Re: Tissues for my HT exam

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Peggy Wenk at the William Beaumont Hospital in Royal Oak MI (folks know who 
William Beaumont was? Quite a story.) replies to a request for tissues for 
the HT exam from Michelle Lowe at Valley Children's Hospital in Madera CA.

Peggy Wenk notes: >>You can get most these tissues from an autopsy...If your 
autopsy service and/or residents are anything like ours, just telling them 
once what you need, or giving them a list, does NOT work. They are too busy 
trying to get the autopsy done, and they forget about the list. We find it 
works best when you find out that there is going to be an autopsy - fill up a 
container with formalin, write the tissues you need on the lid, and place the 
container on the table where they will be dissecting out the organs.<<

This old pathologist concurs strongly with these suggestions. When I was a 
resident, I spent a good bit of time trying to help with requests for tissue. 
All such requests, however simple they appear, need to be negotiated and 
problems worked out in advance. 

Except for the spinal cord, all the tissues you need can be obtained from 
surgical pathology specimens, in significantly better condition. Remember 
that the first specimen you get may not work out, and you may need to go 
after a second one of the same type.

Spinal cord is a special problem - really requires the active co-operation of 
a pathologist or skilled autopsy tech. All you need is the lumbar cord - I 
can get one of those out with an electric oscillating (Stryker) saw in about 
ten minutes - actually, that's how I used to keep this skill fresh. The cord 
should be removed with the dura mater intact, and the dura then slit (with 
small scissors) in the midline fore and aft, for better fixative penetration. 
(At this point you should take the specimen from the pathologist, eventually 
returning them a finished slide.) The specimen should be fixed for at least 
two days, preferably longer and preferably suspended vertical. Tie some 
strings around the cord, and cut blocks so that the tied string holds cord, 
spinal nerves, and dura together. Process the block, and remove the string 
when you embed.

Bob Richmond
Samurai Pathologist
Knoxville TN

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