Special Stains Applications - Essay Example

? HEALTH SCIENCES AND MEDICINE Special Stains Definition Special Stains is a commonly usedterm in the laboratory settings and is applied in two main areas: diagnostics and research. In research, strains are applied as probes in the identification of selected chemical constituent’s in both abnormal and normal cells. The information obtained after identification is based on for further research and study and also used as a base in determining the type of special staining results which can be compared against during diagnostic applications. During such comparison, the significance of the results can be easily interpreted (Simmers 2008). Special strains fall under an assorted stains family for general identification and microscopic visualization of tissues, cells and microorganisms. Special stains is an important laboratory tool used by many technologists and pathologists offering a strong complement to flow cytometry, immunohistochemistry, in situ hybridization and diagnostic technologies defining the medical profile of patients. With greater demands from the medical community for quality and standardized control, protocols on special stains have ended up being more automated leading to higher levels of flexibility and productivity. Automation cannot be considered as being a substitute for the basic understanding of the practices and principles of staining that is of high quality. Most people in the medical field anticipate that such technology will keep on growing so as to evolve in the predictable future. This has left many with high expectations that the technology will eventually result in pathologic diagnosis that is integral. Special stains applications fall under histology and biology including; RNA and DNA content determination, determining the mode of actions of hormones, drugs and food addictives that are toxic, metabolic biochemistry, disease process biochemistry, metastatic tumor primary sites, metastatic melanomas identification especially those that are not-pigmented, detection of tumors at its early stages, micro organism identification, Barr bodies identification and cell staining (Tadrous 2011). Usefulness in the Modern Diagnostic Histopathology Laboratory Pathology texts on liver insists on the value of having a variety of special strains as being a routine and not special during the evaluation process. They include; eosin, hamatoxylin, reticulin, trichome, periodic, iron stain and basement membrane. Most consider the trichrome helpful in the identification of the early lesions of perisinusoidal fibrosis and pericentral found in NASH (Simmers 2008). The other types of stains assist in the exclusion of the rest of the diagnostic possibilities. Stains for copper-associated protein and copper itself are also regarded as useful in situations where there are concerns of cholestatic injuries, chronic bile duct or Wilson disease. Often used in special stains, it adds nothing to the overall liver biopsy cost as it is not expensive and if done on time, there will be no tissues wasted through block resurfacing. Luna (1999) asserts that of equal significance in the studies and diagnosis of NAFLD is the histologic criterion. The results acquired from the study of biopsies together with correlations of clinic-pathology highlights the importance of using careful criteria in distinguishing NASH and NAFLED. International hepatopathologists have come up with their own way of diagnosing NASH. The criteria used by this international group illustrate the varying opinions that are common in the field today. However, they both share a common theme which is; any modern diagnosis carried out in a laboratory depends on lesions combination as it were a pattern of injuries and not a specific single lesion. The lesions that are mostly included in histopathology laboratory include, hepatocyte ballooning, steatosis, perisinusoidal fibrosis and lobular inflammation. In pathophysiology and Clinico-pathologic correlations while considering the findings from histology of NALD, it is advisable to put into consideration both the pathophysiology process and disease in clinical context. Laboratory experiments have recognized NALD as being a metabolic syndrome but manifesting itself in hepatic form. These studies and experiments were conducted and documented the findings of histology together with the important clinical features (Luna 1999). The results indicate that metabolic syndrome have a common insulin resistance link that is variably defined and includes; diabetes or glucose tolerance that is abnormal, central adiposity, systemic hypertension and dyslipidemia .Hyperinsulinemia and insulin resistance causes perpetuated hepatic steatosis. This is because the fatty liver is regarded as being injury prone from self –perpetuating cell injury cycles and initiated fibrogenic stimuli. Special stain helps in the understanding of NAFLD/NASH in terms of putative and recognized pathophysiology. The stain will indicate the imbalances in the delivery of fatty acids to the liver and the insulin resistance which may result in the oxidation and export of steatosis. The same experiments in the laboratory indicate specific lessons present using the stains. This is seen by the pattern formed by the special stains mostly in adults of prefibrotic NASH that were found to be predominant in injury zones and steatosis. Some groups indicated DNA zonal localization damage as traces of oxidative damage products were witnessed on the stains from the CYP 2E1 zone. The presence of Steatosis in the stains can also be interpreted to mean that the availability of predominantly mascrovesicular was due to the small and large mix up of steatosis. Thus special stains play a significant role in locating and identifying liver cell injuries in the laboratories. Fletcher (2000) says that liver cell injuries are mostly identified when the cells of the liver swell. This has been used as key in differentiating feature in the progressiveness of NAFLD. The presence of NAFLD in the stain will indicate the presence of Lobular inflammation but this will be mixed and milled in nature. Portal inflammation might also be present but in its mild form. Other features that might be found present in NASH/NAFLD are Mallory’s hyaline which is normally detected by the use of immunohistochemical stains used against p62 and ubiquintin, glycohenated nuvlei, megamitochondria and acidophil bodies. Special stains can also be used to detect the presence of sinusoidal and Hepatocellular present in the iron cell lining but this is rarely done in the laboratory. Stains also indicate the presence of Fibrosis located in acinar zone 3. This will be seen with the stain having a chicken wire like pattern with some traces in the periportal and portal areas. More studies on NASH on stellate cell indicated activation caused by immunohistochemistry found in zone 3 of the human liver biopsies. The results showed that there are possibilities of periportal and portal fibrosis occurring together with other bridging fibrosis forms. The complication that was found common with NASH was cirrhosis. A liver that has been affected by cirrhosis may retain all or part of its NASH active lesions. This is an indication that cryptogenic cirrhosis cases may have come up as a result of NASH burning out. However, special stain has been unable to accurately show fibrosis histological progression which is believed to be NAFLD’s natural history (Fletcher 2000). Several new concepts regarding pathogenesis of fibrosis have come up and are being experimented in the laboratories to confirm their validity. One of the concepts is the broadening of hepatitis C to NASH so as to include the idea of portal fibrosis correlation reacting with periportal dunctular. This reaction may be facilitated by hepatocyte proliferative measured using senescence markers. Special stain has proved to be useful especially in diagnostic histopathology labs as by using it, many medical conditions can be easily identified, located and experimented for further understanding. Among the many medical process, special stain plays a vital role in the study of liver cells. Reference Fletcher, C. (2000). Diagnostic Histopathology of Tumors. Philadelphia: Churchill Livingstone. Luna, L. (1999). Histopathologic Methods and Color Atlas of Special Stains and Tissues Artifacts. New York: Amer Histolabs Pub Dept. Simmers, L. (2008). Introduction to Health Science Technology. New York: Delmar Cengage Learning. Tadrous, P. (2011). Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum. New York: Wiley Press. Read More