Transmission Electron Microscopy and Serial Sections for Light Microscopy From the Same Block in Routine Renal Pathology

Transmission Electron Microscopy and Serial Sections for Light Microscopy From the Same Block in Routine Renal Pathology

839 MISCELLANECUS enzyme ,rn"uc,c,uvudo,,"y and ta(1l0111l:ill1UHOa:Ssa methods for hepatitis B surface antigen based on the responses of survey par...

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839

MISCELLANECUS

enzyme ,rn"uc,c,uvudo,,"y and ta(1l0111l:ill1UHOa:Ssa methods for hepatitis B surface antigen based on the responses of survey participants, and includes a preliminary evaluation of enzyme immunoassay tests for other hepatitis markers. As a result of this study the following observations were made. Enzyme immunoassay methods have several advantages over radioimmunoassay methods, the most important of which is the elimination of problems associated with the handling and disposal of low level radioactive waste. In addition, the enzyme immunoassay test reagents have a longer shelf-life (3 to 6 months) compared to radioimmunoassay materials (45 days), a factor of particular importance in the small laboratory that performs relatively few tests per month. On the other hand, radioimmunoassay methods are less susceptible to minor variations in the washing technique, changes in pH and other environmental factors, and require less hands-on time than the enzym-e immunoassay techniques because of fewer reagent addition steps. Over-all, the sensitivity of the enzyme immunoassay method using the standard incubation procedures compared favorably to that of radioimmunoassay. On weakly reactive samples, radioimmunoassay appears to be slightly more sensitive. It is possible that increased experience with the method and modification of the test reagent will result in improved sensitivity and specificity. While the radioimmunoassay test appears to be slightly more sensitive than current enzyme immunoassay methods based on the data presented, this difference may not be significant when testing blood donors. Chronic carriers, those most often detected as donors, generally have high concentrations of hepatitis B surface antigen in the sernm and will be detected by either of these methods. Recently, enzyme immunoassay methods for several other hepatitis markers have been introduced. The small number of laboratories currently reporting enzyme immunoassay methods of markers other than hepatitis B surface antigen does not allow comparison of the techniques at this time. Preliminary results suggest that the sensitivity and specificity of the methods are comparable to radioimmunoassay. E.D. Vfl 1 figure, 6 tables, 4 references

MISCELLANEOUS Ti"ansmission Electron lVl:icr'oscopy and Serial Sections for Nficrogcopy From the Same Bllock in Routine Renal Pathology

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H. R GARRETT, J. R. COOVER AND T. R. FLORES, Laboratory Service, Veterans Administration Medical Center and , of i-otnmc,µv Louisiana State University Medical Center, New Orleans, Louisiana HOFFMANN,

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Amer. J. Clin. Path., 80: 441-444 (Oct.) 1983 Several authors recently have recommended the use of transmission electron microscopy histotechnology to improve the study of renal biopsies in the light microscope. This method produces high resolution light microscopy sections not possible with current wax methods. The advantages of high resolution light microscopy are better preservation of tissues, infrequent need for special stains, no overlay of structures, accurate morphometric analysis, better use of the resolution power of the light microscope and potential use of the same block for

for high resolution light and can be used for transmission electron microscopy studies, avoiding separate for light and transmission electron microscopy studies. Procedures currently in use in renal .,-,a•w·•-,,J studies routine serial sections for light from 1 sample and transmission electron selected areas of another sample. The authors present a technique that produces immediate transmission electron microscopy sections from different areas of the same high resolution light microscopy block. This method does not produce fragmentation or waste of the original block, and transmission electron microscopy sections are obtained ~2 hours after large high resolution light microscopy sections are screened. The latter sections are mounted serially on a regular microscopic slide on 8 to 15 separate wells painted with water repellent ink. The methods are simpie and produce large high resolution light and transmission electron microscopy sections in 24 hours, avoiding separate samples for light and transmission electron microscopy studies. Serial sections from the same epoxy blocks also are obtained for routine renal pathological studies. W. W.H. 2 figures, 29 references

Di§opy:ramide-Induced Uitimny Retention: Report of Nine Cases and Review of the Literature L. H. DANZIGER AND J. H. ,,c1.l(u,1.1n,,cr of and Surgery, University Hospitals of Cleveland, Cleveland, Ohio and the School of Pharmacy, University of Washington, Seattle, Washington Arch. Intern. Med., 143: 1683-1686 (Sept.) 1983 Disopyramide phosphate is effective against supraventricular and ventricular arrhythmias. Its mechanism of action is similar to quinidine but, unlike quinidine, anticholinergic side effects are observed more vuauvu,y These side effects usually are mild, transient and well tolerated. retention sometimes is reported as an adverse reaction during disopyramide phosphate therapy. The authors report 1 case of acute renal failure and 8 of retention. Previous reports of this adverse reaction are summarized in this A 75-year-old n1an with acute renal failure was admitted to a serum creatinine of 15 metabolic After passage of a catheter the with creatiniae ~W'V0HHUo

An excretory urogram showed tortuous ureters, phrosis and a trabeculated bladder. He underwent transurethral prostatectomy of 35 gm. of benign hyperplasia and was discharged from the hospital on 150 mg. disopyramide phosphate every 6 hours. The exact cause of disopyramide-induced retention is unknown. It is possible that disopyramide or a metabolite via the anticholinergic properties has some role in the manifestation of urinary tract symptomatology. Treatment of this adverse reaction includes lowering the dose, discontinuing the drug or possibly using a cholinergic drug to compete with the anticholinergic effects of the disopyramide. Patients receiving this disopyramide should be advised of the potential anticholinergic effects of the drug. W. W.K. 3 tables, 25 references