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LABORATORY
SERVICES SECTIONS
The laboratory is designed to handle special needs through several
sections.
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CLINICAL
LABORATORIES:
CHEMISTRY
Made up of three divisions-- automated/routine, toxicology/special
chemistry and immunoassay-- this automated laboratory performs a wide
range of biochemical tests and screening profiles. Services include
drug monitoring and substance abuse detection. The laboratory conducts
fetal lung maturity, glycohemoglobin and sweat tests. A maternal alpha
fetoprotein (AFP) subsection specializes in the detection of fetal
abnormalities, employing a combination of AFP, HCG, and estriol screening.
ANDROLOGY
Dedicated to the evaluation of male fertility, this specialized
service is directed by a Board Certified Reproductive Endocrinologist.
The laboratory analyzes semen specimens for count, volume and viability
and assesses for genital infection and acrosomal morphology.
Using a hamster egg assay that mimics fertilization conditions, the
laboratory conducts antisperm antibody testing to determine whether
antibodies are interfering with sperm penetration of the cervical
mucus or ova. The laboratory also performs intrauterine insemination
(IUI) evaluation and processes semen to select sperm for IUI. Sperm
cytopreservation is also available.
CYTOGENETICS
The Cytogenetics Laboratory performs chromosome analyses on blood
lymphocytes, bone marrow cells, amniotic fluid cells, and skin fibroblasts.
The Lab can perform Fluorescent insitu hybridization (FISH) when routine
chromosome analyses are inconclusive. The laboratory is equipped
as a tissue culture facility and can establish shirt-term skin fibroblast
and amniotic fluid cell lines. A board certified cytogeneticist
directs the Cytogenetics Laboratory and is available for consultation
and interpretation of results. A clinical geneticist affiliate
with the laboratory specializes in genetic counseling and clinical
generic diagnosis.
BLOOD BANK
A fully accredited unit, the University Hospital blood bank is
particularly expert in pheresis. Autologous and directed donations
for inpatient and ambulatory surgery are accepted. A team of medical
experts evaluates difficult blood types, abnormal fibrinogens, use
of fibrin glue, and related conditions.
HEMATOLOGY
The Hematology and Coagulation laboratory provides state-of-the-art
testing for patients with a variety of blood disorders. Both
routine and highly specialized tests are performed. Routine
tests included complete blood counts, blood cell differentials, reticulocyte
counts, prothrombin times (PTT), and partial thromboplastin times
(PTT). The laboratory also performs more complex tests that
are often needed to evaluate patients with clotting problems.
For example, a platelet function analyzer (PFA-100) is now used to
rapidly screen patients for disorders of platelet function.
Platelet aggregation studies are also performed. Tests utilized
to diagnose bleeding disorders including clotting factor determinations
and various assays for von Willebrand disease (vWD) like ristocetin
cofactor activity and vWF antigen. Tests offered to evaluate
abnormal clotting include protein C and S antigen/activity, antithrombin
antigen/activity, and assays for lupus anticoagulants. The lab also
performs testing for platelet-specific and heparin-dependent antibodies.
The latter can cause a conditional call heparin-induced thrombocytopenia
(HIT), which may result in life-threatening clotting if it is not
recognized. Specialized testing for red blood cell disorders
included hemoglobin electrophoresis and osmotic fragility. Consultative
services are available to help determine the most appropriate tests
for patients with suspected hematologic disorders. An on-site
outpatient laboratory provides hematology testing for patients visiting
the hematology and oncology clinics.
IMMUNOLOGY
This premier laboratory specializes in the diagnosis of Lyme
Disease, utilizing such techniques as ELISA, Western blotting, and
cell mediated immunity assays. In support of University Hospital's
AIDS Center, it is also equipped with a modern flow cytometry unit
that provides both simple quantitative measurement of CD4/CD8 lymphocytes
in peripheral blood, as well as full panel assessment of complex lymphohematopoietic
disease in tissues or body fluids. The laboratory provides a full
gamut of immunoglobulin quantitations - immunofixation; ANA and specific
nuclear antigens; complement components by immunoassay; plus functional
testing, and related studies. It has the capability to perform a full
range of serologic studies for infectious and autoimmune diseases.
See the Immunology web site for further details. (http://www.path.sunysb.edu/labsvs/clinical_immunology.htm)
MICROBIOLOGY
A broad spectrum of testing services in aerobic/anerobic bacteriology,
parasitology, mycology, mycobacteriology, and virology are provided
by this lab. In addition to isolation, identification, and susceptibility
testing of microbial pathogens, tests for bacterial and cryptococcal
antigens are conducted. Clostridia difficile toxin, Chlamydia nucleic
acid, and malaria/babesiosis are routinely performed. In conjunction
with Special Histology, the laboratory probes tissue for organismal
RNA and DNA.
MOLECULAR GENETICS
This laboratory specializes in DNA testing for a variety of inherited
and acquired genetic conditions. Included among the diagnostic services
are prenatal and carrier testing for cystic fibrosis and diagnosis
of the fragile X syndrome. Referred cases may require blood sampling
of relevant family members and/or other documentation. Other services
include B and T cell gene rearrangements. The laboratory, which also
provides counseling services, is under the direction of a board certified
clinical geneticist.
ANATOMIC PATHOLOGY:
CYTOLOGY
This laboratory performs and interprets fine needle aspiration
of superficial masses in the thyroid, breast, and lymph nodes. Surface
marker analysis is available. Referred patients are usually accommodated
within a week, and in routine cases diagnoses are ready within 24
hours.
If physicians choose to perform their own aspirations in consultation
with the laboratory, slides, fixatives, mailers and forms are supplied.
To assist physicians in achieving optimal results, laboratory staff
is available for consultation on improving aspiration techniques.
The laboratory also provides routine gynecologic and non-gynecologic
cytology screening.
NEUROPATHOLOGY
Neuropathology staff specialize in the evaluation of nerve and
muscle biopsies. In addition to providing the traditional laboratory
services, selected studies range from histochemistry through immunohistology
to ultrastructural analysis. If requested, the section provides special
equipment and consultation to ensure the optimal processing of material.
SPECIAL HISTOLOGY
Adept in the use of immunocytochemical techniques and DNA/RNA
probes applied to tissue, this laboratory specializes in the diagnosis
of unusual tumors by immunologic techniques and encourages consultation
with a specially skilled pathologist. Capabilities range from routine
skin biopsies to renal biopsies and lymphocyte markers. The laboratory
routinely classifies leukemias and lymphomas using the broadest available
panels of accepted CD antigens and enzymes. If requested, same day
turnaround is provided for special serologic studies such as anti-neutrophil
cytoplasmic antigen (ANCA), used for the diagnosis of vasculitis and
anti-basement membrane antigen (Goodpasture's disease). Probes for
viral nucleic acid (in situ and in situ PCR hybridization) for CMV,
herpes, papilloma virus among others are available. Panels for melanoma,
germ cell tumors, mesothelioma, soft tissue neoplasms and steroid
receptors (used in carcinoma of the breast) are regularly performed.
PEDIATRIC PATHOLOGY
Directed by a certified Pediatric Pathologist, this laboratory
offer expert services and consultation in placental pathology and
routine pediatric pathology.
SURGICAL PATHOLOGY
The surgical laboratory handles diagnostic biopsies and monitors
the removal of diseased tissues. Pathologists with expertise
ranging from cancer of the prostate to inflammatory diseases of the
lung examine surgical material utilizing the latest techniques.
Specimens are analyzed by modalities ranging from traditional staining
to esoteric probes from nucleic acids (the constituents of RNA and
DNA). Great care and rapid reporting are the keynotes sounded
here. Services are available seven days a week, 24 hours each
day. Frozen sections on intraoperative cases are performed regularly
and consultation with our surgeons is always ongoing.
ULTRASCTRUCTURAL LABORATORY
The Ultrastructural Laboratory utilizes transmission, scanning,
and X-ray electron microscopy to reveal the structure of tissues at
the highest magnifications. Many tumors can only be categorized
by studying the innermost details of their cellular structure.
This area is staff by a highly experienced pathologist whose expertise
ranges from genetic errors to those resulting from environmental toxins.
The staff in this area uses special plastics to embed the tissue and
the sharpest bladed to cut extremely thin sections that can be examined
by beams of electrons. This occurs while the specimen is suspended
on metal grids in a vacuum. We can even identify molecular components
by using antibodies attached to tiny gold spheres that are easily
recognized in the electron beam. |
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