Re: [Histonet] Price for preparing IHC slides
A lab I used in Southern California charged $35 per stain for most antibodies. Sent from my iPhone On Feb 3, 2014, at 1:03 PM, Ann Specian thisis...@aol.com wrote: Can anyone tell me the average cost for preparing an IHC slide? thanks, Ann ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC-start-up
Doing ihc on animal tissue is very tricky, if for no other reason than you are trying to standardize an antibody across multiple species. You will need to use every trick in the book and invent some of your own to get reproducible results. I would steer clear of any platforms that do not let you customize everything. I would suggest an OLD Dako or biocare's IntelliPath. Both have their quirks but they have the openness you require. William Chappell Sent from my iPhone On Jan 23, 2014, at 11:49 AM, Erin Sarricks esarri...@gmail.com wrote: Hi all- Our histopathology lab is looking to set up an IHC component to service the request of our clients. All work is on animal tissue. We will probably run about 1,000 IHC slides the first year and hope to increase the workload each year. Some stains we would run would include CD4, CD8, Ki-67 and TUNEL. We looked at the Ventana Discovery XT and appeared to be a good fit for our needs. Does anyone have any other advice on other machines we should look into? Any information or advice would be greatly appreciated. Thank you! Regards, Erin Sarricks, HT (ASCP) ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Processing:
This depends on so many different factors, however, I prefer a frequent rotation over a complete change. Do what is best for your tissue! Sent from my iPhone On Jan 13, 2014, at 9:46 AM, Jb craiga...@gmail.com wrote: I have one tech telling me that when the entire processor is changed the tissue is too dry. We run a lot of fatty tissues, breast, etc on this processor. (Our biopsies are run on a separate processor). Is this correct, or should we only rotate reagents? No other techs complain. I have a hard time believing this, my experience is the opposite. Any input is appreciated. Sent from my iPhone ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] New CPT code for IHC
88343 refers to subsequent antibodies placed on the same slide such as multiplex staining or the PIN-4. Hope that helps. Will Chappell, HTL(ASCP), QIHC Sent from my iPhone On Nov 19, 2013, at 8:31 AM, Leann M. Murphy lmurp...@aultman.com wrote: How will everyone be handling the new CPT code 88343 for IHC going into effect 1/1/14? The CPT code 88342 has a new description stating it is to be used for the first antibody and 88343 is to be used for each additional separately identifiable antibody. The concern is that each antibody at any point and time could be the primary or additional. LeAnn Murphy Aultman Hospital Technical Specialist lmurp...@aultman.commailto:lmurp...@aultman.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Specimen collection/transportation
This to me seems very odd. Almost exclusively specimens are sent to my lab in formalin. Placentas are usually sent fresh simply because of their size. If anything, the birthing unit may not be in compliance, but it has nothing to do with the lab. The formalin containers must be properly labelled, and appropriate SOPs in use on the floor, usually to include a spill kit. I wrote the procedures for the floor units, but it is their responsibility to be in compliance. Will Chappell, HTL(ASCP) Sent from my iPhone On Nov 18, 2013, at 12:02 PM, LeAnn Lang ll...@aipathology.com wrote: We were recently contacted by our hospital indicating that we are in violation of OSHA by using the process we currently are using. Currently, we provided prefilled 10% neutral buffered formalin containers to the surgical suites, birthing units, etc. They fill the containers with the specimens and return them to the pathology lab. We have done this process for many many years and have never been questioned for this by either CAP or Joint Commission. What is your process for specimen collection/transport? Are the specimens put in formalin in the surgery suites/birthing unit/etc or in the pathology laboratory? How about placentas, are they sent in formalin from the floor or are they put in formalin in the histology lab? Thank you! LeAnn ** LeAnn Lang Associates in Pathology Practice Administrator Phone: 715-847-0075 (ext 50259) ll...@aipathology.com mailto:ll...@aipathology.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Specimen collection/transportation
And we just passed CAP with zero deficiencies. Sent from my iPhone On Nov 18, 2013, at 12:06 PM, Will Chappell cha...@yahoo.com wrote: This to me seems very odd. Almost exclusively specimens are sent to my lab in formalin. Placentas are usually sent fresh simply because of their size. If anything, the birthing unit may not be in compliance, but it has nothing to do with the lab. The formalin containers must be properly labelled, and appropriate SOPs in use on the floor, usually to include a spill kit. I wrote the procedures for the floor units, but it is their responsibility to be in compliance. Will Chappell, HTL(ASCP) Sent from my iPhone On Nov 18, 2013, at 12:02 PM, LeAnn Lang ll...@aipathology.com wrote: We were recently contacted by our hospital indicating that we are in violation of OSHA by using the process we currently are using. Currently, we provided prefilled 10% neutral buffered formalin containers to the surgical suites, birthing units, etc. They fill the containers with the specimens and return them to the pathology lab. We have done this process for many many years and have never been questioned for this by either CAP or Joint Commission. What is your process for specimen collection/transport? Are the specimens put in formalin in the surgery suites/birthing unit/etc or in the pathology laboratory? How about placentas, are they sent in formalin from the floor or are they put in formalin in the histology lab? Thank you! LeAnn ** LeAnn Lang Associates in Pathology Practice Administrator Phone: 715-847-0075 (ext 50259) ll...@aipathology.com mailto:ll...@aipathology.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Histo arcania ... Reticulum vs Reticulin
Reticulin is a type of fiber in connective tissue composed of type III collage secreted by reticular cells. Reticulum pertains to the endoplasmic reticulum, the second chamber of the alimentary canal of a ruminant animal, or (less frequent) the plural of reticular cell. Will Chappell Sent from my iPhone On Nov 7, 2013, at 3:02 PM, Morken, Timothy timothy.mor...@ucsfmedctr.org wrote: Oh Great Histonet, how do you describe the difference, if any, between the terms reticulum and reticulin. Tim Morken Supervisor, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center Box 1656 505 Parnassus Ave San Francisco, CA 94143 USA 415.353.1266 (office) tim.mor...@ucsfmedctr.orgmailto:tim.mor...@ucsfmedctr.org ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] RE: Histo arcania ... Reticulum vs Reticulin
Seems like our four-histotechs were the worst offenders for misuse. I believe Barry is right. A retic stain is a silver stain of a reticulum matrix of reticulin fibers (produced, of course, by reticular cells). Sent from my iPhone On Nov 7, 2013, at 4:35 PM, Morken, Timothy timothy.mor...@ucsfmedctr.org wrote: Tim Morken Supervisor, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center San Francisco, CA -Original Message- From: Morken, Timothy Sent: Thursday, November 07, 2013 4:35 PM To: 'Barry Rittman' Subject: RE: [Histonet] RE: Histo arcania ... Reticulum vs Reticulin Not to pick on Barry, but here is some other info These books refer to reticulum stain in reference to staining Reticular fibers: Sheehan Lillie Pearse Carson AFIP manual All stain kit vendors I have looked at These books refer to Reticulin stain in reference to staining Reticular fibers: Histology, A text and Atlas Basic Pathology Color Atlas of Histology Histology for Pathologists Bancroft's Histological Methods Tim Morken Supervisor, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center San Francisco, CA -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Barry Rittman Sent: Thursday, November 07, 2013 4:24 PM Cc: Histonet Subject: Re: [Histonet] RE: Histo arcania ... Reticulum vs Reticulin Reticulin is a type of collagenous fiber that is generally argyrophilic and first recognized as a type of collagen with the advent of electron microscopy. Associated with basement membranes and with fiber networks in bone marrow, lymph nodes etc. Reticulum in* anatomy* refers to a network. In* histology* it is usually used to describe the endoplasmic reticulum organelles in cells, comprised or smooth and rough endoplasmic reticulum and involved in protein synthesis and modification. Barry On Thu, Nov 7, 2013 at 5:48 PM, Weems, Joyce K. joyce.we...@emoryhealthcare.org wrote: I have seen them and have been told they are the same and interchangeable. I've never really looked into it, tho. It will be good to learn! Joyce Weems Pathology Manager 678-843-7376 Phone 678-843-7831 Fax joyce.we...@emoryhealthcare.org www.saintjosephsatlanta.org 5665 Peachtree Dunwoody Road Atlanta, GA 30342 This e-mail, including any attachments is the property of Saint Joseph's Hospital and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto: histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Morken, Timothy Sent: Thursday, November 07, 2013 6:03 PM To: Histonet Subject: [Histonet] Histo arcania ... Reticulum vs Reticulin Oh Great Histonet, how do you describe the difference, if any, between the terms reticulum and reticulin. Tim Morken Supervisor, Electron Microscopy and Neuromuscular Special Studies UC San Francisco Medical Center Box 1656 505 Parnassus Ave San Francisco, CA 94143 USA 415.353.1266 (office) tim.mor...@ucsfmedctr.orgmailto:tim.mor...@ucsfmedctr.org ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet This e-mail message (including any attachments) is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this message (including any attachments) is strictly prohibited. If you have received this message in error, please contact the sender by reply e-mail message and destroy all copies of the original message (including attachments). ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Height detail
None according to cap. Maybe something from OSHA. Must maintain a certain distance from ceiling (8-12 inches I think) and must be up off floor (if stored in lab). They must be safe, however that is subjective. Will Chappell, HTL(ASCP) QIHC And available. Sent from my iPhone On Sep 26, 2013, at 1:55 PM, Amber McKenzie amber.mcken...@gastrodocs.net wrote: What's the height limit you can stack blocks/slides according to CAP? ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] unsubscribe for NSH
Oh dear lord. Not Colleen!! Why man hath wrought?? Sent from my iPhone On Sep 18, 2013, at 11:42 AM, Colleen Forster cfors...@umn.edu wrote: ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Histologist Available for Southern California
Greetings Histonet, I am writing this for a colleague of mine who is not on Histonet. I have a friend who is relocating from Seattle, Washington. He is an experienced HTL with extensive IHC experience (QIHC). He has over 3 years of Anatomic Pathology Management experience, but would jump at the chance for a bench position. He is looking for anything in San Diego, Riverside, Los Angeles, or San Bernardino county. If anybody, including temp recruiters, has anything, please contact me and I will forward it to my friend. Thanks, William Chappell, HTL(ASCP), QIHC ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] picric acid paranoia
Ship them as you would any biological test samples. No problems here. Sent from my iPhone On Jun 4, 2013, at 5:52 AM, Smith, Allen asm...@mail.barry.edu wrote: Picric acid bound to collagen is not an explosion hazard. Even if it were, the surrounding paraffin wax would cushion the picric acid to the point of making it shockproof. Most of the picric acid in a fixative ends up in the hazmat bottle rather than in the tissue. Thus even putting 50 or so blocks of tissue fixed in picric acid into a hot fire would create less blast than a hearing aid battery. Bulk picric acid, where there is no moderator between the crystals, is another story. - Allen A. Smith, Ph.D. Barry University School of Podiatric Medicine -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Tyrone Genade Sent: Monday, June 03, 2013 2:30 PM To: histonet Subject: [Histonet] picric acid paranoia Hello, I am moving to the USA from sunny South Africa. I would like to bring my wax blocks with me but the fish inside them were fixed with Bouin's fluid. I'm worried the picric acid could draw the wrong sort of attention. Courier companies and US Customs (which never got back to me) haven't been able to give me an answer if they are safe to travel. The blocks have sat under my lab bench for 4 years without blowing up so I guess they are perfectly safe. Anyone have an opinion on the issues or some advice on an expert (at US customs?) to contact? I would probably ship them by surface post as it just more cost effective. Thanks Tyrone Genade PhD Department of Human Biology University of Cape Town ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] fungal stain for frozen sections
It appears, from a research paper I was reading, that a 1% solution of uvitex 2b added to eosin will cause fungus to fluoresce under uv light. I haven't performed it, however it could be as quick as an HE stain. Looks promising. Http://rd.springer.com/article/10.1007%2FBF02889994#page-1 Will Chappell CHOC children's hospital. Sent from my iPhone On May 16, 2013, at 9:00 AM, wrg...@aol.com wrote: Hi, I work in a Surgical Pathology frozen section lab outside the OR rooms. Normally we only perform an HE on the frozens. Now we are looking for a fast and inexpensive stain for fungus on our frozen sections. Fast is the operative word because we have to report diagnoses back to ORs in a 20 minute timeperiod. Any ideas to help? Thanks! ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Mohs histology hourly rate
I would expect around $25 in twin cities and between $20 and $23 outside. For MOHs with 10-15 years experience. You could find higher wages, but those would be few and far between. Sent from my iPhone On May 15, 2013, at 5:16 AM, Jaclyn Pitts pitts.jac...@gmail.com wrote: Good Question. I am interested in this too, as I wil lbe starting to do MOHS soon. I am located in Minnesota. On Tue, May 14, 2013 at 8:10 PM, rook...@comcast.net wrote: Hello, I was wondering if anyone knows what the going rate is for a Mohs histologist (Hourly). I have 12 years experience as a histologist doing routine histology and just recently got a job doing Mohs histology. Thanks in advance for any feed back, Christina ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- *Jaclyn Pitts, HT(ASCP)CM* 218-454-3520 Dermatology Professionals, PA 15167 Edgewood Dr. Suite 200 Baxter, MN 56425 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Mohs histology hourly rate
Location matters. Where? Sent from my iPhone On May 14, 2013, at 6:10 PM, rook...@comcast.net wrote: Hello, I was wondering if anyone knows what the going rate is for a Mohs histologist (Hourly). I have 12 years experience as a histologist doing routine histology and just recently got a job doing Mohs histology. Thanks in advance for any feed back, Christina ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Medical Director credentials on reports
Just passed CLIA. It is a CLIA requirement. Not sure about CAP. Will Chappell CHOC Children's Sent from my iPhone On Jan 10, 2013, at 5:45 AM, histot...@imagesbyhopper.com wrote: Does anyone know, and maybe have the regs, whether either the Joint Commission or the CAP *require* that the Medical Director's credentials be included on the genlab and surgical reports? I have heard that it *is* a requirement and now am hearing that it is *not* one. Clarification would be nice! Example: Joe Smith Medical Director OR Joe Smith, M.D. Medical Director Thanks! Michelle - No virus found in this message. Checked by AVG - www.avg.com Version: 2013.0.2805 / Virus Database: 2637/6021 - Release Date: 01/09/13 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] chemical disposal
Chemical hazardous waste. Sent from my iPhone On Nov 28, 2012, at 12:44 PM, Cynthia Pyse cp...@x-celllab.com wrote: Quick question for Histoland. I am having a debate about DAB disposal. Our general manager ( non lab background) insists that the liquid DAB can go into a biological hazardous waste. I disagree, it is a chemical and needs to be disposed in the chemical hazardous waste. What is everyone else doing to dispose of DAB. We are located in NY, I do have those regs. Thanks in advance for any and all help. Cindy Cindy Pyse, CLT, HT (ASCP) Laboratory Manager X-Cell Laboratories 20 Northpointe Parkway Suite 100 Amherst, NY 14228 716-250-9235 etx. 232 e-mail cp...@x-celllab.com ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Help! Liver mistakenly processed in paraffin (had to be in OCT instead)!
Nope, sorry. All your fat is dissolved. Sent from my iPhone On Nov 13, 2012, at 8:52 AM, z o n k e d zon...@gmail.com wrote: Hello Histonetters, First time writer, long time reader. I'm a newbie tech in academia and I was given a simple task which I think I pretty much screwed up. I should have embedded half of a mouse liver in paraffin for microtome sectioning while the other half should have been embedded in OCT for cryosectioning (for oil red o). I made the mistake last night of placing both liver halves into the tissue processor. The liver I intended for OCT embedding is now hard as wax. Is there any way to deparaffinize processed organs and may I embed them in OCT for proper cryosectioning? I imagine that the liver would get dehydrated, I would get crappy sections, and Oil Red O won't work. Any suggestions are welcome. Thank you so much, Zoe W. -- It costs nothing to say something kind. Even less to shut up altogether. --Nathan Fillion ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Block/Slide placeholders
Th product comes unassembled from any vendor, office supply store, paper store, or side of box. Just apply scissors as appropriate. Sent from my iPhone On Oct 31, 2012, at 6:58 AM, Elizabeth Cameron elizabeth.came...@jax.org wrote: Does anyone know where I can get the little cardboard tabs that you use as placeholders when a block or slide is pulled from the file? Thanks! -Liz Elizabeth M. Cameron, HT, QIHC (ASCP) Histology Supervisor The Jackson Laboratory Bar Harbor, Maine 207-288-6326 The information in this email, including attachments, may be confidential and is intended solely for the addressee(s). If you believe you received this email by mistake, please notify the sender by return email as soon as possible. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Number of blocks
In fact, can you share them with all of histonet? Sent from my iPhone On Oct 25, 2012, at 7:33 AM, Hannen, Valerie valerie.han...@parrishmed.com wrote: Rene, I have been asked in the past about productivity in our department. Can you share those articles with me as well? Thanks!! Valerie Valerie A. Hannen, MLT(ASCP),HTL,SU(FL) Histology Section Chief Parrish Medical Center 951 N. Washington Ave. Titusville, Florida 32976 Phone:(321) 268-6333 ext. 7506 Fax: (321) 268-6149 valerie.han...@parrishmed.com -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Rene J Buesa Sent: Thursday, October 25, 2012 10:18 AM To: Dorothy Ragland-Glass; Histonet@lists.utsouthwestern.edu Subject: Re: [Histonet] Number of blocks Hi Dorothy: Your manager is wrong and probably influenced by some productivity consultant trying to appear tough or preparing to justiffy a staff reduction. The average sectioning productivity obtained in 325 histology laboratories (221 in the US and 114 in 24 foreign countries) is 24 blocks per hour. Under separate cover I am sending two articles dealing with this issue and that of staffing that you will be able to show to your manager. René J. From: Dorothy Ragland-Glass techman...@yahoo.com To: Histonet@lists.utsouthwestern.edu Sent: Wednesday, October 24, 2012 8:38 AM Subject: [Histonet] Number of blocks It was annouced by a histo lab manager that techs are expected to cut 40-50 blocks per hour. That seems to me to be rather high. I don't see quality slides being turned out. It is quantity and profit above patient care. I am old school, and I remember something about quality and patient first. Besides what kind of impact on morality of the techs, back problems and carpal tunnel syndrom is laying ahead for the cutter after cranking the microtome repeatedly that many blocks without a break. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet == This email is intended solely for the use of the individual to whom it is addressed and may contain information that is privileged, confidential or otherwise exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately delete this message. Thank you == ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] voice recognition and synoptic reporting
Voice Brook seems to be the market leader. They are powered by Nuance and Dragon which are the market leaders in the consumer market. However, they are pricy. Nuance offers a service that is more similar to a remote transcription service, however my guess is they rely heavily on their automated transcription software, without the cost of purchasing the software itself. If your IT department wants to dedicate 1 or 2 FTE's to getting you up and running, a cheaper solution is to purchase the Dragon backbone from Nuance, however it will take al ot of customization to make it on par with VoiceBrook. Just my opinion. Will Chappell CHOC Children's AP Supervisor On Sep 13, 2012, at 7:49 AM, Hutton, Allison ahut...@dh.org wrote: We have been asked to look at changing our pathology reports over to the synoptic report format. I was wondering if anyone could provide me some information on voice recognition software for pathology and if this would be the best (easiest) way to implement synoptic reporting for our path reports. I am only vaguely familiar with both so any information will be of great use. Thank You in Advance Allison ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Attention Vendors
OK Vendors, I am the new AP supervisor for a hospital laboratory (CHOC Children's) opening up in Orange County California first quarter of next year. I know most of you lurk on here, instead of me trying to track all you down, please have your local reps contact me. Just reply to my email cha...@yahoo.com. We will be purchasing histology, cytology, autopsy and grossing ancillaries. All capital equipment has already been purchased and/or chosen, but we are still in the market for select small equipment. If you have already been in contact with the laboratory, please contact me again separately. Thanks so much, William Chappell HTL(ASCP)QIHC Anatomic Pathology Supervisor CHOC Children's ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] VoiceBrook
There has been a total of ONE post for VoiceBrook transcription/voice recognition software on histonet. Does anyone use it? Does anyone have any recommendations? Pros? Cons? Specifically, what is the approximate capital outlay for the program? Do they have a purchase plan? I would expect a bit more talk as they self-proclaim they are the ONLY real solution for pathology transcription. William Chappell HTL(ASCP)QIHC Anatomic Pathology Supervisor CHOC Children's ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Proteolytic enzyme pretreatment before immunostaining
Enzyme pretreatment, and all steps in epitope retrieval, should follow the same quality control steps as antibody incubation and antibody concentration. Enzyme pretreatment is not magic, however the kinetics involved are very difficult to predict. Epitopes are typically chemical shapes within tertiary protein structure, however they can involve secondary structure and quartinary structure. The purpose of enzyme pretreatment is to get the right epitope in the right configuration so it can be recognized by the antibody. Heat retrieval is meant to break formalin cross linkages, but enzyme pretreatment actually eats away at part of the protein (depending on the protease). Too little protease treatment and it does nothing, too much and the epitope is destroyed. The bottom line, novel antibodies need to be validated with numerous retrieval methods. If it is deemed that a protease is better, numerous times and numerous concentrations should be tried -- even at different temperatures. Finally, there is no reason to believe that different novel antibodies will require the same pretreatment, however, a common pretreatment may be sufficient (though possibly not optimal) for each antibody. One last thing, if you know more about the nature of the antigen used to create the antibody, you may be able to predict the required pretreatment -- talk to the primary investigator. Will Chappell, HTL(ASCP)QIHC Anatomic Pathology Supervisor Children's Hospital of Orange County On Jul 31, 2012, at 8:41 PM, Young Kwun wrote: Dear Histonetters, Could anyone explain about the difference between proteolytic enzymes for immuostaining? We use enzyme pretreatment rarely nowadays, and apart from some ready-to-use one (Dako's Proteinase K), I have used Protease (Sigma) previously when I did manual staining. At the moment I am using Leica's BondMax autostainer and their enzyme pretreatment kit (Trypsin ??, usually one drop per 7 ml vial). I know the pretreatment condition would be affected by the concentration of enzymes, pH, temperature, incubation time etc. My question is that do they have different mode of action on tissues? I am helping a research project and our antibody includes various clones of Integrin 6 subunit and uPAR. I have tried enzyme pretreatment with autostainer and manual staining with Proteinase K (Dako). It seems that some antibodies work better with certain enzymes. I mean that some antibodies work well after BondMax enzyme treatment, but some antibody works better with proteinase K pretreatment manually. I am using the same polymer detection system (Leica Microsystem) for both methods. I would like to find an enzyme which works for both of our antibodies at the same time. Thank you. Young Kwun Senior Hospital Scientist Immunohistochemistry Dept. of Anatomical Pathology Concord Repatriation General Hospital Concord NSW 2139 Australia 02-9767-6075 (Tel) 02-9767-8427 (Fax) young.k...@sswahs.nsw.gov.au ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Billing IHC on MOHS
Well, I don't know if that settles that. I haven't responded, because I have not worked for a Mohs dermatopahtologist who runs Immunos (I have worked at numerous Mohs laboratories), however, this explanation is contradictory. Each stain is reported only once per block, not per slide or per layer (stage). Yet the definition of a block, Tissue flattened by cutting into pieces, embedded, and frozen in mounting medium used by histotechnologists to embed tissue for frozen sections. Every stage represent a new block in which slides are cut. These two statements are contradictory and need clarification. Now, my own opinion (again I have talked with my dermatopathologist and billing specialist and they are as lost as we) is that by definition, Mohs is a frozen section diagnosis that must be made by the surgeon (i.e., for a Mohs to be a mohs the surgeon removing the tissue must diagnose the tissue -- look it up). Every section taken, at every stage is a separate block of the same case. In the event you can charge immunos per case, only one charge can be made. If it can be shown that immunos can be charged per block (per the definition below), every immuno on every block from every stage can be charged. Now for the practicality -- we always start questions like this because medicare sets standards for billing that other insurance companies then adopt. We should NEVER ask, what can we charge for, but should always ask, what work did we do that it is fair for a patient to pay for. Ignore what medicare and insurance companies say, bill clients for the work we perform and for the results they get. How much more raw cost is there in staining two Mohs blocks with the same immuno? Is it fair to charge a patient double the amount for MUCH less than twice the work? Will Chappell HTL(ASCP), QIHC On Jun 19, 2012, at 9:15 PM, Kim Donadio wrote: Great team work! Job well done and a absolute answer is given. Thank you From: Carol Torrence ctorre...@kmcpa.com To: 'Kim Donadio' one_angel_sec...@yahoo.com Cc: 'Weems, Joyce K.' joyce.we...@emoryhealthcare.org; 'Ingles Claire' cing...@uwhealth.org; histonet@lists.utsouthwestern.edu Sent: Tuesday, June 19, 2012 2:10 PM Subject: RE: [Histonet] Billing IHC on MOHS The following is the response I recived from a coding specialist at the American Academy of Dermatology. I am trying not to be concerned that the reference is 6 years old but I think it clears up what we thought to be true. 88342 for IHC 88314 other “special stains” Here is the description for 88314 according to November 2006 cpt Assistant article, the companion piece to the AMA CPT Code Book. The work of processing and interpreting one routine stain is included in the procedure 17311- 17315. This stain is usually hematoxylin and eosin, or toluidine blue. If other special stains are necessary after one routine stain, then the code for special stains may be used (88314) as well as immunoperoxidase stains (88342) or decalcification procedures (88311). Special stains are not typically used and in most Mohs practices are of low frequency. Each stain is reported only once per block, not per slide or per layer (stage). AMA CPT definition of a Block:Tissue flattened by cutting into pieces, embedded, and frozen in mounting medium used by histotechnologists to embed tissue for frozen sections. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] Unregistered techs
I have respected Jay's input in the past, but I too must say something. Without realizing it, and by stating his opinion in a horribly crass way, Jay has touched upon an important truism. There are two types of histologists, those that have a job that pays the bills, and those who have a career in which they thrive. Neither are better than the other, both are needed. I suspect, however, that the majority of Histonetters -- especially avid contributors are in the latter group. I know I am. Histotechs who approach histology as a job, go into work, embed, cut, stain and go home. they are excellent techs, but are just not committed to expanding the field or doing more than is needed to provide the pathologist with a perfect slide. Jay refers to these people as no better than trained monkeys. That is a horrible insult with a small (very small) grain of truth. One day those histologists will be replaced by a mechanical/robotic process. The march of progress is unstoppable. The career histologist has a much longer life span however. We analyze and troubleshoot problems. We understand or endeavor to learn the organic chemistry of stains. We know EXACTLY how a Rabbit Monoclonal antibody is made. We know more about the practice of histology than ANY pathologist. We invent and develop antibodies and special stains. And we conceptualize and perfect the instruments that will replace the first group in the future. Jay, that is why so many are offended. We don't do this simply because it is a good paycheck. We are histologists because we are professionals who choose this career. You may be going to a job cutting slides (which is great and necessary), but we are enjoying our life. Will Chappell, HTL (ASCP), QIHC, MBA and histologist by choice, not accident On May 24, 2012, at 6:48 PM, Davide Costanzo wrote: I'm sorry - I cannot let this rest. The comment: we are just as much needed as pathologists, blah, blah, blah... is so upsetting I cannot sit back and listen to that without saying something! Everyone, regardless of their lot in life, is a very worthwhile part of the whole. Let me ask you a question, since you highly undervalue humans that are not MD's - let's say that you are a patient at Hospital X, and you go in to have your toenail removed. Who plays a more important role in your survival - the Podiatrist or the hospital janitor? I would argue that the janitor is more crucial in this instance, for if he/she fails to clean up the MRSA from the last patient you could conceivably die. The doctor solved your fungal problem, but the janitor prevented you from getting a potentially life-threatening infection. Think before you speak like that - everyone involved in your care is critical - and, yes, sometimes the doctor is not the most important person when it comes to keeping you alive and well! On Thu, May 24, 2012 at 2:01 PM, Jay Lundgren jaylundg...@gmail.com wrote: Scott Lyons sln...@yahoo.com Give me a break, HTs and HTLs do not make diagnoses or treat patients. I am a registered HT and a Florida licensed HTL with 19 years experience, I've done it all in the lab. I believe the certification and licensure of techs is a scam to bleed more money from people. Honestly, you can train a monkey to do our job. And I don't want to hear from everyone saying it's an art form, we are just as much needed as pathologists, blah, blah, blah... I work where they are hiring people from a masters degree program for histology with certification, THEY KNOW NOTHING. Experience it where it's at, whether certified or not, get off your high horse. Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet -- *David Costanzo, MHS, PA (ASCP)* Project Manager *Blufrog Path Lab Solutions* 9401 Wilshire Blvd. Ste 650 Beverly Hills, CA 90212 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] IHC ?
Excellent questions, I get it all the time. Overnight, in buffer, in the fridge will be ok. Do not leave in water as that will obscure morphology. Will On Sep 15, 2011, at 12:40 PM, sdys...@mirnarx.com wrote: Hello all, So I just realized I am out of my block after I have done HIER. Can I leave the slides in buffer in the fridge or something overnight. The block will be here at 10am tomorrow morning... She the slides be ok or do I need to re-cut all of them and start over (please tell me this is not the case) =) Sarah Goebel-Dysart, BA, HT(ASCP) Histotechnologist Mirna Therapeutics 2150 Woodward Street Suite 100 Austin, Texas 78744 (512)901-0900 ext. 6912 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
RE: [Histonet] Immuno's
Toni beat me to it. My suggestion is to contact the vendor where you purchase your detection. The technical support departments for immuno vendors are emmensely helpful. Try Dako at 800-400-DAKO, Biocare at 603-925-8000, or Cellmarque at 800.665.7284. In addition, it has always been my experience that a good hand stain is always better than an instrument stain -- primarily because they are better washed by hand. My best guess is that you are not draining your slides well enough between rinses. What I do is flood my slides with buffer, then put them at an angle (the Biocare IQ stainer is great for this) and rinse again -- Robin Simpkins at Biocare calls this the Jamaican waterfall. I then follow up with a flick of the slide, then proceed to the next step. Again call your vendors. Technical support will be extremely helpful and you may get an expert (applications specialist or TSR) out to help you in person. William Chappell, HTL(ASCP)QIHC IHC Development Specialist CellNetix Pathology Laboratories (503) 358-9567 www.cellnetix.com Our expertise...your peace of mind --- On Mon, 4/11/11, Rathborne, Toni trathbo...@somerset-healthcare.com wrote: From: Rathborne, Toni trathbo...@somerset-healthcare.com Subject: RE: [Histonet] Immuno's To: Hannen, Valerie valerie.han...@parrishmed.com, histonet@lists.utsouthwestern.edu Date: Monday, April 11, 2011, 8:38 AM Who are you purchasing your antibodies from? Any of the companies that I have dealt with would gladly send someone out to optimize their antibodies. The fact that you are performing them manually probably is not the cause for the weak staining. We used to use the old Shandon Sequenza staining system as a backup if our Dako was out of service. When used with the same protocols, the staining was the same. -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu]On Behalf Of Hannen, Valerie Sent: Monday, April 11, 2011 10:26 AM To: histonet@lists.utsouthwestern.edu Subject: [Histonet] Immuno's Hi Folks.. Looking for a bit of help. Is there anyone out there who are doing their immuno's manually? Our Pathologist has just informed us that our immuno's are ALL too weak. He states that they always have been, as he compares them to slides that we get back from the reference labs that we use for the antibodies that we don't do in-house. If you are doing them manually...what companies are you using for antibodies, detection kit and chromogen? And are your stains really dark? I informed our Pathologist that I know for a fact that the reference labs that we use, do the immuno's on stainers, and naturally these stains will be consistently be stronger. I am trying to see if I can keep costs down by trying not to have to buy a stainer and continue to do the immuno's manually. If you all know of a wet-workshop or of a immuno. company who would send someone to our facility to teach us ( the latter is preferred, since my section chief is going to retire in 1 1/2 weeks, I will be taking over her duties and this is going to leave us with only myself and one other tech, until we can get a replacement for my position). Any help or advice that can be given will be greatly appreciated. Thanks so much. Valerie Hannen, MLT(ASCP),HTL,SU (FL) Parrish Medical Center Titusville,Florida ** This email is intended solely for the use of the individual to whom it is addressed and may contain information that is privileged, confidential or otherwise exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately delete this message. Thank you ** ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet CONFIDENTIALITY NOTICE This message and any included attachments are from Somerset Medical Center and are intended only for the addressee. The information contained in this message is confidential and may contain privileged, confidential, proprietary and/or trade secret information entitled to protection and/or exemption from disclosure under applicable law. Unauthorized forwarding, printing, copying, distribution, or use of such information is strictly prohibited and may be unlawful. If you are not the addressee, please promptly delete this message and notify the sender of the delivery error by e-mail or you may call Somerset
Re: [Histonet] uh...
Sounds like your dehydrating alcohol is not dehydrating completely. I would switch out the 100%'s and the clearite. Either they got wet during the course of the day or someone made an oops when changing the stain line. Hope that helps. Will Sent from my iPhone On Apr 7, 2011, at 2:06 PM, sgoe...@mirnarx.com wrote: So I just stained a group of slides all at the same time with the same conditions. About 40 of 150 the eosin looks like it is bleeding out of the sections...this has never happened before? What could be the cause and how do I fix it? Everything is as normal, but again I am being forced to use the crappy stuff called clear rite. Could this be the cause of the bleeding? Thanks Sarah Goebel, BA, HT(ASCP) Histotechnologist Mirna Therapeutics 2150 Woodward Street Suite 100 Austin, Texas 78744 (512)901-0900 ext. 6912 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] uh...
Oh yes, how to fix it. Hydrate through clearite, 100% ETOH, 95% ETOH, and water. Spend an extra 5 mins in running tap water -- that should wash out most of the eosin. Then counterstain again with eosin. Dehydrate with the clean ETOHs and Clearite. That should do it. Another possibility I just thought of, I never used clearite for coverslipping, even in labs that primarily used clearite -- I always finished up in Xylene. Will --- On Thu, 4/7/11, William Chappell cha...@yahoo.com wrote: From: William Chappell cha...@yahoo.com Subject: Re: [Histonet] uh... To: sgoe...@mirnarx.com sgoe...@mirnarx.com Cc: histonet@lists.utsouthwestern.edu histonet@lists.utsouthwestern.edu Date: Thursday, April 7, 2011, 2:11 PM Sounds like your dehydrating alcohol is not dehydrating completely. I would switch out the 100%'s and the clearite. Either they got wet during the course of the day or someone made an oops when changing the stain line. Hope that helps. Will Sent from my iPhone On Apr 7, 2011, at 2:06 PM, sgoe...@mirnarx.com wrote: So I just stained a group of slides all at the same time with the same conditions. About 40 of 150 the eosin looks like it is bleeding out of the sections...this has never happened before? What could be the cause and how do I fix it? Everything is as normal, but again I am being forced to use the crappy stuff called clear rite. Could this be the cause of the bleeding? Thanks Sarah Goebel, BA, HT(ASCP) Histotechnologist Mirna Therapeutics 2150 Woodward Street Suite 100 Austin, Texas 78744 (512)901-0900 ext. 6912 ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
Re: [Histonet] RE: Pin4cocktail negative controls
I assume you mean what reagent to use as the negative control? The ideal control is a mixture of negative mouse serum and negative rabbit specifically titered to match the antibody concentration in the cocktail, which is probably proprietary. The next best solution is to use a universal negative control serum. The universal component typically denotes use with rabbit and mouse antibodies. Will Chappell, HTL(ASCP)QIHC Histologist at large Sent from my iPhone On Feb 21, 2011, at 8:07 AM, Carol Bryant cb...@lexclin.com wrote: I would like that information also. Thank you, Carol -Original Message- From: histonet-boun...@lists.utsouthwestern.edu [mailto:histonet-boun...@lists.utsouthwestern.edu] On Behalf Of Gomez, Milton Sent: Sunday, February 20, 2011 3:00 PM To: 'histonet@lists.utsouthwestern.edu' Subject: [Histonet] Pin4cocktail negative controls Hello Histonetters, What are you folks using as a negative control when running Pin4 cocktail antibody. Thanks in advance, MG /PRE html body br / This email message, including any attachments, is for the sole use of the intended recipient(s) and may contain information that is proprietary, confidential, and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure, or distribution is prohibited. If you have received this email in error please notify the sender by return email and delete the original message. Please note, the recipient should check this email and any attachments for the presence of viruses. The organization accepts no liability for any damage caused by any virus transmitted by this email.br / = /body /html PRE ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet NOTICE OF CONFIDENTIALITY This message, including any attachments, is intended only for the sole use of the addressee and may contain confidential or privileged information that is protected by the State of Kentucky and/or Federal regulations. If you are not the intended recipient, do not read, copy, retain or disseminate this message or any attachment. If you have received this message in error, please call the sender immediately at (859)258-4000 and delete all copies of this message and any attachment. Any unauthorized review, use, disclosure, copying or distribution is strictly prohibited. Neither the transmission of this message or any attachment, nor any error in transmission or misdelivery shall constitute waiver of any applicable legal privilege. ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
[Histonet] Biogenex
I heard a rumor that Biogenex was recently purchased. Can anyone confirm or deny said rumor? Will ___ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet
