Histonet
Sent: ‎1/‎11/‎2016 12:33 PM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] changing tissue processors

Hi Histonetter,


Does any one have guidelines, which indicates how often to change the
tissue processors - Cassette Volume run, Make of processors etc

Thank you


Nirmala Srishan
Histology Supervisor
Holy Name Medical Center
718 Teaneck Road
Teaneck NJ 07666
Lab: 201 833 3023
Office: 201 541 6328







Holy Name Medical Center is ranked among the top hospitals in the nation
for patient care, clinical performance and workplace excellence.
Click here to learn more.

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CONFIDENTIAL and is intended only for the use of the addressee above. If
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[Histonet] NSH Financial and Tax Statements

[WILLIAM DESALVO via Histonet]

As a due paying member of NSH, I ask all members and anyone interested in 
Histotechnology request from NSH office to see the Financial and Tax Statements 
for 2013 / 2014. This is public information. We should all know where our dues 
money, money from educational activities and vendor money from the convention 
is being spent. 

Sent from my Windows Phone
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Re: [Histonet] Help with causes or theory behind failure of nuclear counterstaining after IHC!

[WILLIAM DESALVO via Histonet]

Maria, I. Think you may have a pH issue. High pH results in reduction of 
protons, H+, effects dye structure and can cause light to no staining after 
bluing. If you are using hematoxylin w/ aluminum, most popular, decreased pH = 
decreased intensity. Acid breaks the Al+3. Check your ph throughout the 
process. Sounds like something has changed. Good luck.

Sent from my Windows Phone

From: Morken, Timothy via Histonet
Sent: ‎1/‎4/‎2016 9:20 AM
To: Maria Mejia
Cc: Histonet
Subject: Re: [Histonet] Help with causes or theory behind failure of nuclear 
counterstaining after IHC!

Maria,

If the counterstain is good when done before IHC stain and poor after it sounds 
like proteins are being extracted during the IHC processing and staining. Have 
you tried staining sections after each step of the IHC process to isolate the 
point the stain becomes weak?

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



-Original Message-
From: Maria Mejia via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Sunday, January 03, 2016 8:29 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Help with causes or theory behind failure of nuclear 
counterstaining after IHC!

Happy New Year Everyone,

I'm the lead histologist working in an IHC based research lab focused on early 
stages of Alzheimer's disease.  We work on paraffin sections processed & cut 
from 600um celloidin sections.  Including a lot of 60um cellodin sections from 
whole human brainstem.

For years, everything has going good regarding counterstaining after single & 
double IHC staining on 60um free-floating sections.  However for the past two 
months we've struggled to achieve good visible counterstaining on IHC sections 
to count the stained neurons - to see clearly the nucleus & nucleolus!

For a number of years, Gallocyanine was our choice of counterstain after IHC.  
Now, it's NOT working (neurons not stained visible enough to count).  We've 
also tried cresyl violet
counterstain -  staining too weak!   In both counterstains, we modified
the staining protocols quite a number of times to get good visible staining - 
nothing!!!

Strangle because we get lovely counterstained neurons with NO IHC staining on 
our 60um sections, but as soon as we take the sections through the IHC protocol 
e.g. antigen retrieval, antibodies & chromogens - counterstain is too weak!  
Our paraffin IHC sections work & look wonderful!

Now, my PI wants to try methyl green counterstain, however I think we'll have 
the same problem.
Here's what I need help with:

1) Can someone please explain the reason or theory  behind the failure of 
counterstain uptake by cells such as human neurons on 60um celloidin sections?

2) Can anyone please offer staining protocols that use alternative dehydration 
& clearing reagents.
I've been using alcohols dehydration (96% & 100%) without success as well as 
clearing with xylene - which hardens the tissue if left too long in this 
reagent.

 I was thinking of perhaps using acetone instead of alcohols & maybe using a 
methyl salicylate or chloroform.  Thoughts anyone?

I wish Dr Chris van der Loos was still with us.  I'd dearly like to hear from 
anyone who can help with this issue - Gayle Callis, Terry Johnson, Dr Hohn 
Kiernan et al.

Any assistance anyone can provide will be greatly appreciated!

Best
Maria Mejia
UCSF
Memory & Aging Department
San Francisco, CA
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Re: [Histonet] Collodian bag for cell blocks

[WILLIAM DESALVO via Histonet]

What method are you using? Making your own coated tubes, UCSF or MD Anderson. 
Are you purchasing coated tubes? Once the tube is coated, dried (using hood) 
and filled w dH2O, there should be no odor. Always work w/ collodion under the 
hood. Ethyl ether is main component. Once in cassette and processed, there 
should not be odor.

Sent from my Windows Phone

From: Baldwin, Kathy via Histonet
Sent: ‎1/‎4/‎2016 2:07 PM
To: 
'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] Collodian bag for cell blocks

Hi All
Was wondering if anyone is using the Collodian bag for cell blocks.  We just 
got it and have been using it 'works great' but all the techs are complaining 
of the smell.. Our ventilation has been looked at and has passed however the 
smell still lingers in the room.  Any suggestions??


Thanks
S. Kathy Baldwin
Histology/Cytology Supervisor
Memorial Hospital and Health Care Center
800 West 9th St.
Jasper, Indiana  47546
Office 812-996-0210
Fax 812-996-0232
Cell 812-887-3357





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Re: [Histonet] Best solution for surface decalcification of paraffin block

[WILLIAM DESALVO via Histonet]

I do no recommend surface decal, but if you must use a formic acid product. 
Rinse the block several times to remove decal before cutting a section. Always 
better to go to the source and adjust time in decal and method for determining 
end point before processing.

Sent from my Windows Phone

From: Carlos Defeo via Histonet
Sent: ‎12/‎16/‎2015 8:37 PM
To: 
histonet-requ...@lists.utsouthwestern.edu
Cc: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Best solution for surface decalcification of paraffin block

Hi all, I would like your opinion on the best way to achieve many few
decent sections of calcified material.
IED by Biocare,a strong acid solution, any input would be greatly
appreciated.
Thanks in advance.
Carlos Defeo
Histotechnologist
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Re: [Histonet] Workload

[WILLIAM DESALVO via Histonet]

I measure productivity by unit per task (specimens, blocks, slides). There is 
no right or wrong, but there are multiple tasks associated w/ a CPT code. I 
suggest you talk to you management or finance and find out what they use to 
measure productivity. Using their method/units allows for roll up to other 
reports.

Sent from my Windows Phone

From: Manahil via Histonet
Sent: ‎12/‎8/‎2015 12:13 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Workload

Hi histonet,
I have a query about workload and how do you measure productivity? Do you 
capture it by CPT codes?
Your input is highly appreciated,

Manahil
Sent from my iPhone
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Re: [Histonet] Rapid tissue Programs

[WILLIAM DESALVO via Histonet]

First suggestion is to remove the sponge. There will be carry over on 
biopsy/rapid tissue processor schedules. The sponges do require longer times to 
drain and exchange liquids. Your fixation times must be >6 hours. Make sure you 
are not applying too much heat to processing. Small biopsies are delicate and 
exchange of fluids/paraffin should not need physical elements to assist. 
Additionally, do not over dehydrate through alcohols.  You processor schedule 
will need to be validated, if you make time/ pressure/heat or reagent change. 
Good luck in the problem solving process.

Sent from my Windows Phone

From: Vickroy, James via Histonet
Sent: ‎11/‎24/‎2015 10:27 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Rapid tissue Programs

Our latest CAP survey was returned today and although there are no major issues 
one possible improvement area is evident.   On all of the biopsies the area of 
"fixation/processing" was not rated as excellent.  The suggested possible 
reasons were:   fixation incomplete, nuclear bubbling artifact, tissue poorly 
processed.   The survey also said that many of the samples sent in throughout 
the country had similar  issues in the fixation/processing area most likely 
because of the rapid turnaround times and shortened processing times.   I am 
trying to be proactive here and see if we can adjust some times to improve the 
processing quality even though we have not had any complaints from the 
pathologists.   Of course we all know that other artifacts caused prior to the 
specimen arriving in the lab can also have an effect on the quality of the H 
slides.   Our fixation times should not be a factor so I have to conclude that 
maybe the rest of our processing times need to be adjusted.   Another factor 
that we have is that we use blue sponges for almost all of our tissues.  Our 
largest number of specimens are GI biopsies.If possible can anyone share 
with me their rapid processing schedules or simply the approximate times they 
have for each dehydration or clearing step. We do run a larger overnight tissue 
run on any biopsy or tissue that we feel is too large for the "rapid run".I 
am hesitant to run the biopsies routinely on the longer programs becase of over 
dehydration, etc. even though we do use an alcohol blend.

Any suggestions or similar experiences please share.Again our pathologists 
say everything looks great so I don't want to change much.

Jim

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



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Re: [Histonet] Xylene and Formalin substitutes

[WILLIAM DESALVO via Histonet]

Contact Ada Feldman, Anatech Ltd. Best resource.

Sent from my Windows Phone

From: Bharti Parihar via Histonet
Sent: ‎10/‎21/‎2015 3:49 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Xylene and Formalin substitutes

Hello everyone. I'm interested in starting a conversation at my workplace
regarding substitutes for xylene,  and if there are any substitutes for
formalin. If anyone out there is using any can they please give me feedback
regarding the following questions,

1. Name of substitutes?
2. Pros and Cons?
3. Any quality issues when performing H, IHC or Special Stains?
4. Is it cost effective?
5. Does it require different dehydrants other than alcohol?
6. If formalin is still used as fixative,  what xylene substitute works
best with formalin?

I appreciate any feedback! Thanks!
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Re: [Histonet] dictation systems

[WILLIAM DESALVO via Histonet]

At our lab, we have used a digital server system called Fusion.

I suggest you go digital and then consider if you can also move to voice 
recognition and activation for efficiency.

There are so many more options now as compared to the tape systems.

Sent from my Windows Phone

From: Horn, Hazel V via Histonet
Sent: ‎9/‎17/‎2015 9:00 AM
To: histonet 
(histonet@lists.utsouthwestern.edu)
Subject: [Histonet] dictation systems

All,
We are looking for a new dictation system for grossing.  Will you please share 
what you use?
We still have a Lanier microcassette system and it's outdated and not made 
anymore.
Thanks.

Hazel Horn
Supervisor of Histology/Autopsy/Transcription
Anatomic Pathology
Arkansas Children's Hospital
1 Children's Way | Slot 820| Little Rock, AR 72202
501.364.4240 direct | 501.364.1241 fax
hor...@archildrens.org
archildrens.org







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Re: [Histonet] HE Stainer Question

[WILLIAM DESALVO]

Look at all the automated HE stain instruments on the market. I suggest that 
you consider those that offer the best benefit to your workload and workflow. 
Instruments that utilize the concept of co-location (related tasks linked 
together; oven fro drying, flexible stain configuration and Coverslipping) will 
assist you in developing a LEAN workflow. Consider how many times you need to 
touch the slides to complete all the tasks and how much walk away time you 
gain.  
 
I do not suggest by-passing the validated staining instrument oven. Placing 
slides in another oven creates variation and often results in short and 
extended drying times. All automated HE stain instruments should be used 
according to manufacturer recommendation. My experience is that when shortcuts 
are used, quality suffers. The automated HE stain instruments have great 
through put and you should adjust workflow to maximize the designated batch 
size and stain time.
 
Film coverslip lasts longer than 7 years. Sakura  film is the best and has 
testing to exceed 10 years. I have used it for 13 years and never had the film 
peel. If you use the knock off film products, they only have short term 
accelerated stability testing and probably do not have any version of their 
many changes to the emulsion that have real time stability testing to exceed 10 
years. There are reasons to use glass and reasons to use film. Both are great 
products, when you use them correctly and purchase quality products. Glass 
automated cover slip options on instruments do have more required maintenance 
than film.
 
CAP has made no statement about film cover slipping. In fact, the Hologic (was 
Cytech) Cytology Thinprep system is FDA approved with film as the cover slip 
and the stained and film cover slipped Thinprep slide is digitally scanned for 
analysis. To be CAP compliant, you must keep blocks and slides for 10 years. 
With the advancement of cancer hospital protocols and molecular testing, many 
institutions are considering retaining blocks and slides beyond 10 years. 
Keeping blocks and slides longer than regulation requires introduces a large 
risk factor for the retaining institution and pathologists.
 
Always be forward thinking when considering the purchase of a new essential 
instrument. Will it bar code read, can it be interfaced to LIS or tracking 
system, what analytics can be extract and will the instrument help or hinder a 
LEAN workflow? There are many choices that will meet your basic needs, but 
which one meets your essential needs?

William DeSalvo, BS HTL(ASCP)
 
 From: sim...@upmc.edu
 To: ro...@labcorp.com; pat...@gmail.com; histonet@lists.utsouthwestern.edu
 Date: Tue, 12 May 2015 12:32:43 +
 Subject: Re: [Histonet] HE Stainer Question
 
 To be fair, a batch of slides for Leica is actually 270- slides, It can run 
 9 racks at a time, but, the 9th rack from start to coverslip is 3 hours+
 You can always skip the on-board oven and place your slides in a slide dryer 
 (most labs have them) and then every 3 minutes you can load a rack (1st 
 xylene step 3 minutes) 
 Then it goes much faster.
 As for tape..ugh..it is only guaranteed to last 7 years, after that they pull 
 off the slide and take the tissue with it.
 CAP is starting to frown on this as you need to keep the initial HE slides 
 for up to 10+ years.
 
 Chris Simmons B.S., A.S., HTL(ASCP)
 Supervisor, UPP Dermatopathology
 412.864.3880 office
 412.612.0881 cell
 
 
 -Original Message-
 From: Roy, Lisa [mailto:ro...@labcorp.com] 
 Sent: Tuesday, May 12, 2015 8:19 AM
 To: Paula Sicurello; HistoNet
 Subject: Re: [Histonet] HE Stainer Question
 
 Paula
 Here are my two cents
 
 I currently use a Leica Autostainer XL with attached glass coverslipper.  It 
 is consistent in its staining and easy to use.  The downfall is if you are a 
 large volume lab or just have large volume days, each staining rack holds 30 
 slides and only one rack can be stained in each batch. The stainer also only 
 has one on board oven, so the throughput of this machine is fairly low.  It 
 is only staining 30 slides at a time, with one holding station for the next 
 set.  It will run multiple batches concurrently, but gets to a point where it 
 is all backed up.  We sometimes have 2 racks staining, one in the oven, one 
 in the loading dock, and some sitting on top of the stainer until it can go 
 on. 
 
 On the flip side, the Sakura Prisma is a workhorse.  It is very similar to 
 the Leica in the sense that it is linear and very consistent in staining.  It 
 has two on board ovens and each basket can hold 20 slides.  The difference is 
 that the Sakura can stain 3 racks (60 slides) per batch, with two batches in 
 the oven at the same time.  That gives you 120 slide throughput for each 
 batch.  This stainer also has an attached coverslipper (Sakura Film), but it 
 is film coverslips.  I know, I know.no one likes the film coverslips.  
 One advantage to the film, is that the slides

Re: [Histonet] IHC billing question

[WILLIAM DESALVO]

We have to manually review the IHC billing also and continue to audit. It took 
billing and IT three months to create the logic to automate billing for a 
specimen and account for combination of there being the possibility of 88341, 
88342  88344 and the proper combinations.

Sent from my iPhone

 On Apr 30, 2015, at 2:34 PM, Cartun, Richard richard.car...@hhchealth.org 
 wrote:
 
 Effective January 1, 2015, our LIS team removed all of the CPT 88342 codes 
 for IHC from our CoPath stain dictionary since you couldn't tell whether a 
 Cytokeratin-7 was being performed as an 88341 or as an 88342.  Now, as 
 you might have expected,  none of the inpatient IHC testing has been 
 accounted for (the outpatient IHC has been billed manually from the pathology 
 report), and they want someone to go back and enter all the CPT codes into 
 the system (hopefully, not me!).  Has anyone else encountered this problem?  
 Thanks (I think).
 
 Richard
 
 Richard W. Cartun, MS, PhD
 Director, Histology  Immunopathology
 Director, Biospecimen Collection Programs
 Assistant Director, Anatomic Pathology
 Hartford Hospital
 80 Seymour Street
 Hartford, CT  06102
 (860) 972-1596
 (860) 545-2204 Fax
 
 
 This e-mail message, including any attachments, is for the sole use of the 
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 responsible for delivering the message to the intended recipient, please 
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Re: [Histonet] RE: Nuclear Artifact

[WILLIAM DESALVO]

What type of tissue cassette is being used? What type of insert or wrap is 
used. If one cassette processes correctly and the next to it does not, hard to 
say tissue processor is causing issue.
Sounds like a water problem and it could be water trapped in cassette. Check 
the rest of you process before moving to the processor. 

Sent from my iPhone

 On Apr 29, 2015, at 9:13 AM, Burnett, Brandy bburn...@capecodhealth.org 
 wrote:
 
 We are having similar issues with our tissue. 
 Any troubleshooting insight would be greatly appreciated!
 Thanks!
 
 
 From: histonet-boun...@lists.utsouthwestern.edu 
 [histonet-boun...@lists.utsouthwestern.edu] on behalf of Sue 
 [suetp...@comcast.net]
 Sent: Tuesday, April 21, 2015 7:55 PM
 To: Lisa Roy
 Cc: histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] Nuclear Artifact
 
 OMG we are experiencing the same issue. At first it was just GI and now we 
 are seeing it on prostate. One pathologist said it looks like the tissue has 
 been cooked. The only issue is we can have two biopsies right next to one 
 another in the basket one looks good and one looks bad. My director also 
 thinks it is the processors. I had Thermo out and they could find nothing. We 
 changed out all the reagents and the biopsies were fine than two days later 
 we had some bad ones. I know in July Fisher had a formalin recall associated 
 to the mixture of buffer, water and formalin. We thought that might be it but 
 it is now almost a year later and all the bad formalin should be gone. The 
 histotechs say the tissue is crunchy and they are right. I am running a test 
 tonight of a small needle biopsy that I made from a colon. I placed it is 
 straight formaldehyde overnight and am processing it on our biopsy cycle 
 tonight. My director also wanted us to only put three levels on our Thermo, 
 but he wanted the middle level to have empty baskets. I stopped that today 
 because I think the other issue is that the poor biopsies may be on the top 
 level and as the reagents are used the level changes, and also due to 
 displacement with the middle level being empty the reagent levels may not 
 reach the top. We just do not have the manpower to inspect every reagent 
 every day, we have 6 processor and it would take a tech all day. We actually 
 take a digital picture when they come out of the processor. I want to check 
 my problems cases tomorrow. We do not use sponges but the only other like was 
 the PA who was wrapping the blue paper very tight around the tissue. I really 
 do not think this is the issue though.. Any other insight would be greatly 
 appreciated.
 
 Susan T. Paturzo
 TJUH
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Re: [Histonet] Over- decalcified tissue

[WILLIAM DESALVO]

I would suggest not allowing decalcification to be extended. Better to leave in 
fixative until you can control the time of endpoint of decalcification. What 
type of decal solution are you using? I am not a big fan of trying to adjust 
the chemistry of the stain to compensate for over decalcification. Is there 
opportunity to submit another sample?

Sent from my iPhone

 On Apr 29, 2015, at 9:08 AM, pablo.sanc...@usc.es wrote:
 
 As I usually process gross pieces of bone -that need abouth thirty hours 
 decalcifying- I suffer the same nuissance. Also would thank any hint.
 
 Pablo Sanchez
 
 
 
 Laurie Colbert lcolb...@pathmdlabs.com escribiu:
 
 I have tissue that was left in decal over the weekend and now has very poor 
 nuclear staining.  Is there a fix for this so that I can get better 
 nuclear staining (other than restaining for a long time in the hematoxylin)?
 
 Laurie Colbert, HT (ASCP)
 Histology Supervisor
 PATH MD
 8158 Beverly Blvd.
 Los Angeles, CA  90048
 (323) 648-3214 direct
 (424) 245-7284 main lab
 
 The information contained in this transmission may contain privileged and 
 confidential information, including patient information protected by federal 
 and state privacy laws. It is intended only for the use of the person(s) 
 named above. If you are not the intended recipient, you are hereby notified 
 that any review, dissemination, distribution, or duplication of this 
 communication is strictly prohibited. If you are not the intended recipient, 
 please contact the sender by reply email and destroy all copies of the 
 original message.
 
 
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Re: [Histonet] prevent wrinkles when cutting

[WILLIAM DESALVO]

If you process properly, no over dehydration, there is no reason to soak. 
Keeping block cool will help in cutting. Sharp, clean blade a must. Correct 
water bath temp and time are the most critical factors, after cutting, to 
produce a wrinkle free section. 

Sent from my iPhone

 On Apr 20, 2015, at 10:12 AM, Julio Benavides j.benavi...@eae.csic.es wrote:
 
 Hi there,
 
 I´m curious about the soaking thing. We have never done it in our lab. Which 
 is the purpose to do it?
 
 Than, after facing the blocks, we chill them in a cold plate so, if wanting 
 to do the soaking , when should we? I guess before placing them on the cold 
 plate, but that may cause a bit of ice formation?
 
 Thanks a lot for your help
 
 Julio
 
 
 On 20/04/2015 18:40, Grantham, Andrea L - (algranth) wrote:
 Rachel,
 First off, are you chilling and soaking the blocks after you face them?
 Do that and see if there is a difference.
 Don't try to get many sections to your ribbons. Shoot for a smaller ribbon 
 (5-6) sections that are good. Cut slowly but consistently.
 What microtome are you using? Are you using disposable blades and are they 
 sharp? Don't expect them to cut well if you use the same blade to face the 
 blocks. If you aren't using disposables, get some! They will make your life 
 easier.
 You might try to find a histotech at a local hospital lab who might be able 
 to give you a hands-on lesson.
 Don't despair! We all sat down at our microtomes those first times and 
 suffered trying to get perfect sections. It takes practice. You might make 
 some blank blocks or blocks with tissue you can spare to practice your 
 cutting techniques. I used to do this with my students and it really helped 
 them.
 Good luck!
 
 Andi G.
 
 From: histonet-boun...@lists.utsouthwestern.edu 
 [histonet-boun...@lists.utsouthwestern.edu] on behalf of Rachel M Gonzalez 
 [rac...@gbi-inc.com]
 Sent: Monday, April 20, 2015 9:07 AM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] prevent wrinkles when cutting
 
 Hi
 
 Thursday was the first time I ever used a microtome I move to a lab
 that does not have someone dedicated to cutting. I already miss her.
 
 I have no problems getting ribbons of 10-30 sections long but the pieces
 are half the size of the original block. I am guessing they are wrinkling.
 What am I doing wrong?
 
 Thanks
 Rachel
 Senior Scientist
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Re: [Histonet] IHC and oven temperature

[WILLIAM DESALVO]

Dry heat compared to wet heat. Do not dry your slides at high heat. You are 
removing water trapped between slide and paraffin section. Antigen retrieval is 
an entirely different process. So not try to combine the two processes

Sent from my iPhone

 On Apr 20, 2015, at 8:48 AM, Preiszner, Johanna preis...@mail.etsu.edu 
 wrote:
 
 Hi Netters,
 
 is there something wrong with this logic:
 
 If the tissue needs 95C for HIER, it's ok to dry the slides in an 82C oven.
 
 Of course I'll test it before I try it on real specimens, but maybe someone 
 else already knows the answer...
 
 Thanks!
 
 Hanna Preiszner
 ETSU/QCOM
 
 
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Re: [Histonet] FW: Release of blocks to research facilities

[WILLIAM DESALVO]

There are other issues, besides CAP, that you should consider when releasing 
blocks.
1. A block is a medical record. Has the patient consented to release for 
research?
2. If the block is released prior to 14 days discharge and there are any 
charges, the charge must be sent to your hospital. Post 14 days the charges are 
sent to insurance and patient.
3. Will the research lead to a commercial product? Again, written patient 
consent.
4. You may be able to charge the research facility for sending the block. 
Administrative costs.
5. Communicate with patient is a must.
6. Get written consent and have the receiving facility verify they will handle 
properly, retain or return the block d you will get copies of data for patient 
file.

Make sure you reduce your risk.

Sent from my iPhone

 On Mar 17, 2015, at 5:38 AM, Abbott, Tanya tanyaabb...@catholichealth.net 
 wrote:
 
 I did call the CAP and they stated first of all, that it is a very confusing 
 checklist component! But I was told that the research facility is taking on 
 the ownership of the block, and we need to ensure that whoever we are sending 
 our blocks to are following the proper retention protocols.
 
 From: Abbott, Tanya
 Sent: Monday, March 16, 2015 3:33 PM
 To: 'histonet@lists.utsouthwestern.edu'
 Subject: Release of blocks to research facilities
 
 CAP checklist ANP.12500 refers to Record Retention. I am looking 
 specifically at NOTE 2: Regarding extra-institutional release of blocks for 
 research purposes.
 I am wondering how everyone handles this, especially if you have only 1 block 
 on newly diagnosed patient and the Doctor wants it sent out for research.
 Thanks in advance for your help! Tanya
 
 Tanya G. Abbott
 Manager Technologist
 Histology/Cytology
 St Joseph Medical Center
 (phone) 610-378-2635
 
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Re: [Histonet] Embedding Question

[WILLIAM DESALVO]

Cooling the paraffin and then re melting will not affect the tissue, unless the 
combined heated, liquified state period becomes extended. Cooling the paraffin 
is a great protector of the tissue, no different than what you have with a 
completed block. Be cautious at how fast and at what temperature you reheat at.
With dry embedding, you have to be cautious about small tissue pieces obtaining 
a drying or heat affect. The small tissue pieces are typically at the bottom of 
the cassette and closest to the heating element, without the insulation of the 
liquid paraffin. Wet embedding there is a possibility of debris tissue 
fragments floating amongst the cassette. Both methods require cleanliness and 
short times in liquid paraffin to embedding. 

Sent from my iPhone

 On Mar 12, 2015, at 10:09 AM, Lucie Guernsey lguern...@ucsd.edu wrote:
 
 If I may, I'd like to piggy-back onto what Paula has mentioned regarding
 allowing paraffin infiltrated tissue to cool before embedding it. Hopefully
 someone can help both of us out, even if we seem to warm our infiltrated
 tissue differently (Paula's in a dry bin and mine in a wax bath).
 
 I work in a research lab where we work in large batches and time is not a
 priority like it is in a clinical setting. Rather than leaving 60-80
 cassettes of infiltrated tissue soaking in a hot wax bath for hours at a
 time, we've begun to allow the cassettes to cool and just toss a handful of
 cassettes into the wax bath 5-10 minutes before we're ready to embed that
 batch of cassettes. Sometimes we don't even embed the cooled tissue until
 the next day or later that week. I haven't noticed an obvious difference in
 how our blocks section, though we have troublesome batches sometimes and we
 haven't been able to put our finger on why.
 
 Anyone know if allowing infiltrated tissue to cool and then reheat before
 embedding is better or worse than keeping the tissue soaking in wax for
 hours at a time?
 
 Thanks!
 Lucie
 
 Lucie Guernsey
 UC San Diego
 lguern...@ucsd.edu
 
 
 
 On Thu, Mar 12, 2015 at 9:43 AM, Paula Sicurello pat...@gmail.com wrote:
 
 Hi Tim,
 
 There are several embedding events through-out the day, though mostly in
 the wee hours of the morning.  The embedding centers would be in the same
 room as the  microtomes (another question about those tomorrow).
 
 I worry about the small (GI, needles, etc) biopsies freezing before they
 reach the embedding stations.  In my experience, once they freeze they get
 this outer wax coating (like a permeability barrier) which doesn't melt
 when placed in the dry (no paraffin inside) but hot, holding bin.
 
 They just don't seem to embed that well and have a tendency to drop out of
 the sections when cutting.
 
 Has anyone else had that happen?
 
 Paula
 
 On Thu, Mar 12, 2015 at 9:07 AM, Morken, Timothy timothy.mor...@ucsf.edu
 wrote:
 
 Paula,
 How many times per day?
 Is the embedding close to the cutting area?
 
 Of course any extra walking is a problem, especially in busy areas. Is
 this a non-patient area (hopefully!)? Any restructuring should be to move
 things closer together, not further away!
 
 Having said that, If it comes to that I would be more concerned about
 embedding proximity to the cutting area since having embedding near
 cutting
 enhances workflow and cross coverage. If you don't unload processors very
 often then having them distant might not be too bad. Not ideal, but not a
 necessarily a deal killer.
 
 
 Tim Morken
 Pathology Site Manager, Parnassus
 Supervisor, Electron Microscopy/Neuromuscular Special Studies
 Department of Pathology
 UC San Francisco Medical Center
 
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu [mailto:
 histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Paula Sicurello
 Sent: Thursday, March 12, 2015 6:29 AM
 To: HistoNet
 Subject: [Histonet] Embedding Question
 
 It has been proposed to move the embedding centers to a room about 210 ft
 away from the tissue processors.
 
 The trip from processor to embedding center would take over 2 minutes and
 require the histotechs to carry the baskets full of cassettes down a much
 used hallway.
 
 Opinions?
 
 Do you feel this is a good idea-yes or no and why?
 
 Thanks in advance,
 
 Paula
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Re: [Histonet] Block Counts

[WILLIAM DESALVO]

This discussion is exactly why we do not count blocks at microtomy, only 
slides. Counting slides is the equalizer for multiple levels and slides per 
block. Count the most appropriate unit at a task (i. e. slides at microtomy, 
blocks at embedding, specimens at grossing, specimens at accession inc) that 
allows you to set work pace and creates a corresponding quality measure.

William DeSalvo
william.desa...@sonoraquest.com
602-768-3692
Sent from my iPhone

 On Jan 12, 2015, at 4:05 PM, Morken, Timothy timothy.mor...@ucsf.edu wrote:
 
 I agree with Diana, I found we had over a dozen different task mixes in a 
 given day for various techs. That includes mix of block types (bx, extensive 
 lists of stain requests per block, single HE, recuts, mega block, research 
 cases), other tasks (Staining, speicals, ihc, tissue processor . Grossing 
 would be even more complicated. Instead of a per-day count, use per hour or 
 per two hours - Some period when the person is concentrating on a single task 
 without interruption. 
 
 Tim Morken
 Supervisor, Histology, Electron Microscopy and Neuromuscular Special Studies
 UC San Francisco Medical Center
 San Francisco, CA
 
 CONFIDENTIALITY NOTICE: This email message, including any attachments, is for 
 the sole use of the intended recipient(s) and may contain confidential, 
 proprietary, and/or privileged information protected by law. If you are not 
 the intended recipient, you may not use, copy, or distribute this email 
 message or its attachments. If you believe you have received this email 
 message in error, please contact the sender by reply email and destroy all 
 copies of the original message.
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Diana McCaig
 Sent: Monday, January 12, 2015 2:46 PM
 To: 'Goins, Tresa'; Ellen; histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] Block Counts 
 
 I have always found there are so many variables that having an expectation of 
 setting a set number is not always possible.  I feel they should be compared 
 to their own standards and not of their co-workers.  If they can cut or embed 
 a set number on a particular than they should maintain or gradually increase 
 (for newer techs) over time.  .
 I have seen where in one day they cut so many blocks when the work load 
 mandates it but on a slower day it takes them just as much time to cut half 
 as many blocks.  The work pace should be at their comfort level but should be 
 a standard rate.
 
 Diana 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Goins, Tresa
 Sent: January-12-15 4:58 PM
 To: Ellen; histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] Block Counts 
 
 Depends on the type of tissue.
 Depends on the length of time your day is for a repetitive task.
 Assigning an arbitrary number is counterproductive.
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Ellen
 Sent: Monday, January 12, 2015 1:57 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Block Counts 
 
 I'm looking for raw data on time studies that directly deal with the number 
 of blocks a PA can produce in a day and how many a histo tech can cut a day. 
 
 
 Thanks
 
 Sent from my iPhone
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Re: [Histonet] RE: Angle of Wrist/Hands Using Microtome?

[WILLIAM DESALVO]

OSHA states maintain neutral wrist and arm when working; work with their 
wrists in a neutral or straight

William DeSalvo
william.desa...@sonoraquest.ccom
602-768-3692
Sent from my iPhone

 On Dec 8, 2014, at 2:41 PM, Blazek, Linda lbla...@digestivespecialists.com 
 wrote:
 
 My two cents...  # 2  Keep your wrist straight.
 (you may get rich if you get enough 2 cents!)
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Elizabeth 
 Chlipala
 Sent: Monday, December 08, 2014 4:33 PM
 To: Smith, Denise; 'histonet@lists.utsouthwestern.edu'
 Subject: [Histonet] RE: Angle of Wrist/Hands Using Microtome?
 
 I think you want to keep your wrist straight so it would be 2.   Just my two 
 cents
 
 Liz
 
 Elizabeth A. Chlipala, BS, HTL(ASCP)QIHC Premier Laboratory, LLC PO Box 18592 
 Boulder, CO 80308
 (303) 682-3949 office
 (303) 682-9060 fax
 (303) 881-0763 cell
 l...@premierlab.com
 www.premierlab.com
 
 March 10, 2014 is Histotechnology Professionals Day
 
 Ship to Address:
 
 Premier Laboratory, LLC
 1567 Skyway Drive, Unit E
 Longmont, CO 80504
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Smith, Denise
 Sent: Monday, December 08, 2014 1:53 PM
 To: 'histonet@lists.utsouthwestern.edu'
 Subject: [Histonet] Angle of Wrist/Hands Using Microtome?
 
 Hi all!
 
 When I took HTL exam and there was a question on the exam that bothered me 
 the most but I cannot find an exact answer for it, had to guess!  I'm very 
 curious about your thoughts on this.  I have asked Histology Core and they 
 weren't sure about it either - wanted to share it with you guys if you know 
 the official answer for this!
 
 The question was mainly about the angle of wrist/hands on the rotating 
 microtome and the degree must be correct so it won't cause any stress on 
 wrist/hands, it listed 4 different choices:
 
 
 1.   30 degrees wrist down forward
 
 2.   90 degrees straight without bending the wrist
 
 3.   60 degrees wrist up backward
 
 4.   60 or 90 degrees wrist down forward
 
 
 (Please be gentle with me since I don't remember the EXACT numbers but those 
 were close to numbers provided.)
 
 Thank you!
 
 Denise Smith
 
 
 The materials in this email are private and may contain Protected Health 
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 action in reliance on the contents of this information is strictly 
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Re: [Histonet] fixative

[WILLIAM DESALVO]

What are you going to accomplish? Alcohol will work as a fixative and 
dehydration solution. Less of a disposal issue.

William DeSalvo
william.desa...@sonoraquest.ccom
602-768-3692
Sent from my iPhone

 On Nov 25, 2014, at 8:30 AM, Schade, Adelle a_sch...@conradweiser.org wrote:
 
 Hello,
 I am considering the following fixatives for a high school histology 
 experiment and I would appreciate any input considering safety, disposal, etc.
 
 
 1-   Ultrum II (American MasterTech):  promotes disposal in local sewer?
 
 2-  Excell Plus (American MasterTech):  low-hazard but any idea on 
 disposal from those who use it?
 
 3-  Histochoice Tissue Fixative
 
 Anyone using these products/ advice is greatly appreciated!
 
 Ms. Adelle L. Schade, B.S., M.Ed.
 Anatomy and Physiology
 Conrad Weiser High School
 44 Big Spring Rd.
 Robesonia, PA  19551
 610-693-8599 x6736
 a_sch...@conradweiser.org
 
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[Histonet] Paraffin Used

[WILLIAM DESALVO]

What paraffin do you use in your lab? Do you use different type for processing 
and embedding? Looking to investigate the top used paraffins for a workshop I 
am putting together.

Sent from my iPhone
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Re: [Histonet] slide id

[WILLIAM DESALVO]

We use Vantage Quality and Tracking system and the tech is captured for 
embedding, microtomy and staining

Sent from my iPhone

 On Oct 3, 2014, at 12:55 PM, Tapper, Sheila J. 
 sheila.tap...@essentiahealth.org wrote:
 
 We have our techs fast process the slides that they cut - so the tech is 
 documented in the processing history... same for embedding. 
 
 Sheila 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mike Pence
 Sent: Friday, October 03, 2014 2:51 PM
 To: 'anita'; Histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] slide id
 
 We do.
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of anita
 Sent: Friday, October 03, 2014 2:50 PM
 To: Histonet@lists.utsouthwestern.edu
 Subject: [Histonet] slide id
 
 just wondering if techs are putting their id on the slides that they cut, 
 that way if a mistake is made with labeling the tech that cut it is 
 identified.
 
 thanks for your input,
 
 anita dudley
 
 providence hosp
 
 mobile alabama 
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Re: [Histonet] slide id

[WILLIAM DESALVO]

Vantage works great. We use it to track all blocks and slides as they move in 
and out of the core lab and in and out of archive. You must bar code and make a 
decision on cassette printers. Techs scan their own bar code to log on the 
system.

Sent from my iPhone

 On Oct 3, 2014, at 1:17 PM, Rathborne, Toni toni.rathbo...@rwjuh.edu wrote:
 
 How do you like Vantage? Have you experienced any problems with it, and is it 
 easy to use?
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of WILLIAM 
 DESALVO
 Sent: Friday, October 03, 2014 4:02 PM
 To: Tapper, Sheila J.
 Cc: Histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] slide id
 
 We use Vantage Quality and Tracking system and the tech is captured for 
 embedding, microtomy and staining
 
 Sent from my iPhone
 
 On Oct 3, 2014, at 12:55 PM, Tapper, Sheila J. 
 sheila.tap...@essentiahealth.org wrote:
 
 We have our techs fast process the slides that they cut - so the tech is 
 documented in the processing history... same for embedding. 
 
 Sheila 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mike Pence
 Sent: Friday, October 03, 2014 2:51 PM
 To: 'anita'; Histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] slide id
 
 We do.
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of anita
 Sent: Friday, October 03, 2014 2:50 PM
 To: Histonet@lists.utsouthwestern.edu
 Subject: [Histonet] slide id
 
 just wondering if techs are putting their id on the slides that they cut, 
 that way if a mistake is made with labeling the tech that cut it is 
 identified.
 
 thanks for your input,
 
 anita dudley
 
 providence hosp
 
 mobile alabama 
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Re: [Histonet] slide id

[WILLIAM DESALVO]

We decided to not reprint cassettes or labels on blocks/slides produced prior 
to Vantage. Vantage is a move forward (2 years and counting) process and we 
continue to follow manual process for pre-Vantage material. Each user will have 
to make a decision on how to handle existing material.

Sent from my iPhone

 On Oct 3, 2014, at 1:26 PM, Cooper, Brian bcoo...@chla.usc.edu wrote:
 
 How does Vantage work with blocks and slides that were in your institution 
 prior to the implementation of Vantage?  Suppose you needed to send materials 
 to another institution for further testing?  Do you generate new barcoded 
 labels and affix them to the materials prior to sending them out (for 
 tracking purposes)? 
 
 Thanks, 
 
 Brian
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of WILLIAM 
 DESALVO
 Sent: Friday, October 03, 2014 1:21 PM
 To: Rathborne, Toni
 Cc: Histonet@lists.utsouthwestern.edu; Tapper, Sheila J.
 Subject: Re: [Histonet] slide id
 
 Vantage works great. We use it to track all blocks and slides as they move in 
 and out of the core lab and in and out of archive. You must bar code and make 
 a decision on cassette printers. Techs scan their own bar code to log on the 
 system.
 
 Sent from my iPhone
 
 On Oct 3, 2014, at 1:17 PM, Rathborne, Toni toni.rathbo...@rwjuh.edu wrote:
 
 How do you like Vantage? Have you experienced any problems with it, and is 
 it easy to use?
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of WILLIAM 
 DESALVO
 Sent: Friday, October 03, 2014 4:02 PM
 To: Tapper, Sheila J.
 Cc: Histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] slide id
 
 We use Vantage Quality and Tracking system and the tech is captured for 
 embedding, microtomy and staining
 
 Sent from my iPhone
 
 On Oct 3, 2014, at 12:55 PM, Tapper, Sheila J. 
 sheila.tap...@essentiahealth.org wrote:
 
 We have our techs fast process the slides that they cut - so the tech is 
 documented in the processing history... same for embedding. 
 
 Sheila 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Mike Pence
 Sent: Friday, October 03, 2014 2:51 PM
 To: 'anita'; Histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] slide id
 
 We do.
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of anita
 Sent: Friday, October 03, 2014 2:50 PM
 To: Histonet@lists.utsouthwestern.edu
 Subject: [Histonet] slide id
 
 just wondering if techs are putting their id on the slides that they cut, 
 that way if a mistake is made with labeling the tech that cut it is 
 identified.
 
 thanks for your input,
 
 anita dudley
 
 providence hosp
 
 mobile alabama 
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RE: [Histonet] (no subject)

[WILLIAM DESALVO]

University of Michigan MLabs

William DeSalvo, BS HTL(ASCP)
 
 From: ttro...@petersonlab.com
 To: histonet@lists.utsouthwestern.edu
 Date: Wed, 10 Sep 2014 12:22:55 -0500
 Subject: [Histonet] (no subject)
 
 I was wondering what facility labs are sending nerve and muscle biopsies to.
 
 
  
 
 Thanks,
 
 Travis Troyer
 
 Peterson Laboratory Services
 
 Manhattan, KS
 
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RE: [Histonet] Paraffin blocks

[WILLIAM DESALVO]

I have been following this stream of conversation and thought I might jump in. 
Paraffin blocks and microtomy waste are NOT biohazard waste. The process of 
fixation and tissue processing makes the tissue acceptable for general waste 
disposal. You do have to address the issue of PHI on the blocks, if you are 
using bar  code information and especially if patient information is included 
in the bar code. All bar codes used in the lab can be read in any standard word 
or spreadsheet software. I do not see the need to pay for expensive removal of 
biohazard waste, use general waste disposal for your blocks and cutting waste.

William DeSalvo, BS HTL(ASCP)
 
 From: vriv...@westderm.com
 To: bcoo...@chla.usc.edu; jfra...@hotmail.com; 
 histonet@lists.utsouthwestern.edu
 Date: Thu, 10 Jul 2014 20:37:39 +
 Subject: RE: [Histonet] Paraffin blocks
 CC: 
 
 You would think, especially when you see the amount of waste a tech can 
 produce on high volume days, but we also discard ours into regular trash 
 too. Just curious how other facilities handle this type of waste.
 
 Regards,
 
 Vincent Rivera, HT (ASCP), QIHC, QLS
 Histopathology Supervisor
 West Dermatology Pathology Laboratory
 vriv...@westderm.com
 714-924-7240 (Lab)
 714-390-0906 (Cell)
 
 
 -Original Message-
 From: Cooper, Brian [mailto:bcoo...@chla.usc.edu] 
 Sent: Thursday, July 10, 2014 1:30 PM
 To: Vincent Rivera; JOSEPH FRAZEE; histonet server
 Subject: RE: [Histonet] Paraffin blocks
 
 Good question.  So the linear path would dictate that they too should be 
 discarded into red bags, right?   You could also pose the same question about 
 the kimwipes used to skim your flotation baths.  We've always just thrown 
 both the shavings and kimwipes into the regular trash though.Guess we're 
 not so linear . . . 
 
 Thanks, 
 
 Brian
 
 
 -Original Message-
 From: Vincent Rivera [mailto:vriv...@westderm.com]
 Sent: Thursday, July 10, 2014 1:12 PM
 To: Cooper, Brian; JOSEPH FRAZEE; histonet server
 Subject: RE: [Histonet] Paraffin blocks
 
 I know this is slightly off topic but still along the same lines. How is 
 everybody handling their paraffin shaving waste? The waste that is produced 
 when trimming/facing tissue blocks? Is this also considered regulated medical 
 waste?
 
 Thanks,
 
 Vincent Rivera, HT (ASCP), QIHC, QLS
 Histopathology Supervisor
 West Dermatology Pathology Laboratory
 vriv...@westderm.com
 714-924-7240 (Lab)
 714-390-0906 (Cell)
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Cooper, Brian
 Sent: Thursday, July 10, 2014 12:23 PM
 To: JOSEPH FRAZEE; histonet server
 Subject: RE: [Histonet] Paraffin blocks
 
 In every institution I've ever worked, paraffin tissue blocks were handled as 
 regulated medical waste, and therefore discarded into red biohazard bags.
 
 Brian D. Cooper, HT (ASCP)CM | Histology Supervisor Department of Pathology 
 and Laboratory Medicine Children's Hospital Los Angeles bcoo...@chla.usc.edu 
 
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of JOSEPH FRAZEE
 Sent: Thursday, July 10, 2014 12:13 PM
 To: histonet server
 Subject: [Histonet] Paraffin blocks
 
 How is everyone disposing of paraffin blocks regular trash or biohazard 
 containers
 
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Re: [Histonet] Should I leave histology world

[WILLIAM DESALVO]

Do not give up and try not to blame a process or someone else for your lack of 
developed skill at microtomy, but dedicate yourself to personal improvement. 
You have 6+ years invested in a career, and if your reasons for embarking on 
that career remain, then bear down and find a way to improve your microtomy 
technique. Work w/ a mentor, ask for help, demand helpful criticism, cut extra 
blocks after your scheduled work period and find a way to improve. If 
consistent and quality microtomy was as easy as it sounds, we would not have 
the shortage of technicians that exist. 


I look at your problem from another perspective, lack of training and 
competency standards. From your description, I do not think this is about 
quantity over quality, but one of functionality and commitment to excellence. I 
often hear from newly graduated students, I teach in a Histotechnology program, 
that they consider themselves trained and ready Histotechnologists and often 
expect to be highly paid without always being highly skilled. Unfortunately, 
new graduates are only beginners, or apprentices if you will, and must, as 
Felton states, work on their craftsmanship. Histotechnology has two sides, 
educational and functional, and the individual technicians must take 
responsibility for the functional side. The lab/company your work at to develop 
your skill is responsible for training and support. 


It is counter productive to resist metrics, they are hear to stay and they can 
be very useful. When metrics are properly used, quality and quantity are 
married together to develop the acceptable productivity level. Always remember 
that the ultimate judge of the slide quality is the person creating the slide. 
A pathologist may have a wide scale of acceptance, but only through a skilled 
technician can patient care be directly affected and the quality improved. The 
best path to process improvement in the Histology lab is through a trained, 
competent and skilled technologist/technician. Graduating from a NAACLS program 
is a start not the finish. 






Sent from Windows Mail





From: Nails, Felton
Sent: ‎Tuesday‎, ‎June‎ ‎3‎, ‎2014 ‎2‎:‎00‎ ‎PM
To: Alpha Histotech, histonet





I always tell my students if you can cut, you can get a job. It appears that 
you school did not properly prepare you for the demands of an average histology 
job.
You need to take every opportunity to work on your craft and the major focus of 
histology is cutting. With 6 to 7 years of experience you are expected to know 
the basics and cutting is basic.

-Original Message-
From: histonet-boun...@lists.utsouthwestern.edu 
[mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Alpha Histotech
Sent: Tuesday, June 03, 2014 3:35 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Should I leave histology world

Hi everyone,

I wouldn't give too much detail information as the histology world is very 
small and everyone knows everyone.

I am in a dilemma. I have been a histotech (ASCP HT) for almost 6-7 yrs. I went 
to a NAACLS school and have a Associate in Science in Histology. In the 6-7 yrs 
I have changed jobs 3 times. All the jobs were graveyard shifts. The first 
place I worked for was Quest Diagnostics and I did a good 3 yrs. The other 2 
places I won't mention and I currently still have a histology job. My problem 
is all the places I worked were factory style lab work and they all did derm 
work. In my career I really only embedded most of the time. I did occasional 
other stuff like special stains both by hand and using Dako Artisan and other 
things like cytology cytospin. But I never got to develop in cutting. My first 
job in quest..I maybe cutted one time for 2 or 3 weeks before they yanked me 
and put me back to embed. My 2nd job put me to cut the last 2 months (full 
8hrs) I was working there. My current job I have been cutting since April 2014 
( but only 2-3hrs in the day and then I embed, I have been here now 1 yr, I was 
embedding most of the time before th cutting started). I was told by my 
director I need to speed up in cutting because corporate is asking why I am not 
increasing in speed. And if I don't speed up eventually then they will have to 
demote me to a lab aid and give me a pay cut. (where I work and the state I 
work in they have lab aids doing alot of stuff without being certified, it 
wasn't like that in the other state I am original from as you have to be state 
licensed and ascp) I sometimes laugh inside my head because before my director 
hired me I told him I don't have alot experience in cutting. 

Now everywhere I have gone...speed is the name of the game. They say they care 
about quality but in the end if you can't put up then you will be put out!  So 
I am just thinking I should just get out of histology world all together. Every 
where I have worked unfortunately have management who believe quantity over 
quality. OR Do you guys think I need more time cutting to develop 

RE: [Histonet] Recommendations cryostat

[WILLIAM DESALVO]

Best recommendation I can provide is the Leica 1950 was the hands down choice 
of the employees performing frozen sections at multiple hospital sites in my 
system. From my perspective, the instruments are very reliable, easy to use, 
easy to maintain and pathologists approve of the the slide quality. 

William DeSalvo, BS HTL(ASCP)
 
 From: hi...@skm.org.pk
 To: histonet@lists.utsouthwestern.edu
 Date: Mon, 21 Apr 2014 14:01:36 +
 CC: tahseen0...@gmail.com
 Subject: [Histonet] Recommendations cryostat
 
 Hi All,
 We are going to buy cryostat so opinion required CM 1950  LEICA verses HM525 
 NX Thermo.
 Regards
 Muhammad Tahseen
 SKMCHRC
 
 
 
 
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Re: [Histonet] Negative Reagent Control in Diagnostic IHC Testing

[WILLIAM DESALVO]

Thanks for the great information. Downloaded and being shared w/ my lab.






Sent from Windows Mail





From: Cartun, Richard
Sent: ‎Monday‎, ‎April‎ ‎14‎, ‎2014 ‎4‎:‎04‎ ‎PM
To: histonet





For those of you who are interested, I have an Editorial in the March issue 
(Volume 22, Number 3) of Applied Immunohistochemistry  Molecular Morphology 
titled, Negative Reagent Controls in Diagnostic Immunohistochemistry:  Do We 
Need Them?  An Evidence-based Recommendation for Laboratories Throughout the 
World.  You can download a Free PDF copy using the Journal's website.

Richard

Richard W. Cartun, MS, PhD
Director, Histology  Immunopathology
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596 Office
(860) 545-2204 Fax
richard.car...@hhchealth.orgmailto:richard.car...@hhchealth.org


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RE: [Histonet] Telepathology

[WILLIAM DESALVO]

In the US, FDA has designated the WSI instruments as Class I and, to date, no 
company has received approval/clearance for use. Until the FDA issue is 
resolved, the use of WSI for primary diagnosis is prohibited. Outside the US, 
WSI can be used in all facets of pathology, including primary diagnosis, and is 
used extensively.
 
That said, in the US, using WSI for pathology processes such as frozen section 
diagnosis, case consultation, special stain and IHC review, can occur because 
these processes do not produce a primary diagnosis. There are many other uses 
for WSI in pathology lab that make the consideration for use and implementation 
cost effective.
 
CAP has released guidelines for validating WSI in the lab and there is the 
option to expand the use of WSI by using the laboratory developed test route.
 
The best resource for WSI, in my mind, is the Digital Pathology Association 
(DPA) web site. I am a member and this group is dedicated to the advancement 
and education of WSI. Check out the web site  


William DeSalvo, BS HTL(ASCP)
 
 To: histonet@lists.utsouthwestern.edu
 From: mtitf...@aol.com
 Date: Thu, 10 Apr 2014 08:14:23 -0400
 Subject: [Histonet] Telepathology
 
 
 Victor Tobias asks about telepathology-
 
 I seem to remember there is a rule somewhere that primary diagnosis can only 
 be made using a glass slide. As to chapter and verse, I don't know.
 
 However there are reports in the literarature that it has been tried out for 
 F/S in Alaska and Finland.
 
 Michael Titford
 USA Pathology
 Mobile AL USA 
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RE: [Histonet] What is a level?

[WILLIAM DESALVO]

You should ask the pathologist what their definition of a level. My 
dermatopathologists want 40 microns (10 rotations of the microtome wheel, 
cutting at 4 microns) for a level. This is the typical size of most organells 
they are looking at. Again, the level depth should be discussed and agreed upon 
by the pathologist and microtomist. This takes the guess work out of the 
process. once you have a specific description, make sure this is added to your 
SOP.

William DeSalvo, BS HTL(ASCP)
 
 From: bgapin...@pathgroup.com
 To: histonet@lists.utsouthwestern.edu
 Date: Mon, 17 Mar 2014 21:19:40 +
 Subject: [Histonet] What is a level?
 
 What is a level?
 Levels, deepers, we all call it something different, but what exactly is a 
 level?  I know it is all relative. One would never cut into a prostate needle 
 biopsy the same way they'd cut into a skin.
 But if we suppose are tissue sample is 3mm thick (don't laugh). How deeply 
 would you cut when the pathologist asks for a level? I guess I'm talking to 
 those of us with automated microtomes where we can set the trim to 10, 20, 30 
 microns. I started on a manual microtome where it's impossible to gauge this 
 altogether.
 So let's say I have a nicely processed ellipse of skin grossed 3mm thick.  
 The pathologist asks me for a level. If we assume I gave them a full face on 
 the first slide, how much deeper should I go to get the level? 60-80 microns? 
 Deeper? Less?
 Your thoughts please,
 
 
 Respectfully,
 Bruce Gapinski HT (ASCP)
 
 
 
 
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Re: [Histonet] Interfacing with Meditech Magic

[WILLIAM DESALVO]

Sheila,

I use a tracking / quality system and I believe you should look at the problem 
from another view. What you did before in a manual way, now has to be 
reconsidered, developed and constructed with strict logic for counting and 
tracking all units (specimen, block, slide) throughout your process. Manual 
systems often mix logic and, in my mind, create complexity that leads to 
mislabels. Do not try to fool the LIS, work w/ it. When you cut a block and you 
have HE slides and special staining (i.e. recut, SS, IHC, ISH) slides, you 
need to make sure all slides are unique items and will be tracked so. In our 
system, slides are designated A1-1, A1-2, A1-3. . .  and there is communication 
with the pathologist as to the numbering and what the cut slide contains. We 
even have protocols built into our system that allows us to cur unstained 
slides and they can be reconciled back to a special staining slide. I suggest 
you might want to sit down and “map out’” (flow chart) your cutting and 
pathologist ordering process so that you can create the logical tracking 
process needed to work with your LIS.


William DeSalvo BS, HTL(ASCP)   






Sent from Windows Mail





From: Custompathlabsolutions
Sent: ‎Sunday‎, ‎March‎ ‎16‎, ‎2014 ‎6‎:‎52‎ ‎AM
To: Sheila Adey
Cc: histonet





Shelia,

It's a beautiful Sunday morning so I feel guilty suggesting that you lie 
butonly to a machine. If you input that the HE is at level 2 and the 
next stain is at level 2.1 the new information should not be overridden. When 
you format the labels you can format the level number as an integer so 2.1 
becomes 2.  You could also have levels 2, two  II if you want to mislead the 
computer instead of lie to it. I think as long as one program sees a unique 
level that your eye can read as the same thing you can get around the problem. 

John

Sent from my iPhone

On Mar 16, 2014, at 8:09 AM, Sheila Adey sa...@hotmail.ca wrote:

Hello Everyone:
I am looking for some suggestions. We use Meditech Magic and we are trying to 
interface with the Leica Cerebro system. We are trying to put the correct info 
in the .hist section of Meditech so that Cerebro can pull the necessary info 
for the labels.
My unsolved issue at the moment is how to tell cerebro that I need an HE label 
and  special stain label on the same level. My computer person is saying that 
the second procedure typed in will over ride the first one ordered.
Thanks for any advice. 
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RE: [Histonet] RE: Cornflaking artifact

[WILLIAM DESALVO]

Long time and high volume user of the Sakura Tape. Check the Xylene drops. We 
coverslip thousands of slides daily and have seen no isssue with the tape lots. 
Our experience shows some cornflaking when the slide does not receive enough 
xylens to wet the slide properly.

William DeSalvo, BS HTL(ASCP)
 
 From: kenneth.metz...@aruplab.com
 To: sheila.herring...@interiorhealth.ca; lcolb...@pathmdlabs.com; 
 sscal...@beaumont.edu; histonet@lists.utsouthwestern.edu
 Date: Thu, 13 Mar 2014 16:13:24 +
 CC: 
 Subject: [Histonet] RE: Cornflaking artifact
 
 Can anyone share the lot # on their coverslipping film (Sakura)? We are 
 seeing this as well out of the blue..haven't changed a thing.
 
 Kenneth G Metzger HTL(ASCP)
 Histology Supervisor
 ARUP Labs
 Salt Lake City, Utah
 Phone: (801)583-2787 ext. 3101
 Fax: (801) 584-5244
 Email: kenneth.metz...@aruplab.com
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of HERRINGTON, 
 SHEILA
 Sent: Thursday, March 13, 2014 9:42 AM
 To: 'Laurie Colbert'; Sharon Scalise; histonet@lists.utsouthwestern.edu
 Subject: [Histonet] RE: Cornflaking artifact
 
 We also have recently started to see this artifact more than ever before, and 
 nothing in our process has changed.  We have tried everything to correct to 
 no avail.  Wonder if it is possible to be a change in some type of supply, 
 either xylene or coverslipping film.  Something has changed but am at a loss 
 as to what.
 
 
 Sheila Herrington
 Technical Lead Histopathology and Immunohistochemistry Kelowna General 
 Hospital
 2268 Pandosy Street, Kelowna, B.C. V1Y 1T2
 250-862-4300 ext 7587 or 7510
 sheila.herring...@interiorhealth.ca
 
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Laurie Colbert
 Sent: Thursday, March 13, 2014 6:30 AM
 To: Sharon Scalise; histonet@lists.utsouthwestern.edu
 Subject: [Histonet] RE: Cornflaking artifact
 
 You will also see the cornflaking if your tissue is lifting off of the slide 
 at all.  We used to get this more often on hard, decal specimens than on 
 other specimens.  We used the film to coverslip.  If you remove the film from 
 the problem slides and recoverslip conventionally with extra mountant and 
 glass coverslips, I'm sure you will not see the artifact.
 
 Laurie Colbert
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Sharon Scalise
 Sent: Wednesday, March 12, 2014 8:00 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] RE: Cornflaking artifact
 
 I am looking for help with cornflaking (tiny, brown dry spots under 
 coverslip)artifact.  We have been using fresh xylene on our stainer and 
 coverslipper, cleaned and wiped all containers dry before filling, tried 
 different lots of coverslipping film and had service on our coverslipper to 
 make sure it was functioning properly, including the xylene drip.  We 
 continue to have this artifact and it is driving us crazy.  It is sporadic 
 with no pattern of tissue type or placement on the slide.  Sometimes it lands 
 on tissue other times not.  Most of the time when we remove the coverslip and 
 re-coverslip it goes away (I am assuming because the acetone removes any 
 minute amounts of water that may be present).  We just cannot figure out 
 where the water is coming from.  Has anyone seen this artifact while using 
 the drying step on the prisma stainer?  We just recently started using the 
 drying on some slides and I am thinking maybe it is causing humidity???  I 
 cannot say for a fact that our cornflaking started at the same time, but it 
 is suspicious. HELP!
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Wait, Trevor 
 Jordan
 Sent: Wednesday, March 12, 2014 3:57 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Paraffin type and Tetracycline labelling Questions
 
 For those who have done Decalcified bone processing with paraffinwhat is 
 the best type of paraffin that you guys are familiar with?
 
 Also, if you are wanting to see a tetracycline label on the bone for bone 
 turnover, must undecalcified sections be used? How for a double tetracycline 
 label?
 
 
 Trevor Jordan Wait
 University of Texas Health Science Center, San Antonio Class of 2017 MD 
 Candidate Abilene Christian University Class of 2013 Graduate B.S.  
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RE: [Histonet] Decal and molecular testing

[WILLIAM DESALVO]

To get the most DNA/RNA after decal you will want to stay away from HCL. There 
is the Immunocal that is Formic acid based (same company offers an EDTA 
solution) or Milestone Medical MOL-Decal 10 that is all EDTA. The issue is both 
will take longer to decal than HCL solutions.
 
Fix the bone in 10% Formalin, time is dependant upon the size. Use stirring, 
heat, 50 degrees C, and pH 7.2-7.4. MOL-Decal 10 suggests 5-6 hrs for small 
biopsy bones and Immunocal 2-4 hrs.
 
Try these and test at your site. Make sure you do a validation study to confirm 
results and use. Good luck

William DeSalvo, BS HTL(ASCP)

 
 From: billodonn...@catholichealth.net
 To: histonet@lists.utsouthwestern.edu
 Date: Tue, 11 Mar 2014 18:24:32 +
 Subject: [Histonet] Decal and molecular testing
 
 Can anyone recommend a decal solution that does no damage to specimens for 
 molecular testing - or one that has minimal damage? Thanks - Bill
 
 
 William (Bill) O'Donnell, HT (ASCP) QIHC 
 Senior Histologist
 Good Samaritan Hospital
 10 East 31st Street
 Kearney, NE 68847 
 
 SERENITY is not freedom from the storm, but peace amid the storm.
 
 Cultivate it in PRAYER!
 
  
 
 
  
 
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RE: [Histonet] Clinical histology to Research histology

[WILLIAM DESALVO]

The first BIG difference for me was the workflow. Completely different time 
frames for completion of work. The next pleasant change was the time avaialble 
to work with the specimens. This was many, many years ago. I enjoyed the 
research work, but did not enjoy the low pay and the worry for funding to keep 
the job going.

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 
 From: cda...@che-east.org
 To: histonet@lists.utsouthwestern.edu
 Date: Tue, 4 Feb 2014 09:49:32 -0500
 Subject: [Histonet] Clinical histology to Research histology
 
 Hello Histo World,
 
please share your experience from going from clinical histology to 
 research histology...What are the major difference? Are there complications 
 or pleasant surprises?
 
 Cassandra Davis
 cda...@che-east.org
 302-575-8095
 
 
 
 
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Re: [Histonet] Gross lab seniors

[WILLIAM DESALVO]

Absolutely the Face velocity changes with the work area set-up. This is why I 
like to make sure  the air flow away is maintained at a minimum. Most grossing 
stations have large working area and often the flow away from the grosser is 
not checked, just the vent opening draw. Most important is to set up a process 
and then regularly check. 






Sent from Windows Mail





From: E. Wayne Johnson 朱稳森
Sent: ‎Saturday‎, ‎February‎ ‎1‎, ‎2014 ‎3‎:‎12‎ ‎PM
To: WILLIAM DESALVO
Cc: Vickroy, Jim, histonet





Face velocity is simply the airflow rate in CFM divided by the area of 
the hood opening in square feet.

A smaller opening at the same flow rate gives a higher face velocity.

Titanium tetrachloride in a small plastic squeeze bottle can be used to 
generate smoke.


On 3:59 AM, WILLIAM DESALVO wrote:
 We use a company called C-Scan Technologies, Phoenix, AZ. The way they test 
 all our gross dissection stations is by testing for directional or smoke 
 containment and face velocity. We also check th they external pathway is 
 clear and if the unit has a filtering system, the filters are changed 
 regularly. The air flow measurement is Feet per minute (FPM) for face 
 velocity and includes width, height, depth and total square ft for the 
 working area. They exhaust flow in CFM. Face velocity minimum requirement is 
 100 fpm, exhaust flow requirement is500 cfm. Face velocity fluctuates 
 depending on the room and the air exchange rate for the area. I have always 
 felt the face velocity is most important to gross dissection personnel. There 
 needs to be adequate draw away from the employee, no matter the physical 
 conditions of the room.

 William DeSalvo, BS HTL(ASCP)
 Production Manager-Anatomic Pathology
 Chair, NSH Quality Management Committee
 Owner/Consultant, Collaborative Advantage Consulting



 From: vickroy@mhsil.com
 To: histonet@lists.utsouthwestern.edu
 Date: Fri, 31 Jan 2014 12:46:08 -0600
 Subject: [Histonet] Gross lab seniors


 We have several gross lab senior grossing stations that are vented outside.  
 Our engineering asked today whether the airflow should be checked yearly 
 like other exhaust hoods.   Problem is there is not a door like other hoods 
 of course and how would you measure the airflow?   Recommended airflow is 
 500cfm however clearly the airflow at the working surface is not anything 
 close to that.   I wondered how anybody else monitors the gross lab seniors 
 or do they at all.   CAP used to ask about documentation for checking hoods 
 however I can't recall them ever checking on grossing stations.  We change 
 filters annually  only since they are vented outside.

 Jim

 James Vickroy BS, HT(ASCP)

 Surgical  and Autopsy Pathology Technical Supervisor
 Memorial Medical Center
 217-788-4046


 
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RE: [Histonet] Gross lab seniors

[WILLIAM DESALVO]

We use a company called C-Scan Technologies, Phoenix, AZ. The way they test all 
our gross dissection stations is by testing for directional or smoke 
containment and face velocity. We also check th they external pathway is clear 
and if the unit has a filtering system, the filters are changed regularly. The 
air flow measurement is Feet per minute (FPM) for face velocity and includes 
width, height, depth and total square ft for the working area. They exhaust 
flow in CFM. Face velocity minimum requirement is 100 fpm, exhaust flow 
requirement is 500 cfm. Face velocity fluctuates depending on the room and the 
air exchange rate for the area. I have always felt the face velocity is most 
important to gross dissection personnel. There needs to be adequate draw away 
from the employee, no matter the physical conditions of the room. 

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 
 From: vickroy@mhsil.com
 To: histonet@lists.utsouthwestern.edu
 Date: Fri, 31 Jan 2014 12:46:08 -0600
 Subject: [Histonet] Gross lab seniors
 
 
 We have several gross lab senior grossing stations that are vented outside.  
 Our engineering asked today whether the airflow should be checked yearly like 
 other exhaust hoods.   Problem is there is not a door like other hoods of 
 course and how would you measure the airflow?   Recommended airflow is 500cfm 
 however clearly the airflow at the working surface is not anything close to 
 that.   I wondered how anybody else monitors the gross lab seniors or do they 
 at all.   CAP used to ask about documentation for checking hoods however I 
 can't recall them ever checking on grossing stations.  We change filters 
 annually  only since they are vented outside.
 
 Jim
 
 James Vickroy BS, HT(ASCP)
 
 Surgical  and Autopsy Pathology Technical Supervisor
 Memorial Medical Center
 217-788-4046
 
 
 
 This message (including any attachments) contains confidential information 
 intended for a specific individual and purpose, and is protected by law. If 
 you are not the intended recipient, you should delete this message. Any 
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 action based on it, is strictly prohibited.
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RE: [Histonet] -80 degrees rationale

[WILLIAM DESALVO]

Here is my stab at why -80 C.
 
Temperatures between 0°C and −25°C, the enzymatic activity of cells is only 
slowed but remains active. Below −40°C physiochemical exchanges are frozen. 
Cellular morphology is preserved at -80°C. Shelf life of tissue increases as 
the temperature drops. Once you get below -80°C you will need cryoprotectors 
and when you use cryoprotectors, temperatures must be below −130°C and will go 
as low as −196°C (liquid nitrogen).  Antibodies and proteins in solution are 
stable at −20°C.

William DeSalvo, BS HTL(ASCP)

 Date: Wed, 20 Nov 2013 09:25:54 -0500
 From: pat...@gmail.com
 To: histonet@lists.utsouthwestern.edu; microsc...@microscopy.com
 CC: 
 Subject: [Histonet] -80 degrees rationale
 
 Hello My Fellow Listers,
 
 The question of the day is:  What is the rationale for storing frozen
 biopsies at -80 degrees?
 
 I have seen protocols that range in temperature from -40 to -80 degrees.
 
 Was -80 selected because that was the lowest freezers could go back in the
 day?
 
 Awaiting your chilly responses!
 
 Thanks in advance,
 
 Paula
 
 -- 
 Paula Sicurello, HTL (ASCP)
 Supervisor, Clinical Electron Microscopy Laboratory
 Duke University Health System
 Rm.#251M, Duke South, Green Zone
 Durham, North Carolina 27710
 P:  919.684.2091
 
 HIPAA Privacy Notification: This message and any accompanying documents are
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 agent responsible for delivering it to the intended recipient, you are
 hereby notified that you have received this document in error and that any
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RE: [Histonet] Specimens from surigical units

[WILLIAM DESALVO]

We use the hospital LIS. All specimens/cases are entered and ordered by Surgery 
and they are then received by Surgical Pathology. You are able to effectively 
track w/ pending lists and a full manifest/reconciliation process.

William DeSalvo, BS HTL(ASCP)

 From: vickroy@mhsil.com
 To: histonet@lists.utsouthwestern.edu
 Date: Wed, 20 Nov 2013 10:03:45 -0600
 Subject: [Histonet] Specimens from surigical units
 
 
 We are a large pathology department and process over 35,000 surgical 
 accessions each year.  I am interested in learning how other pathology 
 departments keep track of the specimens that are removed in surgery to make 
 sure they are received in pathology.  Obviously all specimens received by 
 pathology are entered into the pathology accessioning system however the 
 question has come up to how do we know that every specimen taken in surgery 
 for pathology is actually received in pathology.  A couple of our surgical 
 units utilize volunteer couriers since the surgical units are not near 
 pathology.   A couple of other units like special procedures and cardiac 
 surgery have a simple notebook that is a signoff when the specimens are taken 
 to pathology, however from there is no tracking system from the main OR or 
 outpatient surgery. In otherwords a specimen could be removed in the OR that 
 was supposed to be sent to pathology does not arrive in pathology.  Obviously 
 this doesn't happen often but we are trying to close the potential for an 
 occurrence.   Specimens removed in surgery are logged into the surgical OR 
 report however  there is no current way for us to track that everything 
 removed that day that was supposed to go to pathology actually made it to 
 pathology.   Any ideas?
 
 Jim Vickroy
 
 James Vickroy BS, HT(ASCP)
 
 Surgical  and Autopsy Pathology Technical Supervisor
 Memorial Medical Center
 217-788-4046
 
 
 
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[Histonet] RE: Second Question of the Day: -80 degrees rationale

[WILLIAM DESALVO]

The only way to really know is to validate the temperature for the samples you 
want to store. The acceptable range must meet the performance of the unit and 
be in an acceptable range for any manufactureg materials stored in the freezer. 
All this will be tied up in your SOP.   

William DeSalvo, BS HTL(ASCP)

 
Date: Wed, 20 Nov 2013 12:37:01 -0500
Subject: Second Question of the Day: -80 degrees rationale
From: pat...@gmail.com
To: wdesalvo@outlook.com
CC: histonet@lists.utsouthwestern.edu; microsc...@microscopy.com

Hello Again, Gayle and Bill have provided the most succinct answers to the 
question of the day.   Second Question:  Is there a lower end, say -70 or -75, 
that provides the same protection as -80?
 I'm asking all this because I've inherited an old -80 freezer and would like 
it to last as long as possible.  The lab that had this freezer previously had 
an acceptable range of -70 to -90.
 Thanks in advance, again, oh wise ones. Paula -- 
 Paula Sicurello, HTL (ASCP)
 Supervisor, Clinical Electron Microscopy Laboratory
 Duke University Health System

 Rm.#251M, Duke South, Green Zone
 Durham, North Carolina 27710
 P:  919.684.2091
 
 HIPAA Privacy Notification: This message and any accompanying documents are

 covered by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521,
 and contain information intended for the specific individual (s) only. This
 information is confidential. If you are not the intended recipient or an

 agent responsible for delivering it to the intended recipient, you are
 hereby notified that you have received this document in error and that any
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 contents of this information is strictly prohibited . If you have received
 this communication in error, please notify us immediately by e-mail, and
 delete the original message.


 
On Wed, Nov 20, 2013 at 10:58 AM, WILLIAM DESALVO wdesalvo@outlook.com 
wrote:




Here is my stab at why -80 C.
 
Temperatures between 0°C and −25°C, the enzymatic activity of cells is only 
slowed but remains active. Below −40°C physiochemical exchanges are frozen. 
Cellular morphology is preserved at -80°C. Shelf life of tissue increases as 
the temperature drops. Once you get below -80°C you will need cryoprotectors 
and when you use cryoprotectors, temperatures must be below −130°C and will go 
as low as −196°C (liquid nitrogen).  Antibodies and proteins in solution are 
stable at −20°C.


William DeSalvo, BS HTL(ASCP)

 Date: Wed, 20 Nov 2013 09:25:54 -0500
 From: pat...@gmail.com

 To: histonet@lists.utsouthwestern.edu; microsc...@microscopy.com
 CC: 
 Subject: [Histonet] -80 degrees rationale

 
 Hello My Fellow Listers,
 
 The question of the day is:  What is the rationale for storing frozen
 biopsies at -80 degrees?
 
 I have seen protocols that range in temperature from -40 to -80 degrees.

 
 Was -80 selected because that was the lowest freezers could go back in the
 day?
 
 Awaiting your chilly responses!
 
 Thanks in advance,
 
 Paula
 

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-- 
Paula Sicurello, HTL (ASCP)Supervisor, Clinical Electron Microscopy 
LaboratoryDuke University Health SystemRm.#251M, Duke South, Green Zone
Durham, North Carolina 27710P:  919.684.2091 HIPAA Privacy Notification: This 
message and any accompanying documents are covered by the Electronic 
Communications Privacy Act, 18 U.S.C. 2510-2521, and contain information 
intended for the specific individual (s) only. This information is 
confidential. If you are not the intended recipient or an agent responsible for 
delivering it to the intended recipient, you are hereby notified that you have 
received this document in error and that any review, dissemination, copying or 
the taking of any action based on the contents of this information is strictly 
prohibited . If you have received this communication in error, please notify us 
immediately by e-mail, and delete the original message.
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RE: [Histonet] Nail processing

[WILLIAM DESALVO]

This process has worked for us for years. I strongly suggest the Fisher Brand 
Burnt Orange Plus Slides. We have tried them all and consistently the Burnt 
Orange work the best. We use them when we really need something to stick to the 
slide. Can't scientifically explain, just lots of testing and use.



Grossing Sections for Histology:Complete 10% Formalin FixationNails are soaked 
in a 10% solution of
potassium hydroxide.Hard nails may require 30-45 minutes.  Softer nails should 
be soaked for 10-30
minutes.Over soaking can destroy the
specimen.Rinse and place in Formalin to wait for processing.Submit one cassette 
of representative
section(s).


Microtomy of SectionsUse Fisher Brand Burnt Orange Plus
Slides.Cut two sections per slide.Air Dry then place in 60⁰ C oven for 2
hours.Allow to come to room temp before starting staining process.

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

  From: allison.sc...@harrishealth.org
 To: histonet@lists.utsouthwestern.edu
 Date: Fri, 8 Nov 2013 16:58:30 +
 Subject: [Histonet] Nail processing
 
 Happy Friday to all.  I hope everyone has a great weekend.  I am I need of a 
 procedure for processing nails.  We are having problems with keeping the 
 nails on during gms special staining.  We are using the ventana machine not 
 by hand.  I remember a procedure that used nair, it has been along time and I 
 cant remember.  Any help will be appreciated.
 
 
 
 Allison Scott HT(ASCP)
 Supervisor, Histology Lab
 LBJ Hospital
 Harris Health System
 Office: 713-566-2148
 Lab: 713-566-5287
 
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RE: [Histonet] Faxitron Xray digital imaging

[WILLIAM DESALVO]

We have used the Faxitron instrument for the past 3 years at multiple sites. 
Faxitron creates a digital image of a specimen quickly and safely and a t 
multiple magnifications. The instrument is placed in either Surgery or Surgical 
Pathology (SP) and we use it primarily on breast cases to assist in orientation 
and gross dissection, identifying radioactive seeds or locating micro 
calcification. The instrument is easy to use, safe and you can connect to 
multiple LIS systems and a Hospital PACS. There is no code to charge for use 
when used in SP, only when used by Radiology or Surgery.
 
There is only one company that manufactures and sells the instrument:
Faxitron Bioptics, LLC
Tucson, AZ
877-910-0030
 
The are willing to bring a unit to your site for demonstration and you may be 
able to talk them into leaving for a evaluation.
William DeSalvo, BS HTL(ASCP)

 
 From: allison.sc...@harrishealth.org
 To: histonet@lists.utsouthwestern.edu
 Date: Tue, 5 Nov 2013 16:00:11 +
 Subject: [Histonet] Faxitron Xray digital imaging
 
 Hello to all in histoland.  Our chief pathologist is interested in getting a 
 faxitron xray digital imaging machine.  Is anyone out there using this 
 technology and can you suggest a company in which to order one from.  Any 
 help in this will be greatly appreciated.
 
 
 
 
 Allison Scott HT(ASCP)
 Supervisor, Histology Lab
 LBJ Hospital
 Harris Health System
 Office: 713-566-2148
 Lab: 713-566-5287
 
 
 CONFIDENTIALITY NOTICE:
 If you have received this e-mail in error, please immediately notify the
 sender by return e-mail and delete this e-mail and any attachments from 
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 To the extent the information in this e-mail and any attachments contain 
 protected health information as defined by the Health Insurance Portability 
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 review, dissemination or copying of this e-mail and its attachments is 
 strictly prohibited.
 
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RE: [Histonet] Specimen Tracking Systems

[WILLIAM DESALVO]

My lab chose the Ventana Vantage System w/ Thermo PrintMate cassette printers. 
We are a multi-location system and Vantage works well for us. We wanted a 
robust tracking and flexible quality assurance system and Ventana provided what 
we needed and wanted.
 
I suggest you look at the big four to start your evaluation:
Ventana - Vantage
Leica- Cerebro
Thermo- OmniTrax 
General Data - HTS
 
The larger companies have more interfaces built for the different LIS used in 
Histology. There are many smaller companies that offer tracking systems, but 
make sure they can connect w/ your LIS.  After product selection, support is 
critical.
 
Sunquest and Cerner Millennium now offer tracking and quality assurance 
modules. And I imagine there are other tracking systems built into more LIS.
 
You will also want to evaluate multiple printers for your cassettes. Always 
keep in mind the amount of information you will be adding to the cassette a 
this will reduce the number of cassettes/ minute. Start w/ the tracking system 
vendor and see what the have validated. Consider the upkeep and maintenance of 
the printer. We choose heat transfer, but there are Laser and Ink-jet that work 
really well. We chose to point of generation and wanted a very small footprint 
to place the printers in the grossing stations.
 
We also choose not to use a slide printing system and decided the bar coded 
labels at microtomy was the best solution for us. We wanted less maintenance 
and steady throughput. Easier to load a roll of labels than keeping a printer 
up and running.
 
Last, but certainly not least, support. You will need a ton of support to work 
through this project: interfaces, IT upgrades, software adjustments, WORKFLOW 
changes and training. Plan and re-plan before you make your selection. And 
negotiate hard, the pricing is all over the place for the systems.   
 

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Board Member, Digital Pathology Association
Owner/Consultant, Collaborative Advantage Consulting

 
 From: mro...@sfmc.net
 To: histonet@lists.utsouthwestern.edu
 Date: Thu, 31 Oct 2013 20:21:47 +
 Subject: [Histonet] Specimen Tracking Systems
 
 What systems are people using for specimen tracking?  I'm looking for the 
 whole package of cassette printers, work station slide printers, tracking 
 software, etc...
 
 Any help and recommendations would be appreciated!
 
 
 
 Matthew Roark- HT/HTL(ASCP)CM
 Histology Specialist
 Saint Francis Medical Center
 211 Saint Francis Drive
 Cape Girardeau, MO 63703
 573-331-3982
 mro...@sfmc.netmailto:mro...@sfmc.net
 http://www.sfmc.nethttp://www.sfmc.net/
 
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RE: [Histonet] Oil red O

[WILLIAM DESALVO]

I believe the answer should be - Oil Red O is a brand name (not uncommon in the 
dye indutry) and represents the two dyes found in the compound, Solvent Red 27 
and Sudan Red 5B

William DeSalvo, BS HTL(ASCP)

 Date: Mon, 9 Sep 2013 13:32:08 -0700
 From: rjbu...@yahoo.com
 To: adafeld...@anatechltdusa.com; histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] Oil red O
 CC: 
 
 There you have it!
 René J.
 
 
 
 From: Ada Feldman adafeld...@anatechltdusa.com
 To: histonet@lists.utsouthwestern.edu 
 Sent: Monday, September 9, 2013 4:13 PM
 Subject: Re: [Histonet] Oil red O
 
 
 As you are finding out the answers to dye nomenclature you can had these 
 endings to your list of the O' in Oil red O:
 Oil red EGN
 Oil red 4B
 
 
 Ada Feldman
 Anatech Ltd.
 1020 Harts Lake Road
 Battle Creek, MI 49037
 
 Phone: 800.262.8324
 Phone: 269.964.6450
 Fax: 269.964.8084
 adafeld...@anatechltdusa.com
 
 
 
 
 On Sep 9, 2013, at 3:59 PM, Connolly, Brett M wrote:
 
  I'm not sure, but whatever you do... don't store it next to the Sudan Black 
  B...you'll stink up the lab!!
  
  Brett M. Connolly, Ph.D.
  Principal Scientist, Imaging Dept.
  Merck  Co., Inc.
  PO Box 4, WP-44K
  West Point, PA 19486
  brett_conno...@merck.com
  T- 215-652-2501
  F- 215-993-6803
  
  
  
  
  
  
  -Original Message-
  From: histonet-boun...@lists.utsouthwestern.edu 
  [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of P.E. Visser
  Sent: Monday, September 09, 2013 3:41 PM
  To: histonet@lists.utsouthwestern.edu
  Subject: [Histonet] Oil red O
  
  Hi all
  
  I was requested where the O stands for. who has any suggestion.
  
  
  
  Regards Piet Visser 
  
  Histotech Bronovo The Netherlands
  
  
  
  
  
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RE: [Histonet] Requisitions

[WILLIAM DESALVO]

I am not aware of any CAP regulation that requires the requisition to remain w/ 
the specimen. The pathologist/PA at gross dissection needs to be able to 
positively confirm/verify the specimen container information (two forms of 
patient ID and specimen source) w/ the order entry information (taken from the 
requisition). There are many labs that are paperless during the technical 
process and I see more and more use of electronic requisitions and orders.

William DeSalvo, BS HTL(ASCP)
Chair, NSH Quality Management Committee

 
 Date: Wed, 21 Aug 2013 11:55:12 -0700
 From: gmar...@marshallmedical.org
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Requisitions
 
 We are having a discussion as to whether the requisition needs to remain
 with the specimen at the grossing stage or can it be in a separate stack
 on the grossing table, while the actual specimen is left in the on deck
 tray.   I believe I have seen something that speaks to this through the
 CAP guidelines, but am unable to find it.  Any help would be
 appreciated. 
 
 Thanks 
 
 Gary
 
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[Histonet] NSH Quality Management Committee

[WILLIAM DESALVO]

The 39th Annual NSH Symposium and Convention will be held in Providence, RI, 
September 20-25, 2013. There are many quality related workshops and 
presentations scheduled and the Quality Management Committee (QMS) holds it 
annual meeting, Sunday, September 22, 2013, 12:15 pm- 12:45 pm. If you are 
attending, make plans to be at the committee meeting. These are exciting times 
for change and quality improvements. What better way is there to get more 
involved than becoming a member of the QMS. If you have any questions, do not 
hesitate to contact me. I hope to see you at 2013 NSH Symposium and Convention.

William DeSalvo, BS HTL(ASCP)
Chair, NSH Quality Management Committee

  
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RE: [Histonet] Oven recommendations

[WILLIAM DESALVO]

Since you state you are in reasearch, consider air drying your slides. You only 
need to remove the water between the paraffin section and the glass slide to 
allow adhesion of the proteins in the tissue sample to the glass. Melting the 
paraffin in not necessary, your deparaffinization steps in the routine and 
special staining protocols will adequately remove the paraffin from the tissue 
section. 

 

Using an oven that was not designed to melt paraffin off the glass slide can 
be very hazardous. The parafin can drop don into the heating elementsand cause 
an ignition and fire.   

 

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: minnies...@hotmail.com
 To: histonet@lists.utsouthwestern.edu
 Date: Wed, 22 May 2013 13:55:46 +
 Subject: [Histonet] Oven recommendations
 
 
 
 Hi All,
 I had just received a letter from Boekel (models 107800-107801 or 107905 in 
 either 120v or 230v) that my oven can not be used to melt wax of any kind. as 
 this is our bread and butter and need some suggestions to what kind or brand 
 is used that is good for us (histologists). I need a little one since I'm in 
 research and I don't need a big one due to the lack of volume. Does anyone 
 have suggestions or can point me in the right direction, Please?
 Thanks so much and have a great day!!!Minnie
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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RE: [Histonet] Vantage and Prisma

[WILLIAM DESALVO]

I use Vantage and Sakura Prisma. The Sakura Prisma is not interfaced into 
Vantage. You place a bar-coded label on your HE slides at microtomy. We scan 
the slides after staining, case assembly.

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 To: histonet@lists.utsouthwestern.edu
 From: jmasla...@stpetes.org
 Date: Fri, 10 May 2013 09:35:12 -0600
 Subject: [Histonet] Vantage and Prisma
 
 Happy Friday
 Anyone out there using Ventana's Vantage with Sakura's Tissue-Tek Prisma 
 stainer?
 
 
 Joe Maslanka BS, CT,HT (ASCP)
 Anatomical Pathology Technical Supervisor
 St Peter's Hospital,MT 59601
 (P)(406) 447-2406
 (F)(406)444-2126 
 
 Give thanks for ALL things.
 Kindness is the language the blind can see  the deaf can hear- Mark 
 Twain
 
 
 
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RE: [Histonet] Re-use of plastic embedding molds

[WILLIAM DESALVO]

We tried using the disposable molds and they work for reusing  2-3 times( 
cracks started after just a few uses), but we found the cost much higher that 
using the metal molds and cleaning.

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: karynmy...@texashealth.org
 To: histonet@lists.utsouthwestern.edu
 Date: Thu, 9 May 2013 17:26:13 +
 Subject: [Histonet] Re-use of plastic embedding molds
 
 Just wondering... Does anyone re-use their plastic embedding base molds?
 
 Thanks for your input!
 
 
 
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RE: [Histonet] RE: CAP standard GEN 61300

[WILLIAM DESALVO]

To address Gen 61300, you have to check your instrument manuals, and MSDS for 
all your reagents. Create the acceptable ranges and then monitor. Make sure you 
create a process to address out of range issues. We use Tutela Medical devices 
to monitor both temp and humidity. Our facilites installed and maintains 
records.
 
 http://www.tutelamedical.com/

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 Date: Mon, 6 May 2013 08:12:01 -0700
 From: katelin09...@gmail.com
 To: tmcne...@lmhealth.org
 Subject: Re: [Histonet] RE: CAP standard GEN 61300
 CC: histonet@lists.utsouthwestern.edu; dknut...@primecare.org
 
 We are also going through humidity issues post inspection. Our values are
 based on the specifications in the equipment manuals and are 30%-80%. We
 use a digital reader. We have been dipping below that and are working to
 get the humidity up. We have brought in a small humidifier but it is not
 keeping up on very dry days.
 It is in our policy to report out of range values to our supervisor and she
 is now looking in to a more permanent solution.
 We would also appreciate any comments on how other labs have increased
 their humidity.
 
 Katelin Lester, HTL
 On May 6, 2013 7:47 AM, Tom McNemar tmcne...@lmhealth.org wrote:
 
  I am very interested in this as well. We have an ongoing issue with
  humidity/static. I have been unable to find anything that lists a
  recommended humidity level for histology. New construction building codes
  for labs list 30% - 80% and the equipment manufacturers list 30% - 80% for
  their recommended operating environment.
 
  Based on two different digital readers, our humidity is sometimes in the
  20% range (mostly in winter but not always). A hand operated device reads
  about 40% higher than the digitals so I don't quite know what to make of it.
 
  Anyway, I will appreciated any input.
 
  Tom McNemar, HT(ASCP)
  Histology Co-ordinator
  Licking Memorial Health Systems
  (740) 348-4163
  (740) 348-4166
  tmcne...@lmhealth.org
  www.LMHealth.org
 
  -Original Message-
  From: histonet-boun...@lists.utsouthwestern.edu [mailto:
  histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Knutson, Deanne
  Sent: Monday, May 06, 2013 8:13 AM
  To: 'histonet@lists.utsouthwestern.edu'
  Subject: [Histonet] CAP standard GEN 61300
 
  Fellow Histonetters,
 
  I am looking for advice concerning CAP standard GEN 61300 Climate Control.
 
  To those that take humidity records in your lab, what exact % range do you
  use for a normal range?
 
  And what do you do if and when you are out of this range?
 
  Thank you for sharing your workflow info with me.
 
  Deanne Knutson
  Anatomic Pathology Supervisor
  St. Alexius Medical Center
  701-530-6730
  dknut...@primecare.orgmailto:dknut...@primecare.org
 
 
 
  
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RE: [Histonet] cassette labelers

[WILLIAM DESALVO]

I suggest you look at either a heat transfer or laser etch product. The laser 
jet printers can be a bit of a maintenance issue. Also, you need to choose by 
the information needed on the cassette. 2D bar coding will take some time to 
print and requires precision in the printing. This is an important 
consideration in your selection of printer/labeler product.
 
I have tested and used the Thermo PrintMate thermal transfer printer and 
General Data (GD) CL-01 laser cassette labeler. Both will produce a very usable 
and reliable 2D barcode. PrintMate can be used w/ multiple vendor cassettes. 
CL-01 must use a proprietary coated cassette.
 
I choose the Thermo PrintMate, for a variety of reasons specific to process and 
lab, over the GD CL-01. The Microwriter is a different instrument from the 
PrintMate. I suggest the PrintMate over the Microwriter.
 
I strongly suggest you set up your workflow, consider your specific needs and 
then ask each of the vendors to let you demo their units to see which one will 
work best to support your process.  

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: mmargio...@bmhmc.org
 To: histonet@lists.utsouthwestern.edu
 Date: Tue, 30 Apr 2013 16:31:49 +
 Subject: [Histonet] cassette labelers
 
 Hi All,
 We are looking to purchase 2 cassette labelers and would like some feedback 
 on which ones you might recommend. Also, is there a difference between 
 Thermo's Printmate and Microwriter? Looks like the Printmate is just a newer 
 version. Your input would be greatly appreciated.
 
 Thanks,
 Michele
 Histology Supervisor
 BMHMC
 631-654-7192
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RE: [Histonet] Tracking OR specimens

[WILLIAM DESALVO]

We use the OR schedule and have a log at Surgical Pathology that the person 
delivering specimens places a patient label w/ the number of specimens 
delivered and they sign off. This has helped many times when OR believes they 
have delivered all the specimens. We use both the log and OR schedule to 
reconcile cases and contact OR is a case has not been delivered by end of day. 

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: michelle.lamph...@childrens.com
 To: histonet@lists.utsouthwestern.edu
 Date: Mon, 18 Mar 2013 13:14:04 +
 Subject: [Histonet] Tracking OR specimens
 
 Are there any histology labs that actively participate in auditing the 
 Operating Room on a daily basis to make sure that histology receives all of 
 the specimens that the OR should have submitted? If so, how do you do this? 
 Or should the OR be solely responsible for making sure that they specimens 
 make it to histology?
 
 Michelle M Lamphere, HT (ASCP)
 Senior Tech, Histology
 Children's Medical Center
 1935 Medical District Drive
 Dallas, TX 75235
 Office :214-456-2798
 Histology: 214-456-2318
 Fax: 214-456-0779
 
 
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RE: [Histonet] IHC validation

[WILLIAM DESALVO]

Laurie, I would use the control slides to validate and set up the antibodies. I 
good secondary check/control would be to send slides to another lab to check 
for correlation and confirmation of your protocol performance. Once you get an 
established process, then you can later check patient samples to the protocol 
and make adjustments, as necessary.

William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: lcolb...@pathmdlabs.com
 To: histonet@lists.utsouthwestern.edu
 Date: Fri, 15 Mar 2013 16:51:27 +
 Subject: [Histonet] IHC validation
 
 If a lab is just starting up IHC for the first time and has to validate both 
 the IHC stainer and the AB's/detection kit, does the validation have to be 
 done using actual patient cases - or can you use strictly control tissue and 
 purchased microarrays?
 
 Laurie Colbert, HT (ASCP)
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RE: [Histonet] Temperatures

[WILLIAM DESALVO]

Who cares? The patient. I am quite sure the patient wants quality assured 
results. Would any of us use a reagent or chemical from a manufacturer that 
could not prove the quality? If the instrument remains on during periods on 
inactivity in the lab, reagents or chemicals are stored in the the lab during 
the same periods, then you must monitor and prove the quality. It's kind of 
like, when we aren't around and the tree falls, we still need to know when is 
fell and if it fell on anything. Everything we do starts w/ standardization and 
because we produce patient test results, we must prove our processes 
continually meet the standard, good quality control and assurance. The 
accrediting and licensing organizations are just doing their part to check that 
we can, do and will only produce quality work, no exceptions. As has been 
previously mentioned, there are several solutions to the problem. If the lab is 
open, have someone from another area check, record and sign for the process. 
There are several electronic thermometers, w/ a probe, that can be set for a 
minimum and maximum range and accurately record temps during periods when staff 
is not available. We should never wait until we have a questionable result 
before we check for quality. 
William DeSalvo, BS HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

  Date: Fri, 8 Feb 2013 20:03:17 -0500
 From: amosbro...@gmail.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Temperatures
 
 Good Grief!
  Why would this really be an issue. The temperatures are taken
 throughout the week and are constant (or you have a different problem
 entirely) why would they only spike or tank on the weekend, and why would
 it even matter if the equipment isn't being used. If a tree falls in the
 forest and no one is around to hear it who the heck cares?
 
 Face-palm,
 Amos
 
 
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RE: [Histonet] No expiration dates on chemicals

[WILLIAM DESALVO]

Dry chemicals can have an extremely long shelf life. I once visited Chuck 
Churukian's lab (god rest his sole) and he had a wall of dry chemicals, and 
quite proud, that many were well over 20 years old. Test and retest before you 
discard. Liquid reagents can often have an extended shelf life and often past 
the manufacturers expiration date.
 
For patient safety and quality consistency, I suggest you should test for 
efficacy of the chemical or reagent before discarding. If it continues to 
perform as indicated, then you can continue to use. Remember to label the 
chemical from the date of testing and set a new retest date.
 
In your post you do not mention and since you have not labeled the chemicals 
you ask about, I think you may want to check all you labeling. Make sure you 
are compliant w/ the CAP regulation for labeling and expiration dates for all 
chemical and reagents in your lab. Just as a precaution and suggestion, to be 
compliant when you receive any reagent or chemical without a manufacturer 
expiration date, you must place your own label for receipt and retesting, 
creating your lab expiration date. The label must have a date for retesting and 
initialed by the person applying the label. I typically suggest a 12 month 
period, for patient safety and manageable quality control, to retest the 
chemical or reagent. Make sure you document your process along w/ the original 
and retesting results. Also make sure you have labeled any solutions you 
produce and use in the lab.
 
It is never a good thing for you, the lab or the patient to have an inspector 
find a container of chemicals or reagents without a label. Check and double 
check for labels. It is a difficult process to manage and often too easy to 
find containers without the proper labeling.
 

William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 Date: Thu, 31 Jan 2013 15:49:44 -0500
 From: pat...@gmail.com
 To: jpiche-gro...@wtbyhosp.org
 Subject: Re: [Histonet] No expiration dates on chemicals
 CC: histonet@lists.utsouthwestern.edu
 
 We keep ours no longer than 5 years. If there is no expiration date
 on the bottle when we receive it, we mark it as expired 5 years from
 date of receipt.
 
 Paula
 
 -- 
 Paula Sicurello, HTL (ASCP)
 Supervisor, Clinical Electron Microscopy Laboratory
 Duke University Health System
 Rm.#251M, Duke South, Green Zone
 Durham, North Carolina 27710
 P: 919.684.2091
 
 
 On Thu, Jan 31, 2013 at 12:36 PM, PicheGrocki, Jessica
 jpiche-gro...@wtbyhosp.org wrote:
  Hi All,
 
  Just wondering what everyone is doing in regards the ANP question involving 
  expiration dates on chemicals and reagents? Is everyone getting rid of old 
  chemicals that have been opened for 10 years or more?
 
  Please advise.
 
  Have a good day and thank you,
 
  Jessica Piche', HT (ASCP)
  Waterbury Hospital Histology Lab
 
 
 
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RE: [Histonet] vacuum sealer

[WILLIAM DESALVO]

Cardinal Health - Kapac System, 18 inch sealer w/ special bags for storing 
formalin. Best system for Histo

William DeSalvo, B.S., HTL(ASCP)

Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee

Owner/Consultant, Collaborative Advantage Consulting

  Date: Sun, 30 Dec 2012 07:56:05 -0800
 From: badzros...@yahoo.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] vacuum sealer
 
 Hi histonets..Im looking for a good brand of vacuum sealers for storing 
 histology tissue samples.Dont you have any issues with this sealers.Im 
 looking for one which retains a little formalin in it.I want to know which 
 type you are using..Thanks a lot.Have a great day..
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RE: [Histonet] Histotechnician Salary 2

[WILLIAM DESALVO]

I agree w/ Tim that the salary range is very wide and depending upon the 
geographical area. ASCP and Advance magazine publish salary surveys by area. I 
suggest you factor in the cost of benefits, since you are asking for funding 
from a government entity. Benefits can range from 35%- 40% of salary.

William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: timothy.mor...@ucsfmedctr.org
 To: twheel...@mclean.harvard.edu; histonet@lists.utsouthwestern.edu
 Date: Wed, 19 Dec 2012 20:14:05 +
 Subject: RE: [Histonet] Histotechnician Salary 2
 CC: 
 
 Tim, it depends on the going rate in your area. What does your hospital pay a 
 general histotech? How about other hospitals in the area. I'll bet your 
 personnel dept has that data.
 
 In California it can range from $15 to $35 per hour for histotechs with 5 
 years experience. The lower is in the rural areas and the higher in the San 
 Francisco or LA areas. 
 
 
 Tim Morken
 Supervisor, Electron Microscopy/Neuromuscular Special Studies
 Department of Pathology
 UC San Francisco Medical Center
 
 
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tim Wheelock
 Sent: Wednesday, December 19, 2012 12:01 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Histotechnician Salary 2
 
 Hi again all:
 
 I should have mentioned that the position calls for doing classical 
 neuropathology stains, but not IHC.
 We have our immunostains done by another lab.
 
 Thanks,
 
 Tim Wheelock
 Harvard Brain Bank
 McLean Hospital
 Belmont, MA
 
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RE: [Histonet] Bluing

[WILLIAM DESALVO]

Blueing will differentiate and can help crisp the stain. The pH does affect the 
rate and intensity of color change. You want a slightly alkaline solution to 
“Blue” your slides. The blueing process will differentiate the normal purplish 
color of the acid dye, Hematoxylin (pH 2.6-2.9) by changing the color to a blue 
from the reddish purple. This process produces a better contrast with the usual 
red counter stains, Eosin and Phloxine, used in the HE.
 
Common blueing/differentiators I have used are; 0.1% Sodium Bicarbonate (1 g / 
1000 ml distilled water), 0.2% Ammonia Water (2 ml / 1000 ml distilled water) 
and Saturated Lithium Carbonate (1.54 g / 100 ml distilled water). You can also 
use “tap water”, but be careful about how the water is treated. Rinsing in tap 
or distilled water also provides a crisper stain because is rinses away the 
alum. If alum remains, the color will fade with time.

William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 Date: Tue, 18 Dec 2012 11:20:26 -0500
 From: turke...@gmail.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Bluing
 
 Dear Histonetters,
 
 
 I wonder what is the purpose of bluing the hematoxylin. Can bluing effect
 the clarity of the nuclear staining? Can one achieve different bluing
 results varying the composition, pH or time of the bluing reagent?
 
 
 Mes
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RE: [Histonet] Hematoxylin issue

[WILLIAM DESALVO]

I suggest you look at the reagents and protocol used 5 years ago and first 
determine if the same is used today. If you know all the reagents used, then 
start by check three specifics of the process: 1.) Removal of alum - make sure 
the slides are sufficiently rinsed. Suggested is 3-4 minutes to adequately 
remove the alum, you are using only 1 minute; 2.) Mounting Media - make sure 
the mounting media used had an antioxidant to prevent fading; 3.) Xylene - 
mixtures can cause fading, you made need to move to higher grade.
 
This is only a starting point, having the exact protocol and reagents used then 
and compare them to now is critical. I would pull samples for each year forward 
from the found problem and check to see if you have fading. I do not have an 
easy answere to fix and it may be necessary to recut slides, from the retained 
blocks, if the archived case is requested for review.
 
Most important is to find the cause, stop the problem and move forward.


William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 Date: Tue, 18 Dec 2012 14:45:42 -0500
 From: janine.simmsco...@jmmc.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Hematoxylin issue
 
 Good afternoon all, 
 
 
 
 I have been addressed with an issue which I would like some assistance
 with. My pathologist recently reviewed some skin slides from 2007 and
 noticed the hematoxylin was completely gone and only the eosin remained.
 We use Gill's II hematoxylin, and glass cover slips with xylene
 substitute mountant. The concern is that since we must retain slides for
 10 years and the stain has washed out after only 5 this could be a
 pretty big problem. I do not believe this particular lab has experienced
 this problem before but I have only worked here for less than one year.
 We stain in hematoxylin for 3 minutes, use commercially available
 clarifier and bluing solution, each for one minute as well as one minute
 tap water rinses in between and dip in 95% alcohol before and after a 1%
 alcoholic eosin y solution. I searched the histonet archives for this
 problem as well which is why I am mentioning the staining process but I
 was curious if anyone out there had any suggestions or advice to avoid
 this issue for future slides. Thank you in advance. 
 
 
 
 Janine Simms Colon, CPhT(PTCB), HT(ASCP)
 
 Histology/Pathology
 
 Johnson Memorial Hospital
 
 201 Chestnut Hill Road
 
 Stafford Springs, CT 06076
 
 Office: 860-684-8230 ext. 5197
 
 janine.simmsco...@jmmc.com
 
 
 
 
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 and protected from disclosure. 
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RE: [Histonet] Re: Cutting Blocks

[WILLIAM DESALVO]

I have been following this thread and echo many of the comments that this 
discussion is exactly why we like, use and will continue to use the Histonet. I 
would like to add my 2 cents worth. Working at a Six Sigma company for the past 
10 years has taught me two very important points, that I believe are vital to 
this discussion; 1.) Productivity metrics without Quality metrics are useless; 
2.) You cannot Manage what you do not measure. I have also learned that every 
Histology lab is different when it comes to metrics. A block in your lab may or 
may not produce the same number of slides as produced in my lab. We have way 
too much variation in our processes and Histology, in general. I have found 
that all published data on productivity can, at best, only be used for that 
particular site and possibly provide a beginning reference for my or any other 
lab. Again, we have way too many variables (cases, specimens, cassettes, 
slides, tests) that contribute to the workload/productivity metric. I have also 
found that most of this data used for our discussion is collected using short 
term time studies or year end numbers, not daily, continuous data collection, 
and, I believe, this can skew the results. A specimen does not receive the same 
dissection protocol, a block does not have the same embedding protocol, a block 
at microtomy does not have the same cutting protocol; so why do we try to fit 
all of Histology into one productivity metric? When we as a discipline, 
Histotechnology (both the technical and , does not provide valid data 
collection, minimum standards and acceptable defect rates, it is at the mercy 
of other industry methods and standards. Before we start discussing 
productivity numbers, we should all ask ourselves why do we need this 
information and what are we going to do with it and what does our pathologists 
want? Again, productivity in a manual process, without a quality measurement 
means nothing. I think productivity and quality metrics are essential to the 
growth of Histotechnology, Histotechnologists, Pathologists and the well being 
of the patient. We have many pressures on our profession and setting arbitrary 
or after the fact standards, w/out a strong partnership of the technical staff, 
professional staff and administration, will not help any of us develop a 
quality process to meet the patient's needs. What do you plan on doing with 
workload metric data? Who cares how many specimens are grossed, how many blocks 
are embedded, how many slides are cut or how many slides stained, if it cannot 
be performed at the highest quality level or does not add value to the patient. 
Productivity is so much more than a number. What is the proper workflow and 
workload, taking into account the mix of employees, complexity of specimens and 
level of automation (better said semi-automation)? This number should never 
be static and must fluctuate according to change in the variables in your lab. 
I believe that we are all struggling to make better sense out of the Histology 
black hole of metric data. Yours,and my leadership demands better information 
about what we can do, when can we do it and what value can we add, before they 
will consider investing the needed dollars to bring us out of a total manual 
process. Metrics are not designed or should they be used to provide a maximum 
standard or be static. As your process changes (materials, instruments, people) 
so will your metric. As all have pointed out, concentrate on quality first, 
last and always; then move to development of a productivity metric, ALWAYS 
merged w/ a quality metric, to create a tool that will help you understand the 
capability and capacity of the quality process. Do not try to make these 
decisions w/out partnering w/ the pathologist. None of this makes sense if it 
is not used to create a teamwork and improve quality. Make the tuff decision to 
find a way to collect daily data; track, trend and improve your process; 
communicate what you are doing and why to every person working in or invested 
in your process and make a difference in a patient's life. We MUST never lose 
site that we produce patient results, not just blocks and slides. I may have 
added a bit more than 2 cents worth. 
William DeSalvo, B.S., HTL(ASCP)

Production Manager-Anatomic Pathology
Chair, NSH Quality Management Committee

Owner/Consultant, Collaborative Advantage Consulting

  From: thigg...@cddmedical.com
 To: histonet@lists.utsouthwestern.edu
 Date: Fri, 26 Oct 2012 09:47:20 -0500
 Subject: [Histonet] Re: Cutting Blocks
 
 All great points, awesome information, that’s why we all enjoy histonet.
 
 One thing I've learned over the 20 plus years in histology is every person 
 is different and you cant stick them all in the same box.  I personally 
 don't believe 40 blocks an hour is unreasonable as an average as long as you 
 account for time spent doing other functions in the lab.
 
 Some supervisor, admin. heads, whomever, want

[Histonet] NSH Quality Management Forum

[WILLIAM DESALVO]

Creating the Quality Chain in Histology. Attend, share and learn how Quality 
Management tools can help every Histology lab and Histotechnologist create, 
document and improve processes. Learn from the presenters how they have 
incorporated quality process improvement into their labs. Last year we had 
great interaction and discussion and this is a great opportunity to jump start, 
move past an obstacle or just share your experiences about process improvement. 
Attend the forum and increase your knowledge. Hope to see you there!!! 
http://www.nsh.org/content/quality-management-forum Date - October 20, 
2012Location - Bethesda, MD Check out the link for all the details or call NSH 
office at: 443-535-4060
William DeSalvo, B.S., HTL(ASCP)

Chair, NSH Quality Management Committee


  
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RE: [Histonet] prostate trimming protocol

[WILLIAM DESALVO]

Talk w/ the pathologists or residents, have a conversation about what and why. 
The multiple samples could be due to teaching or cancer protocols. The number, 
size and selection area of samples is always the responsibility of the 
pathologists. I find it best to not wonder why, just ask. Typically the 
pathologist will be more than happy to discuss and explain their dissection and 
sampling protocol. 

The variation in thickness and sample size by residents can be corrected by the 
trainer, typically a PA or pathologist. There may be a need to rewrite or 
create an good standardized procedure that the trainner can use. Again, have a 
discussion about how consistency in sample size, crisp edges and consistent 
thickness,  3 mm, can improve quality. I suggest you start w/ a visual, a good 
old nickel. Consider super gluing one to every gross dissection board. 
Precision at the grossing board leads to increased quality in processing, 
microtomy and staining.
 
I am firm believer that if you concentrate on quality, both in action and 
conversation, you will get more bang for your buck! Always remember, when you 
start asking the questions, be prepared to get involved w/ training and 
correcting the process.
 
 
 

William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Control Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 From: cont...@histocare.com
 Date: Tue, 9 Oct 2012 10:53:37 -0500
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] prostate trimming protocol
 
 Good morning all,
 
 Could someone with more knowledge in this matter than I have help shed a 
 little light?
 
 While at a nationally-renowned medical facility, I've come across something 
 rather interesting (to me) for which no one in the immediate lab has a 
 definitive answer for.
 
 I see varying trimming(or grossing) techniques by the residents. I'm told 
 that it's very common to have poorly grossed tissue submitted regularly 
 whenever a new group comes through, but nothing is done to correct it.
 
 It runs the gamut from non-decalcified bone, or humongous chunks of tissue 
 that barely fits in the cassette but has to be nearly shoved into the mold, 
 and tissue that's 5mm, seriously.
 
 This time, it's prostate tissue. I've been places where maybe 3 or 4 sections 
 were submitted from the area of interest and maybe a sample of normal tissue 
 just for differentiation. But here, it's common to receive anywhere from 30 
 to 50 cassettes from the same site. I'm guessing they don't want to discard 
 ANY tissue. 
 
 What's interesting is some of this is submitted as a bunch of very tiny 
 slivers in some cassettes and then nickel and quarter-sized chunks from the 
 same site in others.
 
 Has anyone else seen prostate submitted this way? Is there a rhyme or reason 
 that I'm not aware of?
 
 Thanks
 
 M
 
 
 www.HistoCare.com
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[Histonet] RE: Reliable... Hi Bill (William DeSalvo), Let's try this: A Newbie's Guide to Histonet

[WILLIAM DESALVO]

Marvin, you are always a calming and steady force. Exchange, learn, grow and 
share with respect. . . Histonet

William DeSalvo, B.S., HTL(ASCP)

Owner/Consultant, Collaborative Advantage Consulting

 Date: Wed, 3 Oct 2012 03:16:05 -0400
From: mha...@histosearch.com
To: wdesalvo@outlook.com
CC: cont...@histocare.com; jaylundg...@gmail.com; 
histonet@lists.utsouthwestern.edu
Subject: Re: Reliable... Hi Bill (William DeSalvo), Let's try this: A Newbie's 
Guide to Histonet


  

  
  

Hi Histocare and any other relatively new
  people to
  Histonet,

  

  First, hello from Bill and I in beautiful Vancouver and NSH where
  many
  histologists are enjoying old friends and making new friends from
  around the
  world. Let's remember histology is still a pretty small field in
  the US with
  about 25,000 histologists working in about 7,000 labs, plus more
  and more
  working in research labs and companies. Over a career, you're
  likely to meet many of them if
  you come to enough NSHs. For those of us who have been on Histonet
  since the
  beginning (1996?), we would like to remind others of the facts of
  Histonet:
The Histonet listserver is an email listserver
  for the histology
  profession that is managed by Dr. Margraf and Dr. Cope-Yokoyama
  and is run on
  computers at the University of Texas Southwestern Medical Center.
  University
  policies prohibit advertising, but do allow posting of jobs,
  probably so
  everybody can dream about being a histologist in some distant
  place. There are
  even some temp positions and jobs wanted emails posted every now
  and then. 
Histocare, your first posting was no problem
  and we enjoy
  seeing all the ways histologists use to market their talents.
  Three posts in
  one week is a little redundant. We got it the first time.
Companies (Vendors)  are
  permitted to post in response to problems of labs when they have
  something
  positive to contribute. Histonet currently has more than 4000
  members from
  throughout the world, with many thousands more who keep up with it
  through the
  archives. The archives have over 30,000 visits a month from over
  50 different
  countries. 
We all want to read questions and answers about
  problems in
  histology. Many of us remember before Histonet when labs had to
  actually solve
  their problems by themselves. Now over 30,000 times a month a
  histology problem
  is solved by one of the eloquent answers of contributors to
  Histonet. 
And Histocare, you can be anonymous on Histonet
  if you like,
  but you might want to search the archives for others opinions on
  it. It has
  been discussed previously. And when you have a website, you can’t
  be anonymous,
  because I was able to do a whois search and get your name and
  address. I would
  recommend using your name and credentials proudly. 
So, let’s get back to solving histology
  problems on Histonet and leave
  Dr. Margraf and Dr. Cope-Yokoyama alone. They have patients and
  stuff they’re
  working on. Just remember to treat others in your profession with
  respect on
  Histonet. You just might meet them one day at NSH. And remember to
  think twice
  (or three times) before hitting the send button with a negative
  message. Thousands of us
  really don’t want to hear it.
Histonet welcomes all histology questions and a
  vast
  majority of the participants think if you don’t know the answer,
  it’s not a
  dumb question, so feel free to ask. Those that don’t think so will
  flame you
  mercilessly off list for posting, but I recommend you ignore them.
A little research in the archives shows me that
  94% of the
  time an email war breaks out on Histonet, testosterone is
  involved…
Respectfully,
Marvin Hanna

  webmas...@histosearch.com










  
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[Histonet] NSH Convention Symposium - Quality Control Committe Meeting

[WILLIAM DESALVO]

The NSH is upon us and time to meet, greet and exchange. If you are attending 
and want to become involved in discussing and supporting Quality Improvement in 
the HIstology Lab, then attend the Quality Control Committee meeting on 
Saturday morning, September 29, 2012, 7:00 am - 7:45 am or stop by the 
committee table during exhibit hours.  The committee will discuss:2012 Quality 
Management Forum - Creating the Quality Chain in Histology, Bethesda, MD, 
October 20, 20122013 Forum - format and speakersAsk NSH About Quality - process 
and supportQuality Management in Histology Project - sub-committee and 
contentTissue Control Bank Bring yourself and your ideas. Hope to see you at 
NSH and at the committee meeting.
William DeSalvo, B.S., HTL(ASCP)

Chair, NSH Quality Control Committee

 
  
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RE: [Histonet] Flammables in Histology

[WILLIAM DESALVO]

If you have a safety officer or department, start there. Each city and state 
will have specific regulations. Your company may have even more restrictions.
 

your bulk storage capacity will be dependant upon State, Municipality and your 
company allowable storage outside a flame cabinet. Usually there is a very 
short period of time allowed from delivery and when you MUST move your bulk 
reagents to a cabinet
capacity of the flammable cabinet varies with size. I strongly suggest you vent 
to outside
volume allowed in the lab is again dependant upon State, Municipality and your 
company. Make sure you count all flammable liquids on instrumentation in use. 
in the lab and add to bulk storage
 
Again, I suggest you check w/ your local fire department for regulations and 
requirements. Depending on the city, they typically are responsible for yearly 
inspections.

William DeSalvo, B.S., HTL(ASCP)
Production Manager-Anatomic Pathology
Chair, NSH Quality Control Committee
Owner/Consultant, Collaborative Advantage Consulting

 

 Date: Thu, 6 Sep 2012 15:02:57 -0700
 From: wilson6...@yahoo.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Flammables in Histology 
 
  
 Hi,
 Please  I have questions on flammables in Histology Lab.
1. How much flammables are stored in bulk?
2. What is the capacity of the flammable cabinet?
3. How much is allowed in Histology Lab?
  
  Thank you all.
  
 Wilson
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RE: [Histonet] automated H+E and cover slipper

[WILLIAM DESALVO]

Sakura Prisma w/ tape cover slip. It also is available w/ glass cover slip. 
Reliable, fast and a workhorse.

William DeSalvo, B.S., HTL(ASCP)

  From: bdebrosse-se...@isisph.com
 To: sandra.harris...@va.gov; har...@oncology.wisc.edu; 
 histonet@lists.utsouthwestern.edu
 Date: Wed, 18 Jul 2012 14:18:53 -0700
 Subject: RE: [Histonet] automated H+E and cover slipper
 CC: 
 
 I second on that!
 
 Beatrice DeBrosse-Serra HT(ASCP)QIHC
 Isis Pharmaceuticals
 Antisense Drug Discovery
 2855 Gazelle Ct.
 Carlsbad, CA 92010
 760-603-2371
 
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Harrison, 
 Sandra C.
 Sent: Wednesday, July 18, 2012 1:44 PM
 To: Joe Hardin; histonet@lists.utsouthwestern.edu
 Subject: RE: [Histonet] automated H+E and cover slipper
 
 Leica Autostainer XL with CV5030 coverslipper and transfer station.  
 
 This has been a real timesaver for us.  It automatically moves the slides 
 from the stainer to the coverslipper.  It has been relatively trouble free.
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Joe Hardin
 Sent: Wednesday, July 18, 2012 3:23 PM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] automated H+E and cover slipper
 
 Hi All,
 I will be trying out new H+E autostainers and cover slippers soon. Does 
 anyone have a favorite, and why? Thanks for your responses.
 
 
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RE: [Histonet] please unsubscribe

[WILLIAM DESALVO]

#116 - WHEN WILL IT STOP?

William DeSalvo, B.S., HTL(ASCP)

 

 Date: Thu, 31 May 2012 11:34:52 -0400
 From: dtay...@mcpathology.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] please unsubscribe
 
 Please unsubscribe me from this list. Thanks. 
 
 
 
 Deborah Taylor, MS
 
 Customer Relations/Lab Manager
 
 Marlboro Chesterfield Pathology, PC
 
 672 Hwy 9 West
 
 Bennettsville, SC 29512
 
 Phone: 843-479-2402
 
 Fax: 843-479-6609
 
 
 
 
 
 Note: The information in this message is confidential and may be
 legally privileged. It is intended solely for the addressee. Access to
 this message by anone else is unauthorized. If you are not the intended
 recipient, any disclosure copying or distribution of the message or any
 action or omission taken by you in reliance on it, is prohibitied and
 may be unlawful. Please immediately contact the sender if you have
 received this message in error. Thank you.
 
 
 
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RE: [Histonet] BLock alignment tool

[WILLIAM DESALVO]

Good point. That is why I like the tools that slip onto the stage. A little 
more money up front, but much quicker to align multiple microtomes and all 
microtome chucks are exactly the same. Which, I think, should be the goal.

William DeSalvo, B.S., HTL(ASCP)

 

 From: b-freder...@northwestern.edu
 To: foreig...@gmail.com; vickroy@mhsil.com
 Date: Thu, 31 May 2012 19:10:11 +
 Subject: RE: [Histonet] BLock alignment tool
 CC: histonet@lists.utsouthwestern.edu
 
 As does TechOne Biomedical. www.techoneweb.com. We have one for each 
 microtome. Just bear in mind if your floor or workstation is not level, it 
 may skew the leveling of the microtome.
 
 Bernice Frederick HTL (ASCP)
 Senior Research Tech
 Pathology Core Facility
 ECOGPCO-RL
 Robert. H. Lurie Cancer Center
 Northwestern University
 710 N Fairbanks Court
 Olson 8-421
 Chicago,IL 60611
 312-503-3723
 b-freder...@northwestern.edu
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Patrick Laurie
 Sent: Thursday, May 31, 2012 1:57 PM
 To: Vickroy, Jim
 Cc: histonet@lists.utsouthwestern.edu
 Subject: Re: [Histonet] BLock alignment tool
 
 Newcomer supply has one that works in all standard microtomes. It is rather 
 intuitive. It is essentially a level on an apparatus that goes inside of the 
 block clamp part of the microtome. They call it the universal microtome 
 alignment tool.
 
 On Thu, May 31, 2012 at 11:48 AM, Vickroy, Jim vickroy@mhsil.comwrote:
 
  Awhile back we got an advertisement for a block alignment tool that would
  be helpful in recut cases. Can anyone share with me companies that have
  this device and approximate costs?
 
  James Vickroy BS, HT(ASCP)
 
  Surgical and Autopsy Pathology Technical Supervisor Memorial Medical 
  Center
  217-788-4046
 
 
  
  This message (including any attachments) contains confidential 
  information intended for a specific individual and purpose, and is 
  protected by law. If you are not the intended recipient, you should 
  delete this message. Any disclosure, copying, or distribution of this 
  message, or the taking of any action based on it, is strictly prohibited.
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 --
 Patrick Laurie HT(ASCP)QIHC
 CellNetix Pathology  Laboratories
 1124 Columbia Street, Suite 200
 Seattle, WA 98104
 plau...@cellnetix.com
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RE: [Histonet] RE: CAP vs. CLIA

[WILLIAM DESALVO]

I seemed to have missed something or it might have been all the fresh sea air I 
got in Tampa at the FSH, but I do not understand the outrage expressed towards 
CLIA and CAP because we are not listed as testing personnel. I applaud 
everyone's passion for Histotechnology and the outrage that we are not allowed 
to fully participate in the test system model, but I think we should be 
directing more of our outrage to the individuals working in Histotechnology 
that are not and will not take responsibility to increase the professionalism 
of our profession and our own acceptance of the current state of 
Histotechnology.
 
A TEST SYSTEM is the process that includes pre-analytic, analytic, and 
post-analytic steps used to produce a test result or set of results. As good as 
we are and as complex parts of the Histotechnology process may be, 
Histotechnicians, Histotechnologists and Pathology Assistants do not meet the 
standard stated and do not participate in the post-analytic phase, produce and 
release patient results. We simply are not able to be credentialed as is the 
Medical Technologists and Cytotechnologist. I am not saying any one laboratory 
professional group is better than the other, just that to be considered testing 
personnel, we must be properly credentialed.  
Collectively, we as a discipline, science and group should be working to 
upgrade our education requirements and training so that we can become fully 
invested partners with the Pathologist. We, not CAP or CLIA, must greatly 
increase our professionalism before we can truly be considered competent to 
work in the post-analytical phase. I cannot today accept that every working 
Histotechnician, Histotechnologist and Pathologist Assistant is able to produce 
the result and release. I am quite sure that every Medical Technologist and 
Cytotechnologist is capable and competent to produce and release a patient 
result. As things stand today, Histotechnology and all of us the working in 
this discipline are a support function to the one person in our discipline, the 
Pathologist, that is educated, trained, credentialed and competent to produce 
and release a patient result. I also believe there are many opportunities 
within our process available now, such as histochemical staining for organisms, 
that could allow us to participate in the post-analytic step. There will be 
many more as personalized medicine continues to transform Histotechnology. That 
said, how can we honestly promote our participation in the post-analytic phase, 
when there are far too many individuals (good, decent and hard working) that 
work every day, in every type and complexity of lab, that do not have a formal 
secondary education, have participated in defined clinical trials or have 
completed a certification exam (required and necessary credentials). Just think 
how many practitioners of Histotechnology are out there working today that are 
not properly credentialed. Now think if you know of any Medical Technologist or 
Cytotechnologist are working that do not have the required credentials.  We 
have many obstacles to increasing the professionalism of Histotechnology; wide 
and varied backgrounds, lack of standards, lack of automation, lack of 
certification, but I do not think that CAP or CLIA should be considered one of 
them. This problem is completely our responsibility. We first have to demand 
proper credentials, no exceptions, no matter the problem, before we can expect 
other laboratory professionals to support us in increasing our professionalism 
and participation in the healthcare delivery system. As important the need for 
a robust accreditation process, healthy discussion must take place before real 
change can happen. I suggest we direct our passion and outrage to demand proper 
credentials to work in Histotechnology and then demand full participation in 
the test system and proper recognition by all laboratory professionals. 
 

William DeSalvo, B.S., HTL(ASCP)

 
 From: jel...@yumaregional.org
 To: timothy.mor...@ucsfmedctr.org; histonet@lists.utsouthwestern.edu
 Date: Thu, 17 May 2012 17:52:44 +
 CC: 
 Subject: [Histonet] RE: CAP vs. CLIA
 
 I completely agree with you on this.
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu 
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, 
 Timothy
 Sent: Thursday, May 17, 2012 10:46 AM
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] RE: CAP vs. CLIA
 
 Jesus wrote:
 
  I think the CAP need to re-evaluate this and re consider what high 
 complexity testing is, because CLIA defines it not the CAP.  Remember CAP 
 enforces CLIA regulation as well as their own.  
 
 Certainly the regulations limit the high complexity designation to 
 interpretation of procedure results, but that does not mean a facility does 
 not need very highly trained and competent technologists to do the protocols 
 that lead to good interpretation

RE: [Histonet] LIS questions

[WILLIAM DESALVO]

When we start talking about the issues associated w/ server vs. cloud in 
healthcare, I think discussion needs to start w/ and be centered on capability 
of compliance and enforcement, as it relates to HITECH Act, HIPPA and delivery 
of ePHI. There is a complexity added as more health information exchanges are 
developed and access to data is expanded and the need to develop complex and 
sound Business Associate Agreements.  In my mind, the idea of more access 
and/or ease of access must be directly related to the ability to control and 
provide security of access.
 
I believe this very complex issue and process will rely less on the needs of 
the end user, Histotechnicians/Histotechnologists and more on the need to meet 
HITECH requirements and very secure delivery. This is a very complex IT issue 
and maybe not best discussed on the Histonet w/ technical personnel with 
limited IT knowledge.

William DeSalvo, BS, HTL(ASCP)

 

 From: m...@pathview.com
 To: kdboydhi...@yahoo.com; Histonet@lists.utsouthwestern.edu
 Date: Tue, 24 Apr 2012 08:52:13 -0700
 Subject: RE: [Histonet] LIS questions
 CC: 
 
 Good morning,
 
 I’d like to take up the issue of server vs cloud in Kelly’s original email.
 I have some thoughts that I’d like to share, but more importantly, I’d like
 to hear other people’s opinions. This is going to be a continuing ‘hot
 topic’ in the LIS world for years to come and I think it would be nice to
 have some sort of list for people to start thinking about. I am aware that
 traditionally there has not been a lot of LIS involvement in the histology
 laboratory, but with the advent of 'barcode tracking' and new quality
 initiatives, I am sure that this is about to change.
 
 Server
 Pros:
 1. More control – you know where your data resides and you have full
 control over it.
 2. Ostensibly faster, because you’re just sharing your data traffic
 internally, not across the world web.
 3. We know this model works in both low and large volume operations.
 Cons:
 1. You’re responsible for maintaining the server – operating system
 patches which occur every few months it seems and daily backups.
 2. Cost associated with the server(s) – Often times there will be 2
 servers – production and development, plus there is a license fee. Bottom
 line, think around 10, 000 to 20,000. You also need a ‘place’ to put the
 servers.
 
 
 Cloud
 Pros:
 1. A user can get to the system from everywhere -- great if you don’t
 have an infrastructure already in place.
 2. No hardware costs for the server, but I would imagine that there is
 some fee hidden somewhere – nothing in life is free, right?
 Cons:
 1. No control over your data. It can reside anywhere in the world and
 who knows how the local laws protect your data. If the data resides in the
 US, that’s less of a concern. With less control, you never really know if
 your backups are occurring or not. 
 2. Because you’re on the web, the potential exists for a slower system.
 This is probably not as important when a pathologist is signing out a case,
 but depending on the LIS, it could be a big problem, if there is a lot of
 user interaction. For instance, anything to do with blocks or slides which
 can be numerous and require rapid processing, could be an issue. In my own
 experience, I’ve waited on a ‘web page refresh’ for several seconds from
 time to time. If my specials are due out at 10 a.m. and it’s 9:45, I don’t
 have time for a slow connection.
 3. With current technology, instrument interfaces can be difficult
 because they require more of a realtime or ‘very fast’ response.
 4. Does anyone know of a large volume lab that uses a web based LIS
 where the LIS requires quick response time?
 5. What happens if I change from a web based LIS. I ‘assume’ I don’t
 get access to my data unless I continue to pay some sort of fee. With a
 server based system, I can stop paying maintenance, but I can still access
 my data.
 
 What do you all think? Do you disagree with the list? Do you have more to
 add? 
 
 Bottom line, I think for me, and remember, I’m an LIS vendor myself, system
 functionality would still be a priority as far as system selection is
 concerned. The ‘feel of the company’ would be my next critical concern, and
 then I would think about cost and technology.
 
 Michael Mihalik
 PathView Systems | cell: 214.733.7688 | 800.798.3540 | fax: 952.241.7369
 
 
 -Original Message-
 From: histonet-boun...@lists.utsouthwestern.edu
 [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Kelly Boyd
 Sent: Wednesday, April 18, 2012 11:31 AM
 To: histonet
 Subject: [Histonet] LIS questions
 
 
  
 
 
 Is anyone out there familiar with any of the following LIS systems, if so,
 what are your thoughts??  AIM Path Software systems, Wavefront Software,
 WinSURGE, CSS LIS
  
 What are the opinions out there for a server based system versus a cloud
 based??
 Thanks!
 
 
 Kelly 
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RE: [Histonet] When to toss reagents?

[WILLIAM DESALVO]

Test the new reagent for performance and then apply a date label for 12 months 
from opening/use. Test the reagent at the end of the 12 month period for 
efficacy and if meets specification or standard, date for another 12 months. 
Continue the process until you demonstrate a performance issue. Discard when 
reagent does not perform as expected or meet standard.

William DeSalvo, B.S., HTL(ASCP)

 

 Date: Tue, 20 Mar 2012 09:58:28 -0700
 From: ce...@grh.org
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] When to toss reagents?
 
 When ordering new reagents, I have noticed many do not have an
 expiration date or a 'use by' date. How long after opening do you keep
 your reagents? We have several from the 70's!! Yikes!
 
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RE: [Histonet] picric acid

[WILLIAM DESALVO]

I do not know about a solution, but a REALLY BIG one with a 1 oz bottle of 
picric acid crystals. When I was in college bottle was vibrated off a shelf by 
an out of balance centrifuge. It was common for students to work w/ chemicals 
late at night when taking inorganic chem. The student loaded the centrifuge and 
left the room (went outside for a smoke), bottle dropped to the floor, exploded 
and left a 6 ft x 8 ft whole in the counter and wall and pretty much destroyed 
the 30 ft x 30 ft lab. Very lucky no one was hurt. At the time, i remember 
thinking, hey we will get a pass on the next assignment, only got two days off.
 
University Safety team had an accurate listing of all chemicals on the shelves 
and determined it had to be the picric acid. Safety and the Fire marshal did a 
sweep of the university and found six other bottles in various labs on campus. 
Never did hear how they disposed and I bet that made a BIB BANG!!   

William DeSalvo, B.S., HTL(ASCP)

 

 From: margaret.pe...@sdstate.edu
 To: histonet@lists.utsouthwestern.edu
 Date: Fri, 3 Feb 2012 18:50:37 +
 Subject: [Histonet] picric acid
 
 I am curious how big an explosion there would be from 1% picric acid in 
 acetone if a little dried around the cap.
 
 Margaret Perry HT(ASCP)
 Dept of Veterinary and Biomedical services
 Box 2175
 South Dakota State University
 Brookings SD 57007
 605-688-5638
 
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RE: [Histonet] reagents without expiration dates

[WILLIAM DESALVO]

Per SOP, we relabel, list date of receipt, test for quality and then apply a 12 
month expiration date. We re-test after 12 months and continue to use, with 12 
month dating, as long as the reagent meets quality standards set in the SOP. 

William DeSalvo, B.S., HTL(ASCP)

 

 From: kst...@mcw.edu
 To: histonet@lists.utsouthwestern.edu
 Date: Thu, 2 Feb 2012 12:56:58 -0600
 Subject: [Histonet] reagents without expiration dates
 
 Could anyone share a policy to deal with regents that do not have a 
 manufacturer's expiration date?
 CAP checklist ANP 21382
 
 Thanks,
 Kathryn Stoll, HT(ASCP)
 Depatment of Pathology
 Medical College of Wisconsin
 9200 W Wisconsin Ave
 Milwaukee WI 53226
 414.805.1525
 kst...@mcw.edu
 
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RE: [Histonet] reagents without expiration dates

[WILLIAM DESALVO]

Many, many, many years ago back in the 80's, I worked for Sigma-Aldrich and was 
visiting Charles Churukian's lab. He had a full wall of his lab with shelves, 
floor to ceiling, of dried and liquid Sigma reagents. He had every lab chemical 
and reagent I knew and was very proud that he was a great Sigma customer. The 
labels were none that I had seen in 10 yrs working at Sigma, so I took a few 
containers down and read the manufacturing code. The oldest was sodium 
bisulfate, gallon container, manufactured in 1946. Most were 20-30 yrs old then 
and in large quantities. I have always thought to myself, with many more 
customers like Chuck, Sigma could go out of business. I miss Chuck, but I bet 
he is still teaching the heavens everything they need to know about Histology 
and Staining. I don't know if that beats your stuff, but I bet the chemicals 
Chuck left behind are still in use.   

William DeSalvo, B.S., HTL(ASCP)

 

 Date: Thu, 2 Feb 2012 13:14:53 -0800
 From: rjbu...@yahoo.com
 To: histonet@lists.utsouthwestern.edu; talulahg...@gmail.com
 Subject: Re: [Histonet] reagents without expiration dates
 CC: 
 
 Ha.Ha,Ha!!!
 I used to prepare staining solutions with some Merck-Darmstad anilines 
 manufactured just after the Great War, i.e. the FIRST World War (about 1925 
 before the World Great Depression).
 Try to beat that!.
 René J.
 
 --- On Thu, 2/2/12, Emily Sours talulahg...@gmail.com wrote:
 
 
 From: Emily Sours talulahg...@gmail.com
 Subject: Re: [Histonet] reagents without expiration dates
 To: histonet@lists.utsouthwestern.edu
 Date: Thursday, February 2, 2012, 3:33 PM
 
 
 I've always wanted to have a contest to see who had the oldest reagents.
 My lab once had something that was 20 years old.
 
 Emily
 
 The whole point of this country is if you want to eat garbage, balloon up
 to 600 pounds and die of a heart attack at 43, you can! You are free to do
 so. To me, that’s beautiful.
 --Ron Swanson
 
 
 
 On Thu, Feb 2, 2012 at 2:07 PM, WILLIAM DESALVO 
 wdesalvo@hotmail.comwrote:
 
 
  Per SOP, we relabel, list date of receipt, test for quality and then apply
  a 12 month expiration date. We re-test after 12 months and continue to use,
  with 12 month dating, as long as the reagent meets quality standards set in
  the SOP.
 
  William DeSalvo, B.S., HTL(ASCP)
 
 
 
   From: kst...@mcw.edu
   To: histonet@lists.utsouthwestern.edu
   Date: Thu, 2 Feb 2012 12:56:58 -0600
   Subject: [Histonet] reagents without expiration dates
  
   Could anyone share a policy to deal with regents that do not have a
  manufacturer's expiration date?
   CAP checklist ANP 21382
  
   Thanks,
   Kathryn Stoll, HT(ASCP)
   Depatment of Pathology
   Medical College of Wisconsin
   9200 W Wisconsin Ave
   Milwaukee WI 53226
   414.805.1525
   kst...@mcw.edu
  
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RE: [Histonet] Bleaching in the histo lab

[WILLIAM DESALVO]

The short answer is that you need a detailed procedure for all immediate and 
regular cleaning of infectious materials and hazardous chemicals used in your 
lab.
 
I believe the standard practice your safety officer is referring used in the 
clinical lab is a practice to clean all surfaces after each shift to 
remove/decontaminate all contaminated or potentially contaminated from the work 
surfaces of blood or other infectious material w/ 10% bleach solution (1:10 
dilution of 5.25% solution of sodium hypochlorite) or other lab cleaners 
approved for biohazard approved contamination. The waste generated by this 
process should be disposed of in the non-regulated medical waste. Typically in 
the Histology room there should not be blood or other infectious materials (you 
are working w/ fixed and processed tissue samples), unless you have your frozen 
section and/or gross dissection processes connected to and part of the main 
Histology room. I suggest you use the bleach solution whenever there is known 
or suspicion of contamination of a potentially infectious material.
 
For areas/surfaces and equipment where lab chemicals are used, always remove 
the spilled chemical according to MSDS recommendations and then clean the area 
w/ a damp cloth with water and a detergent and them wipe clean and dry. If or 
when a hazardous chemical is spilled (i.e. Xylene, Formalin or chemicals 
associated w/ IHC or Special staining), it should be treated as a hazardous 
chemical spill and there area should be cleaned according to your hazardous 
chemical spill protocol. Small spills (up to 300 cc) - neutralize and/or 
adsorption; medium spill (300 cc to 5 liters) - adsorption spill kit; Large 
spill (5 liters) - outside help. disposal will be in regulated hazardous waste.
 
The main point here, instances of contamination of infectious materials or any 
size spill of hazardous chemicals should be treated seriously and properly. 
Your cleaning and disposal procedure must be very detailed to protect the 
employees and meet lab, municipality, state and regulatory requirements. I am 
very passionate about properly handling chemicals and protecting everyone that 
must have contact w/ these necessary solutions/products. I suggest you and your 
safety officer have a sit down and discuss how to document and address these 
issues, a drive-by by a safety officer is really not adequate.
  
William DeSalvo, B.S., HTL(ASCP)

 

 Date: Wed, 1 Feb 2012 05:57:27 -0800
 From: we3smi...@yahoo.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Bleaching in the histo lab
 
 I have been told by our safety officer that it is standard practice too clean 
 the lab at the end of the day with diluted bleach. I have noticed a chemical 
 reaction (smell) when cleaning the main area of the lab. I have concerns that 
 this is not a good practice due to chemical reactions as we use so many 
 chemicals in histology. What do other people do?  Also I believe it is unsafe 
 to use bleach with anything formalin related. 
 Please let me know if you have a standard practice or mandated cleaning 
 from your facility.
 Angela 
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RE: [Histonet] interview cutting-OT-disarmingly long for deletiondisinterested

[WILLIAM DESALVO]

I have been following the string and I see the issue from a different 
perspective. I have always found it difficult to find qualified and registered 
techs and have been training science degreed individuals as bench techs for 
several years. I think the issue is identifying the proper individual to add to 
your team. Technical skill is important, but attitude, aptitude, desire and how 
they will ultimately fit into and what they will add to the team are by far 
more important. The question that may be better to ask is How do you cut a 
section and why do you cut a section?. Just being able to cut a section is 
not necessarily going to give you enough information to decide if the 
individual really fits into the team, no better yet, fit into your culture. 
Hiring an individual that does not fit into your lab/company and can fully 
support and promote the mission, vision and goals, will not help you.
 
Why this is now becoming more of an issue may be due to the fact that with the 
shortage of techs in Histology, the situation exists where we have close to 
full employment of all registered and qualified techs. When that situation 
occurs, there will be more opportunities for less skill qualified individuals 
to obtain employment. I would not go so far as to call less skillful techs 
imposters or false, but maybe book smart and not skill smart. Hiring an 
individual to perform to the quality and productivity standards of the lab 
requires significant investment of time to train. Now the catch 22 starts, you 
must invest time to properly add to your team and you do not believe you have 
time to invest.
 
Once you bring a new member into your team, there is a cycle (training, 
functionality and competency) that must take place. You must identify were an 
individual fits into that cycle and how much time will be required to move them 
to competency. I have seen both skill qualified and non-skill qualified 
candidates take the same time to reach functionality. Again, I believe attitude 
is more key than technical skill. Without the proper attitude you will not 
quickly reach functionality and functionality allows you to gain time. 
Competency is the end goal, but functionality is the first critical step. To 
properly move through the cycle you must have a detailed, documented and 
functional training process.  
 
This whole discussion speaks to me that there is a lack of written and 
documented standardized training (it works for MT's) and to develop 
standardized training you must have standardized procedures and techniques (you 
knew I would work this into the discussion). The degree of difficulty of an 
individual to meet the quality and productivity requirements of the lab depends 
on the amount of standardization in the lab. Couple a standardized process with 
attitude and desire and you can quickly develop a new hire into a fully 
functioning member of the team. I believe that is the real goal and that will 
help Histotechnology progress.
 
Is attitude, aptitude and desire really exposed when you ask a candidate can 
you cut a section?

William DeSalvo, B.S., HTL(ASCP)

 

 Date: Tue, 31 Jan 2012 14:14:54 +
 From: koelli...@comcast.net
 To: akbitt...@geisinger.edu
 Subject: Re: [Histonet] interview cutting-OT-disarmingly long for 
 deletiondisinterested
 CC: histonet@lists.utsouthwestern.edu
 
 Fascinating... and that gets me back to my original ponderance. Why all the 
 false histotechs? Are there people trying to sneak into flow cytometry who 
 have never run a flow cytometer or clinical chemistry medtechs who have never 
 sat in front of an analyzer or cytotechs who don't know an epithelial cell 
 from a glandular cell. What is the reason that there seems to be so much 
 trouble now with non-functioning or poorly functioning histotechs or outright 
 imposters? Maybe there is an answer 2 or 3 levels globally deeper in health 
 care and society than the simple question of Can you cut a section at 
 interview? 
 Ray 
 Seattle 
 
 - Original Message -
 From: Angela Bitting akbitt...@geisinger.edu 
 To: Thomas Jasper tjas...@copc.net, Kim Donadio 
 one_angel_sec...@yahoo.com 
 Cc: histonet@lists.utsouthwestern.edu 
 Sent: Tuesday, January 31, 2012 5:36:53 AM 
 Subject: Re: [Histonet] interview cutting-OT-disarmingly long for 
 deletiondisinterested 
 
 I've had a temp, who we interviewed over the phone, come in and sit down at a 
 microtome and create the most horrendous slides I've ever seen. He lasted a 
 week and we sent him back from whence he came. I don't think he was EVER a 
 Histotech or if he was it was many, many moons ago. Point is.he snowed us 
 all during the interview. Just thought I'd throw that out there. 
 
  Kim Donadio one_angel_sec...@yahoo.com 1/30/2012 10:01 PM  
 Oh come on. The truth of the matter of why I like to give a manual test to 
 new hires is because people are graduating some Internet programs without the 
 technical skills to function in a lab. Not all

RE: [Histonet] Breast Fixation with fixatives other than Formalin

[WILLIAM DESALVO]

10% Formalin for the fixative and Xylene in the tissue processing are the FDA 
approved method for Her2. That said, you have to properly manage the tissue and 
fixative or adding days to the process will not improve the result. I would 
suggest that you approach your problem form a different aspect. 10% formalin is 
a fine fixative for breast tissue, but it will not  penetrate you tissue 
samples that are greater then 5 cm thick. ASCO/CAP suggest that for larger 
samples, 5 cm, the tissue should be loafed into slices not greater than 5 cm 
for fixation. This provides only 2.5 cm of distance the fixative needs to 
travel. I am a strong proponent that the samples selected for processing and 
placed into the cassette should be 3 mm thick. If you dissect the specimen and 
the tissue is not fixed, then once the sample is in the cassette, make sure 
you have adequate fixation, stay w/in the ASCO/CAP guidelines, but at least 6 
hrs fixation when you get the raw 3mm sample in the cassette. I would also 
look at the processing schedule you use for tissue sample processing. With 
thick specimens, 3mm, the schedule will need to be extended, 10-12 hrs total 
processing time, and you may continue to get varying results. If you select 
thin samples and apply adequate fixation time once you have a sample in the 
cassette, you will get consistent results. With proper sample size and fixation 
you can consistently process to paraffin in less than 2 hrs, using the Xpress 
rapid tissue processor. Standardize and create precision in your sampling and 
fixation and I know you will have superior and consistent results.  

William DeSalvo, B.S., HTL(ASCP)

 

 Date: Mon, 23 Jan 2012 09:47:38 -0500
 From: carol.fie...@northside.com
 To: histonet@lists.utsouthwestern.edu
 Subject: [Histonet] Breast Fixation with fixatives other than Formalin
 
 Hi Netters,
 Could you please let me know who all is using breast fixatives other
 than 10% formalin and what do you do about CAP requirements? I would
 also like to get in touch with Dr. Richard Cartun because I think he has
 done studies on this for Her2. Our docs will not let us use anything
 other than formalin because of CAP regs and the result is a lot of raw
 breast tissue. This is even holding the tissue for a couple days.
 Any help with this would be appreciated.
 Thank you,
 Carole
 
 Carole Fields, HT (ASCP)
 Histology Supervisor
 Northside Hospital
 Atlanta, GA 30342
 carol.fie...@northside.com
 
 
 
 
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