[Histonet] Re: Ohh the pain (replacing formalin)

[Victor Tobias]

I find this discussion very interesting. I haven't worked in the lab in 
awhile, so would the use of microwaves and their proprietary solutions 
be a step in the right direction? Part of the problem is not knowing 
what is in their reagents.

Victor

Douglas D Deltour wrote:
> It isn't really about decreasing formalin contact or staff safety. It is
> about being labeled as a "green lab". 
>
> Douglas D. Deltour HT(ASCP)
>
>
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Edwards,
> R.E.
> Sent: Thursday, September 27, 2007 10:29 AM
> To: Douglas D Deltour; Johnson, Teri; histonet <@t> lists.utsouthwestern.edu
> Subject: RE: [Histonet] Re: Ohh the pain (replacing formalin)
>
> Why  not simply  reduce  the  amount  of  formalin  used, i.e.  instead
> of  10% neutral buffered formalin use 5% or  less, we  used   cold(4C)
> 4%NBF for  one  particular  study, everything seemed to  work OK. 
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Douglas
> D Deltour
> Sent: 27 September 2007 17:15
> To: 'Johnson, Teri'; histonet <@t> lists.utsouthwestern.edu
> Subject: RE: [Histonet] Re: Ohh the pain (replacing formalin)
>
> Teri, don't be surprised. Let's just say that I can not go into detail
> about the reasoning behind this. I am aware of all of the validation
> that is involved in this task. At least I hope I can get the "I told you
> so" in
> before I am kicked out the door. :)   
>
>
> Douglas D. Deltour HT(ASCP)
>
> -----Original Message-----
> From: histonet-bounces <@t> lists.utsouthwestern.edu
> [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Johnson,
> Teri
> Sent: Thursday, September 27, 2007 9:26 AM
> To: histonet <@t> lists.utsouthwestern.edu
> Subject: [Histonet] Re: Ohh the pain (replacing formalin)
>
> Douglas, if it is your Pathology group pushing you to go to non-formalin
> fixative, I'm quite surprised. Pathologists are accustomed to making
> diagnoses based on formalin-based artifacts. In a lab I worked in (in a
> galaxy far, far away) we did the "Folger's crystals replacement"
> experiment, replacing all the GI and prostate biopsy formalin fixative
> with zinc formalin. I thought the pathologists were going to have a
> major meltdown. The nucleoli were more prominent in all the cells, and
> that freaked them out. We effectively changed what the cellular
> structure looked like (even mild cellular changes can be a
> diagnostically significant).
>
> Disregarding the FDA issue and interlaboratory issues already raised
> (quite valid points!), if you change what fixative you are using, the
> cells will look different. And while that is not an insurmountable issue
> for pathologists, it does take getting used to.
>
> One possible substitute is glyoxal. Anatech provides this commercially
> in a fixative called "Prefer". It is supposed to provide formalin-like
> morphology with heightened immunoreactivity. Remember - ALL your
> immunohistochemistry staining will have to be redone. ALL OF IT. It is
> optimised  using formalin, and changing the fixative changes the
> structure of the proteins. Some immunos may work better, some may not
> work as well, some may no longer require antigen retrieval, some may
> require a different retrieval method.
>
> Do you get any consultation material (outside blocks) from other
> institutions for second opinion? If so, and you need to do staining of
> any kind (H&E, special stains, and IHC), you will need to optimise your
> staining of that material back to formalin. Your non-formalin controls
> will be useless.
>
> I'm not saying this is an impossible task. It will be difficult and seem
> impossible until it's all worked out. It takes a tremendous amount of
> effort and energy to make the switch, and above all, the pathologists
> should have a major stake in how their samples will be fixed, processed,
> and stained. Their reputation depends on it. Their patient's diagnosis
> also depends on it.
>
> If you want to turn your attention to making formalin safer, there are
> ways of doing that. That's fodder for another post altogether.
>
> Good luck!
>
> Teri Johnson, HT(ASCP)QIHC
> Managing Director Histology Facility
> Stowers Institute for Medical Research
> 1000 E. 50th St.
> Kansas City, MO 64110
>
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-- 
Victor Tobias
Clinical Applications Analyst
University of Washington Medical Center
Dept of Pathology Room BB220
1959 NE Pacific
Seattle, WA 98195
victor <@t> pathology.washington.edu
206-598-2792
206-598-7659 Fax
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