Re: What day is this? RE: GI biopsies

From:Shirley Powell <powell_sa@Mercer.EDU>

Hi Tim,
It is not so unheard of, we tried this method many, many, (at least 15) years
ago when I was in the clinical lab.  I learned of the method at an NSH meeting
way back then.  We also used the Gel Foam method Rhonda eluded to, but abandoned
it later on.  When the blue pads came out, the pathologists decided to
discontinue the cucumber method.  But it is unique and gets my vote.


"Morken, Tim" wrote:

> I had to look at my calender to make sure it's not April!
> Maybe we can have a Best of the Histonet for most unusual procedures. This
> one is number one so far!
> Tim Morken
> Atlanta
> -----Original Message-----
> From: Rhonda Rogers []
> Sent: Friday, December 08, 2000 9:37 PM
> To: HistoNet; Carpenter, Judith A.
> Subject: Re: GI biopsies
> Hi Jude,
> For many years (imaybe 15 - 20 years or longer) the laboratory I worked in
> made cucumber pads for the endoscopy suites to use to orient the GI
> biopsies.  I know this may sound strange, but it really works great.
> Improper orientation of the biopsies as we embedded was eliminated.
> Explaining to new endoscopy nurses exactly how the pads were  made or
> requisitioning a dozen cucumbers from the cafeteria or having a tour group
> come through the lab while we were peeling and chopping cucumbers caused
> some very humorous situations over the years.  Usually, while trying to look
> very serious and having difficulty holding in the laughter, I answered the
> cafeteria staff's questions with, "Don't ask me what I am going to do with
> 12 cucumbers in the laboratory.  I am very sure that if I told you,  would
> not want to know.  Believe me; we are not making a salad."
> At any rate, the procedure is simple.
> (1)  Peel the cucumber (thinly, being careful not to leave any of the dark
> green skin).  Slice the cucumber in fourths and remove the seeded part in
> the center.
> (2)  Slice the cucumber into sticks (sort of like French fries) and then
> slice into little rectangles.  The object is to create pieces of cucumber
> that measure approximately 6x6x2 cm or a little larger or smaller according
> to your needs. (Too thin and they break up;  too thick and they are too
> crowded in the cassette; too small and the biopsy can be too large for the
> pad.)
> (3)  Place the sliced and diced cucumber pads in a container and dehydrate
> in 70% EtOH overnight, then 95% EtOH for the next two overnights, followed
> by two overnights 100% EtOH.  Store in 100%.
> We kept the main supply in the laboratory and gave small cups of "GI Biopsy
> Pads" to the endoscopy rooms as needed.  The nurses teased each biopsy off
> the biopsy forceps and onto the pad with the mucosa facing up and dropped
> the biopsy on the pad into the fixative.  (We used Hollande's fixative.)
> The pads were slightly dry when the biopsy was placed on it.  The tissue
> rarely, if ever, failed to stick to the pad.  We never noticed artifacts
> caused from the alcohol the pads were stored in.  Once we had a dry tissue
> artifact that was caused by a very slow, nervous nurse, but with a little
> additional training and experience she improved.
> In the lab, the biopsies (remaining stuck to the pads) were counted,
> measured, described, wrapped in biopsy paper, and processed.  When we were
> ready to embed, we gently removed the biopsy from the pad and turned the
> biopsy 90 degrees to embed on edge.  On very rare occasions, the biopsy
> could not be removed from the cucumber, but that was not a problem because
> the pad could be embedded along with the biopsy still on it, if necessary.
> The cucumber cuts like a breeze with no problems and does not interfere with
> the biopsy.
> Before using the cucumber pads, we tried various ideas including filter
> paper and some sort of mesh used in surgery (the name was gel-something, I
> don't remember the exact name).  The biopsies were difficult to remove from
> both, the gel-something was scratchy to cut, and the filter paper dried out
> the biopsy.  The cucumber pads were perfect.
> This may seem time consuming, but it is very easy to do once you get the
> hang of slicing and dicing the pads.  Every three or four months, we would
> cut several thousand of the little pads.  The satisfaction of a properly
> embedded biopsy was well worth the time we spent manufacturing the pads.  As
> we worked cutting the pads, we always joked about leaving histotechnology
> and going into the cucumber pad business.  We were positive we would end up
> as millionaires!
> Do give the cucumbers a try.  I hope you will like them.
> Rhonda
> Institute for Molecular Medicine and Genetics
> Medical College of Georgia
> Augusta, GA
>  ----- Original Message -----
> From: Carpenter, Judith A. <>
> To: 'NSH' <>
> Sent: Friday, December 08, 2000 8:27 AM
> Subject: GI biopsies
> > Hi folks-
> > Can anyone relay to me what their GI (Endoscopy) clinics use  (if they do
> > use some medium)
> > to orient their small mucosal biopsies ?
> > If it a commercially produced medium please include the product/company
> > information.
> > Have a warm weekend (avoid Vermont).
> > Thanks-
> > Jude
> > Jude Carpenter,BS, HTL(ASCP)
> > Chief Technologist/Surgical Pathology/Histology/Autopsy
> > FAHC/MCHV Campus
> > 111 Colchester Ave.
> > Burlington,   VT  05401
> > (802)847-5116
> > FAX : (802)847-3509
> >
> >
> >
> >

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