Traditional Slide Research Articles

Are we throwing histology out with the microscope? A look at histology from the physician's perspective

A trend in medical schools across the United States is the refurbishing of histology laboratories with digital microscopy systems. Although such systems may reduce curricular time, they do not teach basic microscope skills, and students who learn solely with these systems may be less prepared for their practices or specialties, particularly in rural areas that may not be equipped with digital microscope technology. At the West Virginia School of Osteopathic Medicine (WVSOM), students are trained to practice in a wide variety of environments, especially rural areas. A research survey was conducted to gather information for evidence-based decisions about histology education at WVSOM. The survey asked a range of questions concerning histology knowledge, tissue preparation, and microscopy. Responses did not differ significantly between physicians in urban versus rural practices. Ninety percent of physicians do not utilize digitized images, and only 50% have microscopes readily available. Regardless of the technology available, 90% feel that students must have microscope training and 88% of physicians feel that histology is important to the medical curriculum and use their histology knowledge often (weekly or daily) (66%). These results demonstrate that histology education should move toward a blending of traditional microscope and glass slides with computer-based instructional technologies.

Externalization support of key phrase channel in presentation preparation

In this paper, we propose a framework of supporting presentation scenario composition from a viewpoint of externalizing a presenter's intention. Traditional presentation slides in the style of bullet lists lack in rhetorical relation between idea fra

The effect of in vitro dithioerythritol exposure on human metaphase chromosome structure.

When human lymphoid cells in G2-phase are treated with Dithioerythritol (DTE), a widely used agent which both maintains sulphydryl groups in the reduced state, and reduces disulphides, the frequencies of banded and uncoiled metaphase chromosomes, observed on traditional chromosome slides are increased. In agreement with SUMNERS deduction (1973) it is suggested that sulphydryl-disulphide transition during mitosis is involved in chromosome contraction and that disulphides maintain chromosomes in the condensed structurally stable state during metaphase.

Randomized comparison of virtual microscopy and traditional glass microscopy in diagnostic accuracy among dermatology and pathology residents

Virtual microscopy is being used in medical schools to teach histology and pathology. It is also being used in resident education, in-training examinations (dermatology), and certification examinations (pathology). There are, however, few studies comparing its diagnostic accuracy and acceptability compared with traditional glass slides. This study sought to compare residents' abilities in diagnosing dermatopathology disorders in 2 image formats (traditional microscopic slides and whole mount digitized images) and to assess their perceptions of virtual microscopy in dermatopathology. Residents in dermatology and pathology training programs at 14 institutions were given a randomized combination of 20 virtual and glass slides and were asked to identify the diagnoses from multiple foils. They were then asked to give their impressions about the virtual images. Descriptive data analysis and comparison of groups using Pearson chi(2) and Fisher exact tests for categorical variables and Student t test for continuous variables were performed. Residents in dermatology and pathology performed similarly in diagnosing dermatopathology disorders using virtual slides or glass slides (mean [SD] correct for virtual versus glass, 5.48 (1.72) versus 5.57 (2.06); P = .70). The order of administration of virtual versus glass slides did not affect the percentage of questions answered correctly. Most residents supported the use of virtual microscopy as a learning aid, whereas fewer favored its use in testing (79% versus 44%, respectively). Residents performed similarly in making dermatologic diagnoses using virtual slides compared with glass slides despite the residents' preference for the latter.

A különböző antitestek reaktivitása benignus és malignus melanocitás daganatokban

At the histological examination of an increasing number of melanocytic tumors there is a need to use various immunohistochemical methods. Currently, we are supplied by several antibodies working well on formalin-fixed, paraffin-embedded samples. We have tested five antibodies (S-100, HMB-45, Melan-A, MITF, PNL-2) on 34 benign and 34 malignant melanocytic tumors. We examined the specificity and sensitivity in the junctional and dermal component separately, with special consideration to features disturbing the evaluation (regression, halo-like inflammation, etc.). We have concluded that the histological diagnosis of melanocytic tumors is based on the detailed examination of traditional HE slides and the immunohistochemical methods only confirm or weaken our opinion.

Plastic Polymers for Efficient DNA Microarray Hybridization: Application to Microbiological Diagnostics

Fabrication of microarray devices using traditional glass slides is not easily adaptable to integration into microfluidic systems. There is thus a need for the development of polymeric materials showing a high hybridization signal-to-background ratio, enabling sensitive detection of microbial pathogens. We have developed such plastic supports suitable for highly sensitive DNA microarray hybridizations. The proof of concept of this microarray technology was done through the detection of four human respiratory viruses that were amplified and labeled with a fluorescent dye via a sensitive reverse transcriptase PCR (RT-PCR) assay. The performance of the microarray hybridization with plastic supports made of PMMA [poly(methylmethacrylate)]-VSUVT or Zeonor 1060R was compared to that with high-quality glass slide microarrays by using both passive and microfluidic hybridization systems. Specific hybridization signal-to-background ratios comparable to that obtained with high-quality commercial glass slides were achieved with both polymeric substrates. Microarray hybridizations demonstrated an analytical sensitivity equivalent to approximately 100 viral genome copies per RT-PCR, which is at least 100-fold higher than the sensitivities of previously reported DNA hybridizations on plastic supports. Testing of these plastic polymers using a microfluidic microarray hybridization platform also showed results that were comparable to those with glass supports. In conclusion, PMMA-VSUVT and Zeonor 1060R are both suitable for highly sensitive microarray hybridizations.

Review of the UK NEQAS (H) digital morphology pilot scheme for continuing professional development accessed via the internet

UK NEQAS (H) developed and instigated a pilot scheme for digital morphology, which was accessed by participants over the internet in order to assess the viability of using high quality images as an educational tool for continuing professional development. The pilot scheme was trialled over a 2-year period with eight releases totalling 16 morphology cases. Digital images allowed participating individuals to examine and comment on exactly the same cells and compare their findings with those of other participants, consensus data from traditional glass slide surveys and expert opinion. Feedback from participants on their experience was then relayed back to the development team by UK NEQAS (H) in order to drive the educational format and to ensure that any new scheme would meet the requirements of the users.

Practical Applications of Telepathology Using Morphology-Based Anatomic Pathology

Practical Applications of Telepathology Using Morphology-Based Anatomic Pathology

Development of a synergistic case‐based microanatomy curriculum

This paper discusses the development of an interactive approach to teaching and assessing a microanatomy curriculum in an innovative medical school program. As an alternative to lectures and labs, students are engaged in interactive seminars focused on discussion of clinical and research-based cases matched with normal histology and pathology slides. A virtual microscopic system is used rather than the traditional glass slide and light microscope. Evaluation of student performance consists of self-assessment board style questions, concept appraisal problems, and utilization of a portfolio system where the assessment pieces are continuously integrated as part of written formative and summative assessments.

Annotated virtual microscope laboratory units for teaching general and oral histology to dental students

An integrated approach to learning laboratory concepts and skills in general medical histology has been reported previously (Heidger, et al, 2002; Harris, et al, 2001) which employs both traditional and virtual imaging of microscope slides. This methodology has been extended recently to teaching both general and oral histology to dental students. The annotated images comprising the University of Iowa's Virtual Slidebox of Histology, together with newly prepared virtual slides from our oral histology slide collection, constitute the core of required material for individual virtual laboratory study. Elective opportunities for small‐group interaction with faculty over traditional glass slides are scheduled, as well. In contrast to previous years of laboratory study that relied heavily upon labeled 35 mm slides, the expanded Virtual Slidebox (see www.path.uiowa.edu/virtualslidebox) now offers our dental students a means for individual, comprehensive laboratory study of both general and oral histology preparations. Student reception of this option has been overwhelmingly positive, scores in practical exams have risen, and the quality of the learning experience in dental histology enhanced in the view of faculty and student evaluators, alike. Our histology offerings for dental and medical students at Iowa are now closely linked with common lectures, but with distinct laboratory experiences. This has facilitated desirable cross‐collegiate interactions among students, and better appreciation for the goals and emphases of the respective professional school curricula. Supported by a grant from the National Library of Medicine to FD, and Dental and Medical Educational Development funds to MF and PH.

Visible/Near Infrared Hyperspectral Imaging via Spatial Illumination Source Modulation

A spatially-modulated light encoding system for hyperspectral imaging is presented. A digital micromirror array was used for the optical switching in an illumination system that otherwise resembled a traditional slide projector. The Hadamard encoding scheme was employed in a purely spatial, non wavelength dispersive manner. A single point linear diode array spectrometer measured the spectral dimension. To demonstrate the principle two simple samples were imaged.

Reliability of cyclin A assessment on tissue microarrays in breast cancer compared to conventional histological slides

Cyclin A has in some studies been associated with poor breast cancer survival, although all studies have not confirmed this. Its prognostic significance in breast cancer needs evaluation in larger studies. Tissue microarray (TMA) technique allows a simultaneous analysis of large amount of tumours on a single microscopic slide. This makes a rapid screening of molecular markers in large amount of tumours possible. Because only a small tissue sample of each tumour is punched on an array, the question has arisen about the representativeness of TMA when studying markers that are expressed in only a small proportion of cells. For this reason, we wanted to compare cyclin A expression on TMA and on traditional large sections. Two breast cancer TMAs were constructed of 200 breast tumours diagnosed between 1997–1998. TMA slides and traditional large section slides of these 200 tumours were stained with cyclin A antibody and analysed by two independent readers. The reproducibility of the two readers’ results was good or even very good, with kappa values 0.71–0.87. The agreement of TMA and large section results was good with kappa value 0.62–0.75. Cyclin A overexpression was significantly (P<0.001) associated with oestrogen receptor and progesterone receptor negativity and high grade both on TMA and large sections. Cyclin A overexpression was significantly associated with poor metastasis-free survival both on TMA and large sections. The relative risks for metastasis were similar on TMA and large sections. This study suggests that TMA technique could be useful to study histological correlations and prognostic significance of cyclin A on breast cancer on a large scale.

Factors to keep in mind when introducing virtual microscopy

Digitization of glass slides and delivery of so-called virtual slides (VS) emulating a real microscope over the Internet have become reality due to recent improvements in technology. We have implemented a virtual microscope for instruction of medical students and for continuing medical education. Up to 30,000 images per slide are captured using a microscope with an automated stage. The images are post-processed and then served by a plain hypertext transfer protocol (http)-server. A virtual slide client (vMic) based on Macromedia's Flash MX, a highly accepted technology available on every modern Web browser, has been developed. All necessary virtual slide parameters are stored in an XML file together with the image. Evaluation of the courses by questionnaire indicated that most students and many but not all pathologists regard virtual slides as an adequate replacement for traditional slides. All our virtual slides are publicly accessible over the World Wide Web (WWW) at http://vmic.unibas.ch . Recently, several commercially available virtual slide acquisition systems (VSAS) have been developed that use various technologies to acquire and distribute virtual slides. These systems differ in speed, image quality, compatibility, viewer functionalities and price. This paper gives an overview of the factors to keep in mind when introducing virtual microscopy.

Modified sliding trochanteric osteotomy in revision total hip arthroplasty

Traditional trochanteric sliding osteotomy preserves the lateral aspect of the greater trochanter, the abductors, and vastus lateralis in continuity. Our modification uses a lateral approach to the hip and osteotomy immediately anterior to the insertion of the posterior capsule and external rotators onto the greater trochanter. The osteotomy and attached abductors and vastus lateralis are translated anteriorly, leaving the posterior capsule and external rotators attached to the proximal femur. This surgical approach preserves the posterior soft-tissue stabilizing structures that resist posterior dislocation of the hip. In a retrospective review of 2 consecutive 2-year series of acetabular component revisions only between 1997 and 2001, 4 of 27 acetabular revisions using a traditional trochanteric slide subsequently dislocated; only 1 of 30 subsequent cases using a modified sliding trochanteric osteotomy dislocated. Modified sliding trochanteric osteotomy facilitated surgical exposure and produced a trend toward a lower dislocation rate that did not reach statistical significance with the small numbers of patients available.

Propension au changement et efficacité des prises en charge cognitivo-comportementales de la douleur chronique

Our laboratory has developed a simple two-step multiplex real-time PCR for use on isolates of Haemophilus influenzae for molecular serotype identification and the detection of capsular gene targets. The assay consists of a 2-plex real-time PCR targeting the capsule transport gene (bexA), and serotype b specific gene (bcsB), and a 5-plex real-time PCR detecting serotypes a, c, d, e, and f targeting Region II serotype-specific genes. Both real-time PCR assays are highly sensitive (<8 CFU) for all serotypes and 100% specific when tested by a panel of more than 40 bacterial organisms. A retrospective study of 214 isolates received between 1998 and 2011 were tested and compared against the traditional slide agglutination test (SAT) resulting in 100% concordance. We demonstrate that this two-step real-time PCR approach is more sensitive than previously published PCR assays and provides a simple alternative to the SAT. Reliable, rapid and sensitive H. influenzae serotyping is critical for identifying new emerging strains for epidemiological surveillance.

Breast tissue characterization with high-frequency scanning acoustic microscopy

We have performed imaging of breast tissue using scanning acoustic microscopy (SAM) in the range of 25–50 MHz with the goal of accurately and rapidly determining the structure and composition throughout the volume of the samples. In contrast to traditional histological slides, SAM images can be obtained without special preparation, sometimes even without sectioning, but with sufficiently high spatial resolution to give information comparable to surface optical images. As a result, the use of high-frequency SAM at the time of breast lumpectomy to identify disease-free margins has the potential to reduce reoperative rates, patient anxiety, and local recurrence. However, only limited work has been performed to characterize breast tissue in the frequency range above clinical ultrasound devices. The samples are 4-cm2-thick sections (2–3 mm) taken from mastectomies and preserved in formalin. They are placed between two plates and immersed in water during imaging. Attenuation images are acquired by focusing the acoustic beam at the top and bottom of the samples, although better results were obtained for bottom focusing. For purposes of comparison and identification of histological features, acoustical images will be presented along with optical images obtained from the same samples. [Work supported by CIHR.]

Surgical exposures for primary and revision total hip arthroplasty: Modified trochanteric slide

Traditional trochanteric sliding osteotomy preserves the lateral aspect of the greater trochanter, the abductors and vastus lateralis in continuity. Our modification utilizes a lateral approach to the hip and osteotomy immediately anterior to the insertion of the posterior capsule and external rotators onto the greater trochanter. The osteotomy and attached abductors and vastus lateralis are translated anteriorly, leaving the posterior capsule and external rotators attached to the proximal femur. This surgical approach preserves the posterior soft tissue stabilizing structures that resist posterior dislocation of the hip. In a retrospective review of two consecutive 2-year series of acetabular component revisions between 1997 to 2001, 4/27 acetabular revisions utilizing a traditional trochanteric slide subsequently dislocated; only 1/30 subsequent cases using a modified sliding trochanteric osteotomy dislocated. Modified sliding trochanteric osteotomy facilitates surgical exposure and has decreased the dislocation rate.

Improving the rate of infectivity of Cryptosporidium parvum oocysts in cell culture using centrifugation.

Centrifugation was evaluated as a method to improve infectivity assays of Cryptosporidium parvum in cell culture using the focus detection method, an immunofluorescence-based method for detecting infectious C. parvum oocysts in vitro. Human ileocecal adenocarcinoma (HCT-8) cells were grown for 48 hr on 13-mm cover slips in 24-well microtiter plates and infected with bleach-treated C. parvum oocysts. Plates were centrifuged at 228 g for 10 min and incubated at 37 C for 5, 12, 18, 24, and 48 hr. Foci of infection were stained by immunofluorescence and enumerated using epifluorescent microscopy. Results were compared to noncentrifuged controls. Foci in centrifuged samples could be enumerated after 18 hr. According to most probable number (MPN) analysis, the number of infectious oocysts estimated at 48 hr (13,326 infectious oocysts) was reached by 18 hr in centrifuged samples. After 48 hr, there was no significant difference (P < 0.05) between centrifuged and noncentrifuged samples enumerated by number of foci or the MPN of infectious oocysts. Centrifugation may expedite detection during C. parvum infectivity assays. Furthermore, multiwell plate formats are more cost effective than traditional chamber slides.

Cranial Nerve Clock: Part I. A Declarative Memory Paradigm

Rationale and Objectives The authors performed this study to compare a declarative memory paradigm developed to help teach medical students about the cranial nerves with a traditional text-based approach. Materials and Methods The authors designed a clock-based paradigm to help medical students learn about the cranial nerves. To enhance memorization and related brain activation, the paradigm uses visual, spatial, and word associations in the context of an analog clock face. Twenty-one undergraduate students were randomly divided into two groups. Group T viewed traditional text slides, and group C viewed text slides followed by the corresponding cranial clock slides. Subjects were tested before and after these sessions. Results Group C performed significantly better than group T in learning the names of the cranial nerves and their correct order ( P < .011). Recall of name, number, and function was better for 11 of 12 cranial nerves, with statistical significance reached for nerves III ( P = .005), V ( P = .04), and X ( P = .03). Conclusion Alternative teaching strategies may help improve declarative memory.

The development of a digital image database of clinical photographs.

At the end of December 1998, the traditional clinical slide library at the Media Resources Centre University Hospital of Wales and University of Wales College of Medicine was closed to new acquisitions. This paper describes how a digital image database (Image AXS) has been customized to provide a source of rapidly accessible and easily searchable images, suitable for teaching and reference purposes. The basic functions of the program are explained and areas such as data integrity, image capture, storage, archiving and the impact that this technology has had on departmental workflow are discussed.