[Histonet] RE: Kidney Bx question

Thu Mar 20 13:45:55 CDT 2008

Not sure if this could be your problem or not, but we were experiencing some of the "torn" look to our GI biopsies for some time.  It came down to our alcohols had too much water carryover.  We process with a microwave, and the water basically boiled out of the tissue, "shredding" the components.  We now change our alcohols after each run, not every other run and have not had problems since.  If you are using any heat in your processing, this could be something to look at.

  Good luck! 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
histoinfo <@t> comcast.net
Sent: 19 March 2008 17:14
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Kidney Bx question

We have been having some trouble with the inner surface of the tubules
looking torn look to the tissue. We hand process all our kidney bx's with
the times as follows.

1-formalin 15 minutes
2-50% ethanol 15 minutes
3-70% ethanol 15 minutes
4-80% ethanol 15 minutes
5-95% ethanol 15 minutes
6-100% ethanol 15 minutes
7-100% ethanol 15 minutes
9-xylene 15 minutes
10-xylene 15 minutes
Parraffin x2, 20 minutes each. 
They are then cut at 1 micron for PAS & JONES and 2 microns for H&E &
TRICHROME. 

We are trying to determine if this tearing is an artifact from processing,
collection or some other factor we haven't thought of. Has anyone else come
across this or a similar problem. All thoughts and suggestions welcome.

Jennifer Saunders HT (ASCP)
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From: "Houston, Ronald" <Ronald.Houston <@t> nationwidechildrens.org>
Subject: RE: AW: [Histonet] Kidney Bx question
CC: histonet <@t> lists.utsouthwestern.edu
Date: Thu, 20 Mar 2008 11:10:15 -0400
To: "Marshall Terry Dr,
Consultant Histopathologist" <Terry.Marshall <@t> rothgen.nhs.uk>, 
"Godfrey Guerzon" <Gguerzon <@t> lifebridgehealth.org>,
<histoinfo <@t> comcast.net>, "Gudrun Lang" <gu.lang <@t> gmx.at>

And we wonder why people get so p*****d off with Histonet and unsubscribe for long periods of time.................

Get a grip people! Take a pill and calm down!

Terry & Kemlo, it was brought up previously about the difference in humor on both sides on the Atlantic. Even though many parts of the country are well exposed to British TV, especially British comedies, much of the humor is lost on them. 

There is also a great difference in demands placed on histology labs & personnel in the US. The turn-around-times that exist in the UK at present, just aren't tolerated over here.

Is everything a bowl of cherries over here? Absolutely not, but staff have to work under the expectations and constraints that are placed/forced on them.

To all the Americans that get involved and respond with outbursts - lighten up! Life is too short to send your blood pressure up 20 points over something as trivial as this.

I feel competent to qualify these statements because I worked in Scotland for 18 years, 4 in Middle East, and 16 years in the US.

Well I've said my piece; I'm signing off for another couple of months till peoples egos subside and we can get back to the purpose Histonet was established.

Ronnie Houston, MS, HT(ASCP)QIHC
Anatomic Pathology Manager
Nationwide Children's Hospital
700 Children's Drive
Columbus, OH 43205
(614) 722 5465
Ronald.Houston <@t> NationwideChildrens.org
Columbus Children's Hospital is now Nationwide Children's Hospital
www.NationwideChildrens.org

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Marshall Terry Dr,Consultant Histopathologist
Sent: Thursday, March 20, 2008 10:32 AM
To: Godfrey Guerzon; histoinfo <@t> comcast.net; Gudrun Lang
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: RE: AW: [Histonet] Kidney Bx question

Godfrey,
Nobody has said anything snide, or put anybody down.
Your post is typical of those lacking a sense of humour, and who think being professional is synonymous with being formal.
It is not.

Terry 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Godfrey Guerzon
Sent: 20 March 2008 14:17
To: histoinfo <@t> comcast.net; Gudrun Lang
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: AW: [Histonet] Kidney Bx question

We are supposed to be professionals. What we post are real issues in our situation and ask for help. Professionals don't make snide remarks and put down our colleagues. If we think that it will raise our stature as professionals when we make a joke and condescending comments on things that we need help on, we are greatly mistaken. A wise man once said "if you have nothing good to say about anything - shut up". We need to understand that each situation is different - who are we to judge? We post a real issue in our own situation and we don't need "smart" colleagues make a joke of our situation. Do we want to be treated as professionals - then let us communicate as professionals.

No snide remarks or condescending comments - PLEASE!!! - Help and good ideas are welcome - if you have nothiing to contribute to the issue at hand - please don't waste your (and ours) valuable time with useless comments.

Godfrey

>>> "Gudrun Lang" 3/20/2008 9:53 AM >>>
Would you be so kind and explain, why you have to do a short run. Are these indeed NTX-biopsies, that need a report as fast as possible?
Or is it just the fear to over-process the biopsies?

We have ntx from time to time, but even then, the clinicians wait for the report until the next day, noon. So we can process the biopsies with our regular histo and do the specialstains (Jones, PAS, Congored, EvG, SFOG = kind of trichrome), immunohistochemistry and immunofluorescence. 
We process the needlebiopsies in sponges and with the regular 13-hour protocol. Regarding IHC a fixation-time under 6 hours could also drive to problems.

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 histoinfo <@t> comcast.net
Gesendet: Donnerstag, 20. März 2008 14:01
An: Rene J Buesa; Marshall Terry Dr,Consultant Histopathologist; histonet <@t> lists.utsouthwestern.edu
Betreff: RE: [Histonet] Kidney Bx question

Rene,
Yes they are agitated. And the tearing problem that I originally described is fairly infrequent. It's just that when it does happen we can't figure out why. When it does happen nothing that we can see is any different than any other day. Nothing in common as far as collection site either. I am beginning to think more and more that it may be on days that we have 5 or 6 bxs that are all run together. But even then it is not every bx. I think we will take better steps to prevent solution carryover and see what happens.
Of course it is so infrequent that we have this problem that it will be months before we can say that we "fixed" the problem. I would still like to compare times with others out there though. So please share your times for hand processing.
Thanks,
Jennifer

-------------- Original message --------------
From: Rene J Buesa 

For hand processing at room temperature that schedule is too short, unless the samples are agitated.
René J.

"Marshall Terry Dr, Consultant Histopathologist"
wrote:
Do you have a train to catch?

Terry 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of histoinfo <@t> comcast.net
Sent: 19 March 2008 17:14
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Kidney Bx question

We have been having some trouble with the inner surface of the tubules looking torn look to the tissue. We hand process all our kidney bx's with the times as follows.

1-formalin 15 minutes
2-50% ethanol 15 minutes
3-70% ethanol 15 minutes
4-80% ethanol 15 minutes
5-95% ethanol 15 minutes
6-100% ethanol 15 minutes
7-100% ethanol 15 minutes
9-xylene 15 minutes
10-xylene 15 minutes
Parraffin x2, 20 minutes each. 
They are then cut at 1 micron for PAS & JONES and 2 microns for H&E & TRICHROME. 

We are trying to determine if this tearing is an artifact from processing, collection or some other factor we haven't thought of. Has anyone else come across this or a similar problem. All thoughts and suggestions welcome.

Jennifer Saunders HT (ASCP)
_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu
http://lists.utsouthwestern.edu/mailman/listinfo/histonet
######################################################################
This email and any files transmitted with it may contain confidential and privileged information which is intended solely for the use of the individual or entity to whom they are addressed. Any views or opinions expressed are those of the author and do not represent the views of The Rotherham NHS Foundation Trust unless otherwise explicitly stated.
The information contained in this email may be subject to public disclosure under the Freedom of Information Act 2000 unless the information is legally exempt from disclosure. The confidentiality of this email and your reply cannot be guaranteed.
If you are not the intended recipient please accept our apologies. Please do not disclose, copy or distribute information in this email or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Please inform us that this message has gone astray before deleting it. Thank you for your co-operation.
######################################################################

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From: "Horn, Hazel V" <HornHV <@t> archildrens.org>
Subject: RE: AW: [Histonet] Kidney Bx question
CC: histonet <@t> lists.utsouthwestern.edu
Date: Thu, 20 Mar 2008 10:25:07 -0500
To: "Godfrey Guerzon" <Gguerzon <@t> lifebridgehealth.org>, <histoinfo <@t> comcast.net>,
"Gudrun Lang" <gu.lang <@t> gmx.at>

Amen Godfrey I was thinking the same thing.....

Jennifer,
I would extend the processing times by about 5 minutes each and I would add one more formalin...

Hazel Horn
Hazel Horn, HT/HTL (ASCP)
Supervisor of Histology
Arkansas Children's Hospital
800 Marshall Slot 820
Little Rock, AR 72202

phone 501.364.4240
fax 501.364.3912

visit us on the web at: www.archildrens.org

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Godfrey Guerzon
Sent: Thursday, March 20, 2008 9:17 AM
To: histoinfo <@t> comcast.net; Gudrun Lang
Cc: histonet <@t> lists.utsouthwestern.edu
Subject: Re: AW: [Histonet] Kidney Bx question

We are supposed to be professionals. What we post are real issues in our situation and ask for help. Professionals don't make snide remarks and put down our colleagues. If we think that it will raise our stature as professionals when we make a joke and condescending comments on things that we need help on, we are greatly mistaken. A wise man once said "if you have nothing good to say about anything - shut up". We need to understand that each situation is different - who are we to judge? We post a real issue in our own situation and we don't need "smart" colleagues make a joke of our situation. Do we want to be treated as professionals - then let us communicate as professionals.

No snide remarks or condescending comments - PLEASE!!! - Help and good ideas are welcome - if you have nothiing to contribute to the issue at hand - please don't waste your (and ours) valuable time with useless comments.

Godfrey

>>> "Gudrun Lang" 3/20/2008 9:53 AM >>>
Would you be so kind and explain, why you have to do a short run. Are these
indeed NTX-biopsies, that need a report as fast as possible?
Or is it just the fear to over-process the biopsies?

We have ntx from time to time, but even then, the clinicians wait for the
report until the next day, noon. So we can process the biopsies with our
regular histo and do the specialstains (Jones, PAS, Congored, EvG, SFOG =
kind of trichrome), immunohistochemistry and immunofluorescence. 
We process the needlebiopsies in sponges and with the regular 13-hour
protocol. Regarding IHC a fixation-time under 6 hours could also drive to
problems.

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
histoinfo <@t> comcast.net 
Gesendet: Donnerstag, 20. März 2008 14:01
An: Rene J Buesa; Marshall Terry Dr,Consultant Histopathologist;
histonet <@t> lists.utsouthwestern.edu 
Betreff: RE: [Histonet] Kidney Bx question

Rene,
Yes they are agitated. And the tearing problem that I originally described
is fairly infrequent. It's just that when it does happen we can't figure out
why. When it does happen nothing that we can see is any different than any
other day. Nothing in common as far as collection site either. I am
beginning to think more and more that it may be on days that we have 5 or 6
bxs that are all run together. But even then it is not every bx. I think we
will take better steps to prevent solution carryover and see what happens.
Of course it is so infrequent that we have this problem that it will be
months before we can say that we "fixed" the problem. I would still like to
compare times with others out there though. So please share your times for
hand processing.
Thanks,
Jennifer

-------------- Original message -------------- 
From: Rene J Buesa 

For hand processing at room temperature that schedule is too short, unless
the samples are agitated.
René J.

"Marshall Terry Dr, Consultant Histopathologist"
wrote:
Do you have a train to catch?

Terry 

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu 
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of
histoinfo <@t> comcast.net 
Sent: 19 March 2008 17:14
To: histonet <@t> lists.utsouthwestern.edu 
Subject: [Histonet] Kidney Bx question

We have been having some trouble with the inner surface of the tubules
looking torn look to the tissue. We hand process all our kidney bx's
with the times as follows.

1-formalin 15 minutes
2-50% ethanol 15 minutes
3-70% ethanol 15 minutes
4-80% ethanol 15 minutes
5-95% ethanol 15 minutes
6-100% ethanol 15 minutes
7-100% ethanol 15 minutes
9-xylene 15 minutes
10-xylene 15 minutes
Parraffin x2, 20 minutes each. 
They are then cut at 1 micron for PAS & JONES and 2 microns for H&E &
TRICHROME. 

We are trying to determine if this tearing is an artifact from
processing, collection or some other factor we haven't thought of. Has
anyone else come across this or a similar problem. All thoughts and
suggestions welcome.

Jennifer Saunders HT (ASCP)
_______________________________________________
Histonet mailing list
Histonet <@t> lists.utsouthwestern.edu 
http://lists.utsouthwestern.edu/mailman/listinfo/histonet 
######################################################################
This email and any files transmitted with it may contain confidential and
privileged information which is intended solely for the use of the
individual or entity to whom they are addressed. Any views or opinions
expressed are those of the author and do not represent the views of The
Rotherham NHS Foundation Trust unless otherwise explicitly stated.
The information contained in this email may be subject to public disclosure
under the Freedom of Information Act 2000 unless the information is legally
exempt from disclosure. The confidentiality of this email and your reply
cannot be guaranteed.
If you are not the intended recipient please accept our apologies. Please do
not disclose, copy or distribute information in this email or take any
action in reliance on its contents: to do so is strictly prohibited and may
be unlawful. Please inform us that this message has gone astray before
deleting it. Thank you for your co-operation.
######################################################################

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If you are neither the intended recipient nor the individual
responsible for delivering this message to the intended 
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patient information is strictly prohibited. 
If you have received this email in error, immediately notify us 
by telephone or return email.
-----------------------------------------------------------------

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