POSITION DUTIES: SUPERVISORY CONTROLS Works under the general supervision of the Chief of Immunodermatology, who provides general guidance on goals, priorities, and deadlines for work assignments. The 'Mohs' histopathology technician (the Mohs technician prepares frozen sections necessary for the rapid diagnosis of skin cancer during surgery) will be the immediate supervisor, and will provide any necessary training, and technical assistance as well as providing initial evaluation of any problems. Independently plans and carries out work assignments, selecting procedures required and making appropriate adjustments when needed. In addition to regular testing of controls, work is evaluated in terms of the adequacy of specimens interpreted by the Immunodermatologist. Guidelines include department policy, procedures, and safety manuals as well as articles and texts in the field of histology, immunology, immunofluorescence, and immunohistology. Guidelines include department policy, procedures, and safety manuals, as well as articles and texts in the field of histology, immunology, immunofluorescence, and immunohistology. The employee must use judgment in interpreting and adapting the procedures, especially for use with special stains, and in the selection of controls and corrective actions. MAJOR DUTIES Provides histopalology support in the Dermatology Clinic. Prepares tissue and serum for immunofluorescant staining. 1. Performs direct and indirect immunofluorescence testing (which utilizes a fluorescence microscope and reagent) on skin biopsies and serum Prepares and cuts frozen tissue sections of skin to stain with immunofluorescence conjugates for direct immunofluorescence. Spins down blood to serum to perform indirect immunofluorescence. Prepares split skin substates for testing. Prepares staining reagents to perform a variety of special staining techniques for immunofluorescence and histopathology procedures. Coverslips and labels completed tissue/serum slides for diagnoses. Performs difficult embedding techniques to ensure proper positioning of minute tissue specimens for freezing and cutting frozen sections. Maintain positive tissue and serum controls for these procedures. Assignments involve checking and processing specimens, programming and operating equipment, preparing reagents, correcting procedures, and investigating, adapting and implementing new processes and techniques. The employee evaluates tissue samples and considers the substance to be identified, the chemical or immunologic reaction involved, the microscopic examination and comparison of the control and specimens, and other similar factors. Assignments may require selecting alternate procedures or may require the development of procedures and techniques. 2. Receives all specimens submitted to the Immunofluorescence Laboratory in the Dermatology Clinic, logs them in, and store them appropriately until they can be processed. Performs special testing, including blister mapping, and split skin direct and indirect immunofluorescence testing as needed. Performs administrative functions as follows: labels and stores all submitted specimens, enters all appropriate data from submitted specimens, into a computer database, Faxes and mails completed immunofluorescence reports to the submitting physicians and institutions. Performs a variety of general support duties. Determines, organizes and maintains the immunofluorescence logbook. Organizes and maintains Kodachrome slide file of immunofluorescence cases. Prepares and transports reports and specimens to pathology for review. Organizes slides and biopsy reports in convenience charts. Maintains laboratory records as required by the College of American Pathologists. Physical demands require bending over the cryostat for long periods of time, and standing, walking, reaching, bending and sitting at a computer terminal. Lifting requirements are under 45 pounds. 3. Provides immunofluorescence testing for study protocols as needed. Contacts are with the Mohs histotechnician, the staff immunodermatologist, other dermatology clinic staff, and physicians and residents in the Department of Dermatology, Brooke Army Medical Center, as well as physicians submitting specimens to this department, throughout DOD. Contacts are to plan, schedule and coordinate work, to advise on special procedures, and to resolve problems in processing tissue. Also, to explain procedures for submitting specimens, and to give test results. Operates, programs, maintains, and troubleshoots a variety of equipment (e.g., cryostats, stainers, microtome, scales, microtome knife sharpener, and centrifuge). Conducts quality control procedures of equipment and reagents and maintains prior records. Utilizes a knowledge of accrediting/regulatory agency requirements for safety and quality control to insure adherence by the laboratory. Orders and maintains adequate stock levels of laboratory supplies, equipment and reagents. Evaluates new stains and provides recommendations to supervisor. Provides technical support to the Mohs histopathology technician. Prepares paraffin sections for the dermatopathologists for teaching sets. Demonstrates immunofluorescence and histological tissue preparation and staining techniques to the dermatology residents. Performs other duties as assigned.