Friday, March 9, 2018

PROCESSING OF TISSUES IN HISTOLOGICAL TECHNIQUES


·                     Definition of tissue processing    
-          any treatment of tissues necessary
-           to impregnate them with solid medium
-          to facilitate the production of sections for microscopy
·                     Aim
-          to embed tissues in solid medium
-          to support the tissues
-          to enable the knife to cut the section with little damage to knife or tissues

Dehydration
·                     A process by which water is removed from fixed tissues
·                     Also removal of aqueous and some of the lipid tissues fluids
·                     Tissue blocks are placed in containers or cassette with tag
                         - lid securely closed
                         - tiny fragments should be wrapped in a single layer of  lens paper
·                     Tissues are passed through a series of increasing concentrations of alcohol
                         - with one change in each concentration
                         - duration of one hour in each
                         - keep covered  to avoid evaporation
·                     Starting alcohol is usually 80%
  - for soft tissues 30%, 50%,70%
                          - it is important that the final bath of alcohol is pure and change 3 times
                          - free from water
                   
Dehydrating agents   
i)          Ethyl alcohol (ethanol) C2H5 OH
         -clear colourless inflammable liquid with pleasant odour
         -hydrophillic - miscible with water in all volumes
   - the most common

ii)         Methylated spirit (denatured  alcohol)
         -some physical characteristics as ethanol
         -stronger smell
         -consists of ethanol to which has been added a proportion of methanol

iii)         Methyl alcohol (methanol) CH3OH    
         -clear ,colourless inflammable and poisonous fluid
         -unpleasant  odour ,miscible with water, ethanol

iv)        Isopropyl  alcohol (2 propanol) CH3CHOHCH3
         -miscible with water, ethanol
         -does not harden the tissue
   -99% is the best substitute for ethyl alcohol

v)         Acetone CH3COCH3
         -clear ,colourless ,inflammable fluid
         -pungent odours
         -miscible with water, ethanol
         -more volatile 
         -causes brittleness of tissue if treatment is prolonged
         -when speed is essential - acetone is preferred

Clearing
·                     The removal of dehydrating agents from tissue
·                     To make tissue transparent
·                     Selection of a suitable clearing agent must be based on
         -speed of removal of alcohol
         -ease of removal
         -gentleness towards tissue
         -flammability
         -toxicity
         -cost

Clearing agents
i)              xylene
         -for regular size
         -not thicker than 3 -4mm
         -immersion time must not be prolonged
         -tissues become brittle

ii)         Toulene
         -less damaging on prolonged immersion of tissues
         -suitable for automated tissue processing

iii)         Chloroform
        -slower in action causes brittleness
        -thicker tissue up to 1cm thickness can be processed
        -dangerous - releases toxic gas

iv)        Benzene
        -carcinogenic properties
        -similar to xylene

v)         Carbon tetrachloride
        -similar properties to chloroform
        -toxic

vi)        Paraffin
        -variable mixture of hydrocarbon
        -less flammable
        -less dangerous

vii)       Petrol
        -similar properties to xylene
        -various additives
        -not recommended

viii)       Carbon disulphide
        -unpleasant odour
        -danger of fire –not recommended

ix)        Amyl acetate
        -remove alcohol fairly rapidly
        -costly

x)         Methyl benzoate and methyl salicylate
        -fluids moderate in speed action
        -cause minimal distortion of tissue

xi)        Cedarwood oil
        -slow in action
        -causes little hardening or shrinkage of tissues
        -low volatile properties

xii)         Clove oil
              -similar to cedar wood oil
              -more expensive
             -use in humid climates

Infiltration and impregnation
·                     Tissues are transferred to a bath of molten paraffin wax
·                     During this process xylene is eliminated from tissues by diffusion
      -is called infiltration
·                     Wax diffuses into the tissue to replace the clearing agent
        -is called impregnation
·                     To completely remove the clearing agent
·                     Inadequate impregnation lead  to drying and shrinking of tissues
        -crack and crumble develop                 
·                                 High temperature will over - harden the tissues

Embedding
·                     Placing the infiltrated impregnated tissue in warm liquid paraffin wax that
            solidifies into a firm block when cool to room temperature
·                     Known as casting or blocking - use plastic mould
·                     Precaution should be taken
           -wax to be used must contain no trace of clearing agent
           -no dust particles must be present
           -after embedding the wax must be rapidly cooled to reduce the wax crystal
             size
·                     Orientation of tissues
           -tissues of tubular nature cut transversely
     -skin- cut in a plane at right angles
     - muscle biopsies are sectioned both transverse and longitudinal planes
·                     Wax is dispensed into the mould to a depth to cover the thickest tissue block
·                     When a thin film of semi-solid wax has formed on the base of the mould
      -tissue is introduced with warm forceps gently pressing the tissue into the
             semi-solid wax correctly orientated plane
·                     Then fill the mould with wax
           -make sure that there is no air bubbles
·                     Transfer blocks to refrigerator to complete hardening
·                     Identification label must accompany the specimen through all types of  tissues
      processing

Embedding media
i)          Paraffin wax
-most popular
-large number of tissue blocks may be processed in a short time
-sectioning and staining - fewer difficulties
-cheaper
-melting point in range 40-70oC
-for satisfactory sections melting point 54-58oC
-additives have been proposed
          -to increase hardness to cut thinner section and to support hard tissues
          -to increase stickiness to produce serial ribbon
          -to reduce crystal size
    eg. bee wax (stickiness) stearic acid (hardness)
ii)         Other waxes
         -ester wax
         -microcrystalline wax

iii)         Resins
          -acrylic
  -epoxy
  -urea - formaldehyde

iv)        Other media
         -agar
         -gelatin
          -celloidin

·                     Different medium is required if
          -medium not sufficiently hard and fail to provide adequate support
          -affected by heat
          -distort the tissue
    -tissue breaking away from the wax during sectioning
          -sections cannot be cut thin enough

Manual tissue processing
·                     Necessary in the following
          -large tissue slices
          -speed processing
          -electrical power failure / machine breakdown
          -small tissue slices - need optimum time
·                     Advantage
         -flexibility tissues are treated for the optimum duration in each fluid
         -use of fluids-not dangerous when using -flammable
                                                                          -volatile   eg. acetone
·                     Rapid technique for thin slices of tissue

i)          10% formalin 60oC                             20min
      ii)         fresh acetone                                       20min
      iii)        fresh acetone                                       20min
     iv)         fresh acetone                                       20min
     v)          xylene                                                 10min
     vi)         xylene                                                 15min
     vii)        wax                                                     30min
     viii)       wax                                                     60min (185 min)

 -agitate frequently to assist in the transfer of fluids

Automated tissue processing
·                     Most automated tissues processor have 12 containers processing cycle
·                     Some machines apply - heat and vacuum to increase the rate of processing
·                     Care must be taken for type of tissue eg. spleen, muscle, skin, decalcified
       tissue become hardened if heat and vacuum is applied
·                     Vacuum
 -the degree of vacuum should not exceed 40-50mmHg
-normally in a sealed container of molten paraffin wax-applying suction to the 
  container

                  aim   -to remove air bubbles in the tissue
                     -to remove clearing agents
        
           -tissues particularly - lung ,muscle ,spleen, decalcified bone, skin
·                     For increasing speed of processing
                    -use warm (40-50oC) fixative to ensure fixation is complete
                    -95% alcohol
                    -use a fast - acting clearing agent (eg. xylene)
                    -use of vacuum infiltration at all wax stages
                    -agitation at all stages ,even during fixation
                    -minimum of time at all stages

i.              Routine overnight processing

1                      4% formol saline (1.5 lit.)                                                        2 hrs
                        (40 ml formaldehyde 960 ml water add 9 g. NaCl)
2                      4 % formol saline (1.5 lit.)                                                       2 hrs
3                      70 % alcohol (1.5 lit.)                                                              1 hr     
                        (700 ml alcohol 300 ml water)
4                      90 % alcohol (1.5 lit.)                                                              1 hr
                        (900 ml alcohol 100 ml water)
5                      absolute alcohol (100% alcohol) (1.5 lit.)                                1 hr
6                      absolute alcohol (1.5 lit.)                                                         2 hrs
7                      absolute alcohol (1.5 lit.)                                                         2 hrs
8                      xylene (1.5 lit.)                                                                        1 hr
9                      xylene (1.5 lit.)                                                                        11/2 hrs
10                    xylene (1.5 lit.)                                                                        11/2 hrs
11                    wax                                                                                         2 hrs
12                    wax                                                                                         3 hrs
                                                                                                Total                20 hrs
ii.             Day time processing -for small specimen 
 
1.    formal saline                   15min
2.    formal saline                   15min
3.    70% alcohol                    15min
4.    90%alcohol                     15min
5.    100%alcohol                   15min
6.    100%alcohol                   15min
7.    100%alcohol                   15 min
8.    toluene                             15min
9.    toluene                             15min
10.  toluene                            15min
11.  wax                                 30min
12.  wax                                 30min                                 
                                                 3hrs 30min

Factors influencing the rate of impregnation  
i)    Agitation
    -allow the tissue to sink to the base of container - to make sure interchange of fluids   
      occur
    -mechanical device - vertical agitation
    -average speed of tissue movement is 10-12 inches per minute
    -improved impregnation  by 25-35%

ii)    Heat
      -increases the rate of penetration
      -care must be taken not to overheat tissues and cause shrinkage, brittleness and                                                 
        difficulties  in sectioning

iii)    Viscosity
      -the larger the molecule the higher the viscosity  the slower the rate of penetration

iv)    Vacuum
      -serve to remove air bubbles trapped within the tissue –this will increase the contact
        with fluid to tissue

v)    Ultrasonic - not widely used

·                     Points to note
         -beakers  and wax bath must be filled to the correct fluid level
         -any spillage of fluid should be wiped
         -accumulations of wax must be removed
         -wax bath thermostats set at satisfactory level
         -checked - timing
                         -electrical plugs
         -changing of solution after using them for 2-3 days

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