byVincentR.Klump,Jr.,HT(ASCP),HistologyServices,EastHaven,CT note:Mr.Klumpwasinstrumentalinthedevelopmentofastandardized,consistent,reproducIBLeprotocolformicrowavehistoprocessingintheoriginalEnergyBeamSciencesH2500MicrowaveProcessor. Tissuecriteria:Maximumtissuesizeforthisprocedure:3mmx3mmx3mm.Variationsofthissizecanalsobeaccommodated,buttotaltissuevolumeshouldnotexceed3mmcubed. Examples:3mmpunchbiopsies,coreneedlebiopsies,corebonemarrowbiopsies,shavebiopsies. Tissueshouldbefixedin10%NBFormalinforaminimumoffourhours. Slidecriteria:Positively(+)chargedorsilanetreatedprecleanedglassslides.Tissueplacedcentrallyonslides.Slidesbakedforaminimumof1hourat60ºC(preferably,bakedovernightat60ºC) Antigenretrievalmaybeutilizedforalmostallantibodies,enhancingstainingandallowingforgreaterantibodydilutionaswellasshorterincubationtimes.Mostantibodieswhichrequireenzymetreatmentstainremarkablywellutilizingantigenretrievalprocedures.Remembertoalwaysrunaknownpositivecontrolwitheachantibodyandatruenegativewitheachcase. Citratebuffer:10mMCitrateBuffer(2.1gCitricAcidto1Lofdistilledwater,adjustpHto6.0withapproximately10mLof2MNaOH).Immersesectionsincitratebufferfor10minutesat100ºCinmicrowave. Note:Slides*must*cooltoroomtemperaturebeforeproceedingtoIHCsteps.Rinseslidesindistilledwater,transfertobuffer,andgoontoIHCprocedure.Avarietyofstainingtechniquesaresuitedtothisprocedure,includingAPAAP,PAPandABCComplex/HRP. Note:ThisprocedurewasadaptedfromDakoAntibodyDataSheetforKI-1 Weareallveryfamiliarwithsilverstainsinthemicrowave,butthesethreestainsarehistochemicalstainswhichthemicrowaveacceleratesconsiderably. PAS+DIASTASEdoneatroomtemperaturetakestwohours.PAS+DIASTASEaidedbythemicrowavetakes50minutes. Note:Thisprocedurewasadaptedfrom"TheMicrowaveCookbookforMicroscopists",BoonandKok,CoulombPressLeiden,1992 PASdoneatroomtemperaturetakes45minutes.PASaidedbythemicrowavetakes15minutes. Note:Thisstep*must*bedoneunderahood. Note:Thisprocedurewasadaptedfrom"TheMicrowaveCookbookforMicroscopists",BoonandKok,CoulombPressLeiden,1992 Fe++doneatroomtemperaturetakes30minutes.Fe++aidedbythemicrowavetakeslessthan2minutes. Note:Allmicrowavesvaryinpoweroutput;adjustmicrowavepowerleveltoacheivefinaltemperatureof60ºC.Rinsewellindistilledwater.CounterstaininNuclearFastRedfor15secondsat60ºCusingtemperatureprobeRinseintapwater,dehydrate,clearandmount Note:Thisprocedurewasadaptedfrom"TheMicrowaveCookbookforMicroscopists",BoonandKok,CoulombPressLeiden,1992 BonebiopsiesareusuallydecalcifiedforaperiodrangingfromonehourtodaysinaweakhydrochloricacidsolutionorinEDTA.Withtheaidofmicrowaveexposure,thetimeisacceleratedfromonehourusingconventionalmethodstoaslittleas10minutesforbonemarrowcorebiopsiesusingformicacid. Treatmenttimedependsonthicknessandondensity:solidboneandteethtakemoretimethanspongybone.Bonemarrowbiopsiesrequireaslittleas10minutesexposuretime. Standardfixationprotocolsinformalintakeaminimumoffourhoursatroomtemperature.Fixationaidedbymicrowaveexposureandpre-andpost-treatmentinformalintakelessthan30minutes. 10%NBFormalincanvirtuallybeeliminatedfromthelaboratory.Immunostainingisgreatlyenhancedinmicrowave-fixedtissue.Timeissavedversusconventional4hourfixation. Manylaboratoriesaregenerallyresistanttochangesinestablishedprocedures.Nocontroloftimeinformalinwhenspecimensarereceivedfromoutsidethelab.Immunostainingresultsmayvaryduetochangingtimesinformalinandincreasedcross-linking. Manyfactorsmustbeconsideredwhenthinkingaboutswitchingtomicrowavefixationoftissueratherthanconventionalfixation.First,themannerinwhichspecimensaretransportedtoyourlaboratoryisthemostcriticalfactorincontrollingpre-fixationtimeinformalin.Anyreferencelaboratoryorlaboratoryreceivingspecimensthroughthemailgenerallyreceivethesespecimensalreadyfixed.Theselaboratoriescanconsiderremovingformalinfromthetissueprocessorandstoringspecimensin70%Ethanolforamorechemically-friendlylaboratory. Thelaboratorieswhichprocesssamplesbiopsiedattheirownmedicalcenterorpickedupbyalocalcouriercanbestutilizemicrowavefixation.Theselabscancontroltimesinformalinpre-fixation,whichcanleadtomoreconsistentimmunoresults. Anotherfactortobeconsideredisthechangeinschedulinginthestandardlaboratoryroutine.Schedulingchangeswillaffecteveryone,fromthecouriertotheclericalpeopleinvolvedinreporting. Iconcludethatmicrowavefixationisnotadaptabletoeverylaboratory,but,inthosesituationswherespecimentransportcanberegulated,itcanbebothcost-effectiveandmorehealthyfortechniciansandtheenvironment.Keepinmindthatanylaboratorycanutilizethistime-savingprocedureforstatbiopsies,whichcanultimatelycontributetobetterpatientcareandagoodoptionforfastspecimenturn-around. Slidedryinginaconventionalovenisdoneattemperaturesbetween60ºCand80ºC,fortimesrangingfrom20to60minutes.Slidedryinginamicrowavetakesfrom2to5minutes. Equipment:Laboratorymicrowavewithoutputpowerfrom600-900wattsandequippedwithacarousel.Microwave-safeslideracksholding20-24slides Note:Timeswillvarywithoutputpowerofmicrowave,andmustbedeterminedexperimentallyineachlaboratorywithitsmicrowave Note:Whenconsequetivebatchesaredriedinamicrowave,themicrowavecavitytemperaturewillgetgraduallyhigher.Whennotdryingslides,keepcavitydooropentoallowforcoolingbetweenbatches. **Optionalchangeofparaffin *ThismicrowaveprocessorhasbeenreplacedbytheH2800Equipment:
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AntigenRetrievalusingCitrateBuffer
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SpecialStainsUtilizingtheMicrowavePAS,PAS+DIASTASE,Fe++
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Fe++Procedure:
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MicrowaveStimulatedDecalcification
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MicrowaveStimulatedFixation:AdvantagesandDisadvantages
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SlideDryingintheMicrowaveExample:
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MicrowaveTissueProcessingQCChart
Date: StartTime: EndTime: Reagent Procedure Volume #Specimens TempQC TechInitials 100%Ethanol 15min@65ºC Propanol 10min@74ºC Paraffin 5min@65ºC Paraffin min@74ºC Paraffin 5min@82ºC**