[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] 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
