Re: [Histonet] Retirement in sight!

[Morken, Timothy via Histonet]

Victor, thanks, and I still appreciate your showing me around your lab and 
barcoding system when we were setting that up. It helped a lot in how we 
implemented it. 

VMC was a good place to learn - a small lab, doing a lot of different things. 
Besides newer methods in molecular biology I can say that I learned pretty much 
everything at VMC and since then it has just been refinement. And when I was 
there Dr Price was interested in developing "super techs" and actually paid out 
of his own pocket for a couple of us to go to NSH and EM meetings. I have not 
been anywhere else where that happened!

We're actually moving back to Fresno! My wife is from there and has family 
there. We had looked at other places, and in other states but decided that was 
the easiest place to go to. What really made me decide to take the plunge was 
the spike I housing prices this year. We were able to sell and make quite a 
bit. My wife had  serious case of Fear of Missing Out - thought the market 
would drop and we would lose the gains. So, here we are!

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


-Original Message-
From: Victor Tobias  
Sent: Thursday, September 09, 2021 10:36 AM
To: Morken, Timothy 
Cc: Histonet 
Subject: Re: [Histonet] Retirement in sight!

Congratulations Tim,

It has been a long road. Interesting how we both worked at VMC at different 
times and I would have to say it was prominent in our careers. It was where I 
was first exposed to Histology. I have enjoyed your friendship and comradeship.

Take care
Victor


Sent from my iPad

> On Sep 9, 2021, at 9:26 AM, Morken, Timothy via Histonet 
>  wrote:
> 
> 
> After 40 years in the lab I've decided to retire this year - in a week 
> actually!
> 
> It has been an interesting 4 decades...
> 
> I started out in an EM lab after getting a degree in Physiology and then  
> competing a 2 year EM course at Delta College in Stockton, CA - the only 
> dedicated EM program at that time. I started out running a scanning EM lab 
> for an electronics company looking at microchips but after a couple years 
> moved to a hosptial lab in Fresno, CA running their EM lab. I was the only 
> one, so from day one was the "Manager" of the lab! I did about 150 EM cases a 
> year and in those days it was a mix of kidney and tumor cases - there was no 
> IHC yet so some tumor diagnostics depended on EM. I did not have quite enough 
> work to keep me busy so I started hanging out in the histology lab. As with 
> many people in this field the day I started working there was the first I had 
> heard of "histology."  At first it was helping set up grossing, coverslipping 
> slides and doing immunofluorescence for the kidney cases (and taking 
> "kodachromes" of the results! Does anyone under 30 know what a Kodachrome 
> is?!). But then our director wanted to bring in IHC and so had a tech from a 
> lab at Cedars Sinai in LA come to teach us how to do it. We did all of 10 
> stains at first. Of course it was all manual and so had to know what was 
> going on with every step. I didn't use an automated stainer for the first 12 
> years that I did IHC, and at times was doing 150 slides a day manually.
> 
> Gradually I ended up doing half time in histology and learned cutting, 
> special stains, muscle histochemistry, immunofluorescence for kidney cases. I 
> decided to work on the HT exam since I was doing all that work anyway. We had 
> a lab of four men - pretty rare, Imagine - and we started a study group to 
> all take the test. We met after work a couple times a week for 6 months 
> pretty  much memorizing the Sheehan book. We all took the HT and all but one 
> passed. Later I passed the HTL as well.
> 
> After 11 years of that I moved on to a job in Saudi Arabia - and my wife and 
> daughter went along. I managed the IHC and muscle lab at King Faisal 
> Specialist Hospital in Riyadh. My wife was lucky enough to get a teaching 
> position at the American School where our daughter was in 9th grade. That 
> made all the difference in our life there because if she had not gotten a job 
> I don't think we would have stayed there  5 years. She would have been stuck 
> doing pretty much nothing. I moved on to managing the histology lab as  
> whole. Living in another country is a great experience, even if it is a 
> totally different culture. It certainly changed our outlook on the world and 
> I would not trade that experience for anything. We also did a lot of 
> travelling during those years - being on "that" side of  world makes 
> traveling there much easier!
> 
> Once we decided to leave Saudi I looked for a job back in the States and was 
> lucky enough to land one at the Cen

[Histonet] Retirement in sight!

[Morken, Timothy via Histonet]

After 40 years in the lab I've decided to retire this year - in a week actually!

It has been an interesting 4 decades...

I started out in an EM lab after getting a degree in Physiology and then  
competing a 2 year EM course at Delta College in Stockton, CA - the only 
dedicated EM program at that time. I started out running a scanning EM lab for 
an electronics company looking at microchips but after a couple years moved to 
a hosptial lab in Fresno, CA running their EM lab. I was the only one, so from 
day one was the "Manager" of the lab! I did about 150 EM cases a year and in 
those days it was a mix of kidney and tumor cases - there was no IHC yet so 
some tumor diagnostics depended on EM. I did not have quite enough work to keep 
me busy so I started hanging out in the histology lab. As with many people in 
this field the day I started working there was the first I had heard of 
"histology."  At first it was helping set up grossing, coverslipping slides and 
doing immunofluorescence for the kidney cases (and taking "kodachromes" of the 
results! Does anyone under 30 know what a Kodachrome is?!). But then our 
director wanted to bring in IHC and so had a tech from a lab at Cedars Sinai in 
LA come to teach us how to do it. We did all of 10 stains at first. Of course 
it was all manual and so had to know what was going on with every step. I 
didn't use an automated stainer for the first 12 years that I did IHC, and at 
times was doing 150 slides a day manually.

Gradually I ended up doing half time in histology and learned cutting, special 
stains, muscle histochemistry, immunofluorescence for kidney cases. I decided 
to work on the HT exam since I was doing all that work anyway. We had a lab of 
four men - pretty rare, Imagine - and we started a study group to all take the 
test. We met after work a couple times a week for 6 months pretty  much 
memorizing the Sheehan book. We all took the HT and all but one passed. Later I 
passed the HTL as well.

After 11 years of that I moved on to a job in Saudi Arabia - and my wife and 
daughter went along. I managed the IHC and muscle lab at King Faisal Specialist 
Hospital in Riyadh. My wife was lucky enough to get a teaching position at the 
American School where our daughter was in 9th grade. That made all the 
difference in our life there because if she had not gotten a job I don't think 
we would have stayed there  5 years. She would have been stuck doing pretty 
much nothing. I moved on to managing the histology lab as  whole. Living in 
another country is a great experience, even if it is a totally different 
culture. It certainly changed our outlook on the world and I would not trade 
that experience for anything. We also did a lot of travelling during those 
years - being on "that" side of  world makes traveling there much easier!

Once we decided to leave Saudi I looked for a job back in the States and was 
lucky enough to land one at the Centers for Disease Control in Atlanta in their 
Infectious Disease Pathology division. I worked with 5 infectious disease 
pathology specialists and a dozen technologists from histotechs to EM techs, to 
microbiologists to molecular biologists. We worked on routine cases to 
world-wide outbreak cases. During the 5 years I was there we identified at 
least one novel human virus every year that caused outbreaks. And that was in 
addition to numerous cases of outbreaks of known diseases for which we received 
samples from all over the world. Probably the most notorious case was the 
anthrax attack after 9/11. Four of us histotechs manned the lab 24 hours a day, 
7 days a week for 6 weeks running IHC tests on endless samples while trying to 
get on top of that case. In the middle of it all the power went out to the 
facility and we had to work on generator power with temporary lighting set up 
in the lab and battery packs to keep the equipment running. After 9/11 and then 
anthrax everyone was thinking it was a bioterror attack by the same group, so 
things were crazy. When  I think of all the efforts we made to enhance our 
detection and diagnostic capabilities, and all our meetings about how to handle 
outbreaks, it was hard to see the stumbles the CDC made in this current 
pandemic. But I can say that we had discussed, studied and predicted pretty 
much everything that has happened in this Covid 19 era. Indeed, we had the 
first-hand experience with SARS in the last year I was there, so knew exactly 
how it could play out.

Finally we decided to move back to California and I was able to connect with an 
old friend to get a position at Lab Vision in Fremont, CA. This company made 
the Dako Autostainer and also had a large offering of antibodies. We only had 
25 people but were doing very well and still had a "Startup" culture. That was 
a very interesting experience after being on the "customer" side for so long. I 
got to see a lot of different labs, go to a lot of meetings, make a lot of 
contacts and travel to 

[Histonet] Copy of an old EM resin paper?

[Morken, Timothy via Histonet]

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

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




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

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Re: [Histonet] cryostat

[Morken, Timothy via Histonet]

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

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


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

Hello,

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

Thanks to all,

Mehndi Helgren

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

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[Histonet] EM immunolabeling for kappa, lambda light chains in amyloid?

[Morken, Timothy via Histonet]

Can anyone give me any tips on EM immuno-gold labeling for kappa and lambda 
light chains in amyloid cases? We use Eponate12 for embedding.

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

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Re: [Histonet] Specimen tracking scenario, accountability

[Morken, Timothy via Histonet]

Curt, You can make and use barcodes in MS Excel or Access and print labels. If 
you keep the clients items together in some kind of bag or container you can 
put the label on the outside and scan at each station to track them. You just 
need to be sure the items are all kept together to ensure nothing gets lost. A 
photo now and then at critical steps could be helpful (we still take pics of 
all racks going into our processors - trying to scan cassette barcodes in racks 
is difficult). 

https://www.smartsheet.com/content/excel-barcodes

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


-Original Message-
From: Curt Tague via Histonet  
Sent: Tuesday, June 22, 2021 9:14 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Specimen tracking scenario, accountability

So we're in a reference lab setting here, it's a little different than the 
hospital environment... I've been in both.

We receive specimens from a variety of different hospitals, physician offices 
and even other labs for histology (TC), we send the slides back. What I'd like 
to do is implement some system for tracking blocks throughout the process but 
with so many different clients and number systems/prefixes, most of which are 
NOT barcoded, it can be a challenge tracking the blocks throughout the whole 
process... from receipt to embedding to microtomy...
Aside from manually documenting every blocks on a paper log sheet, would anyone 
have any suggestions on how to track these things?

My initial thought is a simple digital photo of the basket at embedding (when 
removed from the processor) then another photo of blocks you take to your 
microtome and perhaps one last photo when blocks are taken from your cutting 
station to be filed or returned... the simple issue is tracking who is in 
possession of what blocks at all times... accountability... but this seems to 
present challenges too...

Any thoughts are appreciated.

Curt
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Re: [Histonet] Problems with DIF staining of C4d

[Morken, Timothy via Histonet]

Beth, which C4d are you using? And it is a FITC-labeled primary?



We use it as a two-step rather than FITC-labeled primary. That increases the 
sensitivity significantly. Gloms have C4d so act as an internal control.



We use
C4d antibody, 100ul vial, unlabeled primary.  Diluted 1:200 in Dako or Bond 
diluent.
Quidel, Cat#  A-213

Secondary Ab:
Antibody, Goat anti Mouse IgG H+L FITC 1.5mg. Diluted 1:120 in Dako or Bond 
diluent.
Jackson Immuno Research
115-095-062


We store the concentrate in the fridge. We use it daily so go through it pretty 
quickly, but we have it validated for two years at 2-8C. We make fresh 
dilutions a couple times per week.



We stain on the Bond Autostainer, but manual will work fine as well.





Tim Morken

Supervisor, Electron Microscopy/Neuromuscular Special Studies

Department of Pathology

UC San Francisco Medical Center



-Original Message-
From: O'Neil, Beth A. via Histonet 
Sent: Tuesday, June 08, 2021 10:32 AM
To: Histonet 
Subject: [Histonet] Problems with DIF staining of C4d



We perform manual DIF staining at our facility and C4d has always been a 
problem.  We end up repeating the stain more times than not due to lack of 
staining.  We aliquot the FITC and freeze at -70C until ready for use.  We also 
started doing the same with the C4d.  Sometimes it works and sometimes it 
doesn't.  My pathologist said it is not the FITC but the C4d itself.  I have 
contacted the manufacturer of my C4d but they are very slow to respond.  Any 
suggestions or experiences would be appreciated.



Beth ONeil

WVU Medicine, JW Ruby Memorial Hospital



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Re: [Histonet] IF with permanent mounting media?

[Morken, Timothy via Histonet]

Thanks John! This looks interesting to say the least.

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

From: John Kiernan 
Sent: Friday, May 28, 2021 3:20 PM
To: Histonet ; Morken, Timothy 

Subject: Re: IF with permanent mounting media?

Espada J, Juarranz A, Galaz S, Canete M, Villanueva A, Pacheco M, Stockert JC 
(2005) Non-aqueous permanent mounting for immunofluorescence microscopy. 
Histochem. Cell Biol. 123: 329-334. https://doi.org/10.1007/s00418-005-0769-2 ‍ 
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Espada J, Juarranz A, Galaz S, Canete M, Villanueva A, Pacheco M, Stockert JC 
(2005) Non-aqueous permanent mounting for immunofluorescence microscopy. 
Histochem. Cell Biol. 123: 329-334.  
https://doi.org/10.1007/s00418-005-0769-2<https://urldefense.com/v3/__https:/doi.org/10.1007/s00418-005-0769-2__;!!LQC6Cpwp!_WRTrDLz9A3_IM5hW4x-FiEeMCT3HXZL4Eu9Uqk_fZDst6ecNYyWKwri4FYY0-V7kXxI9w$>
A PDF can be downloaded from the Google Scholar entry for this article.

John Kiernan
London, Canada
= = =

From: Morken, Timothy via Histonet 
mailto:histonet@lists.utsouthwestern.edu>>
Sent: May 28, 2021 11:31 AM
To: Histonet 
mailto:histonet@lists.utsouthwestern.edu>>
Subject: [Histonet] IF with permanent mounting media?

Has anyone tried using xylene/permanent mounting media for immunofluorescence 
stains? I had a question from a pathologist who wondered if we could do this. I 
have never heard of anyone doing it.

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

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Re: [Histonet] IF with permanent mounting media?

[Morken, Timothy via Histonet]

Sounds interesting. How about with FITC label?

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

-Original Message-
From: Ho-chun LAI via Histonet  
Sent: Friday, May 28, 2021 8:54 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] IF with permanent mounting media?

Tim,



Yes it is possible. I added a distilled water rinse and air dry step after the 
final wash so the slide became dehydrated enough to be mounted by DPX.

JacksonImmuno does suggest Cy dyes for DPX mounts, but I found as long as you 
don't do the alcohol dehydration, alexa is far brighter.

The fluorescent signal will indeed be much more long lived than temporary mount 
like mowiol, some of my first mounts (GAD67/GFAP) retains signal even after an 
entire year. But you should expect they would fade somewhere around 3 months.



I realized I did not reply to the histonet the last time, I still need to get 
myself familiarized with this : (

John Lai

Posdoctoral Fellow, School of Life Science, HKUST



-Original Message-
From: Morken, Timothy via Histonet 
Sent: Friday, May 28, 2021 11:31 PM
To: Histonet 
Subject: [Histonet] IF with permanent mounting media?



Has anyone tried using xylene/permanent mounting media for immunofluorescence 
stains? I had a question from a pathologist who wondered if we could do this. I 
have never heard of anyone doing it.



Tim Morken

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



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[Histonet] IF with permanent mounting media?

[Morken, Timothy via Histonet]

Has anyone tried using xylene/permanent mounting media for immunofluorescence 
stains? I had a question from a pathologist who wondered if we could do this. I 
have never heard of anyone doing it.

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

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Re: [Histonet] Cryostat

[Morken, Timothy via Histonet]

Guess I missed your other questions. 

I think the fog mist (Cold D) may be better - it reaches all area of the 
chamber. UV light is shaded from some areas, though probably hits most areas 
you might be touching. 

The misting requires a specific solution, not just anything. Hydrogen peroxide 
is the disinfecting agent. 

Other features:
We have the vacutome on the original units but we never use it. We do all 
kidney and muscle sectioning and these small samples do not produce much 
debris. On our new replacement unit (to replace a 7-year old NX70) we opted out 
of the vacuum.  If using in a gross room/Or setting the vacuum may be very 
useful. It only adds a hose and suction manifold in the unit and does not get 
in the way of anything. 




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


-Original Message-
From: Morken, Timothy via Histonet  
Sent: Wednesday, May 19, 2021 8:26 AM
To: Brittany Hethcox 
Cc: Histonet 
Subject: Re: [Histonet] Cryostat

Brittany, we have two of the Epredia Cryostar NX70 and love them. They 're 
reliable and easy to use. We have the elevator on ours and it makes a 
difference for different size people in the lab. It also can have a vapor 
disinfectant system which we use and it works great. 

We use ours for kidney and muscle cryosectioning, not gross room/OR sections 
but these would work fine for that. They have a lot of room inside for 
specimens. 

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


-Original Message-
From: Brittany Hethcox via Histonet 
Sent: Wednesday, May 19, 2021 7:21 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cryostat

Hello everyone!

I am new to the Histology world. You all may know my previous coworker, Rhonda 
Ford. She officially retired and I am so happy for her! With that being said, I 
am in a pickle because the cryostat we had completely broke down. We were 
having issues with it during my training period, so I never officially got to 
use it. We are now looking for a new cryostat for our department. My supervisor 
is asking me about different models and features, but I don't know much about 
any of this. So I was hoping you all could help! Here are the details:

We are looking at two different models:
- HM525NX
- CRYOSTAR NX50

We are also getting questions about UV versus fog mist (More specifically the 
"Cold D" fog mist). So my questions are:

1) Which model do you think is a better investment?
2) Is it ok to buy used?
- It's about half the price, which my supervisor really appreciates!
- A new cryostat will have to come from overseas. The seller says used ones 
will probably be available in the states.
3) Which is better, UV or fog mist?
4) Are there any other features that we should aim to include in our purchase 
(e.g. height adjustment, vacutome, etc.)?

Thanks so much for your help!

--
Brittany Hethcox
Histology/Pathology
765-521-1284
Henry Community Health

--
*"We Make Lasting Connections"*Henry Community Health 
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Re: [Histonet] Cryostat

[Morken, Timothy via Histonet]

Brittany, we have two of the Epredia Cryostar NX70 and love them. They 're 
reliable and easy to use. We have the elevator on ours and it makes a 
difference for different size people in the lab. It also can have a vapor 
disinfectant system which we use and it works great. 

We use ours for kidney and muscle cryosectioning, not gross room/OR sections 
but these would work fine for that. They have a lot of room inside for 
specimens. 

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


-Original Message-
From: Brittany Hethcox via Histonet  
Sent: Wednesday, May 19, 2021 7:21 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cryostat

Hello everyone!

I am new to the Histology world. You all may know my previous coworker, Rhonda 
Ford. She officially retired and I am so happy for her! With that being said, I 
am in a pickle because the cryostat we had completely broke down. We were 
having issues with it during my training period, so I never officially got to 
use it. We are now looking for a new cryostat for our department. My supervisor 
is asking me about different models and features, but I don't know much about 
any of this. So I was hoping you all could help! Here are the details:

We are looking at two different models:
- HM525NX
- CRYOSTAR NX50

We are also getting questions about UV versus fog mist (More specifically the 
"Cold D" fog mist). So my questions are:

1) Which model do you think is a better investment?
2) Is it ok to buy used?
- It's about half the price, which my supervisor really appreciates!
- A new cryostat will have to come from overseas. The seller says used ones 
will probably be available in the states.
3) Which is better, UV or fog mist?
4) Are there any other features that we should aim to include in our purchase 
(e.g. height adjustment, vacutome, etc.)?

Thanks so much for your help!

--
Brittany Hethcox
Histology/Pathology
765-521-1284
Henry Community Health

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Re: [Histonet] Automated Coverslippers

[Morken, Timothy via Histonet]

Jennifer, we have used the Sakura Glas, Glas2 (attached to prisma stainer), and 
now the Sakura tape cover slipper attached to the Prisma. Also we have had the 
Leica CV5030 glass coverslipper. 

All worked as long as they are kept clean. Daily maintenance is a must. If in a 
service contract they can last until parts are no longer available. 

However, we moved to tape once we started scanning all our slides. Tape 
coverslipping is much faster and it dries instantly, allowing scanning 
immediately.

The pop-off issues with the tape was solved 20 years ago, so it has not been a 
problem. The only problem we have seen is that the tape does get scratched if 
the slides are handled a lot outside of flats. Previous to scanning we pulled 
slides a lot for conferences so pathologists did not like it. Once we started 
scanning that became a moot issue - no one pulls slides anymore except for the 
rare send out consultation. 

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

-Original Message-
From: Jennifer Phinney via Histonet  
Sent: Thursday, May 13, 2021 6:18 AM
To: HistoNet 
Subject: [Histonet] Automated Coverslippers

Hello Histonetters,
My lab currently has a Leica CV5030 that is attached to our ST5010 Autostainer. 
We bought it way back in 2012 and it is starting to have progressively more 
issues working reliably.  This is the only one that can be integrated with our 
stainer, so we know we'll have to get a standalone unit and transfer slides to 
a new rack.

What automated coverslipper is everyone using? I know in the past there have 
been issues with tape coverslippers popping off of the slides when stored long 
term, but has this been fixed with newer units? What is everyone's experience 
with them?

I got a quote for the Leica Spectra coverslipper, but I am not familiar with 
what other companies have available.

Thanks all,
Jennifer Phinney  MS QIHC
Histology Laboratory Administrator
Kansas State Veterinary Diagnostic Lab
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Re: [Histonet] JCAHO labs

[Morken, Timothy via Histonet]

Jessica, CAP and JC apply the same CLIA regulations, just in a different 
manner. CAP tends to apply more of their own "upgrades." Ie, makes it a bit 
stricter, which is allowed. CLIA is just the baseline. If you have been thru 
CAP inspections you will not have any problem with JC. 

While CAP will campout in your lab for several days and look at EVERYTHING, JC 
relies on "tracers" to get at the same information, just in a random manner. 
They will give you several specific dates during the past two years  and then 
ask for a number of random cases per day. Then they want to see everything you 
have that pertains to those specific cases. That is from accession logs to 
final report and everything in between - QC logs of stains and equipment, 
maintenance logs, service reports, controls for whatever stains were done. All 
slides and blocks on the case. Records of who did the staining. Personnel 
records of the personnel doing the work, competency records for those 
personnel. Everything. Like most inspections, if you can produce what they want 
quickly they are happy. 

They will also do a walk-through of the lab and ask personnel various questions 
about safety, where SOPs are, look at chemicals, whether it is too crowded or 
cluttered, etc. In our labs in 5 JC inspections I have been through here they 
have never spent more than an hour in any particular lab. But we have many 
labs, so if they come to inspect your one small lab they will be spending more 
time there, I imagine. 

None of the JC inspectors we have had come through had any experience at all in 
anatomic pathology. All were clinical lab techs or administrators. We got 
dinged for some things that were minor - chips in formica that a microbiology 
guy thought were infection hazards, to dust on tops of some cabinets. Not much 
else. 

Our JC inspections last 3-4 days but that also covers many hospital areas and 
other labs besides histo/cyto/grossing/morgue. We have dozens of labs across 
many facilities. If all they did was AP they would be done in two days at most. 
IF you have a very small lab it might be only one day. 

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

-Original Message-
From: Jessica Vacca via Histonet  
Sent: Monday, May 10, 2021 6:07 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] JCAHO labs

Good Morning!
I was wondering if those of you that are accredited by this entity if you 
wouldn't mind sharing some information. I've only worked in CAP labs and have a 
complete understanding of the checklists and have based P on those. 
What/Where do the differences lie and in what items should be more focused on. 
Also if you wouldn't mind sharing some P, QC/QA logs etc.
that would be great. We have some here but would like to see what others may 
have consolidated etc.

Also we are currently Old School in that we DO NOT have a LIS so everything 
done here is offline, so in regards to specimen searches, IHC positive stains 
and Cytology QA is all done manually if you have figured an easy way to do this 
or can guide me in a process that would work, I'd love to hear your thoughts. I 
have been on the IT side of things for hte past 12 years and the hospital that 
I am PRN'ing at needs desperate help in getting some/alot of things done online 
or availabe on ss that can be easily searched.

Equipment/Process:
Peloris
Ventana ultra
Cytology (manual Process)
Special Stain (Poly Kits)
Leica Stainer

Thanks in advance for your help!

-- 

*Jessica Vacca  |Histology Technologist  |  Lower Keys Medical Center | *

5900 College Road   I   Key West, FL   33040   I | jessica.va...@lkmc.com |
Tel: 305-294-5531 x4736   I  
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Re: [Histonet] Antibody diluent

[Morken, Timothy via Histonet]

Maria, we went back to using Dako Diluent, which we had just switched away from 
to save money!

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

-Original Message-
From: Maria Cruz via Histonet  
Sent: Tuesday, March 23, 2021 10:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Antibody diluent

Like other folks in the histo community, I’ve recently experienced the 
inability to buy diluent from Leica.  Now wondering what others are doing to 
handle this problem.  TIA!
Maria
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[Histonet] IHC Disclaimer for immunofluorescence stains

[Morken, Timothy via Histonet]

Those labs doing diagnostic immunofluorescence for kidney or skin, do you put 
in the IHC disclaimer used for peroxidase staining on the reports?

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

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[Histonet] Other Histonet-like listservers?

[Morken, Timothy via Histonet]

Hi all, I'm going to give a presentation on online histology help sites like 
Histonet and the NSH Block. Does anyone know of other listservers that can be 
of help to histotechnologists in all fields? I checked the MSA EM listserver 
but it is down for some technical reason.

Thanks in advance for any help!

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

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[Histonet] Milestone Prestochill for muscle histochem

[Morken, Timothy via Histonet]

Hi all, I was wondering if anyone has used the Milestone PrestoChill for 
freezing muscle for histochemistry.

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

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Re: [Histonet] Order Test in Histology

[Morken, Timothy via Histonet]

Amy, all our orders are thru our LIS, Copath Plus. Residents or pathologist 
order on their own. Except for grossed cases. They get standard panels ordered 
upon accession or grossing. 

Outside cases are all consults. Some are routine (for instance our kidney lab 
where we do routine panels) so they are ordered on accession. Others are custom 
order per pathologist review. 

I'm not sure what you mean by whether a "pathology report serves as a signed 
order for pathologist."

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

-Original Message-
From: Amy Self via Histonet  
Sent: Friday, January 22, 2021 12:06 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Order Test in Histology

Happy Friday Everyone,

How do your pathologist get orders to the histology department? Are they sent 
manual(pencil/paper) - electronic through the case  - email?

Also how do you receive orders from outside facilities? We currently receive 
our orders via email or fax. This process needs to  be improved.

Do pathology reports serve as a signed order for pathologist?

Thanks in advance and I hope that everyone stays safe and has a great weekend.

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


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[Histonet] Pre-made chrome alum slides source?

[Morken, Timothy via Histonet]

Our source for pre-made chrome alum-subbed  slides does not exist anymore. Does 
anyone know of a company that produces these?

(American Master Tech had them but when StatLab bought them they discontinued 
the chrome alum slides)

We used these for EM thick sections because they hold a water drop in place, 
not allowing it to spread out as other adhesion slides do.

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

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[Histonet] FW: Pay range for histology supervisor

[Morken, Timothy via Histonet]

I’m in central PA

Sent from my iPhone

> On Jan 8, 2021, at 3:03 PM, Morken, Timothy  wrote:
> 
> Dee, it depends on where you are
> 
> Tim Morken
> Supervisor, Electron Microscopy/Neuromuscular Special Studies 
> Department of Pathology UC San Francisco Medical Center
> 
> -Original Message-
> From: Dee Neamand via Histonet 
> Sent: Friday, January 08, 2021 11:47 AM
> To: histonet@lists.utsouthwestern.edu
> Subject: [Histonet] Pay range for histology supervisor
> 
> Hello. Can anyone give me some ideas for appropriate pay range for a 
> histology supervisor that is also a grossing technician?
> 
> Thanks,
> Dee Neamand
> 
> Sent from my iPhone
> 
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Re: [Histonet] Pay range for histology supervisor

[Morken, Timothy via Histonet]

Dee, it depends on where you are

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

-Original Message-
From: Dee Neamand via Histonet  
Sent: Friday, January 08, 2021 11:47 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Pay range for histology supervisor

Hello. Can anyone give me some ideas for appropriate pay range for a histology 
supervisor that is also a grossing technician?

Thanks,
Dee Neamand

Sent from my iPhone

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Re: [Histonet] Joint Commission Standards for Pathology

[Morken, Timothy via Histonet]

Amy, they don't have a specific AP and General checklist like CAP has. They 
have a Standards book that lists all the requirements and you need to go thru 
and figure out which apply to your area. It is also on line at the TJC site. 
The thing is that TJC covers the entire hospital, not just the labs, so much of 
it is for other areas besides the lab. 

They don't do inspections in the way CAP does it. CAP will camp out in your lab 
for days going over every detail on the checklist. Instead TJC uses "Tracers" 
and pulls random patient files for random dates of the year and then asks for 
everything related to those files. So any lab work, reports, QC results, 
equipment records, personnel records (qualifications, competencies, etc) of 
anyone who worked on tests for those patients. That is really the part that has 
to be focused on. In the last 5 inspections I've had from TJC they spent about 
30 min in the lab each time. The rest of the time was going over tracer 
records. In the end it checks the same things, but in a very different way. 

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

-Original Message-
From: Amy Self via Histonet  
Sent: Thursday, January 07, 2021 11:22 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Joint Commission Standards for Pathology

Good Afternoon and I hope that everyone had a safe and Happy New Year,

Question:
Does Joint Commission offer a checklist like CAP does that is specific to 
pathology?

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


NOTE:
The information contained in this message may be privileged, confidential and 
protected from disclosure. If the reader of this message is not the intended 
recipient, or an employee or agent responsible for delivering this 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 notify us immediately by 
replying to this message and deleting it from your computer.
Thank you.
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Re: [Histonet] Question about accessioning outside consult cases

[Morken, Timothy via Histonet]

Martha, we give it the same number sequence as any other surgical or cytology 
case, but we can identify our cases by "Specimen Class" so consults get a 
specimen class according to the type of consult - cyto,  cytogyn, surgical, 
etc.  The specimen class is printed on the labels for all materials.

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

-Original Message-
From: Martha Ward-Pathology via Histonet  
Sent: Thursday, December 10, 2020 10:45 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Question about accessioning outside consult cases

We are in the process of switching to AP Beaker and in the midst of the build.  
  My question involves how others are handling outside consult surgical and/or 
cytology cases.   Do you assign them an unique number that identifies them as a 
consult as opposed to an inside case - SO20- verses S20-? We 
currently assign them as just another surgical case but I know some places do 
have outside consult designations.

What is everyone doing?

Thanks in advance for your input.

Martha Ward, MT ASCP (QIHC)
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Medical Center
Winston-Salem, NC 27157
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Re: [Histonet] Maximum and Minimum Temperatures on Embedding Center Paraffin Tanks

[Morken, Timothy via Histonet]

Kelly, You are not going to stay within the temp ranges if putting pellets 
directly into the embedding center tank. A couple solutions: 1) write into your 
procedure that the temperature will go down when pellets are added and that 
once melted should be in whatever range it calls for (and don't turn it up, 
because that means you have to keep adjusting it and someone may forget and as 
you say, exceed the temperature -  you just need to put in far enough ahead to 
let it melt. Or, 2) Get an bulk paraffin dispenser and melt the paraffin in 
that, then draw off liquid paraffin for your embedding center. This is pretty 
common for tissue processor and embedding centers to avoid having to use them 
to melt the paraffin. Gets you back to work faster as well.

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

-Original Message-
From: E. Wayne Johnson via Histonet  
Sent: Tuesday, December 08, 2020 1:26 PM
To: Pairan, Kelly ; 
'histonet@lists.utsouthwestern.edu' 
Subject: Re: [Histonet] Maximum and Minimum Temperatures on Embedding Center 
Paraffin Tanks

You could warm the paraffin in an oven overnight to melt it so that the heat of 
fusion is not extracted from the embedding center paraffin tanks when it is 
added as melted paraffin at 58-65 degrees.

Pairan, Kelly via Histonet wrote:
> Good Afternoon,
> Recently we starting taking the daily maximum and minimum temperature ranges 
> for our embedding center paraffin tanks.  The melting point of our wax is 
> 56oC and our current temperature range is 58 to 65oC.  The problem we are 
> having is that when we add wax, the temp dips below the range until it melts. 
>  If we turn it up, it exceeds the max range.  Any suggestions?
>
> Thanks,
> Kelly
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>

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Re: [Histonet] DIF in paraffin section

[Morken, Timothy via Histonet]

Manahil, we do IF on paraffin sections on occasion when kidney tissue is 
insufficient (and then only IgA, G, M and  K, L) or they want the markers on 
tissue that is only embedded in paraffin, such as kappa, Lambda for amyloid. We 
use at a higher concentration than for frozens (1:10 vs 1:100) and use pronase 
as an antigen retrieval agent. 

We use the Leica Bond stainer. 

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

-Original Message-
From: MANAHIL EL BIREIR via Histonet  
Sent: Friday, October 30, 2020 9:07 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] DIF in paraffin section

Hi Histonet:
Happy Halloween  
Would like to know if any one shift from DIF in fresh frozen section to 
embedded paraffin section!?
And which IHC auto machine are you using ?

Cheers,
Have a nice weekend 
Manahil 

Sent from my iPhone

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[Histonet] FW: Temperature Checks

[Morken, Timothy via Histonet]

Amy, we have been using Awarepoint, but they are apparently going out of 
business so we are switching over to Stanley Aeroscout on all fridges, freezers 
and room temp/humidity throughout our facilities.



We have direct access to the monitoring of each "asset" and can check it online 
at any time from any computer or mobile. We get email and text (and/or pager) 
alerts when it goes out of range for 30 minutes, the door is open (via door 
sensor) or immediately if the power goes off. We have multiple people set up to 
receive alerts in a hierarchy of escalations.



We can see/print a report at any time of the per-minute temperature history of 
any asset. We can also print a report showing the temperature of each asset at 
a given time of day (like the old manual checks). But with immediate access to 
real-time temperature and graphs that is not useful anymore.



We used to do a daily "check" of the online recording "to make sure the system 
is working"  but after many years of zero problems we stopped doing that. Our 
Facilities Department maintains the system and sends out a notice if the 
network system goes down. The ONLY time we do manual checks is if the system 
goes down because we would not get alerts in that case. That has not happened 
in over two years. So we do not check it daily. We only check if we get an 
alert or if we suspect a problem. The "Tag" that is on each asset has a digital 
display of temperature at all times. If it goes out of range there is an 
audible alarm (if anyone is around to hear it) as well as the alert sent via 
email and text message. It records the temperature of every asset once per 
minute. The tag keeps recording even if the network goes down and once the 
system comes back up it will upload all the data to the central system once 
contact is restored.







Tim Morken

Supervisor, Electron Microscopy/Neuromuscular Special Studies

Department of Pathology

UC San Francisco Medical Center







LET'S TAKE HEALTHCARE

FURTHER, TOGETHER



-Original Message-

From: Amy Self mailto:as...@tidelandshealth.org>>

Sent: Tuesday, October 6, 2020 2:51 PM

To: histonet@lists.utsouthwestern.edu

Subject: [Histonet] Temperature Checks



Good Afternoon,



Do any of you get your temperatures for your equipment and\or refrigerators 
monitored by a temperature monitoring company and if so how do you document 
this check?



Thanks in Advance,

Amy Self

Senior Histology Technologist

Tidelands Georgetown Memorial Hospital

606 Black River Road

Georgetown, SC 29440

Office: (843) 520-8711

as...@tidelandshealth.org

Our mission:  We help people live better lives through better health.





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Re: [Histonet] frozen section/histo duties

[Morken, Timothy via Histonet]

Nancy, we have HT (Histotechs) and HLT (Hospital lab techs - lab assistants) 
who work in grossing and do the frozen sections with residents and 
pathologists. There is no requirement that a person cutting sections has to be 
certified in anything.  Our HLT's generally do all the accessioning but do 
frozens when it gets busy. However, they do not select the piece to freeze - 
that is done by a PA or resident. They just cut the sections and stain them. 

We have a similar situation in histology in that we will hire well qualified 
people (ie, degrees in biology, or other science) with no experience as HLT's 
and then train them into histotechs eventually. But in the meantime they can be 
doing many histotech duties like embedding, sectioning, H staining, helping 
with IHC stainers, etc. Many of these HLT's have become certified techs in our 
lab over the years. We have 15 histotechs and all are certified. Our 4 HLT's 
are not. 

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


-Original Message-
From: Nancy Schmitt via Histonet  
Sent: Monday, August 24, 2020 1:12 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] frozen section/histo duties

Hello and Happy Monday-
Would you please share what your processes are for:

  1.  HT's cutting frozen under direct supervision of pathologist - do you do 
this?
 *   Now HT has changed and requires Associates degree - but previous would 
be grandfathered in  - correct?
  2.  Non- certified staff working in histology with supervision - anything 
they DON"T do?
CAP is our guideline and I am reading - want to make sure I am not overthinking 
this but not missing anything.
Thoughts appreciated,
Nancy Schmitt HT, MLT(ASCP)
Pathology Support Services Manager

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Re: [Histonet] frozen section/histo duties

[Morken, Timothy via Histonet]

" The way I read it, the only things in pathology that are actually high 
complexity testing that aren't performed exclusively by pathologists are  
and QCing special stain/ISH/IHC slides (ANP.21395).  "

CLIA regulations specifically state that quality control is not a test so it is 
not covered by the complexity rules. 

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


-Original Message-
From: Dilts,Andrew via Histonet  
Sent: Wednesday, August 26, 2020 5:20 AM
To: 'Nancy Schmitt' ; 
histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] frozen section/histo duties


It's a little tricky and usually brings in CLIA's definition of high complexity 
testing personnel and then the nuanced definition of testing.  As strange as it 
seems, most of what we do in histology is not actually testing until a 
pathologist reads it out and reviews it.

The way I read it, the only things in pathology that are actually high 
complexity testing that aren't performed exclusively by pathologists are 
grossing (ANP.11610) and QCing special stain/ISH/IHC slides (ANP.21395).  This 
can put some labs in a position where, even though a grandfathered histotech 
may be very capable at QCing stains and fully certified, he or she may not be 
able to do the QC for regulatory purposes.  Furthermore, the requirements to 
sit for the exam could be met without being CLIA high complexity testing 
compliant, so we are still pumping out new histotechs in this loophole.  I 
doubt it was intended that way, but there it is.

Other high complexity tasks include report review (ANP.29590), digital image 
analysis (ANP.23038), and circulating tumor cell analysis (ANP.29630) but those 
aren't an issue for our lab because we either don't do them or because our 
pathologists obviously do report review.

More directly to your point, I don't see anything in the requirements about 
histotechs doing or not doing frozens.  I also don't see anything about 
requiring histotechs to be certified at all for any reason other than your 
laboratory's preference.  In fact, you can have non-certified staff that have 
the high complexity testing education who are able to perform routine histology 
tasks that certified (particularly grandfathered) histotechs aren't allowed to 
do.

Hopefully someone with more knowledge will chime in because I'm sure I have a 
lot to learn about the ins and outs of this.




Andrew Dilts  HTL(ASCP)
Histo Supervisor, Laboratory Services
Phone: (417) 269-5021
andrew.di...@coxhealth.com
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-Original Message-
From: Nancy Schmitt 
Sent: Monday, August 24, 2020 3:12 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] frozen section/histo duties

Hello and Happy Monday-
Would you please share what your processes are for:

  1.  HT's cutting frozen under direct supervision of pathologist - do you do 
this?
 *   Now HT has changed and requires Associates degree - but previous would 
be grandfathered in  - correct?
  2.  Non- certified staff working in histology with supervision - anything 
they DON"T do?
CAP is our guideline and I am reading - want to make sure I am not overthinking 
this but not missing anything.
Thoughts appreciated,
Nancy Schmitt HT, MLT(ASCP)
Pathology Support Services Manager





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Re: [Histonet] slide printer

[Morken, Timothy via Histonet]

When we implemented barcoding I was planning on using direct slide printing. It 
seemed the most efficient and safest way (ie, no mislabelling) to do the 
labeling. 

However, when we looked into getting the printers they were on the order of 
$9,000 per printer. And we wanted 20 printers for histology, cytology, grossing 
(frozens) and the kidney/muscle lab (kidney and muscle frozens) . That was a 
huge part of our equipment budget. In fact it was more than the computers, 
handheld scanners combined. 

So we started looking at slide label printers instead. They are far cheaper - 
on the order of $600 per unit. And we would need label printers for other areas 
as well - accessioning (six sites), grossing (three sites), consults 
slide/block labeling, cytology, EM, etc. 

We demoed both the direct slide printers and label printers. It was good to 
test them side by side because the pros and cons were very apparent. 

Besides the price of the direct slide printers we found they jammed often. They 
did not usually have an adequate output chute for the quantity slides we would 
print (often far more than the 5 or 10-slide capacity of the output chutes 
available. Also, we realized that since we use a few different slides types we 
would need to change slides while printing. That means segregating various 
types of labeled slides and somehow printing separately while needing to change 
out the slides each time. It was  a logistical problem for the cutters. (this 
would be solved via centralized slide printing and routing different stain 
types to their correct slide type thru software. But we wanted to print at the 
microtome for best practice safe labeling of slides where they are cut). Then 
we found that if a the printed label on a slide was somehow damaged (smudged, 
scratched, etc) we would need to print a slide label to fix it. And how do you 
label a slide with a control tissue already mounted - it risks damaging the 
tissue section to run it thru a slide printer (and does the control have a 
label of some sort already?)

Slide labels on the other hand were very flexible. We could print as many as 
needed right away  (in literally a few seconds). Output quantity was not an 
issue. Any damaged could be reprinted right away. We could use any number of 
different types of slides to mount sections and apply the label we had. The 
cost of the labels would take 5 to 10  years to meet the cost of a direct slide 
printer (depending on how many labels any given printer produced per year, and 
by then you would probably move on to new printers anyway). 

We do use a direct slide printer for pre-mounted control slides. Then we put a 
printed label on the slide for staining with the specific stain necessary. 

The one issue I was concerned about was whether the techs would accept having 
to apply labels to every slide (which was previously done after staining by one 
person - with many mistakes!). But during testing and implementation we had 
every tech try out both systems and they did not mind putting on labels. They 
thought it was far better than the hand-writing they had been doing. When we 
went live no one ever complained about putting labels on slides. 

We use the same labels for slides, requisitions and containers so no extra cost 
for different kinds of labels and printers. 

1)  What are you using? Cognitive label printers from General Data and 
StainerShield labels (survive every known histology chemical we have tried, 
including antigen retrieval). 

2)  Did you first try any other vendors besides the one you are using now? 
General Data (printed labels), ThermoFisher SlideMate, ShurMark (etcher - very 
slow printing) (we tried other printed label makers as well but GD was the best 
by far). I will note that when using printed labels you must use a matched 
system - the labels and printers from each vendor are designed to work together 
for the ideal results. Mixing and matching printers and labels is very 
difficult. Since the vendor has already done that, use their system (take it 
from someone who tried to do that!). 

3)  Do you like what you are using now? Very much. It works perfectly. 

4)  Is it a one or two slide hopper - ie can you load and then select 
charged or non-charged slides? No need with printed labels. 

5)  Are you using vendor specific recommended slides or have you 
substituted for a cheaper or other option?  We use various slides. Labels can 
go on any slide. However, with label printing you must used the matched system 
a vendor offers - label and printer are designed to work together for best 
results.

6)  We are looking specifically at Leica, SlideMate and ESPO - do you have 
any experience of info from other users you know about these vendors? General 
Data. Absolutely excellent. 


I suggest making a table with each printer or labeler in the columns and then a 
list on the left of the key features you want, or they have. Then compare each 
one. 

Re: [Histonet] Blank Spots on IHC- Bubbles on Bond

[Morken, Timothy via Histonet]

Greg, thanks!

I have a leica engineer coming in to day to look at it, specifically the 
fluidics system, so hopefully he’ll see what you mention and fix it.

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

From: Greg Dobbin 
Sent: Thursday, August 13, 2020 10:20 AM
To: Morken, Timothy ; histonet@lists.utsouthwestern.edu
Subject: RE: Blank Spots on IHC- Bubbles on Bond

Hi Tim,
The usual source of bubbles is a deteriorating syringe or lines or valve. Have 
you observed the syringe while running the Clean Fluidics maintenance function? 
There can be some "micro" bubbles in the syringe on first draw of a reagent 
however, if working properly these tiny bubbles quickly disappear in subsequent 
draws of that reagent. If bubbles persist in the barrel of the syringe 
throughout the flushing, then you have found the source of the problem. If the 
bubbles occur with every reagent then the syringe is the problem but if you 
only see bubbles in one of the reagents then it is a defective valve or line 
for that reagent.
I hope this was helpful.
Greg

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1205 Pleasant Grove Rd
RR#2 York,
PE  C0A 1P0

Everything in moderation...even moderation itself!
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Re: [Histonet] Blank spots on IHC tissues - bubbles on Bond

[Morken, Timothy via Histonet]

Joanna, thanks! You are the first who said they had seen it before. I have a 
Leica tech coming in tomorrow to check out the syringes and lines. That was my 
thought too.

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

From: Bartczak, Joanna 
Sent: Thursday, August 13, 2020 10:10 AM
To: Paula Keene Pierce ; Morken, Timothy 
; Histonet 
Subject: Re: [Histonet] Blank spots on IHC tissues - bubbles on Bond

I have seen this phenomenon years ago on the Bond III when I worked at a 
different laboratory.  If I remember correctly, Leica had to replace the 
syringes and lines as air bubbles were being introduced when aspirating 
reagents.
I would definitely contact Leica technical service and let them investigate.  
Good luck.

Sincerely,
Joanna


Joanna Bartczak

Charge Technologist - Immunopathology
University Health Network - Toronto General Site

200 Elizabeth Street

Toronto, Ontario M5G 2C4

Phone:  (416) 340-4800 ext.6004

joanna.bartc...@uhn.ca<mailto:joanna.bartc...@uhn.ca>




From: Paula Keene Pierce 
mailto:pa...@excaliburpathology.com>>
Sent: Wednesday, August 12, 2020 6:42 PM
To: Morken, Timothy mailto:timothy.mor...@ucsf.edu>>; 
Histonet 
mailto:histonet@lists.utsouthwestern.edu>>
Subject: Re: [Histonet] Blank spots on IHC tissues - bubbles on Bond

I have seen this when using Sequenza cover plates.
My thoughts were that it is dissolved gases in the washes. As I noticed that 
when filling a container with my tap water and leaving it a while, bubbles form 
on the sides.
Do you brush away bubbles in your water bath even when using distilled water 
too?
Try not using freshly made, stirred, agitated, etc. solutions and adding a 
surfactant.
Extreme solution: place solutions in a vacuum.


Sent from Smallbiz Yahoo Mail for iPhone


On Wednesday, August 12, 2020, 5:25 PM, Morken, Timothy via Histonet 
mailto:histonet@lists.utsouthwestern.edu>> 
wrote:

Has anyone solved a problem on the Leica Bond stainer of bubbles over tissue 
sections that cause unstained (ie, clear) areas where bubbles have formed?

We've been trying things like extra buffer wash before reagent, new slide trays 
(tech rep suggestion). It is seen on single- antibody slides and very 
noticeable on dual - stain slides on which the first stain is there but the 
second stain shows numerous bubbles that do prevent the second stain from areas 
of the tissue.  We can see the bubble artifact on the slide away from tissue 
sections as well.

Any clues to solve this will be appreciated!
Tim Morken
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center

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[Histonet] Blank spots on IHC tissues - bubbles on Bond

[Morken, Timothy via Histonet]

Has anyone solved a problem on the Leica Bond stainer of bubbles over tissue 
sections that cause unstained (ie, clear) areas where bubbles have formed?

We've been trying things like extra buffer wash before reagent, new slide trays 
(tech rep suggestion). It is seen on single- antibody slides and very 
noticeable on dual - stain slides on which the first stain is there but the 
second stain shows numerous bubbles that do prevent the second stain from areas 
of the tissue.  We can see the bubble artifact on the slide away from tissue 
sections as well.

Any clues to solve this will be appreciated!
Tim Morken
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center

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[Histonet] slide scanning and glass vs plastic RE: Histonet Digest, Vol 201,

[Morken, Timothy via Histonet]

 of the mounting 
media. Once dialed in, we didn't change media and use one brand and only one.

10) Not all film coverslip rolls are satisfactory either. We had the best luck 
w Brand S film and did not switch.

Hope these observations help.
Steve
Steve A. McClain, MD
631-361-4000  Cell 631-926-3655

Good morning!

I need to provide some information to my team about film vs. glass 
coverslipping. I have a lot of positive info. regarding film but are any cons? 
And I need to come up wit the pros of glass over film. Anyone with extended 
experience have some current information for me?


Message: 3
Date: Wed, 5 Aug 2020 13:00:37
I am interested in this too, with my main question being the quality of digital 
images from film coverslipped slides.
Paula Keene Pierce, BS, HTL
--

Message: 6
Date: Wed, 5 Aug 2020 15:38:14 +
From: "Morken, Timothy" 
To: "Sanders, Jeanine (CDC/DDID/NCEZID/DHCPP)" 
Cc: Histonet 
Subject: Re: [Histonet] Update info. on old topic?
Message-ID:
   


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

Hi Jeanine!

We are using film coverslipping exclusively now and scanning all slides. We 
moved to film because it dries almost instantly and can be scanned right away. 
It has worked very well. The only issues, and not specific to film 
coverslipping,  are that some slides with low contrast sometimes are out of 
focus. That is primarily IHC slides with low contrast counter stain and low 
contrast specific staining.

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

-Original Message-
From: Sanders, Jeanine (CDC/DDID/NCEZID/DHCPP) via Histonet 

Sent: Wednesday, August 05, 2020 5:40 AM
To: 'histonet@lists.utsouthwestern.edu' 
Subject: [Histonet] Update info. on old topic?

Good morning!

I need to provide some information to my team about film vs. glass 
coverslipping. I have a lot of positive info. regarding film but are any cons? 
And I need to come up wit the pros of glass over film. Anyone with extended 
experience have some current information for me?

Thanks very much,

Jeanine Sanders, BS,
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Re: [Histonet] Update info. on old topic?

[Morken, Timothy via Histonet]

Hi Jeanine!

We are using film coverslipping exclusively now and scanning all slides. We 
moved to film because it dries almost instantly and can be scanned right away. 
It has worked very well. The only issues, and not specific to film 
coverslipping,  are that some slides with low contrast sometimes are out of 
focus. That is primarily IHC slides with low contrast counter stain and low 
contrast specific staining. 

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

-Original Message-
From: Sanders, Jeanine (CDC/DDID/NCEZID/DHCPP) via Histonet 
 
Sent: Wednesday, August 05, 2020 5:40 AM
To: 'histonet@lists.utsouthwestern.edu' 
Subject: [Histonet] Update info. on old topic?

Good morning!

I need to provide some information to my team about film vs. glass 
coverslipping. I have a lot of positive info. regarding film but are any cons? 
And I need to come up wit the pros of glass over film. Anyone with extended 
experience have some current information for me?

Thanks very much,

Jeanine Sanders, BS, HT(ASCP), QIHCCM(ASCP) Centers for Diseases Control and 
Prevention
1600 Clifton Road NE
MS H18-SB
Bldg. 18, Rm SB-114
Atlanta, GA 30329
404-639-3590


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Re: [Histonet] Apple Green Birefringence in Amyliod slides

[Morken, Timothy via Histonet]

I neglected to mention sections should be cut at 10um for best results. 

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


-Original Message-
From: Morken, Timothy via Histonet  
Sent: Tuesday, July 28, 2020 11:57 AM
To: Ken M 
Cc: Histonet 
Subject: Re: [Histonet] Apple Green Birefringence in Amyliod slides

Ken, Yes, polarized light and apple green birefringence is diagnostic for 
amyloid with congo red and is the best practice. If you have a problem with 
known control slides  there are two possibilities: 1) make up fresh solution. 
The pH has to be right. Or 2) try other control slides. Maybe you cut through 
the amyloid area. 

Because we have hundreds of microscopes in our department most just use 
polarized film as the polarizer (put over the light source) and another put 
over the top of the slide as the analyzer. Turn one of the polarizing slides 
and you will see the birefringence appear. 

Source: 
"Polarizing film, 2"" x 2"" , PK/10 (BEST For use as a microscope polarizer)"   
Cat# S07372 Thermo Fisher Sci Health$36.75  PK/10   "2" x 2"

These are polarized film mounted in 2" film holders (like the old Kodachrome 
slides). 

Cheap and effective. (and avoids consternation from people losing expensive 
microscope polarizers)

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


-Original Message-
From: Ken M via Histonet 
Sent: Tuesday, July 28, 2020 11:43 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Apple Green Birefringence in Amyliod slides

Hi everyone.  I was wondering if anyone out there has any experience with 
diagnosing Amyloid tissue using Congo Red stained Kidney using polarized 
lenses.  Is it common to use polarized light to detect Amyloid deposits?  Does 
the absence of the "apple green birefringence" indicate a problem with the 
control tissue or the control slides?  Should this green bifringence always 
appear to confirm the diagnosis?  I know that the tissue should be cut thicker 
than normal (we usually cut at 5), but in the future maybe we will cut at 7 or 
8?
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Re: [Histonet] Apple Green Birefringence in Amyliod slides

[Morken, Timothy via Histonet]

Ken, Yes, polarized light and apple green birefringence is diagnostic for 
amyloid with congo red and is the best practice. If you have a problem with 
known control slides  there are two possibilities: 1) make up fresh solution. 
The pH has to be right. Or 2) try other control slides. Maybe you cut through 
the amyloid area. 

Because we have hundreds of microscopes in our department most just use 
polarized film as the polarizer (put over the light source) and another put 
over the top of the slide as the analyzer. Turn one of the polarizing slides 
and you will see the birefringence appear. 

Source: 
"Polarizing film, 2"" x 2"" , PK/10 (BEST For use as a microscope polarizer)"   
Cat# S07372 Thermo Fisher Sci Health$36.75  PK/10   "2" x 2"

These are polarized film mounted in 2" film holders (like the old Kodachrome 
slides). 

Cheap and effective. (and avoids consternation from people losing expensive 
microscope polarizers)

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


-Original Message-
From: Ken M via Histonet  
Sent: Tuesday, July 28, 2020 11:43 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Apple Green Birefringence in Amyliod slides

Hi everyone.  I was wondering if anyone out there has any experience with 
diagnosing Amyloid tissue using Congo Red stained Kidney using polarized 
lenses.  Is it common to use polarized light to detect Amyloid deposits?  Does 
the absence of the "apple green birefringence" indicate a problem with the 
control tissue or the control slides?  Should this green bifringence always 
appear to confirm the diagnosis?  I know that the tissue should be cut thicker 
than normal (we usually cut at 5), but in the future maybe we will cut at 7 or 
8?
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Re: [Histonet] Lab assistant/histotech

[Morken, Timothy via Histonet]

Samantha, Yes there is:

Staffing Benchmarks for Histology Laboratories
Rene Buesa
Annals of Diagnostic Pathology
Volume 14, Issue 3, June 2010, Pages 182-193


He details here how lab assistants make labs more productive by allowing 
trained histotechs to do the embedding, sectioning and staining and leave 
everything else to lab assistants. 


BTW, if you go to Google Scholar and search Histology RJ Buesa you will see a 
series of articles specific to histology laboratory management by Rene.

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


-Original Message-
From: Samantha Golden, HT(ASCP) via Histonet 
 
Sent: Monday, July 06, 2020 9:52 AM
To: christopher.shee...@seattlechildrens.org; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Lab assistant/histotech

Thank you for your input. We currently have a lab assistant but need techs to 
help fill in the gap. Our techs do not like this, but we all are on the same 
team at the end of the day and working for our patients.


Thanks again. Have a great day!


Sam



From: Sheeder, Christopher 
Sent: Monday, July 6, 2020 10:44:16 AM
To: Golden Samantha - Asheville; histonet@lists.utsouthwestern.edu
Subject: {EXTERNAL} RE: [Histonet] Lab assistant/histotech

Hi Samantha,
I have used lab assistants throughout my career. Here is a list of duties they 
would perform:
Accession specimens
File blocks and slides
Clean glassware
Restock supplies
Clean work areas
Fax/scan/print reports
Answer phone
Recycle solvents
Dump tissue
Assist PA's in grossing (make cassettes/document workload)

Have a great Monday!
Chris

Christopher Sheeder, HT(ASCP)CMQIHC
AP Manager | Department of Laboratories
Seattle Children's Hospital
4800 Sand Point Way NE
Seattle, WA 98105
Office: 206-987-6259

christopher.shee...@seattlechildrens.org


-Original Message-
From: samantha.gol...@hcahealthcare.com 
Sent: Saturday, July 04, 2020 5:29 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Lab assistant/histotech

I was curious if there is a source, publication, report, study, general 
information, regarding the use of lab assistants in the histology lab.

I would like the know the percentage of labs that utilize assistants versus 
labs with techs only. I would also like to know that for labs that do utilize 
assistants, what duties do they perform that the techs are exempt from.

I'm simply curious to see how other labs have workflow setup.

Thanks for any insight.

Samantha


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Re: [Histonet] Recommended thickness of Amyloid sections

[Morken, Timothy via Histonet]

Ken, yes, 8 to 10 um. The extra thickness make the bi-refringence under 
polarized light brighter. Also the deposits can be variable so even with the 
light microscope the reddish deposits will stain stronger with thicker 
sections. 

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


-Original Message-
From: Ken M via Histonet  
Sent: Thursday, April 16, 2020 1:06 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Recommended thickness of Amyloid sections

Hello All.  We have always cut all of our histology control slides at 5m.  We 
were told today that it is common practice to cut Amyloid at 8m?  Is this your 
experience?

Ken
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[Histonet] Who works in Hospitals?

[Morken, Timothy via Histonet]

Something for others to know about

https://www.linkedin.com/posts/activity-6653762952572788737-jqh8


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

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[Histonet] EM as a "contract lab" lab for clia purposes

[Morken, Timothy via Histonet]

Here's a question that came up. A stand-alone EM lab at a college that is 
associated with a medical center, but in a different city, wants to do the EM 
workup for the medical center. But they would only take in samples, do the EM 
processing and take images then the pathologist would read the images in the 
other city.

Does that lab need a CLIA certificate? Can they come under the existing 
hospital lab certificate (interpretation and signout is all done at the medical 
center in the other city) and be audited as contract lab?

My guess is they still need a certificate since they are handling human samples 
for diagnostics. But

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

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[Histonet] grossing manuals

[Morken, Timothy via Histonet]

Posted for a friend...



To my knowledge the best institutional manual is the University of Michigan's 
Cutting Manual.

-Izak Dimenstein 


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Re: [Histonet] Pregnant in histo lab. Am I safe?

[Morken, Timothy via Histonet]

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

https://www.cdc.gov/niosh/topics/repro/solvents.html



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


-Original Message-
From: Val L via Histonet  
Sent: Saturday, January 18, 2020 10:02 AM
To: Eck, Allison ; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Pregnant in histo lab. Am I safe?

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

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

> Valerie
> I have worked in histo with both of my pregnancies with my most recent 
> one just three months ago. Embedding and cutting and even grossing are 
> fine to do while pregnant. Under no condition, even with Ppe, should 
> you be changing stainers or processors or dumping waste or mixing 
> chemicals. A pregnant woman should not be near powder chemicals as 
> they are inhalation hazards and xylene in general is an absolute no 
> no. It is a reproductive toxin and you should have no contact with it.
> Please reach out if you have any other questions but your employer mst 
> make accommodations for you while you are pregnant.
>
> Allison
>
> Allison Eck HTL(ASCP)cm, QLS
> 
> From: Valerie Laughlin via Histonet 
> [histonet@lists.utsouthwestern.edu]
> Sent: Saturday, January 18, 2020 7:21 AM
> To: histonet@lists.utsouthwestern.edu
> Subject: [Histonet] Pregnant in histo lab. Am I safe?
>
> Hello everyone. I am currently in the last weeks of my first trimester 
> of my pregnancy.
>
>
> I have asked this question to my Ob-Gyn, family and general pregnancy 
> forums but I wanted to ask people who understand the field of 
> Histotechnology better.
>
>
> I have been very concerned about the side effects of the chemicals 
> that might have on my baby.  The lab works with the typical stuff 
> (formaldehyde, xylene, alcohol of different percentages, glacial 
> acetic acid, stains etc) They make the fixative from scratch.
>
>
> I had to inform my supervisor and manager. I didn’t get the most 
> positive reaction from them but I don’t care as this is my personal 
> business and I have rights like everybody else.
>
>
> I gave them a letter from my doctor informing my pregnancy and that I 
> should be kept away from the chemicals for my own safety.
>
>
> They acknowledged the letter but still decided to buy a respirator 
> mask for me which is fine. It’s good to have protective equipment no 
> matter the circumstance.
>
>
> I told them that I can do the same tasks I do every day such as 
> grossing but with a mask, embedding, cutting and filing but that I 
> don’t feel comfortable changing the chemicals of the tissue processor 
> and slide stainer, and mixing chemicals. Also that I can’t dump the 
> chemicals in the biohazard room as there is not enough ventilation.
>
>
> Literally an hour after I informed this a nurse who was working in a 
> rojom close to the biohazard room had a negative reaction and had to 
> be sent to the ER where she was there for days. She blamed the 
> chemicals  from the biohazard room. Other nurses who work close to 
> that room had reported negative side effects as well. This situation 
> made me more uncomfortable specially when my coworkers think the 
> nurses are over reacting and it has to be some other cause because they don’t 
> get the same reactions.
>
>
> My biggest concern is that despite the letter of my doctor and what 
> ocurred in the past weeks with the nurse I am still feeling pressured 
> by my coworkers to work with the chemicals as they feel that a mask, a 
> lab coat and gloves is enough protection. I am unsure about this.
>
>
> I didn’t get a proper fit test for my respirator by the way. I have 
> worked for another corporation where they did that right after getting hired.
>
>
> I have read that chemicals can be absorbed through the skin too.
>
>
> I just want to know the opinion of pregnant  lab techs and supervisors 
> who have worked with them.
>
>
> I have read older threads 

[Histonet] Recall: SECURE: Please send block to EM lab

[Morken, Timothy via Histonet]

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[Histonet] SECURE: Please send block to EM lab

[Morken, Timothy via Histonet]

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  by 2019-12-18 09:03 PST to read your message.   After that, open the 
attachment.  
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   Click to read message
   If you do not see a button or clicking the button yields no action,
   please click the link in the message.
   [1]More Info
   Disclaimer: This email and its content are confidential and intended
   solely for the use of the addressee. Please notify the sender if you
   have received this email in error or simply delete it.
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References

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Re: [Histonet] contaminating patient requesition forms

[Morken, Timothy via Histonet]

Paula, we use Cerner Copath Plus and scan into the case all requisitions and 
any other paperwork at accessioning.  The person grossing uses the barcode on  
hard copy requisition to access the case but the hard copy stays in the gross 
room so no contaminated paperwork (or any paperwork at all) ever leaves the 
dirty area.  However, they normally review the paperwork before starting the 
grossing, and normally change gloves if they are dirty, so contamination is not 
usually a problem. 

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

-Original Message-
From: Paula via Histonet  
Sent: Tuesday, November 12, 2019 9:05 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] contaminating patient requesition forms

Hello..good morning,

 

Can anyone recommend a creative approach to avoid blood from being transferred 
from disposable gloves onto the patient requisition form during the grossing 
phase of histology?

 

I've seen a number of smudge marks and have asked the grossing doctor to avoid 
touching the requisition form but she says that is unavoidable.  I've asked her 
to change out gloves, but she says that is not practical.

 

In the meantime, if billing or lab personnel sees this, they will put on gloves 
and insert the paperwork inside a protective sleeve cover.  

 

But, what are the types of things the grossing doctor can do to avoid this 
transfer besides changing out gloves or avoiding touching the paperwork?

 

Thank you in advance,

Paula

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[Histonet] Muscle histochemistry workflow?

[Morken, Timothy via Histonet]

I'm wondering how other muscle histochem labs handle their workflow. Because 
the histochem stains require frozen sections and a freshly-prepared reagents, 
and muscle conditions are not usually very time sensitive, we batch all our 
cutting and staining to one batch per week. We have 5-10 cases a week. We run 6 
stains in our standard batch (H, Trich, Dual Myosin, SDH, NADH, COX/SDH, 
MHC-1) and have a menu of 10 extra special stains and 10 immuno stains we can 
do once the slides are cut.

Do you batch once a week?
Batch more often?
Cut/stain as they come in?
Number of cases per week?


Thanks for any info!


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

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Re: [Histonet] Freezing Sprays in Cryostats

[Morken, Timothy via Histonet]

I wonder if it is just a coincidence that and ad for this device from Milestone 
came thru in the middle of this freezing spray string


https://www.milestonemedsrl.com/us/product/prestochill/



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


-Original Message-
From: Bob Richmond via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, September 26, 2019 9:05 AM
To: Histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Freezing Sprays in Cryostats

Freezing sprays for frozen sections in cryostats are deplorable, but try
and get pathologists to give them up. I think that's probably why the CAP
has been reluctant to ban them.

During my career in pathology I saw more than one case where frozen
sections were inadvertently cut on tuberculous tissue. Tuberculosis is a
disease that sneaks up on you. In Baltimore (a hotbed of the disease)
around 1970 when we did this, we'd put the cryostat (one of the basic Damon
IEC models we had then) out of action until somebody (usually the chief
resident) could bring it up to room temperature, scrub it out with alcohol,
lubricate it, and plug it back in to cool down.

The heat extractors are usually all you need. Liquid nitrogen is not a very
satisfactory freezing medium. It's better to submerge a freezing medium
liquid into liquid nitrogen (which will eventually freeze it solid,
however). Shandon used to market a freezing container called a Histobath -
is any equivalent product available today? It held the right temperature
not to freeze the liquid medium solid.

People usually use acetone or isopentane (2-methylbutane) as the freezing
medium, both highly flammable. Better is:
3M™ Novec™ Engineered Fluid HFE-7100
This product belongs to a class of fluorocarbons called
"segregated hydrofluoroethers (HFE's)"
According to various MSDS, HFE-7100 is
methyl nonafluoroisobutyl ether
C4F9-O-CH3

But try to substitute any such thing for freezing spray, and be prepared
for a hissy-fit from your senior pathologist.

I'm glad the CDC weighed in on this. I do remind them that the decision to
do a frozen section is between the surgeon and the pathologist.

Bob Richmond
Samurai Pathologist
Maryville TN
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[Histonet] Reference website RE: Flammable Sprays in Cryostats

[Morken, Timothy via Histonet]

You can see past issues of Morbidly and Mortality Weekly Report (MMWR) at:

https://www.cdc.gov/mmwr/index2019.html

For past issues, click on "weekly report" on the left hand side and you can get 
to a list of past issues.

However, for the publication about cryostats, look under "Supplements" a bit 
lower on the page and choose the 2012 supplement issue (Vol 61) . It is in the 
one on Laboratory Safety. It has a lot more than just cryostat safety.

https://www.cdc.gov/mmwr/preview/ind2012_su.html

Scroll to the very bottom of the page to see the January supplement

The full reference is:

MMWR January 6, 2012 / Vol. 61 / Supplement / Pg. 1 - 105



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

-Original Message-
From: Sheeder, Christopher via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, September 26, 2019 8:00 AM
To: jasonhause...@gmail.com; P Sicurello
Cc: Histonet
Subject: Re: [Histonet] Flammable Sprays in Cryostats

I would like the link as well, if possible.

Christopher Sheeder, HT(ASCP)QIHC
Histology Supervisor | Department of Laboratories
Seattle Children’s Hospital
4800 Sand Point Way NE
Seattle, WA 98105



-Original Message-
From: jasonhause...@gmail.com 
Sent: Thursday, September 26, 2019 6:01 AM
To: P Sicurello 
Cc: Akemi ; Knutson, Deanne ; 
Histonet 
Subject: Re: [Histonet] Flammable Sprays in Cryostats

I woukd like the link to that. I looked around a bit on the web but couldnt 
locate usinf search.Jason HauserSenior HistotechnologistThe South Bend 
ClinicSent from my T-Mobile 4G LTE device-- Original message--From: P 
SicurelloDate: Thu, Sep 26, 2019 7:56 AMTo: jasonhause...@gmail.com;Cc: 
Akemi;Knutson, Deanne;Histonet;Subject:Re: [Histonet] Flammable Sprays in 
CryostatsThis was copied from the Centers for Disease Control's Morbidity and 
Mortality Weekly Report (January 2012)5.9.2. Work at the open benchFrozen 
sections— Frozen sectioning is performed on fresh tissue and is a high-risk 
procedure for infectious exposure. Freezing tissue does not kill organisms, and 
the use of the cryostat cutting blade creates potentially dangerous aerosols. 
Discuss the true clinical necessity for frozen sectioning with the surgical 
team.— Although some cryostat instruments have a downdraft into the instrument, 
aerosols are dispersed into the room where the cutting takes place. Do not use 
freezing propellant sprays, which speed the freezing process by a few seconds 
and cause aerosolization of not only the tissue being frozen but also the 
tissues from previously cut specimens that are at the base of the instrument. 
Such procedures generate aerosol and droplet contamination, posing an 
infectious risk to all personnel in the area (56,79,82). The Clinical and 
Laboratory Standards Institute and others have recommended discontinuation of 
freezing sprays because they are not recommended by the manufacturers of 
cryostat instrumentation (2,79).  Sincerely,

Paula
Sicurello, HTL (ASCP)CM

Histotechnology
Specialist

UC San Diego Health

9300 Campus Point DriveLa Jolla, CA 92037

(P):
858-249-5610



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information transmitted in this e-mail is intended only for the person or 
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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.On 
Thu, Sep 26, 2019 at 4:37 AM jasonhause...@gmail.com  
wrote:








I have heard this before. Any documention of this actually happening.I have 
tested for blood on surfaces outside the cabinet and never observed a positive 
result.Jason HauserSenior HistotechThe South Bend ClinicSent from my T-Mobile 
4G LTE device-- Original message--From: P SicurelloDate: Wed, Sep 25, 
2019 11:17 PMTo: jasonhause...@gmail.com;Cc: Akemi;Knutson, 
Deanne;Histonet;Subject:Re: [Histonet] Flammable Sprays in CryostatsIt's not 
safe to use any type of spray in a cryostat.  It creates aerosols of who knows 
what (tuberculosis) from potentially infectious patient biopsies.  I would not 
recommend it, just as a universal precaution.Sincerely,

Paula
Sicurello, HTL (ASCP)CM

Histotechnology
Specialist

UC San Diego Health

9300 Campus Point DriveLa Jolla, CA 92037

(P):
858-249-5610



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[Histonet] A little temperture monitoring debate

[Morken, Timothy via Histonet]

We had our Joint Commission inspection today (no deficiencies!) and the 
inspector was pressing us to do temperature monitoring in a different way. For 
chemicals in fridges and freezers we use the manufacturer recommendation of 
temperature range to set our ranges. Typically for a fridge it is 2C to 8C. 
That seems pretty standard from datasheets I have. So we set our range at 2-8 
on our automated system and then have a 30 min delay if it goes over before an 
alert sounds. That is to prevent spurious out of range alerts just because 
someone opened the door for a bit longer than usual. And reagents are not going 
to warm up instantly either. The probe is in a liquid bottle so will warm up 
time will be similar to a reagent. Anyway, he thought we should set the ranges 
narrower so it alerts before it reaches the out of range mark. He felt that if 
the fridge goes out of range for any time AT ALL then we need to prove all the 
reagents are still good. He was satisfied with daily control review of immuno 
stains and said that would prove the reagents work. But I also pointed out to 
him that we take the diluted reagents out of the fridge and have them on the 
stainer for up to 8 hours every day at room temperature with no problems. He 
didn't really have an answer to that but said the manufacturer  should consider 
that in their literature. We don't have too many alerts and those that do occur 
are usually due to a door not closed are resolved quickly.

I'm wondering what others think and do. We had debate this internally when we 
set up the automated system and considered wider ranges to avoid too many out 
of range alerts due to opening the doors many times daily, but never considered 
narrower ranges. We decided to go with the manufacturer ranges in order to be 
consistent and not have to defend whatever arbitrary narrow or wide range we 
picked. At least with the manufacturer recommendations we have something on 
paper to point to.


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

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Re: [Histonet] Mallory-Azan stain

[Morken, Timothy via Histonet]

John, we love it when you "ramble!" It gives us an appreciation for the history 
and breadth of histo techniques.

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

-Original Message-
From: John Kiernan via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, September 10, 2019 8:43 AM
To: 'Histonet@lists.utsouthwestern.edu'; Betsy Molinari
Subject: Re: [Histonet] Mallory-Azan stain

Mallory's (easy) and AZAN staining (difficult) are different methods!

Frank B. Mallory's trichrome stain  (Journal of Medical Research 13: 113-136, 
1905) is the earliest and one of the simplest of its kind: acid fuchsine 
followed by a solution containing orange G, aniline blue and phosphotungstic 
acid (PTA).  Martin Heidenhain's trichrome is usually called AZAN (from 
Azokarmin and Anilinblau, the German names of two of the dyes used. I've not 
read his original 1916 publiication, but a very thorough account was given by 
Manfred Gabe in his 1976 Histological Techniques book (ISBN 3540901620), pp. 
219-223. I used this quite a bit in the 1990s mostly on paraffin sections of 
Bouin-fixed decalcified rats' heads. It is a 15-step procedure taking >2 hours 
and it includes two critical differentiations requiring careful microscopic 
control. Instructions based on my experiences can be found in Histological and 
Histochemical Methods (5th ed., 2015, pp.198-200).

AZAN gives a wider range of colours than Mallory's or Masson's trichrome or the 
various one-step trichromes (Cason, Gomori, Gabe). The related Romeis 
"cresazan" procedure was used to identify at least 6 anterior pituitary 
cell-types until the 1950s when more rational histochemically based stains were 
introduced by Adams, Herlant, Pearse and others. Nowadays, immunostainng 
accurately shows the hormones in pituitary cells, but much more expensively.

All trichromes give poor results after simple fixation in neutral formaldehyde. 
Bouin or (better) a mercuric chloride-containing fixative is needed. 
Zinc-formalin is probably also OK. (I haven't tried it myself for this 
purpose). If material fixed in NBF must be used, immerse hydrated paraffin 
sections in saturated aqueous picric acid either for 2h at 56-60C or overnight 
at room temperature, then wash well in water before staining. (Bouin's fluid is 
often used, but its ingredients other than picric acid are unnecessary.) 
Experiments are needed to learn the mechanism of this "rescue" of  staining 
properties of sections formaldehyde-fixed tissue, which is sometimes wrongly 
called "mordanting". My guess is that it's comparable to antigen retrieval. It 
has been claimed that citrate buffer is just as good, though the photos are 
unconvincing (J. Histotechnol. 26, 133).

It should be possible to identify Purkinje fibres with any staining method that 
shows nuclei and myofibrils, such as H or a trichrome method simpler than 
AZAN. A glycogen stain such as PAS might show this substance in the otherwise 
pale areas around the central nuclei of Purkinje fibres. I suggest persuading 
your researcher to let you try something simpler before attempting Heidenhain's 
AZAN. Wheater's Functional Histology has a nice photomicrograph of a section 
stained with H and for endocardial elastin (looks like orcein).

Enough rambling!
John Kiernan
Anatomy & Cell Biology
University of Western Ontario
London, Canada
= = =


From: Betsy Molinari via Histonet 
Sent: 09 September 2019 10:53
To: 'Histonet@lists.utsouthwestern.edu' 
Subject: [Histonet] Mallory-Azan stain

Hi histonetters,
I have a researcher that wants to stain Purkinje fibers and has requested a 
Mallory-Azan stain.
I have no experience with this stain. I have looked online for information but 
am reaching out to you for personal advice.
Thanks.
Betsy Molinari HT,ASCP
Texas Heart Institute
6770 Bertner Ave.
Houston, TX  77030
832-355-6524 (lab)
832-355-6812 (fax)

Betsy Molinari
Sr. Histology Research Technician
CV Pathology Research

Texas Heart Institute
6770 Bertner Avenue, MC 1-283
Houston, TX 77030

Office: 832-355-6524 | Fax: 832-355-6812
Email: bmolin...@texasheart.org
texasheart.org | 
facebook | 
twitter

Re: [Histonet] PPE for the Histology lab

[Morken, Timothy via Histonet]

Martha, that is an extreme view. Eye and face protection in pathology are 
primarily for splash protection from either chemicals or body fluids. I can't 
see any need for people sectioning, embedding, etc. Maybe for special stains. 
Yes for pouring a lot of chemicals. And the idea that anyone visiting the lab, 
not doing any of the work, always needing eye and gown protection is not 
necessary unless they are observing work with possible fluid splash or other 
kind of exposure. And then I would expect to inform them of whatever danger 
they are in by exposure. 

What you need to do is a risk assessment of each task and how likely various 
hazards are for each task, then determine what protections are needed. 

When we have issues like this we call in our Environmental Health and Safety 
department to assess the issue. They are good about keeping things practical. 
We recently had them assess liquid nitrogen use in our lab after CAP came out 
with some recommendations about needing oxygen sensors when using liquid 
nitrogen that spooked our director. They came in with oxygen sensors and 
determined we have plenty of ventilation and don't need them. At the same time 
they reviewed all our use of liquid nitrogen and passed off on our procedures 
and made a few practical recommendations.


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

-Original Message-
From: Martha Ward-Pathology via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Monday, September 09, 2019 8:05 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] PPE for the Histology lab

Our department is looking at safety issues and one suggestion from our CLIA 
director is that everyone in the lab (our lab performs IHC only) should wear 
gloves, a gown and eye or face protection at all times and requiring it for 
anyone that enters the lab.   We have task specific PPE requirements for these 
items to be worn when changing solutions on the stainers or working with serum 
for our indirect immunofluorescence for example but don't require it for FFPE 
microtomy or loading the IHC stainers.   What are others requiring in their 
labs?

Thanks in advance for your feedback on this issue.

Martha Ward
Manager, Molecular Diagnostics Lab
Wake Forest Baptist Health
Winston-Salem, NC 27157
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Re: [Histonet] Disposal of contaminated gloves, paper towels etc... after grossing

[Morken, Timothy via Histonet]

Akemi, all trash in gross room and histo goes into the biohazard waste.


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

-Original Message-
From: Eileen Akemi Allison via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, August 29, 2019 4:21 AM
To: Histonet
Subject: [Histonet] Disposal of contaminated gloves, paper towels etc... after 
grossing

Good morning Histo Peeps:

I am curious as to your laboratory/hospital policies on how to dispose of 
contaminated gloves, paper towels etc… after the PA/pathologists gross a 
specimen.  

Often times we receive fresh tissue in the lab and we do not know if the 
patient has TB, Hepatitis, HIV, or any other infectious disease.  I was always 
taught that to treat these items universally as potential biohazards.  Do you 
discard these items in a Biohazard Waste Container,, or do you discard them in 
a regular trash basket?  

Thank you in advance for your feedback. 

Akemi Allison, BS, HT/HTL (ASCP)
Histology Manager
UMC El Paso, TX
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Re: [Histonet] (no subject)

[Morken, Timothy via Histonet]

Rhonda, that is unfortunate. It seems with the shortage of histotechs in most 
places that experience would be valued. Certainly you qualify since you were 
certified under the rules at the time. But institutions can set their own 
requirements as well which may be more strict. I wonder if your applications 
are being kicked out by automated programs that simply reject applications if 
they don't find certain terms.  Maybe the managers in the department never even 
see your application. I have had applicants in this situation and work with my 
HR department to have them clear such applicants so I can at least get them in 
the system for consideration even if they don't meet all requirements.


Maybe try to find out real people to contact at the institutions pathology 
department and deliver resumes directly to them rather than thru the online 
application system they may have. That way they can have their HR send your 
application through.


Tim Morken


From: Rhonda McCormick via Histonet 
Sent: Wednesday, August 14, 2019 3:10:02 PM
To: histonet@lists.utsouthwestern.edu 
Subject: [Histonet] (no subject)

Help!

I became HT certified in 2004 under the HS degree and lab experience 
qualification.  I do have a Bachelor’s Degree in Education,, with only 12 hours 
of science.  I am looking to relocate to Texas and therefore am job hunting.  
The problem I’m running into is that without an Associates Degree or Bachelors 
in a Science related field, I am not being considered for job opportunities 
even though I have 17 years of experience (and am a good histo tech and good 
employee with great references).
Is anyone else running into this problem? Does the Histonet world recommend I 
go back to school - or just be patient, trusting a job will eventually come 
along?
Thanks!
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Re: [Histonet] Re-embed agar/FFPE tissue in plastic?

[Morken, Timothy via Histonet]

Kate, we regularly re-embed paraffin-embedded tissue in epoxy resin for 
electron microscopy. We are using very small tissue - kidney, liver, 1mm core 
biopsies. 

For that we run thru xylene 4 x 30 min at 60C, 100% ethanol 3 x 10 min, 95, 70, 
50% ethanol 5 min each, then to distilled water, then buffer. Then it goes on 
to processing for resin embedding. The wax is gone and will not interfere with 
the plastic. The agar will not be affected or affect plastic embedding. We use 
agar to embed cilia for EM with good results. 


You might want to do some test tissue to get the timing right before trying on 
your samples. 


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


-Original Message-
From: Kate Davoli via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, May 29, 2019 8:12 AM
To: Histonet Usegroup
Subject: [Histonet] Re-embed agar/FFPE tissue in plastic?

I have a bunch of precious FFPE samples that were embedded in agar prior to
being embedded in wax (so as to orient the tissue easily).  The client now
wants these samples to be taken backwards out of wax and processed for
semithin plastic GMA (JB-4) sectioning.

Is that possible? Will the tissue having previously been embedded in wax
cause problems for the reagent infiltration or the plastic curing?  Will it
interfere with the catalyst?  I know that taking tissue back through
xylenes and alcohols is *supposed *to be able to remove all the wax, but
does it really?

I need the agar support surrounding the sample to STAY on the sample so
that it can stand upright during the plastic curing ... has anybody tried
to do double embedding with agar and then JB-4?  Does that work?

Please help!
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Re: [Histonet] Benchmarks for Reprocessing

[Morken, Timothy via Histonet]

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



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

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


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

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[Histonet] FW: Fridge temp

[Morken, Timothy via Histonet]

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


-Original Message-
From: Morken, Timothy 
Sent: Wednesday, March 27, 2019 8:30 AM
To: 'P Sicurello'; MARY ANN
Subject: RE: [Histonet] Fridge temp

You will need to retest to confirm reliability. That would be easier that 
buying all new -which you would then have to test anyway.

In the old, old days most antibodies were serum-based and were susceptible to 
degradation and bacterial growth. Modern antibodies and buffer formulations are 
very robust and I think you will find that few, if any, will fail. When I 
worked for an antibody company I used to do accelerated longevity testing by 
putting antibodies in a 40C oven for several MONTHS. I can't recall any 
failing, and some worked even better after that exposure! However,  some that 
have been opened and could show bacterial contamination. 

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


-Original Message-
From: P Sicurello via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, March 26, 2019 8:53 PM
To: MARY ANN
Cc: HistoNet
Subject: Re: [Histonet] Fridge temp

Mary Ann,

First I would call the vendor of the antibodies and detection kits and ask
them if they have any data about their reagents being warmed up for those
time periods.  If they can't provide an answer, then I suggest testing
every single one of the antibodies and detection kits to see if they still
work. I would do something like a mini-validation.  Another thing you can
do is a literature search that demonstrates the efficacy of warmed up, or
old, antibodies/detection kits.

Tally up the cost of replacing all the warmed up reagents. Then calculate
the cost of running a test that fails due to the warmed reagents - tech
time (remember to include whatever percentage the company adds in terms of
benefits), reagents used, etc.  Also include the effect on the impression
of the clients if you need to repeat a test because the first one failed
and you were aware of the reason why it failed.

Overall, you are better off replacing all of the items that were warmed up.
As for the refrigerator, install a temperature tracking system that will
notify someone if the temperature goes out of range.

If your lab is licensed by any governing agency, let the CFO/Owner know
about any rules or regulations that you must follow when it is suspected
that a reagent has gone bad, or expires.

Sincerely,

Paula Sicurello, HTL (ASCP)CM

Histotechnology Specialist

UC San Diego Health

9300 Campus Point Drive

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



*Confidentiality Notice*: The information transmitted in this e-mail is
intended only for the person or entity to which it is addressed and may
contain confidential and/or privileged material.  Any review,
retransmission, dissemination or other use of or taking of any action in
reliance upon this information by persons or entities other than the
intended recipient is prohibited.  If you received this e-mail in error,
please contact the sender and delete the material from any computer.


On Tue, Mar 26, 2019 at 4:15 PM MARY ANN via Histonet <
histonet@lists.utsouthwestern.edu> wrote:

> 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] Looking for vendor for Zeus Wash solution

[Morken, Timothy via Histonet]

This from Zeus Scientific: They will now handle all IFA reagents from their 
facility.


https://www.zeusscientific.com/news-events/zeus-scientific-to-offer-its-zeus-ifa-product-line-directly-to-customers-in-the-united-states



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

-Original Message-
From: Kristyn Ferber via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, March 22, 2019 8:45 AM
To: histonet@lists.utsouthwestern.edu; mw...@wakehealth.edu
Subject: Re: [Histonet] Looking for vendor for Zeus Wash solution

You might try searching under Michel Media or Michel's Media. It's the same
> but some people refer to it as Zeus and some Michel.
>

Best,

Kristyn

>
>
> -- Forwarded message --
> From: Martha Ward-Pathology 
> To: "histonet@lists.utsouthwestern.edu"  >
> Cc: "histo...@lists2.utsouthwestern.edu" <
> histo...@lists2.utsouthwestern.edu>
> Bcc:
> Date: Thu, 21 Mar 2019 16:59:43 +
> Subject: [Histonet] Looking for vendor for Zeus Wash solution
> I am having trouble locating a distributor for the Zeus Wash solution
> (cat#103) that we use to wash our skin and renal biopsies.Cardinal and
> Fisher do not seem to carry it and we do not have Zeus Scientific in our
> system as a vendor we can use.   Any help would be appreciated!
>
> Thanks,
>
> Martha Ward
> Wake Forest Baptist Health
> Winston-Salem, NC 27157
>
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Re: [Histonet] ER/PR/Her2 Controls

[Morken, Timothy via Histonet]

Pantomics has several expression controls and has high quality products. 

https://www.pantomics.com/tissue-arrays/breast



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

-Original Message-
From: John Garratt via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, March 20, 2019 1:50 PM
To: Dessoye, Michael
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] ER/PR/Her2 Controls

I suggest you contact Mark Rees at StatLab.

mr...@statlab.com

John


https://protect2.fireeye.com/url?k=6fdad446-339ab910-6fdaf35b-0cc47adb57f0-5caa0b3d866cb5e0=http://www.ciqc.ca/

‐‐‐ Original Message ‐‐‐
On Wednesday, March 20, 2019 12:42 PM, Dessoye, Michael via Histonet 
 wrote:

> Hello Histonet,
>
> Can anyone recommend a commercial source of ER/PR/Her2 control tissue (array 
> blocks would be preferred)? I'm looking for something similar to the breast 
> analyte control from Cell Marque, which is RUO:
>
> https://protect2.fireeye.com/url?k=4d82c7f4-11c2aaa2-4d82e0e9-0cc47adb57f0-946655d0b2e511d4=http://www.cellmarque.com/cms/histocyte/breast-DR.php
>
> Thanks,
> Mike
>
> Michael J. Dessoye, M.S. | Histology/Toxicology/Special Chemistry Supervisor 
> | Commonwealth Health Laboratory Services | 
> mjdessoye@commonwealthhealth.netmailto:mjdess...@commonwealthhealth.net | 575 
> N. River Street | Wilkes Barre, PA 18764 | Tel: 570-552-1432 | Fax: 
> 570-552-1484
>
> Disclaimer: This electronic message may contain information that is 
> Proprietary, Confidential, or legally privileged or protected. It is intended 
> only for the use of the individual(s) and entity named in the message. If you 
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> immediately and delete the material from your computer. Do not deliver, 
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[Histonet] tape for digital scanning...RE: Stainer vs. Stainer

[Morken, Timothy via Histonet]

I'll note that we have used glass coverslips in histology forever but are 
switching to tape not for the speed (though that is appreciated) but because 
the tape dries instantly and can be put in a slide scanner right away, while 
glass slides cannot until dry enough - takes a lot longer. In fact, we were 
cutting tape strips down to use as coverslips for FS slides so we could scan 
right away for remote Dx while the OR was waiting. 

The taped slides scan fine and the images are fine. 

The primary complaint about taped slides is that the tape scratches and so 
makes microscopy a bit more difficult, and we pull slides constantly for 
various conferences. However, with scanned images it makes no difference. The 
slides are scanned when the tape is pristine, stored and rarely pulled again. 

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

-Original Message-
From: Terri Braud via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, March 14, 2019 12:10 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: [Histonet] Stainer vs. Stainer

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

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

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

Subject: [Histonet] stainer v. stainer


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

Any thoughts are appreciated!

Alison Perl, HTL(ASCP)CM
Anatomic Pathology Manager
CareMount Medical
110 South Bedford Rd
Mount Kisco, NY 10549
(914) 302-8424
ap...@cmmedical.com
https://protect2.fireeye.com/url?k=0a167f0a-5656125c-0a165817-0cc47adb57f0-ef5d177b74bfb01b=http://www.caremountmedical.com/



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[Histonet] Really Small acid cabinet?

[Morken, Timothy via Histonet]

Does anyone know of an acid cabinet for just a few 500ml bottles? All I can 
find fit 6 1-liter bottles, no smaller.

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

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[Histonet] Temp for muscle FS and histochem, possibly EM.

[Morken, Timothy via Histonet]

If you do temp work and are looking around for the next position, we are 
looking for at least a 3-month temp specifically for muscle histochem - frozen 
sectioning and histochemistry. Will also do kidney FS and IF staining on the 
Bond.


Or, in addition, if you know how to do EM sectioning that would be useful.

If interested let me know.

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

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[Histonet] Waffle-pattern bench paper?

[Morken, Timothy via Histonet]

Hi all, I used to get bench protector paper (paper and plastic backing) from 
Cardinal that had a waffle pattern. We really like it. Now they substituted it 
with a really flimsy paper surface that constantly bunches up whereas the other 
type did not. Does anyone know where to get the other type of bench paper?

Any help is appreciated!

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

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[Histonet] Histotechnologist I-II opening at UC San Francisco

[Morken, Timothy via Histonet]

Histotechnologist I-II opening at University of California, San Francisco 
Medical Center, San Francisco, CA

Job ID 17907



See posting at:

https://careers.ucsfmedicalcenter.org:8443/psp/hcmprd_cg/EMPLOYEE/HRMS/c/HRS_HRAM.HRS_APP_SCHJOB.GBL?Page=HRS_APP_JBPST=U=Applicant=1=17907=2



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

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Re: [Histonet] Bleach Regs

[Morken, Timothy via Histonet]

Cleaning supplies may be stored under the sink. Bleach is a cleaning agent. We 
do it and no inspector looking there has ever said anything about it. 

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

-Original Message-
From: Laurie Redmond via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, January 31, 2019 8:13 AM
To: madeathri...@pastnashville.com; histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Bleach Regs

We don't store anything under the sinks in our lab per CAP regulations.  I do 
not understand why, nor do I have the specific checklist question at my 
fingertips, but we always make sure everything is removed from under the sinks 
at inspection time.

Laurie Redmond


-Original Message-
From: Maryann Deathridge via Histonet 
To: histonet@lists.utsouthwestern.edu 
Sent: Thu, Jan 31, 2019 7:18 am
Subject: [Histonet] Bleach Regs

Hello Histonetters!
Has anyone heard of a regulation by CAP, CLIA or OSHA regarding commercial 
bleach stored under the laboratory sink.  My lab routinely has a gallon 
container of dated/ bio-labeled commercial bleach stored under the sink for 
cleaning purposes. Daily use to clean special stain coplin jars,etc..  I had a 
suspicious med tech tell my pathologist that is was against regulations to have 
it in the lab anytime !
HUH
Responses welcomed.
Have an awesome Thursday!



Maryann  Deathridge, Lab Manager
Pathology Assoc. of  St. Thomas
4220 Harding  Pike
Bldg. SE,  Suite 504
Nashville, TN  37205
madeathri...@pastnashville.com

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Re: [Histonet] Cameras in the Laboratory

[Morken, Timothy via Histonet]

Caroline, The only cameras in our lab and the histo lab are pointed at the 
tissue processor screens so we can log in and see what is going on when we get 
an error alert. 

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

-Original Message-
From: Pratt, Caroline via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, January 22, 2019 12:29 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cameras in the Laboratory

If anyone is using cameras in the laboratory.  Can you share your experience 
with me and the placement/use/effectiveness, etc?  
caroline.pr...@uphs.upenn.edu.  Thank you!


Caroline M. Pratt, MBA
Practice Administrator Dermpath
3020 Market Street, Ste 201
Philadelphia, PA  19104
Phone 215-349-8178
Cell 610-800-1381
Fax 215-662-6150

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Re: [Histonet] Closed doors in Histology

[Morken, Timothy via Histonet]

That'll be tough for our histo lab - there are no doors. It is open to two 
hallways and adjacent clin lab. That said, we have so many hoods in there that 
we probably make the entire floor negative pressure! And there is no odor from 
the lab.

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


-Original Message-
From: Mike Pence via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, November 16, 2018 8:23 AM
To: histonet@lists.utsouthwestern.edu; histonet-boun...@lists.utsouthwestern.edu
Subject: [Histonet] Closed doors in Histology

OK, How many of you keep your doors to your Histology Dept. closed all the 
time? We were told by a CIHQ inspector that Histology Dept must be under 
negative air flow ALL THE TIME. This was a new one for me. The standard is from 
the ASHRAE 170 table 7.1
This is just an FYI for you all that these are the kinds of things CMS is 
looking at now days.

Michael S. Pence | Supervisor of Laboratory Services
Great River Health Systems
1221 S. Gear Ave. | West Burlington, IA 52655
Office 319-768-4546 | Main 319-768-4525 | Fax 319-768-4557
mpe...@grhs.net | 
www.greatrivermedical.org.
www.Facebook.com/GreatRiverHealthSystems
 | www.Twitter/GreatRiverMed


Information in this communication, including attachments, is confidential and 
intended only for the addressee(s). This communication may contain privileged, 
confidential, proprietary or trade secret information entitled to protection or 
exemption from disclosure under law. If you are not an intended recipient, 
please know that any use, distribution or copying of this communication, or any 
action taken based on the information in this communication, is unauthorized 
and may be unlawful. If you received this communication in error, please notify 
the sender and delete this communication from your device.



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[Histonet] Frozen sections and cold acetone...

[Morken, Timothy via Histonet]

Can anyone give me a rational for using cold (refrig or freezer-temp) acetone 
to fix frozen sections? Or a rational for using RT acetone.

This is for kidney or muscle bx frozens for immmunofluroescence or 
immunoperoxidase staining.

Normally they air dry for at least 15 minutes (just waiting for frozen 
sectioning to be completed) before going into acetone. Just wondering if we can 
reduce complexity...

I haven't seen anything saying why cold acetone is used, just instructions to 
do so. I always wonder about such things...

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

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Re: [Histonet] Competency signoff CAP

[Morken, Timothy via Histonet]

Charles, for grossing you do need to show competency for the types of specimens 
they are allowed to gross.

Histology "competency" is not required under CLIA because it is not high 
complexity  (no "testing" is done. The "test" is the pathologists 
interpretation). Therefore, your histology competency is whatever you define 
within your institution. 

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


-Original Message-
From: Charles Riley via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Monday, October 08, 2018 8:31 AM
To: Histo List
Subject: [Histonet] Competency signoff CAP

I just recently got put in charge of managing the personnel records for
training and am in the process of trying to update our personnel records
for our next CAP inspection. I feel our previous files were over detailed
and excessive in what they covered and wanted to try and consolidate some
of the information under broader categories.

Is anyone willing to send me what they use in their labs for Grossing and
Histology Competency and proficiency testing sign off for their staff so I
can get an idea of how much information I need to provide.

-- 

Charles Riley BS  HT, HTL(ASCP)CM

Histopathology Coordinator/ Mohs
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Re: [Histonet] histology lab temperature and humidity

[Morken, Timothy via Histonet]

Cassandra, the requirement for humidity covers requirements for equipment 
(specifications will specify operating conditions - temperature, humidity), 
chemicals (some are hygroscopic and high humidity can shorten shelf life) and 
"working environment." If you find that you need certain humidity levels for 
good results, or worker comfort,  you can put that in your environmental 
procedures. The question is, what can you do about it to change the levels?


Besides those things, low humidity is a fire danger, and continuous high 
humidity can be an infection control concern.

We set our humidity range at 20% to 60%. Here we never get to 20% but we 
sometimes go over 60% in some our labs on mild foggy days, mainly in older 
buildings.


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

-Original Message-
From: Cassie P. Davis via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, September 18, 2018 10:30 AM
To: histonet
Subject: [Histonet] histology lab temperature and humidity


At one of my jobs we were discussing the way excess humidity can cause tissue 
to fall off slides even when they are charged or treated and may need to be in 
the slide dryer longer. Isn't there a CAP requirement requiring monitoring of 
the humidity as well as temperature in the actual lab not just where slides are 
stored?


Cassandra Davis
Histology Technician
AP Laboratory
302-575-8095
Email:  cda...@che-east.org



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Re: [Histonet] Special stains and hoods

[Morken, Timothy via Histonet]

I guess the question is, who told you this and what is their reference?

Most special stains don't require a hood. Only those that have volatile 
chemicals or odors that may be offensive (ie, ammonium sulfide). We have some 
areas we do specials without a hood. Our main special stain areas have a 
"comfort" hood that is not a real chemical hood but more like a hood in an oven 
hood in a commercial kitchen.  They are not certified or checked in any way and 
we do not claim they are safety hoods.



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

-Original Message-
From: Laurie Colbert via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, August 21, 2018 7:34 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Special stains and hoods

I would like to know how many people perform (manual) routine special stains 
under a hood.  We do basic specials - Giemsa, AB/PAS, GMS, Trichrome, Muci - 
but we do them on the counter, not under a hood.  We have been told the 
staining needs to be done under a hood, but I have never done that in my entire 
career.
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Re: [Histonet] Unstained slides - how long are they good for?

[Morken, Timothy via Histonet]

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

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


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

Hello My Fellow Histologists,

Happy Friday Eve.

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

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

Thanks oodles.

Sincerely,

Paula Sicurello, HTL (ASCP)CM

Histotechnology Specialist

UC San Diego Health

200 Arbor Drive

San Diego, CA 92103

(P): 619-543-2872



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[Histonet] Recall: Histotechnologist, nights, Saturday thru Thursday, UCSF Medical Center, San Francisco, CA

[Morken, Timothy via Histonet]

Morken, Timothy would like to recall the message, "Histotechnologist, nights, 
Saturday thru Thursday, UCSF Medical Center, San Francisco, CA".
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[Histonet] FW: Histotechnologist, nights, Saturday thru Thursday, UCSF Medical Center, San Francisco, CA

[Morken, Timothy via Histonet]

A position is open for an night-shift histotech at UCSF, San Francisco. 
Saturdays thru Thursdays. Starting time is flexible between 10:00 pm and 1:00 AM

The Histology Lab at UCSF is a full service lab with routine, special stains, 
IHC and ISH. The workflow is fully barcoded and all equipment is state of the 
art. 

Pay ranges (hourly, depending on experience) with night shift differential (to 
be confirmed by HR on offer):

Histotech 1:   $41.07 to 51.16, $3.45
Histotech 2:  44.09 to 54.91, $4.50
Histotech 3:  48.16 to 60.07, $4.50

UCSF also offers extensive benefits:  
http://jobs.ucsfmedicalcenter.org/whychoose_employment.html


Apply at:
http://jobs.ucsfmedicalcenter.org/

Job ID is 16324

Contact Yuri Murphy, Histology Supervisor,  at  yuri.mur...@ucsf.edu with any 
questions.


Job Title

Histotechnologist - Pathology-Surgical/Histology (HISTO TCHNO 1, 2 OR 3)
Job ID  16324

Job Code   9065, 9066, 9067 
Job Family,  Technical & Technologist
Location:   Mount Zion (SF)
Weekly Hours:   40 :  100%
Appointment Type:   Career
Department:  Pathology-Surgical/Histology
Shift"  8-hour Nights
Full/Part Time:  Full-Time


Union Information:   This classification is represented by a union


Favorite Job


At UCSF Health, our mission of innovative patient care, advanced technology and 
pioneering research is redefining what's possible for the patients we serve - a 
promise we share with the professionals who make up our team. 
Ranked by U.S. News & World Report as the number one hospital in California - 
and among the top five in the country - UCSF Health is committed to providing 
the most rewarding work experience while delivering the best care available 
anywhere. In an environment that allows for continuous learning and 
opportunities for professional growth, UCSF Health offers the ideal atmosphere 
in which to best use your skills and talents.

Job Summary


Classification of Histotechnologist 1, 2, or 3 will be determined based upon 
the qualifications of the selected candidate.
Under supervision (HT-I, II level) by Senior-level technologists, Lead 
technologist and the Histology Supervisor, or direction (HT-III) by Lead 
technologist and the Histology Supervisor, or direction (HT-Lead) by the 
Histology Supervisor, the incumbent serves as a Histotechnologist in the 
Histology laboratory.
Duties include tissue processing, embedding, paraffin sectioning, H staining, 
Special Staining, specimen receipt and accessioning, Laboratory information 
system operation, Quality Assurance record keeping, instrument maintenance, 
intra-operative frozen sections, and other technical duties as assigned, 
including coverage in the Immunohistochemistry laboratory and Grossing lab as 
determined by the Lab Manager.
Rotates weekly between workstations within the lab. Work schedule is variable 
to include Saturdays and holiday coverage as scheduled. Incumbent must be able 
to flex work hours as needed to meet department operational needs and cover 
work rotations.

Required Qualifications


. HT 1:
o Associate degree or at least 60 semester hours of academic credit from a 
regionally accredited college/university, with a combination of 12 semester 
hours of biology and chemistry, AND one year of experience as a 
histotechnologist, preferably in a high-volume hospital histology laboratory 
within the last five years; or completion of an associate degree from an 
accredited Histotechnology program
o Excellent interpersonal and communication skills
. HT2:
o Current  HT license
o Associate degree or at least 60 semester hours of academic credit from a 
regionally accredited college/university, with a combination of 12 semester 
hours of biology and chemistry, AND two year of experience as a 
histotechnologist, in a high-volume hospital histology laboratory within the 
last five years; or completion of an associate degree from an accredited 
Histotechnology program
o Demonstrated high volume and high quality sectioning skills
o Excellent interpersonal and communication skills
. HT3:
o Current  HT license
o Associate degree or at least 60 semester hours of academic credit from a 
regionally accredited college/university, with a combination of 12 semester 
hours of biology and chemistry, AND four years of experience as a 
histotechnologist in a comparable high-volume hospital histology laboratory 
within the last five years
o Demonstrated high-volume, high-quality sectioning and staining skills
o Ability to organize and prioritize responsibilities and perform well under 
pressure to meet deadlines
o Excellent interpersonal and communication
. The flexibility to orient and work at all UCSF Medical Center locations

Preferred Qualifications


HT 1:
. One to two years experience as a Histotechnologist
. ASCP certification: HT or HTL licensed

HT2:
. One to two years experience as a Histotechnologist
. ASCP certified HTL

HT3:
. Five years experience as a Histotechnologist in a large hospital laboratory
. ASCP certified HTL

Re: [Histonet] Warm up freezer-stored powder, or use right away?

[Morken, Timothy via Histonet]

Here is the answer I got from Sigma-Aldrich Tech Support. 

" We would not recommend bringing the entire bottle up to room temperature to 
weigh.  Repeated freeze/thaw cycles can degrade the product. If you are worried 
about ice crystals affecting weight, you can bring a small sample up to room 
temp before weighing, or weigh out directly from the cold bottle and reweigh 
after equilibration."



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

-Original Message-
From: Bob Richmond via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, May 25, 2018 10:48 AM
To: Histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Warm up freezer-stored powder, or use right away?

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

>>We have a debate going on for those freezer-stored powdered chemicals
used for enzyme histochemistry. One side says warm up the container to room
temperature before opening in order to prevent water condensation in the
container/powder. The other side says to use right away and put back in the
freezer to avoid long exposure at room temperature. I'd like to hear pros
and cons of each and any references stating one practice or the other.<<

Opening that freezer-cold bottle before it warms up is ruinous. What I was
taught to do in a research histochemistry lab (yeeks, this is a little less
than 50 years ago) is to weigh out the needed quantity of the chemical
(say, 10 mg of ATP) into empty gelatin capsules, and put the filled
capsules in the freezer. When you do the procedure, take a single capsule
out of the freezer. You could make up big batches of these capsules on a
slow day.

Bob Richmond
Samurai Pathologist
Knoxville TN
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[Histonet] Warm up freezer-stored powder, or use right away?

[Morken, Timothy via Histonet]

We have a debate going on for those freezer-stored powdered chemicals used for 
enzyme histochemistry.
One side says warm up the container to room temperature before opening in order 
to prevent water condensation in the container/powder.
The other side says to use right away and put back in the freezer to avoid long 
exposure at room temperature.

I'd like to hear pros and cons of each and any references stating one practice 
or the other.

Thanks!



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

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[Histonet] FW: Cerner AB

[Morken, Timothy via Histonet]

Jose, do you have Cerner Copath already? If so, and you plan to keep it, AB 
is probably the best option. If you try to use a third-party system like 
Vantage or Cerebro with Copath, Cerner will require that you buy AB anyway as 
the middle-ware. Then you would need to support two separate systems. You also 
may not be able to have two-way communication, that is, writing back to the 
Cerner database from a third party application (for instance, cannot order 
blocks or stains in the third party system and have it be written to the Copath 
database. All blocks/stains must be entered on the Copath side and then they 
are picked up by the third party system). 

We have Copath Plus v14 and we have been using AB for 3+ years. It works very 
well, but took a lot of work to implement. We barcode from specimen receipt 
thru grossing, histology, IHC and Special Staining, to block and slide storage 
and tissue storage and disposal. 
Cytology as well. All seamlessly. We use the Copath 2D code to run our Leica 
and Ventana stainers without the need to program those stainers - stain orders 
are sent to the stainers from Copath and they "wait" for the 2D-coded slide to 
show up. 

We print cassettes at each gross station and slide labels (General Data 
StainerShield) at each microtome when the blocks are scanned. That has worked 
very well. 

AB has a "status monitor" that allows you to see how materials move thru the 
lab - for instance it shows how many blocks are in "grossed" status" or "cut" 
status at any given time. You can click on the number on the monitor to see 
exactly which cases are in that status. You can also track all materials of a 
case very easily with one report. 

We have pretty much eliminated paper from the lab with this system.

The only downside I have seen is that Copath does not have a good statistics 
reporting tool. They only provide static reports, and "raw data" that must be 
exported to Excel to do any analysis. You can get third party reporting tools 
that tap into the Copath tables and build our your own live stats reports but 
they are pretty expensive.

We have also used AB to make our own materials tracking system for our 
courier system, and chemical tracking in the gross room. It is very flexible in 
that way. 

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

-Original Message-
From: deGuzman, Jose R via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, April 24, 2018 2:10 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Cerner AB

Hello Histonetters.

I'm looking for opinions from users of Cerner's Advanced Barcode labeling and 
Tracking Software. I'd like to know your experience working with the software, 
and if you've worked with another software.

Thank you.

Jose de Guzman

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Re: [Histonet] Congo Red- Glass wool

[Morken, Timothy via Histonet]

Fran, I've never heard of that. The books I looked at just say "filter" with no 
specific filter recommendations. 

For Sudan Black and Congo red  we use Whatman "Reeve Angel 802" (Pleated). It 
has a 15um pore size which is "coarse."
Fisher catalog number 09-901A


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

-Original Message-
From: Frances Pearsall via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Monday, March 26, 2018 12:28 PM
To: Histonet@lists.utsouthwestern.edu
Subject: [Histonet] Congo Red- Glass wool

Can anyone tell me what kind and/or size glass wool do you use to for filtering 
the Working Congo Red solution right before use? From what I've read, it 
recommends not to use regular filter paper.

Thank you so much,
Fran Pearsall, ASCP


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Re: [Histonet] IHC validation

[Morken, Timothy via Histonet]

I've used hundreds of TMA's from Pantomics and Biochain with great results. 

https://pantomics.com/

https://www.biochain.com/


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

-Original Message-
From: Dessoye, Michael via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, March 22, 2018 9:00 AM
To: Terri Braud; 'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] IHC validation

Can anyone recommend a vendor that they've had good luck with for TMA slides?

Michael J. Dessoye, M.S. | Histology/Toxicology/Special Chemistry Supervisor | 
Commonwealth Health Laboratory Services | mjdess...@commonwealthhealth.net | 
575 N. River Street | Wilkes Barre, PA 18764 | Tel: 570-552-1432 | Fax: 
570-552-1484

-Original Message-
From: Terri Braud [mailto:tbr...@holyredeemer.com] 
Sent: Tuesday, March 20, 2018 1:54 PM
To: 'histonet@lists.utsouthwestern.edu'
Subject: Re: [Histonet] IHC validation

Just another note:  You can order unstained tissue microarrays with the 
prerequisite number of cases, both positive and negative, and stain your 
validation all on one slide.  I've done this for years and for 3 different 
validations of entire IHC platform changes, ranging from 40 to over 100 
antibodies each time.  Saves time and money.

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

Message: 2
Date: Fri, 16 Mar 2018 06:54:30 -0700
From: "Paula" 
Subject: [Histonet] Antibody Validation CLIA

Hello,
We've been discussing about the quantity of slides to run as a validation for 
IHC antibodies. We are governed by CLIA, and we would like to know if there is 
a set number of slides to run for a particular antibody we would like to bring 
in-house for Validation.  I think CAP requires 20 slides..?
And so we are asking if there is  a requirement with CLIA to run a certain 
number of slides, or is it up to us (the laboratory director) to decide how 
many slides to run for Validation/Verification.
Thank you in advance
Paula




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[Histonet] Prosthetic lens processing, cutting?

[Morken, Timothy via Histonet]

Hi all,


Does anyone have any experience with embedding an acrylic prosthetic lens for 
EM, or any other way ? We have a case where they wanted EM on a lens to 
identify a  specific bacteria. We have never done it and it would take some 
work to figure it out. Also, I told them that unless there is some morphologic 
marker for the bacteria, EM would not help much identifying it.

Any ideas?

Any labs that handle this kind of thing? They are willing to send it out.

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

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Re: [Histonet] Histonet Digest, Vol 170, Issue 13 histology hacks

[Morken, Timothy via Histonet]

Kind of in that same vein, but not to denigrate the book ( I have not seen it), 
I try to impress on people that "enabling" a poor process via "workarounds" or 
"shortcuts" does nothing to solve the original problem - it just prolongs the 
problem and peoples frustration with the problem. A much better path is to 
figure out why people feel the need for a workaround and then solve that 
problem. In other words, if a workaround is needed, then you have a problem 
that needs solving!

So now I have people come to me  saying  "I think this thing we do is a 
workaround for another problem." That is the kind of observation you like to 
hear.


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

-Original Message-
From: Steve McClain via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, January 16, 2018 4:25 AM
To: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Histonet Digest, Vol 170, Issue 13 histology hacks

I purchased the book and applaud the effort because there is some decent 
information.  However, the term hack is a poor choice for histology and many of 
the fixes or secrets described are because some hack failed to do her/his job 
at an earlier step in the process. (Definition of hack. transitive verb. 1 a : 
to cut or sever with repeated irregular or unskillful blows. b : to cut or 
shape by or as if by crude or ruthless strokes. As a noun it is used to mean a 
mediocre performer or worker; tiresome drudge.)

Some methods, while useful in some settings, have important cons not listed, 
cons which may be counterproductive. For example using Mercurochrome or Eosin 
to mark tissue may preclude further testing with fluorescent endpoints, such as 
FISH.  Plus if you really want to use Eosin to mark the dermis, it is far 
easier to add used Eosin to one alcohol in the tissue processor. That gives a 
visible indicator of carryover, indicating need to change or rotate solutions.

Other methods seem (to me) like workarounds or Band-Aids for Labs w poor 
grossing, poor processing or poor reagents or poor technique or poor method 
choices, eg, 2.14 describes a situation where an incompetent grosser truly 
hacks or crudely cuts into unfixed tissue yielding too thick a slice. The real 
solution is to fix the tissue before slicing. Poor fixation results in poor 
processing and poor sectioning and poor staining reactions.

For another example, Cassette sponges offer few advantages, while folding lens 
paper allows the grossers to see through the paper and know all pieces are 
inside before closing the cassette lid.  The tissue does not stick to it, and 
small flakes can be scraped from the lens paper at embedding. Last during 
folding, the forceps can be cleaned at grossing and during unfolding, forceps 
may be cleaned w the paper after embedding.  Sponges also result in greater 
solution carryover.

Several colloquial naming conventions, eg, chamber saver 2.16 for 
underprocessed tissue may be memorable to some readers, yet seem  are odd to me.

This 2.16 method is an especially useful technique which may also be done to 
extend paraffin time, whenever poor sectioning due to poor processing is 
encountered at the microtome.
Variation 1 Place the block back into the proper sized mold and return to the 
heated side of the embedding center for an hour to extend processing 
(reprocessing). Then remove the old paraffin from the mold w a plastic pipette, 
 then re-embed, replacing the paraffin w new.
Variation 2 for outside blocks we routinely replace an unknown paraffin from 
another lab by melting in a mold, and 'reprocess' in our (blue ribbon) paraffin 
for 1 hr in a mold in the embedding center then re-embed.

Good first effort, yet this book could be improved by a good editor, by more 
collaborators, by illustrations, and the addition of variations or other uses 
as described above for 2.16.
The font size and format will cause many readers to suffer because of the small 
font.

Steve
Steve A. McClain, MD
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Re: [Histonet] Hard Water and Auto Stainers

[Morken, Timothy via Histonet]

Sandra, yes, we use DI water from a water system in our lab

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


-Original Message-
From: Sandra Cheasty via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, December 20, 2017 10:44 AM
To: Histonet (histonet@lists.utsouthwestern.edu)
Subject: [Histonet] Hard Water and Auto Stainers

Hello all,
Thanks for everyone's response to error 90 on our Prisma 
stainer; it has been cleared! Does anyone use filtered, softened, or DI water 
in their H stainer to avoid clogging up the system?
Thanks!
Sandy

Sandra J. Cheasty, HT (ASCP)
Histology & Necropsy Supervisor
UW-Madison, School of Veterinary Medicine

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[Histonet] FW: Recycling formalin

[Morken, Timothy via Histonet]

Martha, The question to ask your EHS is how much extra exposure they will allow 
employees. Recycling removes all the salts so you need to add them back. Then 
it is just like making up formalin from scratch. Does anyone do that anymore? 
You need a minimum of full-face vapor masks to prevent vapor exposure. And risk 
of spill is high. Our EH  decided it was not worth the risk. 

Filtering is another option, but, again, you are handling large amounts of 
formalin so risk high exposure and possible spills. We tried it and it was too 
labor intensive, the filter was constantly clogging and we had to keep large 
carboys around that seem to just leak due to the poor quality of the spigots. 
Again, we abandoned  it. 

The other questions are, who is going to do this (s EHS volunteering their 
staff?!?!)? Is there space to do it (waste carboys, plus filled carboys, plus 
transporting)? I can bet your lab does not have space or personnel for this 
procedure. Does EHS? 

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


-Original Message-
From: Martha Ward-Pathology via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, December 20, 2017 11:00 AM
To: histonet@lists.utsouthwestern.edu
Cc: histo...@lists2.utsouthwestern.edu
Subject: [Histonet] Recycling formalin

I am posting this for our Histology lab manager:

Is anyone recycling formalin and if so, exactly what are you using the recycled 
formalin for?Putting it on processors, adding to specimens, etc?
Apparently our EHS department is pushing this.


Also thank everyone for their help with our questions about unstained slides 
for prostate biopsies.It was very helpful.

Thanks in advance for your help with our recycled formalin question.

Martha Ward
Wake Forest Baptist Health
336-716-2109
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Re: [Histonet] Noise Levels in Lab

[Morken, Timothy via Histonet]

We don't but there are decibel monitor phone apps. Not sure how accurate they 
are...

I've used one called Sound Meter. It shows 70+ db next to our -80 freezer and 
90+ db next to the 6-foot fume hood.

In our lab with cryostats it shows 60+ and in a quiet lab, no equipment 
running, it shows 50+


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

-Original Message-
From: Melissa Burns via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, December 05, 2017 5:46 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Noise Levels in Lab

Does anyone monitor the noise levels in their lab? If so, what is your 
protocol? Do you have a  device to do this?

Thanks in advance :)

Melissa
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Re: [Histonet] Beaker with or without Vantage

[Morken, Timothy via Histonet]

Ginny, when you say "slow down our whole process" is that slowness in the 
system or mismatch of the LIS to the pathology process?

My understanding is that this was originally designed for use in public health 
labs (EpicLab), which are quite different than pathology labs. Now they are 
trying to adapt a thirty-year old non-pathology system to pathology. Sure would 
be nice if someone would just use a new pathology-specific LIS built with new 
technology!  Why do we keep having to keep having non-pathology people shove 
things on us and demand we adapt to their ignorance? We went thru this with 
Copath for many years and had to teach them how pathology works (they should 
have been paying us for our knowledge, not charging us to teach them!). Now it 
seems it is coming around again in a new form.


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

From: Kurth Virginia L. [mailto:vku...@uwhealth.org]
Sent: Wednesday, November 29, 2017 10:16 AM
To: Morken, Timothy; Martha Ward-Pathology
Subject: Re: Beaker with or without Vantage


Hello

We switched to beaker this year, and it definitely had growing pains.

 I personally believe it was made for a doctor not a lab, and seemed to slow 
down our whole process,

but everyone is going to it.  It helps patient care in the aspect of everyone 
is on the same page with that

patient.  I think that more and more kinks will be worked out as it continues 
to adapt to the lab setting.  I think

asking people when they switched should be considered because it has evolved.  
Good Luck!





Ginny Kurth


UW Hospital of Wisconsin


From: Martha Ward-Pathology via Histonet 
<histonet@lists.utsouthwestern.edu<mailto:histonet@lists.utsouthwestern.edu>>
Sent: Tuesday, November 28, 2017 12:30:57 PM
To: Morken, Timothy
Cc: histonet@lists.utsouthwestern.edu<mailto:histonet@lists.utsouthwestern.edu>
Subject: Re: [Histonet] Beaker with or without Vantage

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




"They" aren't the ones that will have to use it.therein lies the rub!   I 
have not heard many positive things about AP Beaker.



Martha Ward, MT (ASCP) QIHC
Manager

Molecular Diagnostics Lab
Medical Center Boulevard  \  Winston-Salem, NC 27157
p 336.716.2109  \  f 336.716.5890
mw...@wakehealth.edu<mailto:mw...@wakehealth.edu>





-Original Message-
From: Morken, Timothy via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, November 28, 2017 11:48 AM
To: Histonet
Subject: Re: [Histonet] Beaker with or without Vantage

I am interested as well. "They" are threatening us with a move to Beaker in the 
future


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

-Original Message-
From: Blake Taylor via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, November 28, 2017 8:10 AM
To: histonet@lists.utsouthwestern.edu<mailto:histonet@lists.utsouthwestern.edu>
Subject: [Histonet] Beaker with or without Vantage

I'm looking for anyone out there that has switched to Beaker for AP, Also do 
you use Ventana Connect with Beaker?  Did you choose to use the Beaker tracking 
system or is anyone using Beaker in conjunction with Vantage?  Our Hospital is 
in the beginning phase of moving from Copath Sunquest to Beaker (2017 version) 
.  Any thoughts of what has gone well and what has not would be appreciated.

Thanks so much

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

PRIVILEGED AND CONFIDENTIAL: This electronic message and any attachments are 
confidential property of the sender. The information is intended only for the 
use to the person to whom it was addressed. Any other interception, copying, 
accessing, or disclosure of this message is prohibited. The sender takes no 
responsibility for any unauthorized reliance on this message. If you have 
received this message in error, please immediately notify the sender and purge 
the message you received. Do not forward this message without permission.
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Hi

Re: [Histonet] Beaker with or without Vantage

[Morken, Timothy via Histonet]

I am interested as well. "They" are threatening us with a move to Beaker in the 
future


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

-Original Message-
From: Blake Taylor via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, November 28, 2017 8:10 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Beaker with or without Vantage

I'm looking for anyone out there that has switched to Beaker for AP, Also do 
you use Ventana Connect with Beaker?  Did you choose to use the Beaker tracking 
system or is anyone using Beaker in conjunction with Vantage?  Our Hospital is 
in the beginning phase of moving from Copath Sunquest to Beaker (2017 version) 
.  Any thoughts of what has gone well and what has not would be appreciated.

Thanks so much

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

PRIVILEGED AND CONFIDENTIAL: This electronic message and any attachments are 
confidential property of the sender. The information is intended only for the 
use to the person to whom it was addressed. Any other interception, copying, 
accessing, or disclosure of this message is prohibited. The sender takes no 
responsibility for any unauthorized reliance on this message. If you have 
received this message in error, please immediately notify the sender and purge 
the message you received. Do not forward this message without permission.
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Re: [Histonet] mounting medium

[Morken, Timothy via Histonet]

We use Permaslip acrylic for manual coverslipping. Sakura media for our 
automated coverslipper. We have also used Richard-Allan CytoSeal with great 
resuls. We stopped using one called Quick-mount (comes in  tube) because they 
had a batch that was bad and the media turned cloudy and the slips dropped off 
after about 6 months. That has been a pain

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

-Original Message-
From: Reilly, Laurie via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Monday, November 13, 2017 3:35 PM
To: Allan Wang; warda hassan; Histonet@lists.utsouthwestern.edu
Cc: Hautaniemi, Walter; Reilly, Sue; Reeks, Karen
Subject: Re: [Histonet] mounting medium

We also would be interested in other's thoughts on mounting media. We are 
having coverslips coming unstuck from some of our teaching slides after 3 or 4 
years. It is very frustrating when cover slipping manually and wondering how 
long it will last.

Thanks and regards, Laurie.

Mr. Laurie REILLY
Histopathology
Veterinary and Biomedical Sciences
James Cook University
Townsville  Qld.  4811
Australia.

Phone 07 4781 4468
Mobile 0448 957747


-Original Message-
From: Allan Wang via Histonet [mailto:histonet@lists.utsouthwestern.edu]
Sent: Tuesday, 14 November 2017 8:47 AM
To: warda hassan 
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] mounting medium

Hi,

This information would be very useful for me and probably others as well, since 
I've just arbitrarily chosen one.
Can you summarize the responses you received for us?

Allan

On Wed, Nov 8, 2017 at 10:28 AM, warda hassan via Histonet < 
histonet@lists.utsouthwestern.edu> wrote:

> Hello to all
>
> Can anyone suggest which mouting medium is best that will help 
> preservation of staining properties without creating fading of stains 
> and bubbles on long run.
> Thanks alot
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Re: [Histonet] Inventory purchasing question

[Morken, Timothy via Histonet]

Charles, we use General Data labels on the Cognitive printers (not sure if that 
is the printer you are using). We were using their 22 x 22 StainerShield for 
the Leica Bond as well as all histo labels. Then we switched to their 
StainerShield 24 x 22 "Ventana-style" label and use them on both Leica and 
Ventana stainers (both printed from our LIS to Cognitive printers at the 
microtome.  We switched to ensure an uncomplicated workflow for all histo 
labels. These are used for all histo - H, SS, IHC, ISH). We also use General 
Data StainerShield 19x22 for another set of Leica Bond stainers that are not 
integrated with the LIS so are printed from the Leica software to a Cognitive 
printer. All work very well in all applications.

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

-Original Message-
From: Charles Riley via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Tuesday, October 10, 2017 7:50 AM
To: Histo List
Subject: [Histonet] Inventory purchasing question

Does anyone use the Leica bond printers with labels and ribbons from another 
company?

-- 

Charles Riley BS  HT, HTL(ASCP)CM

Histopathology Coordinator/ Mohs
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Re: [Histonet] FW: cutting a 5um frozen section from a 50um section of brain

[Morken, Timothy via Histonet]

Haley, 

Maybe ask Stephen directly. He is on histonet, and has a website:  
https://www.pathologyinnovations.com/


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

-Original Message-
From: Haley Huggins via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, October 06, 2017 10:31 AM
To: Dessasau III, Evan
Cc: histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] FW: cutting a 5um frozen section from a 50um section of 
brain

I would also be interested in knowing this tip if anyone knows it. I will also 
have to check out that book. We only do cryostat sections at our lab.

*Haley Huggins, HT (ASCP)cm*
*Technical Lab Supervisor*
*1050 Las Tablas Rd, Suite 14*
*Templeton, CA 93465*
*Office: 877-230-1518*

On Fri, Oct 6, 2017 at 9:09 AM, Dessasau III, Evan via Histonet < 
histonet@lists.utsouthwestern.edu> wrote:

> Hi Histonet , I have been trying to cut a FLAT 4 to 10 um frozen 
> section from 50um sections of brain.  Every time I think I have the 
> tissue flat the sections are never in the same plane.  I found a 
> wonderful book in pdf format(A Practical Guide to Frozen Section 
> Techniques, Stephen R. Peters) online with lots of wonderful tips but 
> I'm having no luck implementing the tips.  Has anyone ever tried this?  Any 
> help is GREATLY appreciated.
> Thank you,
> E-van
>
> E-van D. Dessasau, III, HTL(ASCP)cm
> Supervisor, Histology Division of Pathology Emory University Yerkes 
> NPRC Main Center Rm. 2122
> 954 Gatewood Rd.
> Atlanta, GA. 30329
> (404)727-7744 lab
> (404) 727-7902 office
>
>
> 
>
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Re: [Histonet] Water Quality from Lab Gen Checklist distilled vs deionized vs reagent grade water

[Morken, Timothy via Histonet]

Renee, for practical purposes in histology they are pretty much the same. Note 
that the original water quality is key because certain things can carry over in 
each type of system. Commercial suppliers do all the filtering, conditioning 
and finishing for you. 

Deionized (DI) is now the usual water produced in institutions because it is 
easier to maintain and produces adequate amounts of water. Distillation 
requires a still and produces relatively small quantities compared to DI.  In 
our histo lab we have a DI system, but it would be over-kill for a small lab. 
Buying distilled water will be fine. The company that makes distilled water 
does all the filtering and finishing for you so it is pure. If really concerned 
you can buy from a scientific supplier rather than a grocery store. In our EM 
lab we make up muscle histochemistry stains and  with type 1 water we buy in 1 
liter bottles. We have a DI system for everything else. 

This is a good article on the difference between DI and Dist. Water:

http://www.labmanager.com/laboratory-technology/2014/09/the-right-water#.WdZwx4TyuUk


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


-Original Message-
From: Renee H. Workman via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, October 05, 2017 10:18 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Water Quality from Lab Gen Checklist distilled vs deionized 
vs reagent grade water

Going over checklist needed input on water quality.  We are a small lab and use 
distilled water purchased commercially.  We do IHC but no special stains.  We 
use the water in our water baths and for preparing IHC buffer.  Should we 
upgrade to deionized or use distilled?

Renee H. Workman
Histology Supervisor
Virginia Urology
9105 Stony Point Drive
Richmond, VA  23235
W: 804-527-1316 | F: 804-270-0917
rhwork...@uro.com | www.uro.com





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Re: [Histonet] Old control blocks

[Morken, Timothy via Histonet]

Elaine, blocks last a very long time. The at the face the tissue may be 
oxidized, like a section on a slide, but the deeper tissue should be good. If 
you have several extra blocks just coat the face with paraffin to protect it.

However, the only way to be sure is to test them occasionally. If they are used 
regularly you can just note the last successful test (we keep a validation 
record of each block and note re-validation results on the form). If not used 
too often, test once a year to ensure it is good. Test the "extra 
paraffin-coated" blocks when  they are needed, not every year - maybe when the 
previous block is nearing its end test the next block in line to be sure you 
have a control available.

For the cryostat, for what part of the cryostat is the probe displaying a 
temperature?  It may not be the chamber temperature. Our cryostat display (and 
controls) are for the knife and object holder. There is no built-in display for 
the chamber. We did put in a manual-read thermometer for the chamber, and all 
show different temperatures.

The "correct" temperature is the one at which you get the best results!


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


-Original Message-
From: Elaine allison Hoffman via Histonet 
[mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, October 05, 2017 8:42 AM
To: Histonetters Histonet
Subject: [Histonet] Old control blocks

 Hi everyone,
Just want to put a question out there. . . . 
How long can we keep control blocks (paraffin embedded tissue) before they go 
bad?  I just went through our old control blocks in our filing container and 
some of our control blocks have dates as far back as 10 years ago.  They have 
not been refrigerated or anything but didn't know if they should be thrown out 
and start over or how long they are good for?  They are filed in alphabetical 
order, anything from amyloid controls to yeast control blocks and many others 
in-between.  Or probably should be tested to see just how positive the staining 
results turn out to be.  I was just wondering if anyone knew off the top of 
their head, lol. Another brain teaser
Our cryostat is displaying a temperature of -23 degrees but the thermometer 
sitting inside the chamber is reading -15 degrees.  The thermometer was just 
recently purchased and does not need calibrated or anything.  Our supervisor 
thought we should have a thermometer inside the cryo-chamber just to be certain 
that the digital display is accurate.  Now we have a dilemma!  Did anyone else 
experience this problem with the temperature readings with their cryostat?  Not 
really sure what to do about the different readings.  What should the correct 
temperature be anyways?
We would really appreciate any feed-back or suggestions.
Thank you,

Elaine Hoffman, HT(ASCP)
Steward Trumbull Memorial HospitalWarren, OH 
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[Histonet] Replacement filters for Lerner Fume-Gard benchtop hood?

[Morken, Timothy via Histonet]

Hi, does anyone know a source for the charcoal filters for the old Lerner 
Laboratories Fume-gard hood, model 912, filter #906?



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

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[Histonet] EM renal embedding of long cores

[Morken, Timothy via Histonet]

Hi all, I am interesting anyone's experience EM embedding of  long renal cores, 
say in 5mm increments, rather that dividing to 1 to 2 mm pieces, for blocks, 
and thick sections.

We are wondering about then going on to produce EM thin sections of gloms 
identified for EM. Is the core re-trimmed to smaller pieces and re-embedded, or 
some other method?

Any info will be appreciated.

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

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Re: [Histonet] IHC

[Morken, Timothy via Histonet]

Emily, ? Are you ensuring excess water is not under the section that would 
prevent adherence to the slide? Are you using slides recommended by the outside 
lab? Do they recommend a procedure for drying the slides before sending?
Just a starting point...

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

-Original Message-
From: Emily Horst via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Thursday, August 10, 2017 2:42 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC

Hi everyone,

We send our IHCs to an outside lab. I send them the unstained slides. I cut 
them at 4 microns and put them on charged slides. We are having a lot of issues 
with the receiving lab saying the tissue is falling off. Their supervisor says 
the sections are too thick (remember 4 microns) and my pathologist says they 
are not too thick. Any suggestions for resolving this issue with the receiving 
lab?

Thanks!
--
Emily Horst, HT (ASCP) Office manager Interventional Pathology of Ohio 
Kettering, Ohio 937.297.0028 ___
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Re: [Histonet] Fresh tissue soaked in ethanol solution prior to formalin fixation

[Morken, Timothy via Histonet]

Luca, sounds like a project to figure that out! 

Anytime you soak the tissue in any percentage alcoholic solution there is going 
to be some dehydration - substitution of water with alcohol. 

When adding alcohol you will cause precipitation of some of the proteins in the 
tissue - depends on the alcohol concentration. This does not normally affect 
immuno or other staining, but can cause some morphological artifacts from the 
wave effect of the alcohol moving thru the tissue. 

Then if you put back in aqueous formalin, that rehydrate the tissue which may 
induce other artifacts. A better idea may be to  use alcoholic formalin for the 
rest of the fixation in the same concentration. However, alcoholic formalin is 
normally used in a tissue processor after normal fixation with aqueous formalin 
at which time the tissue should be fixed enough to avoid the morphological 
changes.  It is an attempt to start the dehydration process earlier in the 
cycle. 

If the tissue is small, or thin - less than 5mm - it will alcohol fix all the 
way thru. If larger you could get alcohol fixation artifacts in some areas and 
not in others where the alcohol does not reach.

What is the staining solution supposed to accomplish as a pre-fixation 
technique that can't be done later in the process?

An out of the ordinary process like this requires some test studies to see how 
it affects whatever it is you want to see, in parallel with normal methods.

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

-Original Message-
From: Lucas Cahill via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Monday, July 10, 2017 7:57 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Fresh tissue soaked in ethanol solution prior to formalin 
fixation

Hi all,

I am using a protocol where fresh breast tissue is immersed in an alcohol based 
staining solution (50% ethanol, 50% water) for 2-5 minutes before formalin 
fixation and paraffin processing for H, immunohistochemistry, and 
immunofluorescence. I have not seen differences in subsequent processing on the 
tissue that I've tested, however, I'm wondering if the 50% ethanol solution on 
fresh tissue has an effect. I know tissue can be alcohol fixed but this is not 
standard in clinical breast tissue processing and 2-5 mins does not seem like 
it would fix the tissue.
Are there any protocols that use an alcohol based solution on fresh tissue 
prior to formalin fixation that are known not to affect subsequent processing 
such as immunohistochemistry? Does anyone have any intuition on how this could 
affect tissue analysis?

Best,

Lucas


--
*Lucas Cahill*
PhD Candidate | Medical Engineering & Medical Physics Harvard-MIT Health 
Sciences & Technology ___
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Re: [Histonet] IHC for secreted proteins and cytokines in frozen sections - Pre-fix or post-fix?

[Morken, Timothy via Histonet]

Ana, you should fix before sectioning. Chris Van der Loos did an excellent 
study on loss of cytokines in frozen sections vs whole cells. See his paper:

Immunohistochemical Detection of Interferon-y, Fake or Fact? CM Van der Loos, 
et.al., J Histochem Cytochem, 49(6):699-709, 2001.  Www.jhc.org



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




-Original Message-
From: Ana Maluenda via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Friday, June 02, 2017 1:01 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] IHC for secreted proteins and cytokines in frozen sections 
- Pre-fix or post-fix?

Hi everyone,

Just wondering what is people's opinion and protocols for IHC in mouse frozen 
sections targeting secreted proteins and cytokines. I see lots of places using 
fresh frozen sections/snap-freeze and cold acetone or methanol/ethanol 
post-fixation. Is this an issue when it comes to diffusion of such proteins in 
the tissue, since they are not well localized or linked to cellular structures? 
Would it be better to pre-fix (either immersion in 4%PFA or infusion with 
fixative) than post-fix?

Any thoughts would be much appreciated.

Kind regards,

Ana

Ana Maluenda
Research Assistant


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Re: [Histonet] Send-Outs

[Morken, Timothy via Histonet]

Really? You want to compare your lab to Amazon? If you have stock on-hand, 
located in one place, have robots to retrieve it, people who do nothing but 
pack boxes and trucks standing by to take any order at any time of day, then 
you are in the league of Amazon and can receive an order and send it out within 
an hour.

However most of us first need to find the material to send out - slides? where 
are they? Pathologist, resident? waiting to be filed? Removed from file by 
someone else? Can't find anything in THAT office...Same with blocks - not in 
file, is there a card telling who took it? Maybe for recuts, maybe for 
research, then back into the batch to be filed. Look 5 different places. Frozen 
tissue is usually easier but, whoops...already sent some out for another 
requested test...

Anyway, that is what my experience is!

We don't have any set time requirement. It could be an hour or a few days 
depending on if can easily find the material they want to send. Usually it is 
within a day.


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



-Original Message-
From: Cristi Rigazio via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Monday, May 15, 2017 10:55 AM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Send-Outs

Hi Histoland!

We have been reviewing our send out procedures and I have been tasked with 
researching what TAT's other institutions define.  Currently, we allow 48 hours 
for the preparation of "orders" to the time sent out.  Is this reasonable?  Do 
other facilities allow more or less time?

I feel like Amazon can get something to my door step in a matter of hours, so I 
must be missing something obvious in our steps that could be simplified, but I 
can't put my finger on it.  Any feedback on what others are doing is greatly 
appreciated.

Sincerely,
Cristi
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[Histonet] FW: PA Supervisor Position, San Francisco

[Morken, Timothy via Histonet]

We have a PA Supervisor position open at UCSF Medical Center. Oversees 3 
grossing sites (3 hosptitals) and morgue/autopsy, trains residents.

Oversees 9 PA's, 4 accessioners, administrative staff.

Apply online at: http://jobs.ucsfmedicalcenter.org/

Job Description
Pathologists' Assistants Supervisor - Pathology-Morgue (SPEC)
Job ID: 12043
Job Code: 0461


Under minimal direction of the Directors, the incumbent serves as a supervisor 
and lead technical expert in the Surgical Pathology Gross Labs at Mission Bay, 
Parnassus and Mt Zion campuses, and in Autopsy at Parnassus, supervising and 
providing leadership and direction to certified and non-cerified Pathologist 
Assistants (PAs) and technical staff.

The incumbent's primary goals for this position are to train and educate 
residents and staff on grossing large and complex cancer resection specimens 
and create an efficient Gross Lab and Autopsy service.  In addition to serving 
as a practitioner, educator/role model for fellows, residents, and staff 
members on grossing complex specimens, it is the role of the supervisor to 
continuously interact and consult with the laboratory director(s), 
administrative director, lab managers, and designee. The incumbent determines 
the need to consult with pathologist, makes operational decisions, 
troubleshoots and resolves specimen receiving issues.

The incumbent serves as a lead technical expert in grossing the most complex 
cancer specimens (pancreas, breast, prostate, GYN, etc.) as well as simple 
benign resections and biopsies. The incumbent must have an extensive knowledge 
of the full scope of general PA technical duties in the laboratory when 
required (lab preparation, receiving, accessioning, cryostat frozen sectioning, 
staining of stat operating room specimens, gross sectioning, dictation, 
photography, etc.). The incumbent will participate in resident education as 
pertains to gross lab activities and maintain the departmental and web-based 
surgical pathology manual. The incumbent must also have a thorough 
understanding of what sections are essential, and perform duties efficiently 
(focusing on quality and quantity). The incumbent's responsibilities include 
handling the competency program and providing education sessions to staff to 
learn to gross large resections and complex cancer specimens.

As supervisor the incumbent recruits, hires, trains, completes performance 
evaluations, and resolves employee issues; provides orientation, completes 
competency assessments, maintains staff schedules, training and compliance 
documentation and operating procedure; maintains equipment for the laboratory 
and adheres to compliance requirements; proactively advises and assists faculty 
and residents planning research projects. As directed, the incumbent provides 
operational support in other managers' absence; as determined, works a variable 
schedule and rotates at other work sites as needed; provides technical and 
leadership support to the Electron Microscopy & Neuromuscular (EM & NM) 
Laboratory and Histology Laboratory as needed. Other duties are as assigned.
The flexibility to orient and work at all UCSF Medical Center locations is 
required.

Required Qualifications:

  *   Previous leadership experience in a hospital laboratory
  *   American Society for Clinical Pathology (ASCP) certification must be 
maintained as long as one works in this position
  *   ASCP certified as Pathologists' Assistant
  *   Bachelor's degree
  *   Demonstrated proficiency in teaching, communication and interpersonal 
skills
  *   Knowledge of medical terminology, specifically understanding of Pathology
  *   Ability to organize and prioritize responsibilities and perform well 
under pressure to meet deadlines
  *   Excellent data entry, word processing, spelling, grammar, and editing 
skills
  *   Ability to assume leadership responsibilities and assist with operational 
oversight of Gross Rooms
The flexibility to orient and work at all UCSF Medical Center locations is 
required

Preferred qualifications

  *   Minimum five years' experience as an ASCP-certified PA
  *   A graduate from a National Accrediting Agency for Clinical Laboratory 
Sciences (NAACLS) accredited pathologists' assistant training program
  *   Master's degree
  *   Current Fellow member of the American Association of Pathologists' 
Assistants (AAPA) (highly preferred)
  *   Current Member of the American Society for Clinical Pathology
  *   Previous leadership experience in a hospital laboratory
Experience working in the Pathology Department of an academic health center

Licensure:

  *   American Society for Clinical Pathology (ASCP) certification must be 
maintained as long as one works in this position
  *   ASCP certified as Pathologists' Assistant




Tim Morken
Pathology Site Manager, Parnassus
Supervisor, Electron Microscopy/Neuromuscular Special Studies
Department of Pathology
UC San Francisco Medical Center
505 Parnassus Ave, Box 1656

Re: [Histonet] Breast Her2Neu IHC vs FISH

[Morken, Timothy via Histonet]

Jason, 

The only way is to validate for those conditions. You would need some 
specimens, including known controls,  handled and processed in those same 
conditions and compare to samples processed under the acceptable conditions. 
You can do it, it will just take some time. 


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



-Original Message-
From: Jason McGough via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Wednesday, April 19, 2017 12:29 PM
To: histonet@lists.utsouthwestern.edu
Subject: [Histonet] Breast Her2Neu IHC vs FISH

Does anyone know or can you point me in the right direction to some literature 
about how to properly test for Her2Neu (IHC vs. FISH) on breast tumors if the 
cold ischemia time is greater than 1 hour or if the formalin fixation times are 
outside of the recommended time range? Also, what if the specimen has been 
placed in decal? We are struggling to find any documentation of how to properly 
test Her2Neu if the specimen is outside of these ranges. Thanks for your help!



Jason McGough, HT(ASCP)

Operations Manager

Clinical Laboratory of the Black Hills

605-343-2267

jmcgo...@clinlab.com  

www.clinlab.com  

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Re: [Histonet] Hirsch-Pfeiffer cresyl violet method

[Morken, Timothy via Histonet]

Bob, Thanks for the offer! I finally found a copy and Google Translate did a 
pretty good job on it, and we have a person in the lab who, it turns out, can 
read german, so I think we are set.

As an aside, the "clues" I got from tidbits of the procedure mentioned in other 
papers turned out to have little basis in reality to the original method 
described in the paper (concentrations, times, temperatures all different!), so 
I'm glad I found the original.


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



-Original Message-
From: Bob Richmond via Histonet [mailto:histonet@lists.utsouthwestern.edu] 
Sent: Saturday, April 15, 2017 11:46 AM
To: Histonet@lists.utsouthwestern.edu
Subject: Re: [Histonet] Hirsch-Pfeiffer cresyl violet method

Tim Morken in pathology at UC San Francisco Medical Center asks about the 
Hirsch-Pfeiffer (correct spelling) cresyl violet stain for frozen sections.

"I've found many references to it, but none that give the procedure. And the 
original paper is from 1955 not easily available. And is in German."

If you can get the paper, I can read it for you.

Bob Richmond
Samurai Pathologist
Maryville TN
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