MSH Announcements
Region II Meeting For the complete printable brochure of the 2010 meeting, click this link |
Abstracts for Presentations Thursday, June 10th: PM Sessions This lecture is sponsored by Polysciences. In learning how to communicate the troubleshooting of special stains in the laboratory it will increase camaraderie, decrease workflow bottlenecks in the lab as well as frustration, and most importantly address patient care directly when working with small specimens or blocks that have little tissue in them. Although we as histology professionals have been used to staining manuals this workshop is not presented as a staining manual, but one source of many that will enable the histology professional to avoid staining issues and help with workflow. Staining issues not only arise with the staining procedure but also with the staining reagents, and as more and more commercially available reagents are bought and used due to time as well as personnel constraints in the laboratory more factors contribute to staining issues than ever before. Routine as well as special stain troubleshooting in cytology, hematology (bone marrow processing in the histology lab) and histology will be addressed as growing histology labs process cytospins and bone marrows. The consequences of using impure dyes and expired reagents will be addressed as well as the role that the BSC plays when certifying dyes and the importance of dye certification. The CI or Color Index nomenclature will be addressed as to making solutions and the importance of this number and the impact it has when used to make commercially available stains and reagents. Other information will come from addressing artifacts related to individual staining procedures. Other staining issues that will be addressed are related to processing and microtomy. Manager’s Forum: Roundtable Discussion for Anatomic Pathology Managers An informal anecdotal discussion among peers, this forum will be conducted by and for individuals who are in a supervisory or managerial role which encompasses technical and/or administrative oversight in the field. A variety of topics will be discussed with various solutions presented and shared by participants. Registrants are encouraged to submit at least one topic that she/he would like to discuss via e-mail to dgoodwin100@comcast.net no later than two weeks prior to the event. Attendees should be willing to share information such as procedures, processes and means of documentation, as well as contact information. |
Friday, June 11: AM Sessions For the complete printable brochure of the 2010 meeting, click this link Conventional Davidson is the fixative of choice for opthalmic pathology; however the random occurrence of multiples vacuoles in the optic nerves of rats has been an ongoing problem in our laboratory. This workshop will discuss the overall histomorphologic changes of the eyes fixed with Conventional Davidson and four different types of modified Davidson’s fixative namely Tests 1, 2, 3 and 4 using alcohol, glacial acetic acid, formalin, and formaldehyde in different concentrations. This workshop will also provide a better understanding of eye collection and discuss the advantages and disadvantages of different types of fixatives. Have Your Fluorescent Label and Chromogen Too Are you interested in working with fluorescent dyes, but hesitate because of their quenching properties? Does working in a GLP environment prevent you from working with fluorochromes considering the fluorescently labeled tissue sections cannot be retained as permanent (raw) data? Come and see how formalin-fixed, paraffin-embedded tissue can be labeled with fluorescent dyes and through the use of serial sections, conjugate the fluorescent signal to a permanent color chromogen. Images can be captured from one or both sets of slides, but the chromogenic labels can be retained as raw data and serve as your permanent record. Come see what reagents are needed to make this technique work for you. Selection, Production and Characterization of Probes for in situ Hybridization In situ hybridization has been established as a uniquely powerful tool for the study of gene expression in tissues, allowing both the visualization and quantification of gene expression at the regional and cellular level. While a highly sensitive and versatile technique, its value is dependent on the careful selection and characterization of probes. This presentation will focus on three critical aspects of probe selection. First, we will outline a strategy that can be used to select a probe that is unique to the gene sequence of interest. This section will also discuss ways to deal with similar unwanted genes such as other members of a super family of genes. Next we will discuss the benefits and drawbacks of ribonucleotide versus oligonucleotide probes and how their length can be used to enhance specificity. Finally, I will provide and overview of different methods used to label probes and provide examples generated using these different methods. Antibody Production We use antibodies in all of our daily functions in the immunohistochemistry lab, but did you ever stop to think about how they are actually made. This presentation is going to walk through some of the production methods used to produce the antibodies we use every day. We will discuss monoclonal, polyclonal, and rabbit monoclonal antibody production along with the science and basic immunology behind it. During our discussion we will also talk about how antibodies come into the lab and some tools for researching the antibodies we use for our assays. Room B Why are my sections coming off thick and thin? What's causing the microchatter in the GI biopsies? Is it better to cut skin through the epidermis first, or through the connective tissue? Why does the pathologist complain about folds in the cervix or skin sections, but never in the liver or lung sections? Why can I never cut with this company's disposable blades? What are these unidentified objects on top of the tissue, and where did they come from? Why are my frozen sections shattering/chattering/curling? The causes often lie, not just with the microtome, but in all the previous steps of fixation, processing and embedding. Causes and cures to these questions, and many more, will be discussed in this 3 hour workshop, and demonstrated with the use of photos. Room C Recently LEAN Principles have entered the healthcare arena as a means to address inefficiencies and reduce costs. Often paired with “Six Sigma”, another quality based system that seeks to locate root cause to maintain accuracy; LEAN has fit well with the clinical laboratory for total quality management. Standardized patient testing methods and automated testing systems, lend themselves well to the repetitive processes of a clinical lab. But can they work as well in other histology venues? Yes they can. By simply adapting LEAN principles of operation and using Value Stream Mapping (VSM) to improve process flow, any histology lab can successfully improve out-put and turn-around- time, remove inefficiencies and errors in their system, and create an environment for staff to work better, not harder. This presentation will lead your through the basic steps to creating your own process improvement “toolbox” with LEAN and VSM. Room D This presentation is intended to provide a comprehensive overview of the one of most important issues within the field of immunohistochemistry, and assumes a working knowledge of specimen fixation, positive/negative control-material selection, pretreatment procedures, reagent ‘compatibility’ and selection, and essential procedural and documentation requirements. The lecture will also cover such concepts as regulatory guidance on validation (or lack thereof), suggestions for exceeding regulatory-agency expectations, and use of automated staining systems. Other issues that will be discussed include staff responsibilities, ongoing quality control, instrument maintenance, and troubleshooting unacceptable staining. Participants will be encouraged to participate in a ‘question- and-answer’ session at the conclusion of the presentation, as a means of soliciting different opinions and personal preferences. Handout material, including sample forms, comparison tables, and ‘flow- diagrams will be provided. Heat-induced Epitope Retrieval: A Review of Methods, Reagents, and Devices |
Friday, June 11: PM Sessions For the complete printable brochure of the 2010 meeting, click this link Room A Clinical Seminars: Troubleshooting Amyloid Staining The goal of this program is to provide participants with an understanding of the variables in amyloid staining. Any changes made to the structure of the amyloid, or to the staining procedures, can result in less than optimal staining. The different types of amyloid may also have variable staining, depending upon the procedure used. This presentation will begin with a review of the ultrastructure of amyloid as well as its chemical and immunological structure. Techniques for proper fixation, processing, and sectioning of amyloid will also be discussed. The final portion of this program will address the known staining mechanisms of iodine, periodic acid-Schiff (PAS), metachromatic and polychromatic stains (methyl violet), Congo red, and thioflavin T (TFT) and will cover factors that can prevent with optimal staining. Whole Slide Imaging and Practical Applications of Image Analysis This talk will focus on practical applications of image analysis and both whole slide as well as spectral imaging. Two main themes will be addressed. The development of a histocytometry platform for cell based analysis of cellular and subcellular events within tissues and the analysis and extraction of data from slides. The second portion of the talk will focus on how whole slide imaging is allowing pathologists to integrate primary slide data into complex high dimensional biologic analysis and will focus on how we are merging radiology, pathology and proteomics data in our studies of prostate carcinoma Reprocessing: Beyond GIGO (Garbage In, Garbage Out) IHC Controls Room B The cardiovascular system is comprised of the heart and vasculature and it functions to transport blood to all tissues of the body. Structural integrity of the system is important in order to maintain healthy cardiovascular function. This workshop is designed to provide an integrated understanding of how the cellular structure and organization of the cardiovascular system relates to is function. Cellular anatomy and basic physiological mechanisms of normal heart and blood vessel function will be covered including impulse conduction, myocardial contraction and blood flow. Normal processes will be compared with how cellular changes that occur in major cardiovascular diseases, such as myocardial ischemia and atherosclerosis, alter the function of the system. Room C If you have experienced sample defects which require recuts, repeat staining, add to turn-around-time (TAT), excess paperwork, delays for equipment/paperwork/people, doing more work with no additional resources, then Principles of Lean Overview is the place to be to find tools and techniques that will help. This workshop will explore the different Lean tools that may be applied to alleviate these common laboratory issues. Some of those tools will include Value Stream Mapping, Standard Work, 5/S Workplace Organization, and Visual Controls. Lean strategies are tried and true methodologies that have been used by organizations for over fifty years. In this workshop you will not only hear a Lean presentation but receive hands on experience through multiple rounds of simulation. As each group of Lean tools is introduced, participants will get the opportunity to try them out in the simulation rounds. If you answered yes to any of the above questions, you can’t afford not to be LEAN in your lab. Room D Laboratory work is changing with increased time on computers and faster and more complex lab equipment to operate. Histologists need to be able to work safely in the lab and know how to avoid ergonomic risks in the workplace. Course participants will be able to identify Ergonomic Risk Factors, how to set up a workstation, proactive techniques to reduce musculoskeletal strain, and when to call in a professional. Using case studies and hands on interactive methods (learning lab stretches, proper pipetting techniques, etc) this course can show you how to work safer in the lab. |
Saturday, June 12: AM Sessions For the complete printable brochure of the 2010 meeting, click this link Room A Ionizing Radiation Safety in Anatomic Pathology This workshop will discuss the various types of radiation and will identify the most common types of ionizing radiation sources that may be encountered in the department of anatomic pathology. The physical characteristics of these ionizing sources will be described, along with the potential radiation exposure levels to staff. The radiation dose limits for the staffs, members of the general public and pregnant women will be presented and compared with naturally occurring sources of radiation exposure. The biological effects of radiation exposure will be reviewed. Also presented will be specific radiation precautions for: handling, fixing, processing and sectioning sentinel lymph nodes; handling radioactive seeds or implants found in prostates; using uranium containing chemicals. Radiation safety practices specific for x-ray producing machines, such as portable x-ray machines and electron microscopes, will also be discussed. Lab Safety Issues – Past, Present, Future Through time, knowledge of chemical and physical hazards has increased, but has safety? Do organizations struggle with safety – if so, why? Lab Safety will be explored from different angles and techniques for improved safety compliance will be reviewed. Attendees will hopefully leave with a better understanding of workplace controls, and behavior modification which can lead to improved Laboratory Safety. Room B Prostate cancer is the most common form of cancer detected in men. The introduction of the biomarker PSA and an aging population have led to an increased number of biopsies to assist in diagnosis. The histology laboratory plays a vital role in determining benign from malignant lesions after biopsy. The importance of knowing the basic anatomy of the prostate and what factors could effect staining is a necessity. The fact that most needle biopsies are taken with needles and provide very small amounts of tissue to work with have made it increasingly important that the immunohistochemistry section of the laboratory stay up to date with the latest markers available to provide the most accurate and earliest diagnosis with the smallest amount of tissue. Room C Today’s turnover of lab staff presents a demand for knowledge in Ultramicrotomy. Unique differences between UM and Histology equipment and sample size require specialized techniques. Training is presented in this program to understand these unique operations by describing the use of an ultramicrotome and specific techniques in specimen orientation, working with knives and collecting sections. Problems encountered with UM sectioning will be discussed. Room D This presentation will be comprised of sessions reviewing the goals, scope and philosophy of the CAP Laboratory Accreditation Program and how it interacts with CLIA and Joint Commission, an overview of inspection preparation and inspector training for inspection team members and specific points and tips related to the anatomic pathology and cytology checklists and the laboratory general checklist where is applies to anatomic pathology including recent updates. Saturday, June 12: PM Sessions Room A Basic Troubleshooting for Histology Laboratory Equipment This lecture is sponsored by Leica Microsystems. This course will provide a basic preventive maintenance guide that will assist users of histology equipment in the upkeep and troubleshooting of their instruments. The type of cleaning solvents that can and cannot be used will be discussed (along with some pictures that show what happens when the wrong cleaning supplies are used) and how and where to clean for best results. The types of tools that should be kept in the laboratory’s tool chest, and how and when to use them, will be demonstrated. Common types of faults that can be reasonably repaired by the average Histo-tech will be discussed and the ways, tools and thoughts behind the troubleshooting process will be investigated. Some symptoms that precede failures will be made known so that the users can notify their biomedical technicians or repair group of a pending failure, before the instrument breaks completely. IHC Instrumentation: How to Decide What’s Best for Your Lab Whether you are bringing a new test into the lab, or replacing/adding another instrument to an already automated Histology department, the process should include sufficient research into the current options available. Will it be an outright purchase? Reagent agreement? Lease? What are the benefits and drawbacks to each? What is best for the staff involved? What about your LIS? Will the pathologists have any impact on the decision? How will the vendor selected be able to help you with your future needs? How will you justify your decision? All of these questions need to be addressed in addition to planning a successful trial period. At the end of this presentation you should have a better understanding of how the entire process should work. Bone Biology and Histomorphometry Research efforts are committed to obtaining a greater understanding of bone function and the pathogenesis of metabolic bone diseases. Histology is an invaluable tool for research on bone and for evaluating the effects of new therapeutic agents. Specific information on bone activity at the cellular level can be obtained through histomorphometic analysis of bone samples. This quantitative analysis provides a profile of bone changes that can not be obtained with other methods. However, bone histology presents many technical challenges that are not encountered with soft tissue. This presentation will give an overview of bone physiology, and it will focus on the histological techniques and morphologic evaluation used to study bone in rodent models. A Review of Formalin Fixation This lecture will review the development and use of formalin in the histology lab, describe the dynamics of formalin fixation, and dispel common misconceptions about this fixative by presenting published scientific data. A comparison of optimal fixation times for both human and animal tissues will be presented. Also, how to set up a CAP approved disposal plan for formalin will be discussed. Room B This workshop will present an overview for candidates preparing for the HT/HTL certification exam. Participants will receive information on the ASCP HT/HTL eligibility routes, pertinent study information, and sources of continuing education. Handouts will detail an organized method of preparing for the exam. Topics that will be covered include: lab operations, fixation, processing, microtomy, and staining. Room C Due to limited personnel in many hospitals, histotechnologists are sometimes asked to process cytology specimens or to supervise this preparation. This Workshop presents an overview of the cytopreparatory techniques used in the laboratory encompassing all body sites. Fundamentals and theory of cytopreparatory methods will be discussed along with staining methods employed. Topics to be discussed are smears and brushings, fluids using liquid-based technologies and cytocentrifugation, sputum processing, and fine needle aspiration techniques. The workshop will conclude with “hands-on” practice with making smears. After the conclusion of this workshop, the participant will be able to list all the techniques available to process cytology specimens. Attendees will be able to apply the various cytopreparatory techniques as required by the type of specimen. & Immuno-staining Cytologic Material: Practical Considerations and Potential Pitfalls This lecture is sponsored by Biocare Medical, LLC. This workshop is intended to provide participants with a comprehensive overview of the procedures involved in immuno- staining cytologic (i.e. cellular) specimen material – including smears, fine- needles aspirates, Cytospin™ preparations, ‘monolayer’ preparations (such as those produced with the Hologic-Cytyc ThinPrep™ and BD-TriPath SurePath™ systems) and cell-blocks prepared using newer technologies (such as the Hologic-Cytyc Cellient™ system). Although fundamentally similar to immuno-staining histologic (i.e. tissue) specimens, the primary differences in ‘processing’ and ‘handling’ cytologic specimens will be emphasized. Handout material, including reference tables, sample forms, and troubleshooting ‘flow-diagrams’ will be provided. Room D Over the past ten years, many new technologies have simplified immunohistochemical procedures and drastically improved the success rate of identifying antigens in tissue sections. The latest advancement is the production of enzyme labeled polymer systems. These systems are equivalent, or in some cases, superior in sensitivity to the avidin/biotin systems that have been utilized as the “gold standard” in IHC for many years. The benefits to using the polymer systems will be discussed. This workshop is NOT for beginners since basic material will not be discussed. It is intended for researchers familiar with IHC and routinely running avidin/biotin systems who would like to learn polymer techniques for use on various animal tissues. It will provide hands-on experience since participants will perform a short assay using a polymer system. During incubation steps, topics that will be discussed include: Advantages over ABC Methods, Comparison of Products (by manufacturer and species), Fixation, Antigen Retrieval Techniques, and the Use of Control Slides. Also, a large part of the workshop will be dedicated to an extensive discussion of troubleshooting background problems, and the proper use of blocking solutions for different tissue types including rat, mouse and monkey. For the complete printable brochure of the 2010 meeting, click this link |