![](media/image1.emf){width="2.14375in" height="2.201388888888889in"}

![](media/image2.emf){width="1.6465277777777778in"
height="0.7986111111111112in"} **EM News**

**Volume 1 Issue 3 March 1995**

**annual EM Ad hoc review group meeting**

Review of EM Programs

The annual meeting of the Electron Microscopy Program Ad Hoc Review
group was held in Durham on Feb. 21-22 1995. The EM instrument
utilization data and workload productivity of each EM laboratory was
reviewed and evaluated against requirements in the current VA Manual,
M-2, Part VI, Chapter 6 quality assessment standards. The five or more
EM diagnostic cases submitted by each program were also critiqued and
evaluated by the peer review group. The annual EM Program review letters
have been completed and should shortly be sent to the Hospital Directors
by the appropriate Regional Director. The EM instrument utilization
letters were mailed out previously with most of those letters having
gone out in November 1994. A small number of the letters were retained
for additional discussion and review by the Ad Hoc committee and then
those were mailed to the Hospital Directors during the middle of March.

For the FY 1994 Program reviews, the M-2 VA Manual, EM Quality
Assessment productivity standards in effect during that year were used.
Those standards were 300 specimens examined by EM for Center of
Excellence or Full level program and 150 specimens for Half level
programs. During this current fiscal year (FY 1995) which started Oct 1,
1994, the productivity standards have been returned to 250 and 125
specimens for each respective level program, which is what they were a
number of years ago. Details are provided at the end of this newsletter.

The reviewers noted that the vast majority of the programs are doing
excellent work. The selection of the review cases submitted and the
variety of cases was very good. In addition those programs which were
noted to have specific concerns during previous annual reviews responded
very positively.

The majority of the critiques which were specifically noted by the
reviewers for a significant number of EM programs were: (a) "no 'thicks'
were discussed" (no description of the thick sections), (b) no clinical
history, (c) little or no case discussion, (d) a few extended
turn-around time outliers were also mentioned. It should be observed
that starting with this annual review, the individual case cover sheet
indicated the specific criteria the reviewers would use during the case
evaluations. These criteria are listed on the bottom half of each case
cover sheet

Dr. Beals, Acting Director of Pathology and Laboratory Medicine Service,
National Headquarters (formerly VACO), and Mrs. Stitak, Pathology
Service Quality Management Coordinator, provided some information about
the ongoing re-organization plans and efforts of Dr. Kizer, the new
Department of Veterans Affairs Under Secretary of Health. This
information is also updated monthly during the Pathology Hot-line calls
by Dr. Beals as it becomes available. The following is the most recent
information available at printing time of this newsletter.

"The Department of Veterans Affairs has submitted to Congress for review
a major reorganization plan for its health-care system that will realign
medical facilities into geographic networks, decentralize decision
making and reduce supervisory layers in Veterans Health Administration
headquarters.

The plan outlines a new veterans\' health-care structure which abolishes
VA\'s current four-region system in which each region has oversight
responsibility and broad control over some 40 medical centers. The
regions will be replaced by 22 smaller Veterans Integrated Service
Networks, called VISNs, ranging in size from five to 12 medical centers.

The 22 VISNs will allocate resources among the medical centers, and use
contract services with the private sector and sharing agreements with
the Department of Defense to ensure high quality care, easier access to
services and improved cost management."

Dr. Beals and Mrs. Stitak emphasized the need and importance to promote
and explain the significance of EM to patient care and also to advocate
the EM program's somewhat unique peer review QM/QA functions to the
leaders of the re-organized "support centers", formerly known as the
four regions, and to new (yet to be named) leaders of the 22 geographic
healthcare network areas identified as "VISNs". These areas are roughly
analogous to previously mentioned VA healthcare networks, i.e., -
VSA's - (Veterans Service Areas).

The EM Centers of Excellence mission: "**To facilitate sharing of
available technical capabilities and diagnostic expertise of designated
EM Center of Excellence laboratories with other government medical
facilities by providing assistance in the diagnosis of unusual or
difficult interpretive cases,**" and the willingness of EM programs to
establish sharing agreements with other government or private medical
facilities should be actively promoted and disseminated to the new
leaders of the VA healthcare networks. The importance of EM programs to
patient treatment within their healthcare domain must be emphasized and
advocated as much as possible to these new people.

Version 5.2 EM workload capture

The new software functionality available in version 5.2 lab package
which allows automatic workload capture is not very intuitive nor well
understood by a significant number of sites during this early phase of
the national installation schedule. The v5.2 laboratory documentation
provided concerning work load implementation will be further explained
during a series of teleconference calls by the national lab software
development team (second Thursday of each month, 1PM eastern
800-767-1750). In addition specific EM workload capturing explanations
and file setup instructions and /or recommendations will be developed
and distributed in a soon to be mailed interim issue of the EM News.
That issue will be exclusively concerned with EM workload capture.
Hopefully the contents of that issue will be useful to the EM or
laboratory person responsible for obtaining this workload management
information from DHCP and also to the lab package coordinator in that
facility.

**USCAP Toronto**

**meeting**

***The Society for Ultrastructural Pathology*** met Sunday morning,
March 12, 1995 and discussed "[Diagnostic Electron Microscopy of skin,
metabolic diseases and genitourinary tract - state of the
art]{.underline}". The moderator for the meeting was Dr. Irving Dardick,
University of Toronto, Toronto, Ontario. Speakers were: Dr. Wedad Hanna,
"Clinical Applications of Electron Microscopy in Dermatopathology"; Dr.
Raoul Fresco, "Ultrastructure of Genetic and Acquired Lysosomal Storage
Disease"; Dr James Powers, "Ultrastructural Aspects of Neurometabolic
Diseases"; Dr. Anthony di Sant'Agnese, "Neuroendocrine Cells of Prostate
and Neuroendocrine Differentiation of Prostatic Carcinoma"; and Dr. John
Srigley, "Role of Electron Microscopy in Classification and Diagnosis of
Renal Epithelial Neoplasms". The business meeting of the society was
held on the same afternoon. Details will be presented in a future
edition of the Society for Ultrastructural pathology newsletter.

The meeting of the ***Arthur Purdy Stout Society of Surgical
Pathologists*** was a competing session, also held that same morning.
The meeting topic was "[Update in diagnostic
immunohistochemistry]{.underline}". The talk by Dr. Bruce MacKay on the
"Role of Electron Microscopy in the Immunohistochemical Era" was very
positive about the importance of Electron Microscopy and was well
received.

The ***Association of V.A. Pathologists*** meeting was held March 12,
1995 in the evening. Chair was the current President, Dr. Fred
Rodriguez, Chief of Pathology and Laboratory Medicine Service at the New
Orleans VA Medical Center. The speakers this year were Dr. Ted Daoud of
Albany VAMC and Dr. Ted Beals of Ann Arbor VAMC. Both recounted the many
accomplishments of Dr. Marjorie Williams, including the establishment of
the VA Electron Microscopy program.

**Editorial Article**

***A realistic approach to the use of electron microscopy and other
ancillary diagnostic techniques in surgical pathology - Editorial by
Robert A. Erlandson and Juan Rosai* (**The American Journal of Surgical
Pathology 19(3): 247-250, 1995)

In this editorial the use of ancillary diagnostic procedures such as
immunohistochemistry, electron microscopy, cytogenetics, and molecular
pathology are critically evaluated, and a proposal for their
cost-effective use in the practice of surgical pathology is presented.
This is a very good article which also expressed the belief that
transmission electron microscopy, although less used now than in
previous years, remains an important and sometimes essential tool in
diagnostic pathology.

**Microwave EM tissue processing technique**

Dr. Irving Dardick of the Toronto Hospital Department of Pathology has
graciously provided information about a microwave technique for EM
tissue processing which he wishes to share with the VA EM program
facilities. ***Please see attachments at the end of this newsletter for
an explanation and details of the procedure.***

**Announcements:**

**Mort Maser, 60 years old, passed away recently. He was MSA Executive
Secretary and founder of Woods Hole Associates. A son and daughter are
survivors.**

**Electron Microscopy Technical Staff Position listed:** The Atlanta
VAMC Department of Human Resources has the official announcements and
job application available for an Electron Microscopy Technologist (GS-9)
vacancy with the EM Program under direction of Dr. Suzanne S. Mirra. Dr.
Mirra's area of expertise includes Alzheimer's, CNS infections and
Neurodegenerative disease. In general the position requires a minimum of
five years hands-on EM laboratory experience in tissue processing, dark
room photography, and operation of electron microscope including minimum
of two years experience with [human]{.underline} tissue specimens with
knowledge of histology and pathology. Position involves supervising of
GS-7 Health technician in the EM section. Laboratory Management skills
and advanced computer skills, e.g. image analysis, desirable. For
specific information and application procedures call FTS 700-248-6000 or
404-321-6111 and ask for Human Resources Department. **[Travel
reimbursement for relocation has been authorized]{.underline}**

Microscopy Calendar

M**eetings, courses and conferences listed.**

The Microscopy Society of America (**MSA**) and the Microbeam Analysis
Society (**MAS**) plan the following:

**1995 MSA** - Kansas City, KS (Aug. 13-18, 1995)

**1996 MSA/MAS** - Minn.., MN.

**1997 MSA/MAS** - Cleveland, OH

**1998 MSA** - Atlanta, GA

**1999 MSA** - TBA

**Courses: *Tutorial in Ultrastructural Pathology and Diagnostic
Electron Microscopy of Tumours*** [July 10 - 14, 1995]{.underline} at
the Ramada Hotel and Suites, 111 Cooper Street, Ottawa, Ontario K2P 2E3,
Canada. Phone (613) 238-1331 or FAX (613) 231-2179 (about \$62.U.S./day)
Fee. \$600, check made payable to Dr. F.N. Ghadially, response before
June 1st is requested. Contact Dr. Ghadially at (613) 224-9879 if there
are any questions.

ICDD X-RAY CLINICS, **[5-30 JUNE, 1995: 5-9 JUNE,]{.underline}**
FUNDAMENTALS OF X-RAY POWDER DIFFRACTION; **[12-16]{.underline}**
**[JUNE,]{.underline}** ADVANCED METHODS IN X-RAY POWDER DIFFRACTION;
**[19-23 JUNE,]{.underline}** FUNDAMENTALS OF X-RAY FLUORESCENCE;
**[26-30 JUNE]{.underline}**, ADVANCED METHODS IN X-RAY FLUORESCENCE.
CONTACT: Theresa Maguire, International Centre for Diffraction Data, 12
Campus Boulevard, Newtown Square, PA 19073-3273 Telephone 610 325 9814;
FAX 610 325 9823; EMAIL: Maguire@ICDD.COM.

THIRD INTERNATIONAL CONFERENCE ON MODERN METHODS IN ANALYTICAL
MORPHOLOGY, SHOWBOAT HOTEL, ATLANTIC CITY, NEW JERSEY, **[5-6 JUNE,
1995]{.underline}**;

HANDS-ON WORKSHOP, **[7-9 JUNE, 1995.]{.underline}**

The program features in situ polymerase chain reaction and in situ
hybridization, nuclei acid and antigen detecting techniques,
immunogold-silver staining, confocal microscopy, antigen retrieval, and
image analysis. CONTACT: Editor, Cell Vision-Journal of Analytical
Morphology, Deborah Research Institute, Browns Mills, NJ 08015-1799.

PROTOCOLS IN: IMAGE ANALYSIS AND CONFOCAL AND ELECTRON MICROSCOPY, THE
GEORGE WASHINGTON UNIVERSITY CENTER FOR MICROSCOPY AND IMAGE ANALYSIS,
WASHINGTON, DC, **[7-9 JUNE, 1995.]{.underline}**

This Twenty-First Annual Program will provide in-depth training for
research scientists and technical staff in the basic and clinical
sciences, as well as the biotechnology industry, all of which employ
laser confocal microscopy, electron microscopy, image analysis and image
archiving. Contemporary lectures, demonstrations and hands-on experience
will cover confocal microscopy, cryo-fixation, cryo-sectioning,
fluorescent labeling, freeze-drying, freeze-substitution, gold/silver
labeling, imaging archiving, image enhancement, and quantitative image
analysis. CONTACT: Fred G. Lightfoot, The George Washington University,
CMIA, Suite 406, 2300 I St. NW, Washington, DC 20037; Telephone 202 994
2881; FAX 202 994 8885; EMAIL: FredL@INDY.CMIA.GWUMC.EDU.

COURSES, LEHIGH UNIVERSITY, BETHLEHEM, PA: SCANNING ELECTRON MICROSCOPY
AND X-RAY MICROANALYSIS, **[12-16 JUNE, 1995]{.underline}**; ADVANCED
SEM WITH DIGITAL IMAGING PROCESSING, QUANTITATIVE X-RAY MICROANALYSIS OF
BULK SPECIMENS AND PARTICLES, ANALYTICAL ELECTRON MICROSCOPY, CONCURRENT
COURSES, **[19-22 JUNE, 1995]{.underline}**; ATOMIC FORCE AND OTHER
SCANNING PROBE MICROSCOPIES**[, 20-23 JUNE, 1995]{.underline}**.
CONTACT: Prof. David B. Williams, Dept. of Materials Science &
Engineering, 5 E. Packer Avenue, Lehigh University, Bethlehem, PA,
18015, Telephone 610 758 5133, FAX, 610 758 4244.

CONGRES \"TRINOCULAIRE\" DE MICROSCOPIES ELECTRONIQUES, JOINT MEETING
SBM, SFME, SGOEM, EPFL, CH-LAUSANNE, FRANCE, **[26-30 JUNE,
1995]{.underline}**. CONTACT: P.A. Buffat, EPFL-CIME, Bat. MXC, CH-1015
Lausanne, FAX: +41 21 693 44 01; EMAIL: philippe.buffat@cime.epfl.ch

MICROBEAM ANALYSIS SOCIETY 1995: BEAVER RUN RESORT, BRECKENRIDGE,
COLORADO, **[6-11 AUGUST, 1995.]{.underline}**

The annual MAS meeting will include a technical program to address a
broad range of topics covering all aspects of microbeam analysis.
Sessions will include invited and submitted contributions covering
fundamentals, instrumentation and methodologies, and applications in
microbeam analysis. CONTACT: Greg Meeker, Local Arrangements Chairman,
Telephone 303 236 1081; FAX 303 236 1414.

14TH PFEFFERKORN CONFERENCE ON THE SCIENCE OF BIOLOGICAL SPECIMEN
PREPARATION FOR MICROSCOPY AND MICROANALYSIS, SAINT LOUIS, MISSOURI,
**[6-11 AUGUST, 1995]{.underline}**. CONTACT: Scanning Microscopy
International, PO Box 66507, Chicago (AMF O\'Hare), IL 60666-0507,
Telephone 708 529 6677, FAX 708 980 6698.

MICROSCOPY SOCIETY OF AMERICA 53RD ANNUAL MEETING (JOINTLY WITH THE
HISTOCHEMICAL SOCIETY), KANSAS CITY, MO, **[13-17 AUGUST,
1995.]{.underline}**

CONTACT: MSA Business Office, Box EM, Woods Hole, MA, Telephone 800 538
3672; FAX 508 548 9053.

9TH INTERNATIONAL CONGRESS FOR STEREOLOGY, COPENHAGEN, DENMARK, **[20-25
AUGUST, 1995]{.underline}**. CONTACT: Karsten Nielsen, Institute of
Pathology Aalborg Hospital, DK-9000, Aalborg, Denmark. Telephone +45 99
32 16 02, FAX +45 98 11 59 90.

14TH INTERNATIONAL CONGRESS ON X-RAY OPTICS AND MICROANALYSIS (IXCOM),
HUATAI HOTEL GUANGZHOU , CHINA, **[29 AUGUST-2 SEPTEMBER,
1995]{.underline}**.

The theme of the congress will emphasize not only the latest
developments in instrumentation and methods but also the most recent
results of the applications to high technology, advanced materials, the
environment and life sciences. CONTACT: Congress Secretariat, Foreign
Affairs Division, Guangzhou Branch, CAS, 100 Xianlie Rd. C. Guangzhou
510070 China, Telephone +86 20 7775213, FAX +86 20 7775791.

3RD INTERAMERICAN CONGRESS ON ELECTRON MICROSCOPY & XV MEETING OF THE
BRAZILIAN SOCIETY FOR EM, CAXAMBU, MINAS, GERAIS, **[2-6 SEPTEMBER,
1995]{.underline}**. CONTACT: Dr. E.W. Kitajima, Depto de Biologia
Celular, Univ de Brasilia, 70919-970-Brazilia-DF-Brazil, FAX +55 61 274
1065.

EMAG\'95: RECENT ADVANCES IN ELECTRON MICROSCOPY AND RELATED TECHNIQUES,
UNIVERSITY OF BIRMINGHAM, UK, **[12-15 SEPTEMBER, 1995]{.underline}**.

The conference will primarily be concerned with recent developments in
electron microscopy and analysis techniques which can be incorporated
into electron microscopes. Advances in other areas which can provide
similar or complementary results will also be covered. These include
scanning tip microscopies, novel optical methods and image processing.
The emphasis will be on state of the art instrumentation and novel
applications of microanalytical techniques. Plenary lectures will be
followed by both oral and poster presentations. CONTACT: Prof. A.G.
Fitzgerald, Dept. of Applied Physics and Electronic & Manufacturing
Engineering, University of Dundee, Dundee DD1 4HN Scotland, Telephone
0382 23181 ext 4553/4555, FAX 0382 202830/25413, EMAIL:
A.G.FITZGERALD@UK.AC.DUNDEE.

ADVANCED SCHOOL ON MICROSTRUCTURAL ANALYSIS: Two-day course on Analysis
of Microstructural Defects, to precede EMAG\'95. CONTACT: Dr. I.P.
Jones, School of Metallurgy and Materials, The University of Birmingham,
Edgbaston, Birmingham, England,

B15 2TT.

WORKSHOP ON ULTRAMICROTOMY FOR MATERIALS SCIENCE APPLICATIONS, ARIZONA
MATERIALS LABORATORIES, UNIVERSITY OF ARIZONA, TUCSON, AZ, **[24-27
OCTOBER, 1995.]{.underline}**

This intensive, hands-on four-day short course will cover topics such as
microtomy for EM and light microscopy, including metals and alloys,
composites, minerals, glasses, plastics, rubbers, papers, corrosion
products, modified surfaces, coatings, foils and thin films,
multilayers, fibers and powders. Registration deadline: **[25 September,
1995]{.underline}**. CONTACT: Dr. Bob Chiovetti or Beth Boone, RMC, 4400
S. Santa Rita Ave. Tucson, AZ 87514. Telephone 520 889 790; FAX 520 741
2200.

MICROSCOPY SOCIETY OF AMERICA 54TH ANNUAL MEETING (JOINTLY WITH THE
MICROBEAM ANALYSIS SOCIETY AND THE MICROSCOPY SOCIETY OF CANADA),
MINNEAPOLIS, **[11-15 AUGUST, 1996.]{.underline}**

MICROSCOPY SOCIETY OF AMERICA 55TH ANNUAL MEETING (JOINTLY WITH THE
MICROBEAM ANALYSIS SOCIETY), CLEVELAND, OHIO, **[10-14 AUGUST,
1997.]{.underline}**

CONTACT: MSA Business Office, Box EM, Woods Hole, MA Telephone 800 538
3672; FAX 508 548 9053; EMAIL: mmaser@mbl.edu

(Membership application for **M**icroscopy **S**ociety of **A**merica
can be arranged by writing to MSA, Box MSA, Woods Hole, MA 02543 or
calling 1-800-538-3672 or FAX to 508-548-9053) regular annual
membership, \$40. Student membership, \$10. Corporate, \$350.

Any MSA member interested in technology and/or who considers themselves
a technologist is welcome to join the

"Technologists' Forum" (TF); this committee is chaired by Sandra Silvers
(706-546-3471). An all day scientific symposium is usually held during
the annual MSA meeting on a technology topic such as energy dispersive
spectroscopy which was presented at the August 1994 MSA/MAS meeting in
New Orleans by speakers such as A. Garratt-Reed, Dale Newbury, John
Shelburne, A.Sandborg, and Patrick Echlin.

**FY 1995 EM**

**Productivity Standards now in effect.**

In M-2, Part VI, Chapter 6 (6.12 Operations of Electron Diagnostic
Microscopy Units) under d. Quality Assessment (2) ***The basic
productivity/utilization standard for a program funded at the full level
is a minimum of 250 specimens examined annually with at least 83 percent
(208) of the 250 specimens examined by electron microscopy. At least 67
percent (168) of the basic 250 specimens examined per year will be
patient-related material. At least 51 percent (128) of the basic 250
specimens examined per year must come from VA patients. Programs funded
at the half level will be expected to examine a minimum of 125 specimens
annually with no less than 104 being examined by EM.***

  ------------ ------------ --------------- ---------- ---------- --------------- ---------- ---------- --------------- ---------- ---------
                            Electron                                                                                               
                            Microscopy                                                                                             
                            Standards                                                                                              

                                                                                                                                   

                            **1978**                   **1994**                              **1995**                              

                            **Standards**                         **Standards**                         **Standards**              

  **EM Program              **Full**        **Half**              **Full/CE**     **Half**              **Full/CE**     **Half**   
  level**                                                                                                                          

                                                                                                                                   

  **\#                                      **250**    **NA**                     **300**    **150**                    **250**    **125**
  Examined**                                                                                                                       

                                                                                                                                   

  **\#                                      **NA**     **NA**                     **250**    **125**                    **208**    **104**
  Examined by                                                                                                                      
  EM (\>83%)**                                                                                                                     

                                                                                                                                   

  **\# Pat.                                 **168**    **NA**                     **201**    **100**                    **168**    **84**
  Related                                                                                                                          
  (\>67%)**                                                                                                                        

                                                                                                                                   

  **\# VA                                   **128**    **NA**                     **153**    **76**                     **128**    **64**
  Patients                                                                                                                         
  (\>51%)**                                                                                                                        
  ------------ ------------ --------------- ---------- ---------- --------------- ---------- ---------- --------------- ---------- ---------

**Comments/Suggestions for
future**![](media/image2.emf){width="0.2791666666666667in"
height="0.16944444444444445in"} **EM Newsletters:**

If you have any comments, suggestions, article submissions for use in a
future Newsletter, please send to: Alex Tuszynski (EM-QA/QM) Coordinator
via FAX 919-286-6818 or call 700-671-6925x5218