[Histonet] Re: Blue Nevus

Sun Feb 4 12:37:38 CST 2007

Hello Histoneters:

  I would like to know if anyone can help me with some specific information for my research paper/capstone on Blue Nevus. I have found information on doctor's doctor website and on emedicine, but the one thing that i am not finding is a case report in histological detail
  Preparation Assessment: (Fixing – Staining)

   Evaluate the effectiveness of each histological tissue preparation step and its effect on a future patient diagnosis.

   Identify and describe histological tissue preparations unable to perform (and why) that would enhance the likelihood for a more accurate diagnosis.
  If anyone can help me out with my question, that would be greatly appreciated. 
  Thanks in advance. 
  Ms. S. Humphrey, Argosy U Student 

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Today's Topics:

1. AW: [Histonet] Sentinel node protocol? (Gudrun Lang)
2. RE: ASCP Exam Long opinion (patsy ruegg)
3. peptide-blocking (Carlos G. Perez-Garcia)
4. Re: Re: Nuclear Fast Red (Lynette Pavelich)
5. Re: ASCP Exam Long opinion (Joe Nocito)
6. Re: EBER (Richard Cartun)
7. Re: ER control tissue (Richard Cartun)
8. Re: ER control tissue (Bryan Hewlett)

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

Message: 1
Date: Sat, 3 Feb 2007 19:38:56 +0100
From: "Gudrun Lang" 
Subject: AW: [Histonet] Sentinel node protocol?
To: 
Message-ID: <001301c747c2$919b9ab0$eeeea8c0 <@t> dielangs.at>
Content-Type: text/plain; charset="iso-8859-1"

Last year we started a program for the breast sentinels with serial cuts in
50 µm steps. The first and the last were HE stained, the others
Pancytokeratin. The pathologists wanted to see, if there is any significant
differenc in the results to our former protocol with 250µm steps.
Now we turned again to the larger distance.

We also do frozens on the half part of the sentinel if it is smaller than 5
mm, and on the middle 2mm-part if it is larger. We perform also one slide as
rapid ck-pan. 
But for all good reasons to get the information of the frozen, we cannot be
sure about the result until the last immuno-slide.

Gudrun Lang

Biomed. Analytikerin
Histolabor
Akh Linz
Krankenhausstr. 9
4020 Linz
+43(0)732/7806-6754

-----Ursprüngliche Nachricht-----
Von: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] Im Auftrag von MICHELLE
SEAGLE
Gesendet: Samstag, 03. Februar 2007 00:45
An: histonet <@t> lists.utsouthwestern.edu
Betreff: [Histonet] Sentinel node protocol?

I was interested in knowing what other hospital labs use for their sentinel
lymph node protocols for breast cases and melanoma cases. I think our
hospital's is a little over kill.

thanks

Michelle Seagle
Rutherford Hospital HT (ASCP)

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

Message: 2
Date: Sat, 3 Feb 2007 13:05:18 -0700
From: "patsy ruegg" 

Subject: RE: [Histonet] ASCP Exam Long opinion
To: "'Joe Nocito'" , "'Rittman, Barry R'"
, "'Edwards, R.E.'"
, "'Jasper, Thomas G.'" 
Cc: Histonet <@t> lists.utsouthwestern.edu
Message-ID: <200702032005.l13K5CC3070217 <@t> pro12.abac.com>
Content-Type: text/plain; charset="US-ASCII"

I think I am even more of a dinosaur than you Joe.
I think all the automation is taking us farther and farther away from
connecting with the patient which is after all why we do what we do. 
I came from a unique situation, early in my histology career I took a job at
the U of Colorado with Dr. Matthew Block in the department of
Hematology/Oncology. Dr. Block was a practicing hematologist/oncologist who
also became a board certified Pathologist and set up his own histology lab
because he did not like the service he got from the pathology/histology
department. He literally treated the patient and did his own path
processing and report. We would go with Dr. Block to the patient and assist
with taking a bone marrow biopsy or lymph node biopsy, take it back to the
lab, process it into GMA plastic in those days because Dr. Block wanted
really thin tissue sections. He was a hematologist who looked at everything
under oil immersion and insisted on impeccable cell morphology. We saw the
faces of the people we were preparing tissue sections for. I remember
helping mothers hold babies while bone marrow was taken. I think these
experiences continue to remind me that there is a patient whose parts we are
attending to. I know this experience is not common and certainly not
practical anymore but I think the more and more we push buttons and don't
look at our slides the farther we are removed from remembering that there
are patients we need to do our best for.
Patsy

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Joe Nocito
Sent: Friday, February 02, 2007 6:02 PM
To: Rittman, Barry R; Edwards, R.E.; Jasper, Thomas G.
Cc: Histonet <@t> lists.utsouthwestern.edu
Subject: Re: [Histonet] ASCP Exam Long opinion

I agree with you Barry. Techs need to know how the procedure is working to 
be able to troubleshoot when something happens. Is it the machine or the 
procedure? That's what I stressed when I was giving my intro to IHC 
lectures. Something intricate like immunos should be done manually until the

tech is familiar with the procedure before they put slides on a machine. 
But, then again, I've been told that I'm a dinosaur. Oh well, it's Friday, I

think I'll have a scotch. Enjoy

Joe
----- Original Message ----- 
From: "Rittman, Barry R" 
To: "Edwards, R.E." ; "Jasper, Thomas G." 

Cc: 
Sent: Friday, February 02, 2007 8:59 AM
Subject: RE: [Histonet] ASCP Exam Long opinion

Nothing is black and white nowadays and I think that the current
discussion on Histonet is important in putting forward all points of
view..

I agree that automation is very important for producing consistent
results and in many ways these have relieved us of tedious, repetitive
tasks.
I also respect the supervisors who are often stuck between a rock and a
hard place.

The problem I currently see is that in many cases these machines may be
operated in a robotic fashion. If the individual operating the machine
is knowledgeable about the process taking place be it histochemical,
immunochemical or special stains and can take appropriate steps if
problems arise then there should be no problem.
Unfortunately in today's market, not just for histology, the emphasis
appears to be on minimal qualifications to carry out a task. This may
work perfectly well in those cases where instructions are concise and
easily followed and solutions changed at specific intervals and times
adhered to.
However, I believe something is lost to the histotechs in such a
situation.

After all I operate my car with minimal knowledge of the mechanics and
electronics. However were I to get paid to operate my car I would hope
that I had time and make the effort to try understand the processes
involved. I would consider this part of responsibilities and also a
bonus in enhancing my work experience.
My point is, are we going to "progress" into an era where we are just
button pushers?
This automation also releases individual so that many histotechs may
carry out tasks that never used to be their responsibility.
This appears to be a national trend. As an example, I am paid as a
faculty member here but my time spent includes memos, filing etc. a task
originally carried out by secretarial staff. It is not that I resent
doing such tasks but after all I am paid more than secretaries and the
"secretarial tasks" never appear anywhere in my yearly report of
activities.

Perhaps we will end up with histotechs plus a second group of button
pushers? Perhaps secretaries will be reincarnated - probably not.

I guess that I am from an era where work was varied and pleasurable
rather than one in which the bottom line was the aim, and where employee
and employees worked as a team.
Hoe that this makes sense, this has been a one coffee morning so far.
Barry

-----Original Message-----
From: Edwards, R.E. [mailto:ree3 <@t> leicester.ac.uk]
Sent: Friday, February 02, 2007 8:09 AM
To: Jasper, Thomas G.; Rittman, Barry R
Cc: Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] ASCP Exam Long opinion

Laboratory automation surely is as much due to obtaining
reproducibility of results than saving on staff costs, as to date
at least, all machines need human minders, who earn their corn
when the machine malfunctions and for example they have to do a
batch of H <@t> Es by hand.

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jasper,
Thomas G.
Sent: 01 February 2007 18:17
To: Rittman, Barry R
Cc: Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] ASCP Exam Long opinion

Hey Barry,

I appreciate your long opinion, at times life requires long opinions. I
agree with much of what you say and I will try to concisely explain how
I see things. I totally agree that elimination of the practical was a
bad idea. And I understand the arguments for getting rid of the
practical. Let's start with automated staining. Unfortunately most
labs in the clinical world of the US, Can., UK, Western Europe, S.
Africa, Aus., NZ and Japan (sorry if I've omitted someone) have turned
to this technology out of necessity. This is due to staff shortages and
for cost containment. The consistency and reproducibility are greatly
enhanced by reduction of variables (I know more science than art). But
there you are, so a lab's automated stainer produces a stain, candidates
submit. If this is the technology a candidate will likely use, that
should be taken into consideration.
I expect a candidate to cut their own sections. That would be subject
to evaluation as it always was. And I expect someone to know what an H
and E or any other stain is supposed to look like, automated or not.
With so much emphasis on academics they should know what the stain looks
like and why. Heck, with all this automation you could even expect a
basic level of understanding about the mechanics involved and make that
part of the written exam.
Perhaps the elimination of the practical was not necessary, but a
reassessment of the whole thing, or as you so cleverly stated "...what
is needed for the entire system is a good enema!" I agree with the
statements from others that they want to know that folks who are
certified can cut sections. It is more balanced and despite all of our
wonderful automation Histology is the one laboratory discipline that
still requires a deft hand and an artistic eye. I'm not aware of any
automated substitute for manual dexterity.
I also agree with this whole ASCP/fox in the henhouse analogy of yours.
I understand we've got good intentions here, but there is a mindset,
amongst certain pathologists, about cheap labor. Despite pay increases
in recent years (and I'm grateful) Histotechs overall, are the lowest
paid laboratorians. Increased educational requirements (which I believe
in) still have not eradicated this mindset. Please understand, I am not
speaking about all pathologists, but there are enough to validate the
analogy.
Now Barry, I think your educational background is great and I suspect
you're a better man because of it. It seems to me in this day and age
that it would be near impossible to pull off. We've taken incredible
leaps in technology just for Histology alone. I would be wary of an MLT
or MT today that thought they could come into our Histology lab and
perform at the level I expect (that whole dexterity thing again). And
frankly, I think it would be extremely difficult to go into the General
Lab, Blood Bank, Chemistry, Special Hematology, Microbiology or any
other sub-discipline and perform at an acceptable level. Now do I think
folks should have an understanding and appreciation for these other
disciplines? Absolutely. And maybe that needs to be incorporated in
Histology training at an academic level. But doing the work is another
thing entirely.
Anyway, I don't know if my opinion will count for much, but there you
have it. It would be nice to see some changes and I think reinstating
the practical is worth considering. I understand that logistical
problems exist as well, along with some of the other subjective
variables that Joe Nocito mentioned. Maybe judges could be sent
regional sites or something. Anyway it's food for thought.
Thanks for letting me ramble.

Thomas Jasper HT (ASCP) BAS
AP Supervisor
SMDC - Duluth, MN

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

Message: 3
Date: Sat, 3 Feb 2007 17:35:05 -0800
From: "Carlos G. Perez-Garcia" 
Subject: [Histonet] peptide-blocking
To: histonet <@t> lists.utsouthwestern.edu
Message-ID: <7BDD827B-AF0D-49C4-9C52-46D43BF326CF <@t> salk.edu>
Content-Type: text/plain; charset=US-ASCII; delsp=yes; format=flowed

hi everybody

i need to do a peptide-antibody blocking experiment to check the 
specificity of an antibody i made. i wonder if somebody has 
experience on that. i suppose that just adding 5-10 times more 
peptide than antibody in the solution will be enough right? does 
anybody have any protocol or suggestion?

thanks in advance

Carlos

Carlos G. Perez-Garcia, Ph.D.

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

Message: 4
Date: Sat, 03 Feb 2007 22:41:39 -0500
From: "Lynette Pavelich" 
Subject: Re: [Histonet] Re: Nuclear Fast Red
To: ,
Message-ID: <45C50FA4020000EE00011055 <@t> smtp-gw.hurleymc.com>
Content-Type: text/plain; charset=US-ASCII

I have used "Brazilliant" for a few years, and has given good nuclear
staining. No complaints from the docs.
Lynette

>>> 02/02/07 11:28 PM >>>
Beth Delescavage asks about sources for nuclear fast red.

Nuclear fast red is a dye whose future is pretty uncertain. Anatech
offers an 
alternative, "Brazilliant", brazilin in alum. Brazilin is a natural dye 
botanically and chemically related to hematoxylin, but it's red. 

Has anybody on the list tried this stuff? With what results?

(I have no connection with Anatech.)

Bob Richmond
Samurai Pathologist
Knoxville TN
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------------------------------

Message: 5
Date: Sun, 4 Feb 2007 09:46:01 -0600
From: "Joe Nocito" 
Subject: Re: [Histonet] ASCP Exam Long opinion
To: "patsy ruegg" 
, "'Rittman, Barry R'"
, "'Edwards, R.E.'"
, "'Jasper, Thomas G.'" 
Cc: Histonet <@t> lists.utsouthwestern.edu
Message-ID: <006601c74873$941dac40$649eae18 <@t> yourxhtr8hvc4p>
Content-Type: text/plain; format=flowed; charset="iso-8859-1";
reply-type=original

Patsy,
I am closer to you than you think. At my first lab after histology school at 
Keesler AFB, MS, I had to assist on bone marrows and worked in the blood 
drawing room when I had no pathologist. I saw how bone marrows were 
performed and it scared me to death when I had to embed and cut the blocks. 
I didn't not want to mess it up and then have the patient return for another 
procedure because of my mistake.
There were many retirees in Miami that were getting cancer treatment at 
the base. Often, the regular patients would request me to draw their blood 
because I also joked with them and was able to get the blood on the first 
try. I remember one lady was trying to fix me up with her granddaughter, a 
total knockout. She had told her granddaughter so much about me that the 
granddaughter was coming done for the summer. Unfortunately, the grandmother 
succumbed to cancer and I never had the chance to meet her. The attending 
wanted an autopsy. I was the only tech so I had to assist on it. When the 
pathologist and I were about to start, I got teary eyed. The doc asked what 
was up, so I told him. He told me to go back to the lab and he would get 
someone else to put her back in the cooler when he was done, all I had to do 
was clean up.
Number 1= you are right, we just don't have the patient interaction we 
used to. It is hard for tech to try in put a face with the block. Still, to 
this day, 3 years later, I remember those experiences. Experiences that 
students today may or may not experience.
Number 2= some pathologists today would not have understood and would 
tell me to suck it up. Today it's more of a turn around time/insurance 
payment issue than ever.

Joe
----- Original Message ----- 
From: "patsy ruegg" 

To: "'Joe Nocito'" ; "'Rittman, Barry R'" 
; "'Edwards, R.E.'" ; 
"'Jasper, Thomas G.'" 
Cc: 
Sent: Saturday, February 03, 2007 2:05 PM
Subject: RE: [Histonet] ASCP Exam Long opinion

>I think I am even more of a dinosaur than you Joe.
> I think all the automation is taking us farther and farther away from
> connecting with the patient which is after all why we do what we do.
> I came from a unique situation, early in my histology career I took a job 
> at
> the U of Colorado with Dr. Matthew Block in the department of
> Hematology/Oncology. Dr. Block was a practicing hematologist/oncologist 
> who
> also became a board certified Pathologist and set up his own histology lab
> because he did not like the service he got from the pathology/histology
> department. He literally treated the patient and did his own path
> processing and report. We would go with Dr. Block to the patient and 
> assist
> with taking a bone marrow biopsy or lymph node biopsy, take it back to the
> lab, process it into GMA plastic in those days because Dr. Block wanted
> really thin tissue sections. He was a hematologist who looked at 
> everything
> under oil immersion and insisted on impeccable cell morphology. We saw 
> the
> faces of the people we were preparing tissue sections for. I remember
> helping mothers hold babies while bone marrow was taken. I think these
> experiences continue to remind me that there is a patient whose parts we 
> are
> attending to. I know this experience is not common and certainly not
> practical anymore but I think the more and more we push buttons and don't
> look at our slides the farther we are removed from remembering that there
> are patients we need to do our best for.
> Patsy
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Joe Nocito
> Sent: Friday, February 02, 2007 6:02 PM
> To: Rittman, Barry R; Edwards, R.E.; Jasper, Thomas G.
> Cc: Histonet <@t> lists.utsouthwestern.edu
> Subject: Re: [Histonet] ASCP Exam Long opinion
>
> I agree with you Barry. Techs need to know how the procedure is working to
> be able to troubleshoot when something happens. Is it the machine or the
> procedure? That's what I stressed when I was giving my intro to IHC
> lectures. Something intricate like immunos should be done manually until 
> the
>
> tech is familiar with the procedure before they put slides on a machine.
> But, then again, I've been told that I'm a dinosaur. Oh well, it's Friday, 
> I
>
> think I'll have a scotch. Enjoy
>
> Joe
> ----- Original Message ----- 
> From: "Rittman, Barry R" 
> To: "Edwards, R.E." ; "Jasper, Thomas G."
> 
> Cc: 
> Sent: Friday, February 02, 2007 8:59 AM
> Subject: RE: [Histonet] ASCP Exam Long opinion
>
>
> Nothing is black and white nowadays and I think that the current

=== message truncated ===

Scheherazade H. 

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