Re: [Histonet] Pathology modernisation
We are developing the sort of centralised Gynae cytology network you describe, here in sunny Cambridgeshire with a centralised Gynae preparation/staining/screening laboratory based in a new building in Newmarket. Currently this serves all of Cambridge and West Suffolk and West Cambridgeshire (us here in Huntingdon) will be joining in at a later date.
The Non-gynae however, has remained where it has always been at the original labs and the prep work etc is now being done by Histology staff instead of Cytology staff.
I think the idea is to keep it close to the Pathologists who are mainly based at the original hospitals (Addenbrooke's and West Suffolk).
Changing from conventional smears to LBC in Gynae is going to be hard enough as it is without involving Non-gynae, at least in the first instance, although there are obvious merits in including Non-Gynae specimens as well.
>From what I understand, you can already do a certain amount of Non-Gynae specimens such as body cavity fluids etc on the conventional LBC machines.
Interesting times I think.
Kemlo Rogerson wrote:
Leaving behind Terry's fixation on fixation I would like, for once, to
ask a serious question.
Pathology modernisation in London appears to be 'ahead of the game', I
assume because in London Pathology modernisation was already happening
before it became a National Sport. The advent of LBC means that, to
justfy a Processor, then Labs may have to merge or employ a 'hub and
spoke' method of delivering Cervical Cytology. I don't wish to get into
a LBC debate as I have had enough of that to last me a lifetime. I am
assuming that what I have just said is the future; collaboration or
merging to produce a workload that can use the capacity of T3000,
multiple T2000 or a SurePath processor.
But where does Non Gynae stand in all this? Traditionally, it has been
the remit of the Cytology Lab to service Pathology's Non-Gynae
commitment, but is that logical? I assume Non-Gynae will be served by
either a T2000 or something SurePath can come up with; it may be we stay
with traditional methods. My question is, given that many histological
techniques are carried out on Non-Gynae specimens, could Non-Gynae sit
within Histology. It would divorce it from the 'Pap Factory' scenario
and could place it fairly and squarely where, in my opinion, it belongs.
Could Non-Gynae Cytology actually find its 'place in the sun' if it was
within the Histology Department of Cell Path?
Mr Kemlo Rogerson MSc DMS MIBiol CBiol FIBMS
Sho Dan BSK
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[mailto:firstname.lastname@example.org] On Behalf Of Steven
Sent: 21 April 2004 20:09
To: Marshall Terry Dr,Consultant Histopathologist; Kemlo Rogerson; kevin
Subject: RE: [Histonet] Microwave Processing
Hello again HistoNetters
Yes, there are these hybrid mixtures called coagulative fixatives.
They are usually combinations of ethyl alcohol and polyethylene
glycol, and, occasionally, acetic acid. They do not cross-link
proteins. The PEG helps prevent the shrinkage associated with the
use of ethanol as a fixative.
The advantage of all these mixtures is that, no cross-linking having
taken place, no subsequent antigen retrieval (or "unmasking") of the
proteins would be necessary for IHC. Dr. Boon has a good chapter on
them in support of her "Boon-Fix".
To muddy the waters further, there are still other non-formalin
fixatives, which are neither coagulative fixatives, nor cross-linking
fixatives, based on glyoxal, such as Anatech's "Prefer", but which
still are said to chemically "fix" the tissue. I'll leave the
mechanism of their chemistry to the experts.
At 3:51 PM +0100 4/21/04, Marshall Terry Dr, Consultant Histopathologist
>"Am I talking a load of..........."
>You talk as if formalin was the only fixative. What about the group
>called, oddly enough, coagulative fixatives? Now .... I wonder how they
>work. Let me see ...... Furthermore, you flit between the several
>different subjects in an unstructured way.
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