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Origin of artifactual quantitation of electrolytes in microprobe analysis of frozen sections of erythrocytes.

Frozen sections of erythrocytes have been used to validate microprobe X-ray analysis of diffusible elements in biological samples. At this meeting last year we reported that intracellular Na concentrations measured by microprobe were much higher than those measured by bulk chemical methods. It was suggested that this might be due to the movement of extracellular material over the cells by microtomy. We now present evidence that such results are better explained by electron scattering within the sample during analysis. This evidence includes observations that the excess measured Na varies directly with section thickness and inversely with accelerating voltage. At 80 kV accelerating voltage there is excellent agreement between microprobe and chemical analysis. It may be concluded that specimen preparation techniques such as used in our laboratory are satisfactory for reliably localizing diffusible elements in small volumes, but that instrumental factors can seriously affect their quantitation.

Electron Probe Microanalysis

Accuracy of frozen section diagnosis of parotid lesions.

The accuracy of frozen section diagnosis was analyzed in a review of 132 parotid lesions. Of 107 benign lesions, 93% were correctly diagnosed on frozen section analysis, but of 25 malignant lesions, only 9 frozen sections were accurately interpreted. This study points out the difficulty encountered in using the frozen section technique when dealing with malignant parotid lesions and the importance of the surgeon's active participation in the analysis.

Biopsy

A Bodian method for mounted frozen sections.

For application of the Bodian method to frozen sections, cut frozen peripheral nerve or muscle at 10 mum and mount. Fix for 4 days in 18 parts 80% ethanol, 1 part 10% formalin, and 1 part glacial acetic acid. Fix central nervous tissue in the same mixture prior to freezing and sectioning, and after mounting postfix for 4 days. Impregnate by the Bodian procedure. The results equal Bodian stains of paraffin sections. The technique is simple and reliable. The use of 10 mum frozen sections produces little artifact and allows alternate serial sections to be stained with other techniques.

Animals

[The rapid microscopical diagnosis of brain and spinal cord tumors by cryostat-cut frozen section (author's transl)].

The rapid histological diagnosis of neurosurgical biopsy material is of prime importance for the neurosurgeon. Cryostat-cut sections of fresh frozen tissues have been used in our department. The surgical materials are rapidly frozen at - 150 degrees C, and serial sections, 10 microns thick, are cut in a cryostat at -18 degrees to -20 degrees C. The sections are adhered to cover glasses and stained with Metachrome solution (a mixture of 1% Azure A and 0.5% Erie Garnet B). The rapid and accurate diagnosis can be obtained within 5 minutes. The advantage of cryostat-cut frozen section is the preservation of cell density and tissue architecture, which is most important in the diagnosis of neurosurgical materials, especially in case of diffusely infiltrating glioma. The previously reported methods, such as smear technique and frozen sections by using freezing microtome are also reviewed and discussed.

Brain Neoplasms

Immunocytochemical localization of hepatic legandin and Z protein utilizing frozen sections for light and electron microscopy.

Ligandin (glutathione-s-transferase) and Z protein are soluble hepatocellular proteins that are involved in the transfer of organic ions, including bilirubin and some hormones and carcinogens from the plasma to the liver. The intracellular distribution of ligandin and Z protein was studied by applying the peroxidase-antiperoxidase procedure of L. A. Sternberger (Immunocytochemistry, Prentice Hall Inc., 1974) to paraffin sections and free-floating 10-micrometers frozen sections that were processed for both light and electron microscopy. Ligandin and Z protein were localized to the cytosol of hepatocytes in association with smooth endoplasmic reticulum (SER), but no reaction product was present between cisternae of rough endoplasmic reticulum. Penetration of reagents was enhanced in 10-micrometers frozen sections and the preservation of subcellular structures was equivalent to thicker, unfrozen sections.

Animals

A rapid method for demonstrating skeletal muscle motor innervation in frozen sections.

Longitudinal 50-100 mum-thick frozen sections of muscle are picked up on slides coated with 3% EDTA and after drying are incubated to demonstrate acetylcholinesterase. Subsequent incubation in 0.5% K3Fe(CN)6 is followed by fixation for 30 minutes in formol-calcium or formol-saline. After washing, the slides are incubated in 20% aqueous AgNO3 containing 0.1% CuSO4 for 2-30 minutes at 37 C. Following development in a 1% solution of quinol (w/v) 5% with respect to NaSO3 (w/v), axons and subneural apparatus stain dark brown to black in contrast to the less well stained muscle fibers and nuclei. This procedure permits study of the pattern of neuromuscular innervation in skeletal muscle 3 1/2-4 hours after receipt of a sample, and makes possible determination of the terminal innervation ratio.

Frozen Sections

A simple stain for myelin in frozen sections: a modification of Mahon's method.

A simple and rapid method for demonstrating myelinated nerve fibers in frozen sections of the central and peripheral nervous system is described. Material fixed by perfusion with mixed aldehydes gives the best results but the method also works on specimens fixed by immersion in formaldehyde. Frozen sections varying in thickness from 15-50 micron are mounted on slides subbed with chrome alum-gelatin. After hydration (60-120 min), sections are mordanted (20-40 min) in 2.5% iron alum and rinsed briefly in three changes of distilled H2O (total 2 min). Staining is for 60-180 min in 20 cc freshly made 10% alcoholic hematoxylin diluted with 165 cc distilled H2O to which 15 cc saturated Li2CO3 is added. The sections are washed in distilled H2O (5-15 min) and dehydrated in graded alcohols without differentiation in mordant, and covered. Myelin stains a dark blue-purple against a light grey background. Fiber tracts, as well as individual myelinated fibers, are clearly demonstrated.

Animals

Scanning electron microscopy of frozen sections: a method for studying selected planes in small specimens.

A procedure for studying small biological specimens with the SEM, using frozen sections of fixed material is described. Controlled fixation schedules and convenient handling of sections insure optimal preservation of cell shape and size. The greatest advantage of the method presented is to allow scanning through any desired plane of the specimen, even in those planes parallel to an epithelial face. SEM of frozen sections is thus helpful for the study of cell distribution and organization within a tissue.

Animals

[Cytochemical studies of ultrathin frozen sections of blood platelets].

Results obtained by conventional techniques and freeze-ultramicrotomie have been compared. Ultrathin frozen sections of platelets, which are fixed by glutaraldehyde, freeze-protected by polyvinyl-pyrrolidone and encapsulated in gelatin show a well preserved fine structure after staining with buffered OsO4, phosphotungstic, phosphomolybdic or ammoniummolybdic acid. The preservation of polysaccharides or mucopolysaccharides depends on a suitable fixation, that of glycogen in certain cases depends on a double fixation (glutaraldehyde and OsO4). Cytoplasmic nucleoproteins like ribosomes are visible only after drying of sections and staining with uranyl-acetate. Lipids, both membrane lipoproteins as well as lipids in the matrices of cell organelles, are well preserved. For example the zinc-iodide osmiumtetroxide reaction yields positive results in frozen sections contrary to such obtained by conventional methods. Furthermore, the extraction of altered lipids after staining with dyes like acridine orange does not take place with this method. For this reasons the freeze-ultramicrotomy seems to be an useful alternative method.

Animals

Electron microscope autoradiography of a diffusible intracellular constituent, using freeze-dried frozen sections of mammalian intestinal epithelium.

Autoradiograms were prepared from freeze-dried frozen sections of rat intestinal epithelium, previously incubated in vitro with 3H-galactose. Although the sections showed evidence of disruption by ice-crystal growth during freezing, they retained sufficient recognizable ultrastructure to facilitate the identification of several subcellular compartments. Statistical analysis of the grain distribution indicated that a significant non-uniform distribution of the labelled galactose occurs in the absorptive cells during transport, and is maintained in the sections throughout the various stages of autoradiography.

Animals

[Comparative studies of simultaneous intraoperative frozen sections and imprint cytology of the mamma (author's transl)].

250 tissue biopsies of the mamma were examined simultaneously by intraoperative histology (frozen sections) and imprint cytology. In 95% of the cases there was a good agreement between the histologic and cytologic diagnoses. The reliability of the imprint cytology was tested in some complicated cases such as proliferating fibroadenomas, sclerosing adenosis and carcinomas and the significance of the imprint cytology for the diagnosis of difficult cases was pointed out in detail. The results have demonstrated, that such a cytologic examination can not be a substitute for intraoperative frozen sections - but the simultaneous cytologic examination of unfixed mamma biopsies can be a good searching method and can be helpful in the intraoperative diagnostic.

Adenocarcinoma, Mucinous

Intra-operative frozen section technique for pituitary adenomas.

Orange G-hematoxylin stains performed on frozen sections from the sella turcica had a diagnostic accuracy of over 90% when compared to permanent sections on the same tissue. This technique allows the pathologist to make an intra-operative contribution to the establishment of tumor margins in the selective removal of pituitary adenomas.

Adenoma

Culture and microscopy of microorganisms in frozen sections.

A simple method is described in which frozen sections are prepared from tissue cell suspensions with added microorganisms and then cultured. The enhanced growth of the organisms makes their indentification easier. A number of applications is suggested.

Culture Media

Frozen section control in the surgery of basal cell carcinoma of the eyelid.

Two groups of patients, 37 with primary basal cell carcinoma of the eyelid and 16 with basal cell carcinoma of the eyelid previously treated by other physicians were reviewed. All of the tumors were excised with at least 3 to 4 mm of normal-appearing tissue at each margin of resection. All of the excised specimens were submitted for frozen section studies of the margins. A total of 20 (54.04%) of the previously untreated tumors and eight of the previously treated tumors had at least one margin involved with tumor cells. Repeated excisions under frozen section control were done until all of the margins were free of tumor cells. To date, none of the patients treated in this manner had a recurrence of the tumor.

Adult

Palatal process movement in the rat as demonstrated in frozen sections.

During mammalian secondary palate development, movement of the lateral palatine processes from the vertical plane to the horizontal plane involves a complex interaction of the palatine processes and the tongue within a dynamic growing oronasal cavity environment. This study of pre-fixation facial profile photographs and frozen sections was undertaken to evaluate external and internal changes in the oronasal complex during secondary palate elevation without the shrinkage known to be present with routinhistological preparation of embryonic tissues. Frozen sections of Sprague-Dawley rat embryos between 15 and 17 days of (conceptual) age were prepared by hexane quenching and cryostat cutting. The results showed that, during the stages of palate development prior to shelf elevation, the tongue and mandible became positioned beneath the primary palate, and the vertical dimension of the oronasal cavity increased by the lifting of the nasomaxillary complex. The tongue and mandible maintained contact with the primary palate, whereas a space developed above the tongue in the middle and posterior palate regions. As the vertical dimension increased the volume of the palatomaxillary processes increased rapidly, the tongue became squeezed, and the palatine processes bulged medially above the level of the tongue. After shelf elevation extensive contact between the palatine processes was present, and the tongue became flattened. The results of this study support the observations of Lazzaro (1940) that rapid increase in shelf volume owing to increased intercellular volume contributes to movement of the processes above the tongue. But, rapid increase in shelf volume occurred contemporaneously with the time when the tongue and mandible outgrew the oronasal cavity and became positioned beneath the primary palate. Therefore, it would appear that the simultaneous occurrence of a lower and more forward tongue position, and an increased palatomaxillary process volume without change in maxillary width, contributed to the medial movement of the processes above the tongue.

Animals

Electron microscopy of virus particles in ultrathin frozen sections.

A procedure with the use of polyethylene glycol (PEG) 600 to support biological materials for ultracryotomy was developed. Developing and mature virions were demonstrated by electron microscopy in negatively stained frozen sections of vaccinia virus-infected human diploid cells and of herpes simplex virus (HSV) type 1 infected primary rabbit kidney cells. Approximate localisation of the virus particles in the cells was possible.

Culture Techniques

Accuracy of frozen section for HPV-Associated squamous cell carcinoma of unknown primary.

INTRODUCTION: Current guidelines for the management of metastatic squamous cell carcinoma of unknown primary (SCCUP) recommend submission of suspicious primary sites for frozen section analysis (FSA). This study aims to investigate the diagnostic accuracy of FSA for identification of HPV-associated SCCUP. METHODS: A retrospective cohort study of patients with biopsy-proven p16-positive SCCUP who underwent diagnostic operation at two tertiary care institutions was performed. Sensitivity, specificity, PPV, and NPV of diagnostic FSA were assessed. RESULTS: 77 patients were included in analysis. 66 patients underwent definitive TORS (diagnostic TORS operation with subsequent neck dissection after identification of the occult primary tumor), 7 patients underwent diagnostic TORS (TORS to identify occult primary tumor, no neck dissection), and 4 patients underwent direct laryngoscopy and biopsy only. Primary tumors were identified in 63 patients (82%) with a mean tumor size of 1.1 cm. There was no significant difference in size between patients whose tumor was identified on FSA (mean 1.1 cm) and on permanent only (mean 0.9 cm) (p = 0.26). The sensitivity, specificity, PPV, and NPV of FSA for SCCUP was 86%, 100%, 100%, and 86%, respectively. Diagnostic frozen specimens included 52 direct laryngoscopy biopsies and 69 TORS excisions. In the biopsies, sensitivity was 100% and NPV was 100%, whereas in the TORS-excised specimens, sensitivity was 77% and NPV was 77%. CONCLUSIONS: In this case series of 77 patients with SCCUP, the sensitivity and NPV of FSA for identification of the primary tumor was over 85%. FSA is valuable during diagnostic operation for SCCUP.

Humans