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Tim Webster twebster <@t> nmcinc.org
Thu Jul 13 10:30:01 CDT 2006



 Tim Webster
Histology Specialist
Northwestern Medical Center
133 Fairfield Street
St Albans, VT 05478
(802) 524-1070 x4349 (Dept. & Voice mail)
twebster <@t> nmcinc.org
 
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Sent: Sunday, July 09, 2006 12:53 PM
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Subject: Histonet Digest, Vol 32, Issue 9

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Today's Topics:

   1. Re: Mordant for PTAH (RSRICHMOND <@t> aol.com)
   2. Special stains and IHC for Gastric Cancer (Diana Schleicher)
   3. Re: IHC Workload (Alan Bishop)
   4. RE: IHC workload (Orr, Rebecca)


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Message: 1
Date: Sat, 8 Jul 2006 14:10:50 EDT
From: RSRICHMOND <@t> aol.com
Subject: [Histonet] Re: Mordant for PTAH
To: histonet <@t> lists.utsouthwestern.edu
Message-ID: <431.473e7b6.31e14f2a <@t> aol.com>
Content-Type: text/plain; charset="ISO-8859-1"

Charlene Henry HT (ASCP), QIHC at St. Jude Children's Research Hospital 
[Memphis, Tennessee] asks:
>>We are trying to rid the lab of all mercury products and I was wondering 
what everyone is using as a mordant for the PTAH. We are currently using 4% 
mercuric chloride and I would like to replace it with another mordant.<< and
Rene 
J Buesa replies>>Try using 5% potassium dichromate at 60ºC for 30 minutes. It

has worked for me.<<

But then you have to dispose of chromium, which is as difficult as mercury to

get hauled away, I think.

But what does anyone use phosphotungstic acid hematoxylin (PTAH) for nowadays

anyway? Forty years ago it was of some use for staining muscle striations (in

suspected rhabdomyosarcomas) and astrocytes - if the tissue had been fixed in

Zenker/Helly (mercury, chromium, and formaldehyde). I recall it being said 
that the chief virtue of PTAH was that it took overnight to do the stain, and

that gave you time enough to try to identify an unusual tumor. (It also took 
three months to make PTAH - you didn't add an oxidant, just put it on the
back 
porch like sun tea.)

According to Giuseppe Verdi or his librettist, Aida praised it to the skies 
("Omnipotente Ptah" - sorry about that), but I think PTAH's fortunes have
been 
in decline ever since.

Bob Richmond
Knoxville TN and Gastonia NC


------------------------------

Message: 2
Date: Sat, 8 Jul 2006 12:30:14 -0700 (PDT)
From: Diana Schleicher <dianaschleicher <@t> yahoo.com>
Subject: [Histonet] Special stains and IHC for Gastric Cancer
To: histonet <@t> lists.utsouthwestern.edu
Message-ID: <20060708193014.94230.qmail <@t> web53503.mail.yahoo.com>
Content-Type: text/plain; charset=iso-8859-1

I am currently a histotech student. I am writing a paper and preparing a
power point presentation on the subject of Gastric Cancer.  I would like to
find out what tests labs are performing for this disease.  Thank you.

Diana

 			
---------------------------------
Sneak preview the  all-new Yahoo.com. It's not radically different. Just
radically better. 

------------------------------

Message: 3
Date: Sun, 9 Jul 2006 11:43:31 +1200
From: "Alan Bishop" <muddymoo <@t> gmail.com>
Subject: Re: [Histonet] IHC Workload
To: "Rene J Buesa" <rjbuesa <@t> yahoo.com>
Cc: histonet <@t> lists.utsouthwestern.edu
Message-ID:
	<b474df0d0607081643n3dda13b1nc107a444bba9a465 <@t> mail.gmail.com>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed

Some interesting stats there.

Our lab does around 20,000 IHC slides a year. Most blocks already processed
and embedded from us doing the routine histology but the daily workload of
recutting, adding controls and the whole IHC process is done by one person!
All of our workload is done by hand at the moment and all achieved in less
than a standard working day - usually all issued to the paths by mid
afternoon.

>From the survey I should probably think about getting some more staff for
the IHC :-)

Cheers

Alan

On 08/07/06, Rene J Buesa <rjbuesa <@t> yahoo.com> wrote:
>
> Jennifer:
>   From a survey I finished in Feb./06 (Advance Magazine 3 July/06) I can
> give you some general information:
>   1-the average of IHC tests/year in 22 foreign labs = 18,000
>   2-the average for USA labs (23) = 8,000 [General averages between 300
> and 69,000 slides/year for all labs).
>   3- the difference in IHC workload between foreign and USA labs is
> significant (P<0.05)
>   4- usually the slides are cut in the same lab (average 2 hours/day).
>   5-46% of labs use autostainers (different makes).
>   6-for total workload = between 1 and 27 HTs (Average = 8; data from 122
> labs).
>   7-lab assistants: between 0 and 7, average = 2 (48 labs).
>   Hope this will help you!
>   René J.
>
>
> Jennifer MacDonald <JMacDonald <@t> mtsac.edu> wrote:
>   I have a few questions for IHC labs related to workload and staffing.
> Thank you.
> 1. How many slides per day?
> 2. Are slides processed, embedded, and cut by the IHC staff or elsewhere?
> 3. Automation or manual.
> If automation what instrument?
> 4. Number of staff members to perform the workload?
> How many histotechs? How many lab assistants?
>
> Thanks to all who help with this.
> Jennifer MacDonald
> Mt. San Antonio College
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------------------------------

Message: 4
Date: Sun, 9 Jul 2006 10:09:15 -0500
From: "Orr, Rebecca" <ROrr <@t> enh.org>
Subject: [Histonet] RE: IHC workload
To: <histonet <@t> lists.utsouthwestern.edu>
Message-ID:
	<A7FC3A4F98964A44B0B71B7B25EA6F960760F659 <@t> EXCHANGE03.enhnet.org>
Content-Type: text/plain;	charset="us-ascii"

Hi Jennifer,
Our IHC lab is separate from the Routine Histology lab. We do not rotate
techs into the IHC lab here.  We have a Technical Specialist (HTL, QIHC)
who is responsible for the IHC lab.  He works 7:30am-4pm. Then we have a
Tech (HT,) who comes in from 10:30am -7:00pm (she actually LIKES THAT
SHIFT!) So we have 2 people covering almost 12hours. 
This helps when the Docs come in late in the afternoon with IHC
requests; we have coverage until long after they are gone to cut
everything that comes in. Overnight in the oven is a luxury we love
having. On occasion though, we do run slides the same day.

Lately we've been looking at the LEAN 6-sigma set up where instead of
one large batch of slides once a day, we're processing several smaller
runs to cut down on total run processing time.  I'd be glad to discuss
this further in a separate email, if you're interested.
We run approx. 100-150 slides/day with a Ventana Benchmark and a Biocare
Nemesis.  The Autostainer platform of the Nemesis is great for working
up research projects that require larger numbers of slides.

To finish answering your questions, the Histology lab cuts the H/E
slides. 
Docs read the H/E and order IHC.  We get the orders and then hunt down
the blocks (some Docs are trained to submit the blocks) and cut our own
IHC.  We have a cassette holder re-alignment instrument that keeps all
of the microtomes lined up, so blocks can be cut from any microtome.
There are always cases that arise where an FNA core biopsy is submitted
and the IHC lab cuts the H/E and takes unstained slides immediately.
IHC lab does not embed.
I recommend that the person leading the IHC section have a propensity
for running these stains.  It would be advantageous for this person to
have a keen interest in keeping the lab updated with new antibodies.

It kind of depends,  on your Pathologists.  Our lab is part of a
teaching hospital with 13 Pathologists and a dozen Pathology residents
each doing separate research projects.  We are always working on a
poster or abstract for one of them.  So in our IHC lab, we need a
progressive leader who is interested in working with the consistency of
change...someone who has the experience and the progressive attitude to
research new antibodies and juggle research and clinical assignments on
a very regular basis. 

There are many labs that  require  a menu of 20-30 antibodies to be run
in a consistent routine, so in this case the IHC personnel requirements
might be a bit  different.(My opinion)

Hope this helps,
Becky

Becky Orr CLA,HT(ASCP)QIHC
Assistant Manager, Anatomic Pathology
Evanston Northwestern Healthcare
847-570-2771
 

Message: 15
Date: Thu, 6 Jul 2006 14:43:18 -0700
From: Jennifer MacDonald <JMacDonald <@t> mtsac.edu>
Subject: [Histonet] IHC Workload
To: histonet <@t> lists.utsouthwestern.edu
Message-ID:
	
<OF431E4EEF.873CB8D4-ON882571A3.00759DF2-882571A3.007759C5 <@t> mtsac.edu>
Content-Type: text/plain; charset="US-ASCII"

I have a few questions for IHC labs related to workload and staffing. 
Thank you.
1.  How many slides per day?
2.  Are slides processed, embedded, and cut by the IHC staff or
elsewhere?
3.  Automation or manual.
        If automation what instrument?
4.  Number of staff members to perform the workload?
        How many histotechs?  How many lab assistants?

Thanks to all who help with this.
Jennifer MacDonald
Mt. San Antonio College

------------------------------





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