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- •Foreword
- •Preface to the Fourth Edition
- •Preface to the Third Edition
- •Contributors
- •Commonly Used Abbreviations in Medical Laboratories
- •Contents
- •29. Biochemical Processes of the Body Under Normal and Pathogenic Conditions
- •Normal and Abnormal Biochemical Processes of the Body
- •Basic Physiology and Biochemistry of the Body
- •Interrelated Metabolic Processes of the Body
- •Functions of Various Organs
- •Biochemical Changes in the Body Under Pathologic Conditions
- •Basic Clinical Biochemistry
- •Diagnostic Biochemical Profiles
- •Review Questions
- •30. Specimen Collection and Processing for Biochemical Analyses
- •Specimens of Biochemistry and their Handling
- •Types of Specimens
- •Review Questions
- •31. Techniques of Analytical Chemistry
- •Introduction to Analytical Chemistry
- •Analytical Chemistry and Clinical Chemistry
- •Applications of the Principles of Analytical Chemistry
- •Instrumentation for Proteomics
- •Osmometry
- •Analytic Techniques for Point-of-Care Testing (POCT)
- •Review Questions
- •32. Automation in Clinical Biochemistry
- •Introduction
- •History of Laboratory Automation
- •Present State of Laboratory Automation
- •Benefits of Automation in Clinical Laboratories
- •Classification of Automated Systems
- •Steps of Automation in Biochemical Analysis
- •Quality Control and Preventive Maintenance
- •Computers in Clinical Laboratories
- •Automation in the Clinical Laboratories of Developing Countries
- •Point-of-Care Testing: A New Approach
- •Time-Saving Devices and Kits
- •Conclusion
- •Review Questions
- •33. Routine Biochemical Test Procedures
- •Introduction
- •Routine Diagnostic Tests in Clinical Chemistry
- •Blood Glucose
- •Serum Protein
- •Blood Urea Nitrogen (BUN)
- •Uric Acid
- •Creatinine
- •Bilirubin
- •Diagnostic Enzymology
- •Brain Natriuretic Peptide (BNP)
- •Lipid Profile
- •Thyroid Function Tests
- •Electrolytes
- •Acid–Base Balance and Blood Gases
- •Review Questions
- •34. Biochemical Test Profiles
- •Analytes Commonly Tested in Chemistry Profiles
- •Kidney (Renal) Function Tests
- •Liver Function Tests
- •Cardiac Function Tests
- •Lipid Metabolism
- •Carbohydrate Metabolism
- •Thyroid Function Tests
- •Other Tests of Organ Functions
- •Gastric Function Tests
- •Pancreatic Function Tests
- •Test for Malabsorption
- •Review Questions
- •35. Therapeutic Drug Monitoring and Clinical Toxicology
- •Drug and Drug Addiction
- •Diagnostic Screening in Emergency
- •Comments on Commonly used Drugs
- •Classification of Illegal Drugs and Their Uses
- •Toxicology Laboratory and Forensic Medicine
- •Drug Screening in Clinical Chemistry Laboratory
- •Laboratory Assay of Drugs and Poisoning
- •Laboratory Investigation of Drug Abuse
- •Investigation for New Illegal Drugs
- •Popularity of Immunoassay
- •Laboratory Screening for Heavy Metal Poisoning
- •Point-of-Care Testing
- •Review Questions
- •36. Introduction to Histotechnology and Cytotechnology
- •Introduction to Histophathology and Exfoliative Cytology
- •Basic Terminology
- •Histopathology Laboratory Equipment
- •Laboratory Supplies
- •Reagents
- •Routine and Special Staining: A Review
- •Review Questions
- •37. Laboratory Techniques in Histology
- •Overview
- •Logging in of Specimens
- •Preparation of Tissues
- •Processing of Tissues
- •Special Stains and Staining Techniques
- •Routine Staining Procedure in Histology
- •Post Staining Processes
- •Stains for Particular Substances
- •Stains for Microorganisms
- •Staining Kits from Commercial Companies
- •Frozen Section Technique
- •Handling and Embedding Small Tissue Fragments
- •Review Questions
- •38. Laboratory Techniques in Diagnostic Exfoliative Cytology
- •Introduction to Exfoliative Cytology
- •Four Phases of Exfoliative Cytology
- •Collection of Specimens
- •Preparation of Specimens
- •Cytological Stains and Staining Techniques
- •Identifying Characteristics of Benign and Malignant Cells
- •Review Questions
- •Evolution of Tissue/Cellular Level Diagnostics
- •Drying of Paraffin Sections
- •Postanalytical Phase of IHC
- •Panel Markers in IHC
- •Evolution of PCRs
- •Point of care PCR for Clinical Diagnosis
- •Medical Terminology
- •Suffixes and Prefixes in Medical Terminology
- •Glossary of Technical Terms
- •Appendices

1216
material being stained, the xative being used and most importantly, the avidity of the
haematoxylin solution. An average dierentiation time is from 2–6 s.
4. Wash in water, followed by the bicarbonate solution for 10–20 s. It neutralizes all the
acid.
5. Rinse in water.
6. Stain with eosin for 10–20 s.
7. Rinse in water, dehydrate (take through increasing concentrations of alcohol).
8. Clear and mount as desired.
Medical Laboratory Technology: Volume 3
Grunwald-Giemsa Staining (GGS)
Some laboratories prefer Romanowsky-type stains for examination of ne needle aspiration
and serous uid smears. Nuclear detail, the nucleoli in particular, is well delineated but
experience is still needed for accurate cell determination. With serous uids, adenocarcinoma
cells are distinguishable, especially if any intracytoplasmic vacuolation is present. For best
results, smears should always be air dried, followed by xation in methanol for 5–10 min.
Reagents
• May–Grunwald solution
Stock solution: Grind 0.3 g of the powdered May–Grunwald dye in a lile amount of
methanol.
Decant and then add more methanol continuing to grind until the dye is in solution for
a nal volume of l00 mL; lter.
Working solution: Dilute 20 parts of May–Grunwald solution with 30 parts of pH 6.8
phosphate buer.
• Giemsa solution
Stock solution:
Giemsa powder 1 g
Glycerine 66 mL
Absolute methyl alcohol 66 mL
Mix Giemsa powder and glycerine, and place in a 60°C oven for 30 min to 2 h. Add 66
mL of absolute methyl alcohol.
Working solution:
Stock Giemsa solution 50 drops
Distilled water 50 mL
Prepare solution at the time of use. Do not reuse.
Procedure
1. Fix the smear by routine procedure.
2. Stain the xed smears in diluted May–Grunwald solution for 10 min.
3. Rinse in pH 6.8 buer (close to neutral).
4. Stain in the diluted Giemsa solution for 30 min.
5. Wash and dierentiate in pH 6.8 buer for 5–20 min until the desired color balance is
achieved.
6. Allow smears to dry and mount in a DPX-type mount.
Results
Nuclei: Purple
Cell cytoplasm: Blue to mauve
Red blood cells: Pink

Laboratory Techniques in Diagnostic Exfoliative Cytology
1217
Other Staining Procedures
Several other staining procedures, described in staining tissue sections, are also used in
exfoliative cytological investigations. These include periodic acid-Schi (PAS), silver stain
method and Feulgen reaction.
Periodic Acid-Schiff (PAS) stain kit
Intended use
The commercially available Periodic Acid-Schi (PAS) stain kit is used for staining bone
marrow and blood cell smear.
Principle
Periodic Acid-Schi reaction (PAS) oxidizes Ethylene Glycol (—CHOH—CHOH) which is
contained in glycogen polysaccharides of cells, to turn into dialdehyde (—CHO—CHO).
Subsequently, aldehyde will react with colorless Fucshin to form a red-fuchsin compound
in cytoplasm.
Contents of the kit
1. Fixative (solution A)
2. Periodic Acid Solution (solution B)
3. Schi's reagent (solution C): Keep in brown bole. Cap tightly. Long exposure in the
air shall cause emission of SO2 and solution will easily turn red to be denatured. Schi
staining is suggested to be carried out at room temperature.
4. Hematoxylin (solution D)
Procedure
1. Dry the smear before subjecting to staining.
2. Fix smear in solution A for 30 s
3. Rinse with distilled water.
4. Air dry or dry with absorbent paper.
5. Drop solution B (PAS acid solution) on slide to fully cover the smear for 5 min.
6. Rinse with distilled water.
7. Dry with lter paper or dry in the air.
8. Drop solution C on slide to fully cover the smear for 10–15 min.
9. Rinse with distilled water for 5 min.
10. Counterstain with solution D for 1–2 min.
11. Rinse with distilled water.
12. Dry the smear for microscopic examination.
Expected results
Red (or purple) granules found in cytoplasm means positive. Interpretation may vary with
dierent kinds of cells in specimen.
Special note
1. PAS stain can be used in old but well-preserved smear and smear stained with Wright’s
stain. However, smear stained with Wright’s stain should be decolorized with ethanol
before performing PAS staining.
2. Microscopic examination should be performed immediately aer PAS staining, since
positive reaction will turn weaker aer one week.
3. Always read the instruction given in the kit as insert.
4. Do not use the reagents beyond the stated expiration date.
5. Wastes should be disposed with care as biohazardous materials by following local EPA
guidelines.

1218
Medical Laboratory Technology: Volume 3
Methenamine silver–Grocott’s modified stain
(Available as kit)
Purpose
To identify fungi
Principle
The mucopolysaccharide components of the fungal cell wall are oxidized to release aldehyde
groups. The aldehyde groups then react with the silver nitrate, reducing it to metallic silver,
rendering them visible.
Control: Any tissue containing fungus. A control block made-up from tissue containing
aspergillosis and Pneumocystis is preferred.
Fixative: 10% formalin
Technique: Cut paran sections 4–5 mm.
Equipment
• Acid cleaned glassware
• Coplinjars
• Microwave oven
Reagents (available in kit)
1. 2% Chromic Acid:
• Chromium trioxide 10 g
• Distilled water 500 mL
Solution is stable for 6 months. Caution Corrosive acid, possible carcinogen, avoid
contact and inhalation.
2. 1% Sodium metabisulphite:
Sodium metabisulphite 5 g
Distilled water 500 mL
Solution is stable for 6 months.
3. 5% Borax:
Sodium borate 5 g
Distilled water 100 mL
Solution is stable for 3 months.
4. Methenamine Silver Stock Solution:
3% Methenamine (hexamethylenetetramine) 100 mL
5% Silver nitrate 5 mL
Mix, pour into an acid-cleaned brown bole. Store in a refrigerator. Solution is stable for
3 months. Caution Corrosive, possible carcinogen.
5. 0.5% Gold Chloride:
Gold chloride 0.5 g
Distilled water 100 mL
Store in acid cleaned bole, refrigerate. Stable for 1 year. Caution Avoid contact and
inhalation.
6. 0.2% Light green:
Light green SF yellow 0.2 g
Distilled water 100 mL
Glacial acetic acid 0.2 mL
Mix. Stable for 6 months. Caution Avoid contact and inhalation.

Laboratory Techniques in Diagnostic Exfoliative Cytology
Safety: All chemicals are potentially dangerous and carcinogenic.
Procedure
Following is a general procedure which can be modied for cytological specimens.
1. Deparanize and hydrate with distilled water (dip through decreasing concentrations
of alcohol).
2. *Stain with 2% Chromic acid, microwave Hi power for 45 s, and allow it to stand for
5 min.
3. Wash in tap water, rinse in distilled water.
4. Stain with 1% sodium metabisulphite and leave for 1 min at room temperature.
5. Wash in tap water, rinse in distilled water (3 changes).
6. *Stain with working methenamine silver solution, microwave Hi power for 70 s. Tissue
should be the color of a brown paper bag. Agitate the slides in hot solution.
7. Rinse in distilled water (2 changes).
8. Stain with 0.5% gold chloride. Leave for 1 min or until gray.
9. Wash in distilled water.
10. Stain with 5% hypo and leave for 3 min.
11. Wash in tap water, rinse in distilled water.
12. Working light green, 1 min.
13. Rinse in distilled water.
14. Dehydrate, clear, and put coverslip.
* Conventional Method
•5% chromic acid, 60°C water bath for 1 h.
•Silver solution, 60°C water bath for 1 h or until brown.
1219
Feulgen reaction
Kits are available in the market. It takes about 1 h and 5 min to perform the test. Stability—
one year when stored in a refrigerator (2–8°C).
Purpose
•This product is for the preparation of cyto-histological samples for optical microscopy.
•Application demonstration of DNA in tissue sections (and cytological specimens).
Principle
The method is divided into two parts:
• Acid hydrolysis (5N HCl, ambient temperature, 40 min), designed to separate
selectively 2 purine bases, namely adenine and guanine, from DNA molecule.
• Staining of apurinic acid resulting from hydrolysis with Schi reagent. This reagent
can be used since free deoxyribose changes to aldehyde in acid environment.
Feulgen reaction is highly selective for DNA. In fact, RNA does not react because the
presence of a hydroxyl on carbon 2 of ribose prevents HCl from hydrolysing sugar. Moreover,
this reaction allows a very precise localization of DNA since, aer purine bases have been
removed, deoxyribose radicals are bound to phosphoric acid of apurinic acid macromolecule.
Reagents
A. Hydrochloric acid solution 5N 30 mL
B. Schi Reagent according to Feulgen 30 mL
C. Sodium thiosulphate solution 30 mL
D. Fixative solution 30 mL

1220
Procedure
1. Bring section to distilled water.
2. Put on the section, 10 drops of reagent A; leave to act 40 min.
3. Double washing in distilled water.
4. Put on the section, 10 drops of reagent B; leave to act 10 min.
5. Drain the slide without washing and put on the section, 10 drops of reagent C; leave to
act 2 min.
6. Drain the slide without washing and put on the section, 10 drops of reagent D; leave to
act 3 min.
7. Wash in running tap water for 5 min.
8. Dehydrate through ascending alcohols; clear in xylene and mount.
Results
Magenta red: DNA
Warning and precaution: The product must be used exclusively by specialized technical
operators. The product is classied as hazardous. Read the instructions of the manufacturer
very carefully before using the product.
Storage: Store the preparation at 2–8°C. Keep the containers tightly closed.
Stability: Aer the rst opening, the product is usable until the expiry date, if correctly stored.
Disposal of hazardous preparation: Observe all state and local environmental regulations
regarding waste disposal.
Medical Laboratory Technology: Volume 3
IdEntIfyIng charactErIstIcs of BEnIgn and malIgnant cElls
Although the technician is not responsible for evaluating the stained smears, he/she should
be able to dierentiate between normal and abnormal cells. This knowledge enables the
evaluation of specimen preparation for microscopic examination and if not satisfactory,
the process can be repeated. Additionally, an experienced technician can participate in the
pre-screening of the slides and draw the aention of the cytopathologist to abnormal slides.
Nonetheless, the limited training received by the technician restricts his/ her ability to identify
the types of malignant cells. The evaluation by the cytopathologist is essential.
Normal and Malignant Cells
Epithelial cells line skin epidermis and the surface layer of mucous and serous membranes.
The presence of various types of epithelial cells in the specimens submied for exfoliative
cytology is considered normal. The epithelial cells may or may not be nucleated, depending
on the stage of development. In some normal specimens, reticuloendothelial cells and
macrophages may also be present.
Epithelial malignant tumors (carcinomas) exhibit changes in the cellular structure of the
exfoliated cells, including abnormalities in nuclear structure (increased diameter with dense
chromatin) and increased nucleus. Cytoplasm ratio is one of the most important criteria of
abnormal malignant cells. This is comparable to the presence of blast cells in circulating blood
in patients with leukemia. Another criterion that may identify the presence of malignant
cells is their grouping. Epithelial cells oen remain in groups, closely aached to each other.
This adhesiveness decreases in malignant tumour cells, appearing as single cells or loosely
aached groups of cells.

Laboratory Techniques in Diagnostic Exfoliative Cytology
1221
rEvIEw quEstIons
1. Discuss the clinical signicance of cytological investigation.
2. What are the most commonly submied specimens for the study of exfoliative cytology?
3. How are the specimens prepared for microscopic examination?
4. What is the most commonly used xative for cytological studies?
5. What is a Pap smear? Describe the technique.
6. List some of the identifying characteristics of malignant cells.
7. What is the most commonly used xative for cytological specimens?
8. What is the dierence between Schaudinn’s uid and Carnoy’s uid? Discuss the
advantages of each of these xatives.
9. How are watery specimens concentrated prior to their microscopic observations?
10. How are cytological specimens mailed to the reference laboratories?

Basics of
39
Immuno histochemistry
Evolution of Tissue/Cellular Level Diagnostics
To begin with initial diagnosticians studied body uids and aspirates (cytology) which were easy to
obtain, subsequently it ascended to tissue diagnostics (histopathology). However, with further advances
it advanced to the molecular level with simultaneous interplay of immunology at a molecular level
(immunohistochemistry).
Introduction
The IHC technique is a combination of immunologic and chemical reactions visualised with a photonic
microscope. Immunohistochemistry (IHC) is used in histology to detect the presence of specic protein
markers that can assist with accurate tumour classication and diagnosis. Immunohistochemistry has
evolved to complement the Hematoxylin & Eosin (H&E) and special stain techniques that typically
show tissue morphology. Where H&E and special stains are nonspecic, IHC is directed to a specic
protein marker or markers. IHC is used as a diagnostic tool to assist in the diagnosis of solid tumours
and cytological specimens and has been used as a primary diagnostic tool.
The technique can be divided into three phases (Table 1). Phase 1 (preanalytical) starts with sample
procurement, followed by tissue xation, processing and embedding, and ending with tissue sectioning on a
microtome. Phase 2 (analytical) starts with deparafnation of tissue sections; includes preincubation steps
Table 39.1: Phases, steps and variables involved in immunohistochemistry
Phases Steps Variables
Preanalytical
phase
Analytical
phase
Sample procurement Delayed fixation, prolonged ischaemia, thickness of sample
Fixation Cross-linking vs coagulating fixatives, duration
Decalcification Type of decalcification solution and duration
Tissue processing Paraffin-embedded vs frozen tissues
Tissue sectioning Thickness of tissue section, drying temperature and
duration, tissue section ageing
Deparaffinisation Dewaxing agent
Antigen retrieval Detergents, enzymes, HIER
Blocking nonspecific
reactivities
Primary antibodies Monoclonal vs polyclonal, Ag recognition (native vs
Endogenous enzymes, hydrophobic binding, pigments
linear), specificity, species
Variability
1222
Contd.

Basics of Immuno histochemistryBasics of Immuno histochemistry
Table 39.1: Phases, steps and variables involved in immunohistochemistry (Contd.)
Phases Steps Variables
Detection system Avidin-biotin vs polymer-based systems, ultrasensitive
methods
Postanalytical
phase
Enzyme-substratechromogen
Counter stain Contrast between chromogen and counterstain
Control performance Animal species compatibility, tissue processing
Interpretation Pathologist vs automated evaluation
Report Percentage of positive cells, positive vs negative threshold,
Colour detection
stand-alone test vs ancillary test
Diagnostic, prognostic test
1223
(e.g. antigen retrieval, blocking of nonspecic activities), incubation with the primary antibody, and
labeling of the antigen-antibody reaction; and ends with slide counterstaining and mounting of the tissue
using a coverglass. Phase 3 (postanalytical) includes interpretation of results and generation of an IHC
report, after the evaluation of the IHC controls.
Preanalytical Phase of IHC
Fixation
Fixation refers to the chemical and physical processes by which cells and tissues are stabilised and
made ready for subsequent histopathological treatments such as slicing and staining. Fixation attenuates
postmortem autolysis as well as preserves lifelike morphology and optimises macromolecules for
histochemical and biochemical analyses. Fixation of tissues is necessary to (1) adequately preserve
cellular components, including soluble and structural proteins; (2) prevent autolysis and displacement
of cell constituents, including antigens and enzymes; (3) stabilise cellular materials against deleterious
effects of subsequent procedures; and (4) facilitate conventional staining and immunostaining. Chemical
xation is generally used for diagnostic IHC; the most common chemical xative is 10% neutral buffered
formalin (10% NBF). Formalin not only reacts with tissue molecules, creating cross-links that anchor
them in place, but also may render molecules inaccessible to antibodies used for immunohistochemical
staining, a blocking process that can be reversed by antigen retrieval methods.
Decalcification
Decalcication describes the technique for removing mineral from bone or other calcied tissue so
that good-quality parafn sections can be prepared that will preserve all the essential microscopic
elements. Decalcication is carried out after the specimen has been thoroughly xed and prior to routine
processing to parafn.
Strong acids such as hydrochloric or nitric acid at concentrations up to 10% are the most rapid in action
but if used for an excessive time will rapidly cause a loss of nuclear staining and can macerate tissues. It
is important that an appropriate end-point test is used to minimise exposure of the specimens to these
agents.
Weak acids such as formic acid are popular and are widely used for decalcication. Formic acid can
be used as a simple 10% aqueous solution or combined with formalin or with a buffer. Although it is
slower than the strong acid agents it is much gentler in action and less likely to interfere with nuclear
staining. Other acids such as trichloroacetic acid (TCA) have also been used. Picric acid, as a component
of some xatives has weak decalcifying properties.

1224
Medical Laboratory Technology: Volume 3
Chelating agents such as ethylenediaminetetra-acetic acid (EDTA), work by capturing the calcium
ions from the surface of the apatite crystal, slowly reducing its size. Because the process is very slow but
very gentle (weeks may be required depending on the size of the specimen), this reagent is not suitable for
urgent specimens but more appropriate for research applications where very high quality morphology is
required or particular molecular elements must be preserved for techniques such as IHC, FISH or PCR.
It is used at a concentration of approximately 14% as a neutralised solution. The rate at which EDTA will
decalcify is pH dependent. It is generally used at pH 7.0. It works more rapidly at pH 10 but some tissue
elements can be damaged at alkaline pH.
If high-quality results are to be obtained it is important to determine the point at which all the calcium
has been removed, because, from this point on, tissue damage seems to occur at an increasing rate. Overdecalcication, particularly with the strong acid decalciers, spoils the staining of basophilic elements
such as cell nuclei and in some circumstances can cause maceration of the softer tissue elements. On the
other hand specimens that are incompletely decalcied may be difcult or impossible to section.
Tissue Processing and Incubation Buffers
Once the tissue has been xed, it must be processed into a form in which it can be made into thin
microscopic sections. The usual way this is done is with parafn. Tissues embedded in parafn, which is
similar in density to tissue, can be sectioned at anywhere from 2 to 5 microns. The technique of getting
xed tissue into parafn is called tissue processing. The main steps in this process are dehydration,
clearing and impregnation. Wet xed tissues (in aqueous solutions) cannot be directly inltrated with
parafn. First, the water from the tissues must be removed by dehydration process. This is usually done
with a series of alcohols, say 70% to 95% to 100%. The next step is called “clearing” and consists of
removal of the dehydrant with a substance that will be miscible with the embedding medium (parafn
wax). The commonest clearing agent is xylene. Finally, the tissue is inltrated with the embedding
agent, almost always parafn wax. The above processes are almost always automated for the large
volumes of routine tissues processed. Automation consists of an instrument that moves the tissues
around through the various agents on a preset time scale. Tissues that come off the tissue processor are
still in the cassettes and must be manually put into the blocks by a technician who must pick the tissues
out of the cassette and pour molten parafn wax over them. This “embedding” process is very important,
because the tissues must be aligned, or oriented, properly in the block of parafn.
Although xation is paramount in the outcome of the antigen-antibody reaction, the incubation
buffer and tissue-processing solutions can also alter antigenicity. The combination of cross-linking
xatives with heat and the nonpolar solvents used in parafn embedding is thought to modify the
antigen conformation so that specic epitopes may not be recognised by antibodies that would recognise
those epitopes in frozen sections. Shifts in the tertiary structure of proteins (during processing) alter the
structure of protein so that hydrophoebic areas are oriented outward and hydrophilic regions inward
(hydrophoebic inversion) during dehydration and clearing steps, can reduce or abolish antibody binding
without anigen retrieval, especially with poorly stabilised (unxed or suboptimally xed in formalin)
tissues/proteins exposed to a weakly polar or nonpolar solvent. This negative effect varies with the
dehydrating and clearing agent used. There is also increased background reactivity in tissues left in
xylene for prolonged periods during processing.

Basics of Immuno histochemistryBasics of Immuno histochemistry
1225
Figure 39.1:
Formaldehydexationcanalterthe3-Dstructureoftheepitopecrosslinkages;whichisreversed
byhightemperatureheating
Tissue Sectioning
The tissue sections are cut from the FFPE blocks to a desired thickness using a microtome. As a rule of
thumb, the ideal thickness of the tissue should be between 2 and 4 micron for immunohistochemistry.
Sectioning tissues is a real art and takes much skill and practice. Histotechnologists are the artists of the
laboratory. It is important to have a properly xed and embedded block or much artifact can be introduced
in the sectioning. Common artifacts include tearing, ripping, “venetian blinds”, holes, folding, etc. Once
sections are cut, they are oated on a warm water bath that helps remove wrinkles. Then they are picked
up on a positively charged (slides that are coated with poly-L-lysine or organosilane or APES at different
concentrations) glass microscopic slide.
Adhesion of Oppositely Charged Surfaces
When immersed in an aqueous medium in the pH range 5 to 7, most tissues carry a net negative charge,
owing to a small excess of acidic over basic amino acids in the structural proteins. Majority of the issues
are composed largely of cellulose, which does not itself form ions but is impregnated with a variety of
weak acids, and these too confer an overall negative charge. Sections of almost any tissue can therefore
be expected to adhere well to a glass surface that has been treated in such a way as to make it positively
charged. The modication is usually accomplished either by coating the slide with a basic polymer or by
a chemical reaction that leaves amino groups linked by covalent bonds to the silicon atoms of the glass.
A frequently used basic polymer is polylysine or APES, in which every amino acid unit has an amino
side chain that is quite strongly basic. Its pKa is 10.53. This is the pH at which half the amino groups are
protonated. The side-chain of lysine has an unusually high pKa for an amino group and consequently
polylysine is positively charged even in moderately alkaline media. Polylysine is applied to slides as an
aqueous solution, which is then allowed to dry by evaporation.
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