Milestone PRESTO PRO Operator's Manual

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MILESTONE

HELPING PATIENTS

PRESTO PRO

Automatic processor/stainer for next generation frozen sections

Operator Manual - MM136

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PRESTO PRO MM136-002 – Operator Manual

Thank you for choosing one of our systems and welcome to the ever more crowded club of Milestone laboratory instrumentation users. We feel confident that you will be fully satisfied adding this new device to your laboratory. We recommend to ready carefully this operator manual and to always keep it within reach for convenient and quick referencing. For any clarification or request for assistance, please contact our representative in your country:

Or contact:

Milestone s.r.l. Via Fatebenefratelli, 1/5 24010 Sorisole (BG) Italy Tel. +39.035.412 8264 Fax +39.035.575498 web site www.milestonemed.com e-mail marketing@milestonemedsrl.com

Read carefully this manual before using the instrument.

MM136-002 – PRESTO PRO – Operator Manual 2018-11

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PRESTO PRO MM136-002 – Operator Manual

CONTENTS

CONTENTS ....................................................................................................................................................... 4

1. INTRODUCTION ........................................................................................................................................ 6

1.1. Symbols used .................................................................................................................................... 6

1.2. Designated uses ................................................................................................................................ 7

1.3. Technical specifications ..................................................................................................................... 7

1.3.1.

Touch control terminal ............................................................................................................... 7

1.4. Transport and storage conditions ...................................................................................................... 8

1.5. Warning information ........................................................................................................................... 9

1.6. Label ................................................................................................................................................ 10

1.7. Compatible reagents ........................................................................................................................ 10

1.8. Waste disposal ................................................................................................................................ 11

2. INSTALLATION ........................................................................................................................................ 12

2.1. Space requirements ......................................................................................................................... 12

2.2. Unpacking and check list ................................................................................................................. 13

2.3. Fume extraction system ................................................................................................................... 16

2.4. Water fitting ...................................................................................................................................... 17

2.4.1.

Water drain .............................................................................................................................. 18

2.5. Electrical installation ........................................................................................................................ 19

2.5.1.

Power supply ........................................................................................................................... 19

2.6. Final placement ............................................................................................................................... 20

2.7. General description .......................................................................................................................... 20

2.7.1.

Remove or place the reagent cover disc ................................................................................. 21

2.7.2.

Add protection labels to the disc covering the reagents .......................................................... 22

2.7.3.

Cover of the second loading position ...................................................................................... 22

2.7.4.

Loading positions of the racks on the arm of the PRESTO PRO ............................................ 23

2.7.5.

Remove or replace the caps to the reagent vessels ............................................................... 23

2.7.6.

Remove or place the tray of reagent vessels .......................................................................... 24

2.7.7.

Reagent positions inside PRESTO PRO ................................................................................. 25

2.7.8.

Connect the barcode reader .................................................................................................... 26

2.7.9.

Rear panel ............................................................................................................................... 27

2.8. Remote alarm connection ................................................................................................................ 28

2.9. Reagents.......................................................................................................................................... 28

2.10. Accessing and exiting the system ................................................................................................... 29

2.11. Create a new user ........................................................................................................................... 30

2.12. Changing the language .................................................................................................................... 32

2.13. Set Date and Time ........................................................................................................................... 33

2.14. Fill the FineFIX reagent in the PRESTO PRO ................................................................................. 33

2.14.1. Load the consumable changes ................................................................................................ 33

2.14.2. Sequence of software activation .............................................................................................. 34

2.15. Load the reagents in the PRESTO PRO vessels ............................................................................ 35

2.15.1. Labels ...................................................................................................................................... 35

2.15.2. Load fixation, staining and cleaning reagents in the PRESTO PRO ....................................... 36

2.15.3. FineFIX heating settings .......................................................................................................... 40

2.16. Most used programs ........................................................................................................................ 42

2.17. Owner Settings ................................................................................................................................ 44

3. USE PRESTO PRO.................................................................................................................................. 46

3.1. Loading slides in the rack ................................................................................................................ 46

3.2. Run a program ................................................................................................................................. 46

3.2.1.

Run a favourite standard protocol............................................................................................ 48

3.2.2.

Run a favourite “Continuous” protocol ..................................................................................... 51

3.2.3.

Press the start button to run a standard protocol .................................................................... 57

3.2.4.

Press the start button to run a “Continuous” protocol .............................................................. 59

3.3. Editing a program ............................................................................................................................ 60

3.3.1.

Modify a standard protocol ...................................................................................................... 60

3.3.2.

Modify a “Continuous” protocol ................................................................................................ 62

3.3.3.

Modify the temperature of the fixation reagent ........................................................................ 63

4. REAGENT MANAGEMENT ..................................................................................................................... 64

4.1. Use of FineFIX ................................................................................................................................. 64

4.2. Reuse of reagents ........................................................................................................................... 66

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4.3. Setting the configuration of reagents ............................................................................................... 68

4.4. Edit reagents list .............................................................................................................................. 69

5. SAFETY PROCEDURE ........................................................................................................................... 70

5.1. Water error ....................................................................................................................................... 70

5.2. Arm position lost error ...................................................................................................................... 73

6. MAINTENANCE ....................................................................................................................................... 76

6.1. Introduction ...................................................................................................................................... 76

6.2. Before/after every process ............................................................................................................... 76

6.3. Daily ................................................................................................................................................. 77

6.4. Weekly ............................................................................................................................................. 77

6.5. Yearly ............................................................................................................................................... 77

7. DECONTAMINATION AND CLEANING .................................................................................................. 78

7.1. Safety precautions ........................................................................................................................... 78

7.2. Procedure for PRESTO PRO decontamination and cleaning ......................................................... 78

7.2.1.

Detergents ............................................................................................................................... 78

7.2.2.

Procedure ................................................................................................................................ 79

8. REPORTING ............................................................................................................................................ 81

8.1. Exporting saved process data ......................................................................................................... 81

8.1.1.

How to delete a saved process................................................................................................ 82

8.2. Exporting the events log .................................................................................................................. 83

9. OPTIONALS ............................................................................................................................................. 84

9.1. External exhaust fume filter kit (Code 61550/F) .............................................................................. 84

9.2. FineFIX tanks ................................................................................................................................... 84

Appendix – Hints and tips .................................................................................................................... 85

A.1. Fatty tissues ..................................................................................................................................... 85

A.2. Tips to modify the staining protocol ................................................................................................. 85

Appendix – Alarm management .......................................................................................................... 86

B.1. Alarm management ......................................................................................................................... 86

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1. INTRODUCTION

1.1. Symbols used

The instructions marked with this symbol are important and must be read carefully.

An instruction accompanied by this WARNING symbol means you need to proceed with caution. Failure to follow the instruction may endanger the user or cause damage to the device.

When an instruction features this symbol, great care is required as there is the risk of an electric shock. Carefully follow the instruction in order to avoid this kind of accident.

Biohazard: pay attention when performing a procedure marked with this symbol, as there is a biological contamination hazard.

Pay attention: parts identified with this symbol are areas at risk of crushing hand and or fingers.

Surfaces identified by this symbol feature a high temperature hazard.

Inflammable material.

CE Logo: this instrument complies with European Community directives.

IVD medical device according to directive 98/79/EC.

Symbol of the European WEEE directive (2002/96/EC): electric/electronic material – do not disperse in the environment.

Fragile

Manufacturer.

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1.2. Designated uses

Milestone PRESTO PRO and its optional parts have been designed for laboratory use and are therefore able to withstand the harshest lab conditions. They have been developed for continuous use in procedures for fixation, processing and staining of specimens for extemporaneous diagnoses in a quick, reliable and standardized manner.

Milestone PRESTO PRO must solely be used with the reagents listed in the “Compatible reagents” chapter, refer to chapter 1.7.

Any other use of the instrument should be deemed as misuse and voids the manufacturer's warranty.

1.3. Technical specifications

REF 100300: PRESTO PRO 230V~ 50/60Hz 180W REF 100301: PRESTO PRO 115V~ 60Hz 180W

Productivity: 120 slides per hour 194 slides per hour with loading “Continuous” Rack capacity: 6 slides Number of stations: 10 Reagent vessel volume: 200ml Operating Temperature: 18°C – 30°C (64.4°F – 86°F) Humidity (relative): up to 80% non-condensing Maximum altitude: 2000m (6561ft) Air intake flow interval: 35-45m3/h (cubic meters per hour). Weight: 42Kg (92lb)

The instrument is intended for laboratory use (indoor use) only.

1.3.1. Touch control terminal

The following picture shows the Touch Control Terminal of the PRESTO PRO unit. It is possible to operate the unit simply by touching the icons on the screen.

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Two USB ports are at the sides of the Touch Terminal.

When the USB ports are not used, it is required to leave the port protection on, as shown in the picture above.

Characteristics: TFT-LCD 7” widescreen color display Resolution 800X480, Resistive Touchscreen Mass storage 4GB CPU 1GHz Windows™ Embedded Compact 7 Programs: Pre-stored and customizable user defined programs. I/O-Interface: 2x USB ports 2.0, 1x LAN Ethernet 10/100 Mbps RJ-45.

The manufacturer reserves the right to change and/or improve the specifications with no prior notice and without incurring any obligation.

1.4. Transport and storage conditions

Temperature: –20°C up to +60°C (-4°F up to 140°F) Humidity: up to 80% (up to 50% at 40°C) (104°F) non-condensing.

Before switching on PRESTO PRO (when coming from a storage chamber), allow the instrument to reach operating environment conditions (at least half an hour).

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It is important that normal standards for safety and good laboratory practices are

1.5. Warning information

Any use of the instrument other than specified forfeits the warranty provided by the manufacturer.

PERSONAL DATA The Device described herein is not intended for managing personal data of natural persons. Personal data of natural persons shall not be inserted into the Device during the use of the Device. The organization that uses the Device shall implement appropriate measures to ensure that no personal data of natural persons are inserted into the Device. All the data referred to a person and inserted into the device shall use, at least, the pseudonymization, in such a manner that the personal data can no longer be attributed to a specific data subject without the use of additional information, provided that such additional information is kept separately and is subject to technical and organizational measures to ensure that the personal data are not attributed to an identified or identifiable natural person.

The main power supply plug is to be considered as disconnect device. Disconnect all plugs from the power outlet before assembling the system, before connecting optional parts (if any) and before cleaning it.

The equipment must be connected to well visible sockets and accessible by the operator.

The instrument is supplied with replaceable fuses, but their replacement must be effected by trained and authorized SERVICE personnel. If the system is still not properly working, please contact the local authorized and trained SERVICE representative or the manufacturer.

All parts of the equipment and its optional parts shall be supplied only by the manufacturer.

DO NOT OPEN THE UNIT'S BODY. Failure to comply with the instructions in the documentation might lead to a reduction in the device's safety. Should the equipment not work correctly you are kindly requested to contact the supplier or manufacturer.

Do not remove the instrument, optional parts, panels or cover. Only authorized and qualified personnel may repair and access the instrument's internal components.

applied. Always use common sense and the best-known laboratory practice when operating the instrument.

The Competent Authority who owns the instrument has the primary responsibility for incidents due to operations on the instrument without attending personnel in charge of use or repairs.

Only use the reagents listed in chapter 1.7 “Compatible reagents”, to avoid damage to the instrument. Failure to follow the instructions might lead to decreased device safety.

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PRESTO PRO MM136-002 – Operator Manual

Fixative

Staining

Cleaning

1.6. Label

MILESTONE SRL

Via Fatebenefratelli, 1/5 – 24010 Sorisole (BG) – ITALY

Tel. +39.035.4128264 Fax. +39.035.575498

PRESTO PRO

REF 100300

SERIAL NUMBER (SN)

INPUT

MANUFACTURED:

For an explanation of symbols see chapter 1.1.

1.7. Compatible reagents

reagents

Milestone

FineFIX

Limonene

Reagents

Haematoxylin

Eosin

Reagents

Ethanol >99.9%

(Ethanol)

Acetic Acid 2% in

water

(Acetic Acid 2%)

Xylene

(Xylene)

Isoparaffin

(Isoparaffin,

MileGREEN)

Isopropanol

(Isopropanol)

DO NOT USE REAGENTS OTHER THAN THOSE LISTED ABOVE. In case of doubts please contact: application@milestonemedsrl.com.

DO NOT USE HYDROCHLORIC ACID in any concentration.

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Handle with care and st

ore in a cool dry space using a tightly closed container.

1.8. Waste disposal

This instrument is a medical in-vitro device and is usually installed in a laboratory where are specimens and other biological tissue. For your safety, it is therefore required to clean and disinfect the instrument prior to coming into contact with it. It is also required to wear gloves when operating the system. In the event this instrument should be returned to Milestone S.r.l., it is required to clean and disinfect the unit before shipping it. Non-disinfected devices shall not be accepted and you will be contacted to pay the relative disinfection costs. International health standards require shipments of biological hazard material to be effected in standard containers (risk of sanctions).

Do not remove the frame panels of the unit during cleaning operations.

Disconnect the power supply before any operation. Do not use direct or high-pressure water to clean the unit.

For safety reason, any operation without the personal protective equipment must be avoided.

It is recommended to use polyphenolic based disinfectants to clean and disinfect the instrument. For further information, please contact the manufacturer: application@milestonemedsrl.com.

Complying with directive 2012/19/EC of the European Parliament and of the Council of 4 July 2012 on waste electrical and electronic equipment (WEEE), the separate collection environmental managed of equipment is mandatory. It is necessary to return the used equipment to the distributor or to inquire about the presence of a local empowered system for collection and disposal of WEEE. The in-observance of Directive 2012/19/EC or of the local law which acknowledge it can have potential effects on the environment and human health.

This symbol indicates separate collection

for electrical and electronic materials

If additional requirements on accident prevention and environmental protection exist in the country of operation, this instruction manual must be supplemented by appropriate instructions to ensure compliance to such requirements.

Waste disposal of the reagents

Vapours may collect in empty containers. We therefore recommend treating empty containers as hazardous waste. Waste material should be disposed of in an approved incinerator or in a designated landfill site, in compliance with all provincial and local government regulation. Certain reagents may have effects on health and cause environmental pollution.

For further information please refer to the SDS (Safety Data Sheet) provided by your supplier.

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20cm

44cm

50cm

2. INSTALLATION

Milestone PRESTO PRO is an instrument that requires the utmost attention when unpacked and installed.

Arrange a bench at least 84cm (33in) wide and 70cm (27.5in) deep able to withstand the weight of PRESTO PRO which is 42Kg (92.5 lbs). Then place PRESTO PRO on the bench, ensuring the unit is level and the table is not flammable and vibration proof. Ensure the instrument is positioned away from heat sources or from direct sunlight. Finally, ensure the box collecting excess reagents is in the proper position.

Ensure the unit is not placed against any side surface thus restricting intake/outlet cooling air: leave at least a 20cm (7.9in) distance on each side.

Maximum height 860 mm

Height 610 mm

Width 440mm Depth 525mm

2.1. Space requirements

PRESTO PRO is shipped in a wooden case with the following dimensions:

Width: 580mm (23in) Height: 1000mm (39.4in) Depth: 1050mm (41.3in)

Unit dimensions:

Width: 440mm (17.3in) Height: 610mm (24in) Depth 525mm (20.7in)

Dimensions of the space required to place the unit

Width: 840mm (33in) Height: 900mm (35.4in) Depth: 725mm (28.5in)

The MINIMUM depth required for the bench is 725mm (28.5in).

PRESTO PRO is a heavy instrument. Ensure the bench can withstand it.

At least two people are necessary to move and unpack the instrument.

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PRESTO PRO MM136-002 – Operator Manual

2.2. Unpacking and check list

On opening the package ensure all parts are present by checking the list attached with the shipment. The utmost attention must be paid during PRESTO PRO unpacking to prevent scratches or damage to the body.

The PRESTO PRO system (REF 100300 and REF 100301) includes the following components:

• Qty.1 Main power supply cable (Code 50036 for 230V version)

• Q.ty. 1 Exhaust tube with 2 metal clamps (Code 61410)

• Qty. 1 20µm water filter (Code 100180L) with two G 1/2’’ connectors (Code 68278)

• Qty. 2 Water pipe 2m (Code 68309)

• Qty. 3 Electro-polished steel rack for 6 slides (Code 100177)

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Code

100323

Code 100212

• Qty. 10 Steel reagent container (Code 100197). Eight containers are labelled and designated for the

positions in the PRESTO PRO. The other two are for transporting the slides from the cryostat and the stained ones to their place of assembly.

• Qty. 1 Aluminum vessel for heated reagents (Code 100344)

• Qty. 1 Reagent container cover disc (Code 100375)

Consisting of:

10 protective polyester discs (

Cover of the second position (

)

• Qty. 1 Safety screw of the reagent container cover disc (Code 100348)

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PRESTO PRO MM136-002 – Operator Manual

• Qty. 1 Tray for vessels (Code 100367)

• Qty. 1 Kit reagent labels (Code 100356)

White labels for customization of reagents

• Qty.1 Magnetic pen to work with the touch screen terminal (Code 50597/M)

• Qty.1 Operation manual in electronic form

• Q.ty 1 Linear barcode reader (Code 370059)

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PRESTO PRO MM136-002 – Operator Manual

2.3. Fume extraction system

PRESTO PRO is ventilated through the external exhaust outlet located at the rear of the instrument, with a pipe connected to the fume extraction system (if any).

The external fume extraction system must be properly installed at all times, according to local regulations in force on laboratory safety.

The customer is required to adapt the hose connector. The plastic hose supplied has these specifications:

• Length: 3m

• Outer diameter: 69mm

• Inner diameter: 60mm

The external fume extraction system must assure an air flow of 40m3/h (cubic meter per hour).

There is no filter on the fume extraction system of the unit.

it is possible to connect an external exhaust fume extraction kit (Code 61550/F), please refer to chapter 9.1.

Connect the exhaust tube (Code 61377) to the appropriate outlet on the back panel.

Use the metal strap to fasten the pipe to the fume exhaust duct. (Code 50051).

Now connect the other end of tube to the fume extractor of the laboratory.

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PRESTO PRO MM136-002 – Operator Manual

It is mandatory to install the water filter between the tap and the

water inlet in the PRESTO

2.4. Water fitting

The PRESTO PRO unit is to be connected to the water system in order to work properly. On the back of the unit are the ports for water inlet (left) and drain (right), pictured below.

Connect the (cold) water pipe to the water inlet at the rear of the unit. Gradually open the water "supply". Connect the drain pipe to the water outlet at the rear of the unit.

PRO. The filter prevents the formation of limestone and dirt in the water system of PRESTO PRO. The filter fittings are G 1/2’’.

In order to simplify the replacement of the filter cartridges, it is important to have a tap upstream of the filter, as pictured below.

Milestone recommends working in cooperation with the hospital’s clinical engineering department when installing the water system of PRESTO PRO.

Water connections:

Water inlet: connection for a 17mm pipe (with G 1/2’’ fitting) Water outlet: connection for a 17mm pipe (with G 1/2’’ fitting)

The minimum difference in height between the water outlet and the water system is at least 50cm (19.7in), otherwise the system does not drain water properly.

Ensure the drain pipe has a slope of approximately 10cm (4in) for every meter. Incoming water pressure: maximum 2bar, minimum 1bar

Milestone recommends using a water softener.

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PRESTO PRO MM136-002 – Operator Manual

2.4.1. Water drain

The drain water is polluted with the reagents in which the rack is dipped before rinsing. The amount of reagent that a fully loaded rack (6 slides) takes in is about 1 – 1.5ml. Therefore, the drain water of a standard process, with water flow duration 30 seconds, contains about 1.5ml FineFIX, haematoxylin and 2% acetic acid. In other words, the concentration of these substances in the drain water is about 0.075% FineFIX and haematoxylin and 0.0015% of acetic acid.

The waste water may contain pathogens and must be connected according to local regulations.

In the interest of safety, the operator must be present throughout the entire process.

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PRESTO PRO MM136-002 – Operator Manual

Before connecting the plug to the laboratory’s socket, check that the power supply voltage

2.5. Electrical installation

2.5.1. Power supply

The power supply line needs to be grounded. The earthing connection of the power supply socket must be designated and come directly from the electrical distribution board of the laboratory.

Carefully ascertain that:

• There is an earthed connection in the laboratory. Do not connect Milestone units without earthing

connection.

• The power cords (size and distance from the electric board) are compliant with the label on the back

of the unit.

• The socket is visible and accessible.

The power supply line needs to be grounded (Class I device). Power line protection: 115V version: Miniature circuit breaker curve C, 15A, residual current device: 30mA. 230V version: Miniature circuit breaker curve C, 10A, residual current device: 30mA.

A power cord is supplied with Schuko plug.

of the unit matches the power supply line of the laboratory. Damage occurs if the instrument is supplied with incorrect power supply.

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PRESTO PRO MM136-002 – Operator Manual

2.6. Final placement

The PRESTO PRO unit may now be placed in its final position of use. Ensure the unit is level.

Then connect: The main power supply cable to the power plug located at the rear of the unit, then plug the power supply cable into the socket. Now it is possible to switch PRESTO PRO on.

2.7. General description

1. Work area cover

2. Intake

3. Disc covering the reagents

4. Reagent vessels

5. Tray of the reagent vessels

6. Touch screen terminal

7. USB ports

8. Main power switch

9. Collecting tray (Code 100360) BEA

1. Arm with rack supports

2. Standard rack position (BLUE)

3. Secondary rack position (YELLOW)

4. Reagent containers

5. Water container

6. FineFIX Container

7. Tray of the reagent containers

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PRESTO PRO MM136-002 – Operator Manual

2.7.1. Remove or place the reagent cover disc

Removal of the reagent cover disc is required for reagent change operations and for PRESTO PRO cleaning and maintenance.

To remove the disc, move the safety screw of the covering disc to the front, moving the arm of the standard position (BLUE) back (see section 2.7.7). In case of filling or changing the reagents or for cleaning PRESTO PRO press the icon of the reagent management page: the software automatically moves the arm in that position (see chapter 2.15).

At this point, loosen the screw and lift the rack support, which allows the covering disc to be extracted as it is connected to it. Pay attention not to hit the reagent vessels.

Upon completing the operations that required disc removal, always place it back in position.

Always place the disc back in position to prevent excessive evaporation of the reagents and preserve their cleanliness.

To put the covering disc back in position, place it on the central piston so that the standard position (BLUE) is at the back; the hole for the safety screw is visible and the hole engages to the base of the arm. The hole in fact has a semicircular shape with one straight side, which must be positioned in front of the operator. Place the safety screw and tighten it, while holding the rack support steady.

Always tighten the safety screw completely.

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PRESTO PRO MM136-002 – Operator Manual

2.7.2. Add protection labels to the disc covering the reagents

The cover disc is in direct contact with the reagents and in some cases, it needs greater protection. Some vinyl labels are supplied together with the reagent cover disc, which make the disc more resistant once they are applied. Milestone recommends to reinforce the protection disc in the positions where the following reagents are:

• acids

• alcohol solvents (ethanol, isopropanol)

• xylene and xylene substitutes (isoparaffin, limonene)

For further information, please contact: application@milestonemedsrl.com.

Underneath the disc there are slots to indicate the position for the protection labels. Turn the cover disc over and apply the label in the appropriate position, following the guide markings.

2.7.3. Cover of the second loading position

The reagent covering disc has a hole at the secondary loading position (marked in yellow) so that it can be used. This hole can be closed when the protocols are not used continuously, in order to reduce evaporation of the reagents. Remove the reagent covering disc and, while holding the arm raised, place the cover on the hole and push it downwards until the hole is completely covered.

Remove the cap to use the second loading position (yellow).

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PRESTO PRO MM136-002 – Operator Manual

Secondary

Standard

2.7.4. Loading positions of the racks on the arm of the PRESTO PRO

The arm of the PRESTO PRO has two loading positions for racks: The standard loading position: it is the position used for all the standard protocols and for all the odd numbered cycles of the “Continuous” protocols, and is marked in blue The secondary loading position: it is the position used only for even numbered cycles (from the second cycle onwards) of the “Continuous” protocols, and is marked in yellow.

This manual refers to the standard loading position, in blue, unless specified otherwise.

loading position

2.7.5. Remove or replace the caps to the reagent vessels

The reagent vessels are fitted with a cap that prevents evaporation and oxidation of the reagents. The caps must be removed before any process and it is suggested to place them back after using PRESTO PRO if it is not going to be used for a long time (more than 24 hours).

Remove the cap while holding the vessel steady and with a slow and gentle movement to prevent the vessel from moving and spilling the reagent. After removing the cap clean it from any trace of reagent and set it aside (for instance, in the space behind the reagent vessel tray).

Place the cap back while holding the container and with a slow and gentle motion paying attention not to spill out the reagent in the vessel.

It is possible to apply a label with the number on the cap, so as to always use the same cap for each vessel. Use the Kit of reagent labels (Code 100356).

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PRESTO PRO MM136-002 – Operator Manual

2.7.6. Remove or place the tray of reagent vessels

The support disc of the vessels is required for correct positioning of the reagent vessels. To remove the support disc (for the purpose of cleaning), remove the reagent protection disc (refer to chapter

2.7.1) and all the reagent containers (do not remove the container in position 3 which is for water). It is required to bring the PRESTO PRO arm to lower position, preferably in the 5DOWN position with arm turned backwards (see section 2.7.7). Press the icon of the reagent management page: the software automatically moves the arm in that position (see chapter 2.15). Lift the support disc and extract it from the water container and the housing for the fixative container.

Remove the support disc without fitted vessels.

To replace the support disc, insert its central hole in the arm shaft, turn the disc so that the number 10 on the disc label is in front of the operator and the metal water glass and support for the FineFIX container go through the side holes.

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2.7.7. Reagent positions inside PRESTO PRO

The slide rack support may make two movements:

• circular motion to move the rack in one of the 10 reagent positions

• vertical motion to lift the rack for moving from one reagent and lower it for dipping in another. In every

position, the vertical movement also allows to perform:

- dripping to move the rack up and down in the reagent, so as to stir the reagent and achieve better contact between specimen and reagent.

- dipping to shake the rack in order to remove excess reagent from the slide (this function is recommended after staining reagents).

There are 10 positions inside the PRESTO PRO and they are numbered clockwise:

• Position 10: position immediately in front of the operator. It may be:

- 10UP, PRESTO PRO reset position

- 10DOWN, standby position where the cover disc closes the reagent vessels to prevent evaporation.

• Position 1 In this position the reagent vessel is designated for FineFIX for specimen processing. This

is the only heated position of PRESTO PRO. Position 1DOWN with arm lowered is the loading position of the rack at the start of a process.

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PRESTO PRO MM136-002 – Operator Manual

• Position 3: This position is fixed and designated for the rinse water reagent, the flow of which is

regulated automatically.

• Position 5DOWN Position taken for reagent change that assures simple removal of the cover disc.

• Positions 2, 4, 5, 6, 7, 8, 9 and 10: these positions are designated for the staining and cleaning

reagents. The reagents set by default in these positions are those used in the default HIGH QUALITY program recommended by Milestone (refer to chapter 3.2). The reagents in these positions are not fixed and may be set by the user, refer to chapter 4.3 Setting the configuration of reagents .

2.7.8. Connect the barcode reader

Connect the reader’s USB to one of the USB ports on the right side of PRESTO PRO.

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PRESTO PRO MM136-002 – Operator Manual

2.7.9. Rear panel

The following are found on the PRESTO PRO rear panel:

1. Connection to the fume extraction system

2. External alarms connector

3. Ethernet/LAN connection

4. General fuses

5. Spare fuses

6. Power plug

7. Label with serial number

8. Water inlet/outlet connections

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Reagent REQUIRED for operation: FineFIX Concentrate (5L tank: REF: 70148 or 10L

Please refer to manual MM029 for proper usage and dilution of FineFIX.

Handle reagents with care and store in a cold dry space using a tightly closed container.

2.8. Remote alarm connection

PRESTO PRO is also fitted with connection for external alarm devices.

Output Contact Status

1. Identifies the alarm status of the PRESTO PRO …

2. External pump command, 24Vdc 1A max output

Output 2, for the external pump, can be used only for demonstration purposes. It is strictly forbidden to use the contact for auxiliary pumps during operation with histological samples.

For safety reasons and to prevent damages to the internal relays, the voltage of the external devices that are connected to PRESTO PRO must be lower than 24 VDC - 1A.

See also the equipment's label which provides some important information. Always provide the unit's serial number to Customer Support.

1 Normally OPEN 2 COMMON alarm

7 +0Vdc 1A max Pump 8 +24Vdc 1A max Pump

2.9. Reagents

Complete the set up with reagents, by providing at least:

FIXATION/PROCESSING REAGENTS:

• 200mL of diluted FineFIX

tank: REF: 70149) is not included in the unit, to be ordered apart.

STAINING REAGENTS:

• 200mL Hematoxylin

• 200mL Eosin

CLEANING REAGENTS:

• 200mL of Isopropanol

• 200mL 2% Acetic Acid in water

• 400mL 100% Ethanol (2 vessels).

The above reagents must be on site and available at the time of unit installation.

Vapours may build up in the vessels. Treat empty vessels as hazardous. Waste reagents are to be disposed of in suitable incinerators, in compliance with all local, regional and state laws. For further information please refer to the SDS (Safety Data Sheet) provided by the reagent’s supplier.

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2.10. Accessing and exiting the system

When the System is switched on, the LOG IN screen is displayed by default. Press the “Admin” button, enter the password (published in the separate document inserted in the Operation Manual) and press “Enter”.

THE MAIN ADMINISTRATOR PAGE is displayed which shows the MAIN FUNCTIONS.

In any screen, press the HOME button to go back to the MAIN PAGE. The MAIN PAGE may be customized in the USERS settings, choosing from FAVOURITE and MAIN FUNCTIONS (see chapter 2.11).

Log-in as SERVICE is only available for authorized persons. SERVICE has full access to all functions.

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2.11. Create a new user

Access the “Settings” screen by pressing the icon which is in the status bar on the left, then in the new screen select “Users” to create a NEW USER.

The USERS setting screen is displayed, as shown below. Click on Add, a keyboard appears. Enter the NEW USER name and press “Enter”.

Now select and configure the parameters of the NEW USER choosing the:

• CATEGORY.

• USER PASSWORD: click on the password box, a number pad appears as shown below, enter the

password (max 6 digits and minimum 1) and confirm.

• USER CONFIGURATION: select the control box “Set ‘Favourites’ as Home Page” in order to have the

FAVOURITE PROGRAMS set as the new user's main page.

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Ask p

assword for processing

Ask password for reagent replace

Now select the appropriate FUNCTIONS for the NEW USER:

WHEN MARKED the new USER can:

Create and edit programs

Replace waste reagents

Set reagent position, open the list of reagents and edit reagents details

By pressing the arrow (see picture below) it is possible to choose the appropriate ACCESS LEVEL upon program start “Ask for USER and PASSWORD” or “Automatically login as ADMINISTRATOR”. The following screen is displayed:

Select:

procedure

The software recognizes who starts the program (through password). The software recognizes who is performing the reagent replace procedure (through password).

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2.12. Changing the language

From the HOME PAGE, go to the “Settings” screen and select “Language” (see figure below).

Choose the required language from the drop down menu then press OK and Yes below the message displayed and the system automatically reboots to enable the changes.

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2.13. Set Date and Time

Access the “Settings” screen from the MAIN PAGE by pressing the icon which is on the status bar on the left, then in the new screen select “Date/Time”.

In the time setting window, it is possible to set the Time Zone, thus activating the automatic time update throughout the year.

2.14. Fill the FineFIX reagent in the PRESTO PRO

2.14.1. Load the consumable changes

On each container of FineFIX there is a barcode to enable the use of PRESTO PRO and for counting the reagent changes. The barcode of a FineFIX 5L container (REF 70148) fills about 100 changes. The barcode of a FineFIX 10L container (REF 70149) fills about 200 changes. The amount of diluted FineFIX obtained with these containers is higher than required to perform the number of changes loaded. The FineFIX that can be prepared in excess is intended for maintenance of wet slides, up to loading in the PRESTO PRO, please refer to chapter 3.1.

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2.14.2. Sequence of software activation

Select the icon “FineFIX code”

Select “Recharge FineFIX loads”

These icons are on the FineFIX heater page.

Insert the FineFIX barcode with the reader or manually (in this case press ENTER)

The “FineFIX Heater” page indicates the available number of loads. It is now possible to load the code of another container of FineFIX or fill in the vessel in position 1 of the PRESTO PRO with the reagent, please refer to next chapter.

The software accepts each code once.

There is a warning threshold in the “Owner settings” section (chapter 2.17), by default it is 10 loads. When the available loads fall below this threshold, the reagents icon shows a yellow symbol, which indicates that it will be shortly required to load another code.

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2.15. Load the reagents in the PRESTO PRO vessels

Follow the procedures below to load the PRESTO PRO with the staining reagents.

2.15.1. Labels

Each glass has two labels:

1. POSITION NUMBER

2. REAGENT NAME

Eight glasses already have the label with numbers up to 10, except for number 1 as this position is for the aluminum container for the heated reagent, and number 3 as the container in this position is fixed and intended for flushing water. Place the label with the reagent name on the numbered glasses based on the configuration required for staining, see section 2.7.7. The picture below shows an example of the rinsing ethanol in position 6. Some white labels are available for customization of reagents (see chapter 2.2).

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2.15.2. Load fixation, staining and cleaning reagents in the PRESTO PRO

Select “Reagents” from the MAIN FUNCTIONS screen. The slide rack support goes into position 5DOWN (see chapter 2.7.7), and the reagent in vessels management screen is displayed (picture below right). Reagents of the vessels loaded in the PRESTO PRO are divided into three categories, for diversified management of reagents:

1. FIXATIVE

Milestone recommends the use of FineFIX as fixation reagent to achieve better quality results. Thanks to its special composition, FineFIX fixates, dehydrates and clears the sample. FineFIX is a concentrated reagent that is to be diluted in ethanol for use.

Please refer to manual MM029 for preparation of FineFIX to the work dilution and its usage.

To replace/load the fixation reagents select the Fixative section (blue circle in the picture below). Tap the “Replace fixative reagents” box to open the reagent change page and update the date and clear the number of cycles made by the fixative reagents.

Open the lid and remove the reagents cover disc, refer to chapter 2.7.1

Then remove the fixation reagents vessels. The software indicates the positions and short name of the glasses containing the fixation reagents and shows a diagram of reagents configuration. Glasses have labels with the position number and name of the reagent that help not to mix them up. In the procedure to replace reagents, after emptying the glasses, it is advisable to clean them with paper in order to remove any precipitate.

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he inside of the vessel has two etched lines, which indicate the MAX and MIN level (see

Add 160mL of reagent in the vessel and slowly and carefully place it back in the position indicated by the software (position 1).

photo below). Keeping the reagents within the two levels assures proper staining of specimens. Milestone recommends keeping the fixation and staining reagents level to the minimum and the cleaning reagents to the maximum.

The vessel is to be placed inside the heating housing for the fixation reagent.

At the end of the procedure press the icon to go back to the reagent management page. The fixation reagent is to be heated and brought to the operating temperature. If the heater is on, the following message is displayed, asking to wait 5 minutes for the reagent to be ready before starting a process:

Press OK to complete the procedure. At this point, the date and number of cycles performed by the fixation reagents are cleared.

It is possible to start a process before the heating time. Milestone recommends waiting for the reagent to heat.

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The inside of the vessel has two etched lines, which indicate the MAX and MIN level (see

2. STAINING

To replace/load the staining reagents select the Staining section (blue circle in the picture below). Tap the “Replace staining reagents” box to open the reagent change page and update the date and clear the number of cycles made by the staining reagents.

Open the lid and remove the reagents cover disc, refer to chapter 2.7.1

Then remove the staining reagents vessels. The software indicates the position and short name of the glasses containing the staining reagents and shows a diagram of reagents configuration. Glasses have labels with the position number and name of the reagent that help not to mix them up. In the procedure to replace reagents, after emptying the glasses, it is advisable to clean them with paper in order to remove any precipitate.

Add 200mL of reagent in each vessel and slowly and carefully place it back in the position indicated by the software.

photo below). Keeping the reagents within the two levels assures proper staining of specimens. Milestone recommends keeping the staining reagents level to the minimum and the cleaning reagents to the maximum.

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The vessel is to be placed inside the housing in the vessel tray. On this tray, positions are indicated by a central label.

At the end of the procedure press the icon to go back to the reagent management page. At this point, date and number of cycles performed by the staining reagents are cleared.

3. CLEANING

To replace/load the cleaning reagents select Cleaning reagents (blue circle in the picture below).

Tap the “Replace cleaning reagents” box to open the reagent change page and follow the instructions given by the software as instructed above for the staining reagents.

At the end of the procedure press the icon to go back to the reagent management page. The date and number of cycles made by the cleaning reagents will be reset to zero.

At the end of these operations, log out from the reagent change page by pressing the HOME icon.

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The right operating temperature of FineFIX is between 35 and 40°C

(95°F and 104°F)

. Within

Now the icon will no longer have the STOP red symbol.

2.15.3. FineFIX heating settings

FineFIX is the only reagent in PRESTO PRO that is used at a temperature other than room temperature.

Upon first switching on the unit FineFIX heating is not active and the relevant icon in the settings screen shows a red symbol at bottom right (see picture below left).

For settings of the FineFIX reagent maintenance temperature, select “FineFIX heater” from the MAIN FUNCTIONS screen. The “FineFIX heater” page shows that the heater is OFF.

Switch on FineFIX heating by clicking on the “ON” button in the center of the screen (picture at top right).

Heating enabled can only be set by ADMINISTRATOR and users authorized to modify the reagents (Chapter 2.11).

this range, FineFIX is able to process and fixate tissue sections up to 6 µm thick in 15 seconds, with high quality results.

At this point, heating is enabled and brings the reagent to the set temperature. The time required to reach the temperature varies from 10 to 20 minutes and depends on the laboratory and reagent temperature. The icon shows an orange warning dot until the set temperature is reached. In this case, it is not advisable to start a process but it is possible by replying YES to the following message displayed when the process is started up:

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When the maintenance temperature is reached, heating status becomes “ready”, the icon no longer shows the warning symbol and the process may be performed using the reagent at the optimal temperature.

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2.16. Most used programs

This function lets you insert FAVOURITE programs in the MAIN PAGE.

Access the “Settings” screen by pressing the icon which is on the status bar on the left and the

•

icon then select “Set favourites”. The “Choose the Favourite to set” page is displayed.

Press the “Not defined” icon.

•

Select the “Program” and Colour of the button.

•

The “Preview” is displayed at bottom left (see picture below).

Press “Save Favourite” to save changes.

•

The icon of the new program is now visible in the list of the "Choose the Favourite to Set" screen.

•

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If the user's main page is set as FAVOURITES (picture at bottom left), press to go back to the main

•

functions page. If the main page is set as MAIN FUNCTIONS (picture at bottom right), press “Favourites” to open the screen shown at bottom right.

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GENERAL

VENTILATION

2.17. Owner Settings

This function is available only for SERVICE and ADMINISTRATOR.

Access the “Settings” screen by pressing the icon which is on the status bar on the left, then select the

settings page by pressing the icon , then in the new screen select “Owner”.

The Owner's settings screen is displayed as shown in the pictures below.

Select “General” to modify:

Institute name where the unit is installed.

•

Department name where the unit is installed.

•

Consumable alert threshold of the number of

•

available loads below which the software alerts to the need to load the FineFIX code (see chapter 2.14.1).

By default, the threshold is set to 10 loads.

Select Ventilation to manage the work area's extraction:

• Always ACTIVE: extraction is activated when

the machine is switched on.

• Always OFF: extraction is always off, even

during processing.

NOT RECOMMENDED. Risk of fumes in the laboratory.

• Processing and cover opening: extraction is

only activated during the process and when the cover is opened.

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ENABLES

INTERNET CONNECTION

Select “Enable” to choose whether to enable or not:

• Water during the entire run

• Sound 10 seconds before the end of the run

To connect PRESTO PRO to the internet.

MILEWATCH

Not available.

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3. USE PRESTO PRO

Milestone PRESTO PRO is controlled by a Touch Control Terminal, based on Windows CE 7. Milestone PRESTO PRO has been specifically designed to fixate, process and stain slides for extemporaneous diagnoses in a quick, reliable and standardized manner.

3.1. Loading slides in the rack

PRESTO PRO's rack can house up to 6 slides. Insert the slides in the rack, gently, sliding them between the appropriate partitions. To keep the slides wet, keep them immersed in FineFIX, using the reagent vessel with the specific label “Cryostat FineFIX”.

While loading the slides in the rack, keep the rack immersed in FineFIX, to prevent the specimens from drying.

It is important to ensure the “Cryostat FineFIX” is clean. Milestone recommends changing it at least once a week.

3.2. Run a program

The default protocols on the PRESTO PRO are: ULTRA QUALITY, which lasts 3 minutes and 52 seconds:

STEP. VESSEL REAGENT TIME

(sec) 1 1 FineFIX 60 35-40°C (95—104°F) YES NO 2 3 Water 10 Room YES NO 3 2 Haematoxylin 30 Room YES YES 4 3 Water 10 Room YES NO 5 4 Acetic ac. 4 Room YES NO 6 3 Water 4 Room YES NO 7 5 Eosin 14 Room YES YES 8 6 Ethanol 10 Room YES NO 9 8 Ethanol 10 Room YES NO 10 7 Isopropanol 10 Room YES NO

HIGH QUALITY, which lasts 2 minutes and 18 seconds

STEP. VESSEL REAGENT TIME

(sec) 1 1 FineFIX 15 35-40°C(95—104°F) YES NO 2 3 Water 5 Room YES NO 3 2 Haematoxylin 15 Room YES YES 4 3 Water 5 Room YES NO 5 4 Acetic ac. 1 Room YES NO 6 3 Water 3 Room YES NO 7 5 Eosin 5 Room YES YES 8 6 Ethanol 7 Room YES NO

TEMPERATURE IMMERSION DRIPPING

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The first two steps of the program are fixed: it is not possible to change position and reagent

Water steps cannot last less than 3 seconds.

Milestone recommends using the following working solutions:

9 8 Ethanol 7 Room YES NO 10 7 Isopropanol 5 Room YES NO

CONTINUOUS, which lasts 2 minutes and 20 seconds

STEP. CONTAINER REAGENT TIME

(sec) 1 1 FineFIX 10 35-40°C (95—104°F) YES NO 2 3 Water 5 Room YES NO 3 2 Haematoxylin 15 Room YES YES 4 3 Water 5 Room YES NO 5 4 Acetic Acid 1 Room YES NO 6 3 Water 3 Room YES NO 7 5 Eosin 1 Room YES YES 8 6 Ethanol 10 Room YES NO 9 8 Ethanol 5 Room YES NO 10 7 Isopropanol 15 Room YES NO

TEMPERATURE IMMERSION DRIPPING

The Standard protocols (HIGH and ULTRA QUALITY) require the first cycle to end before the second one can start. The Continuous loading protocols allow another cycle to start even when the previous one is still in progress, saving time as a result.

(FineFIX for step 1 and water for step 2). When drawing up a new program, these stages cannot be deleted.

- Harris Haematoxylin

- 1% Alcohol eosin (with 0.1% Phloxine)

- 2% acetic acid in water

In the interest of safety, the operator must be present throughout the entire process.

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Before starting a process ensure the reagent vessels do not ha

ve the cap (see

chapter

3.2.1. Run a favourite standard protocol

For reasons of safety, if the cover of the work area is opened while the arm is moving, the arm stops immediately.

2.7.5) and check proper reagent level, as they are subject to evaporation. The correct level of reagents is between the two lines etched inside the vessel. Milestone recommends keeping the staining reagents level to the minimum and the cleaning reagents to the maximum.

Select a Favourite Standard Protocol (picture below) from the list of favourite protocols (see chapter 2.16). The standard protocols do not have the word “CONTINUOUS” in the title.

The standard loading position (BLUE) of the slide rack goes in the loading position above the container in position 1DOWN, ready to load the rack in the FineFIX container. Refer to chapter 2.7.7 for the positions in the PRESTO PRO.

The support of the slide rack goes in the loading position above the vessel in position 1DOWN, ready to load the rack in the FineFIX vessel. Refer to chapter 2.7.7 for the positions in the PRESTO PRO.

At the start of each process the software performs a water flow check which lasts few seconds.

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Open the PRESTO PRO cover and load the rack on the support, in position 1DOWN. Once closed, the START button is displayed at bottom right: press this button to start a process.

The cycle starts only when the START button is pressed.

The processing screen is displayed, which shows process information. On the left, the schematic depiction of the positions of PRESTO PRO's reagents, with the rack's position highlighted in green and information concerning the stage in progress. The following is displayed at top right: the selected protocol, the process identification code (if entered) and the total process time. The remaining time before the end of the process is shown in the yellow box immediately underneath.

Below are two examples of screens during processing: on the left during the FineFIX stage and on the right while moving to the water cleaning stage after the haematoxylin phase:

Upon completing the process, the rack is kept immersed in the last reagent to prevent the specimens from drying and a buzzer warns the user. Extract the rack. The process ends when PRESTO PRO's cover is opened to remove the rack with the specimens.

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It is recommended

to close the reagent vessels with the relevant caps after using PRESTO

During a process, if required, press “A

bort” to stop the process and remove the rack with

Once the rack with slides is removed, the software goes back to the main screen.

PRO if it is not going to be used for a long time (more than 24 hours). Refer to chapter 2.7.5.

slides.

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Before starting a proce

ss ensure the reagent containers do not have the cap (see

chapter

3.2.2. Run a favourite “Continuous” protocol

For reasons of safety, if the cover of the work area is opened while the arm is moving, the arm stops immediately.

2.7.5) and check proper reagent level, as they are subject to evaporation. The correct level of reagents is between the two lines etched inside the container. Milestone recommends keeping the staining reagents level to the minimum and the cleaning reagents to the maximum.

With this type of protocol, a cycle can be started when the previous one is still in progress.

CYCLE 1 (Blue)

Select a Favourite Continuous Program (picture below) from the list of favourite protocols (see chapter 2.16). The continuous loading programs have the word “CONTINUOUS” in the title.

The standard loading position of the slide rack goes in the loading position above the container in position 1DOWN, ready to load the rack in the FineFIX container. Refer to chapter 2.7.7 for the positions in the PRESTO PRO.

At the start of each process the software performs a water flow check which lasts few seconds.

A screen is displayed, in this case with blue background, for entering the data of the process and starting it. Enter the number of slides in the rack, pressing the number keys from 1 to 6, then enter “Case ID” and “Run ID” (process identification code) data. It is not mandatory to enter any of this data. The protocol is set already, based on the selected favourite, and cannot be changed.

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Open the PRESTO PRO cover and load the rack on the support, in position 1DOWN. Once closed, the START button is displayed at bottom right: press this button to start a process.

The cycle starts only when the START button is pressed.

The processing screen appears, which has two sections: the one on the left is for the process in the standard position (BLUE) and the one on the right is for the process in the secondary position (YELLOW).

The following is shown in the left section when the first cycle starts: the selected protocol, the process identification code (if entered) and the total process time. Immediately below are the timers counting down to the end of the process and the end of the stage in progress. The yellow box provides information on the stage in progress and the schematic depiction of the positions of PRESTO PRO's reagents, with the rack's position highlighted in green and information concerning the stage in progress. The section to the right shows the time remaining before the secondary position (YELLOW) can be used to start a second cycle before the previous one has ended.

When the first cycle is in the Ethanol stage, the secondary position (YELLOW) of the arm is in the rack loading position and a second cycle can therefore be started while the first is still in progress.

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The option of starting a second cycle is available while the ethanol stage of the first cycle is in progress (10 seconds). There is an audio alarm during this period of time and the time remaining to start the second cycle and the button for starting it are shown in the right section of the page.

There are two courses of action:

A) If the second cycle does not need to be started, simply ignore the start button and the current cycle will continue as normal.

In this case, the audio alarm can be silenced by pressing the relevant button in the bar on the right side . The following screen is displayed at the end of the first cycle and there is an audio alarm. Remove the rack to end the cycle.

Once the rack with slides is removed and the cover of the work area is closed, the software goes back to the main screen.

B) If other sections need to be processed/stained, press the start button to start the second cycle (yellow):

CYCLE 2 (Yellow)

A screen appears, in this case with yellow background, for entering the data of the process and starting it. Enter the number of slides in the rack, pressing the number keys from 1 to 6, then enter “Case ID” and “Run ID” (process identification code) data. It is not mandatory to enter any of this data. The protocol is set already, based on the selected favourite. It is the same as that of CYCLE 1 and cannot be changed.

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Open the PRESTO PRO cover and load the rack on the support, in position 1DOWN. Once closed, the START button is displayed at bottom right: press this button to start the second cycle and continue the first.

The second cycle starts and the first continues only when the START button is pressed.

The processing screen appears. It has two sections: the one on the left is for the process in the standard position (BLUE) and the one on the right is for the process in the secondary position (YELLOW).

When the second cycle starts, the two sections of the screen display the information of the relevant cycle: the selected protocol, the process identification code (if entered) and the total time of the process, the time remaining before the end of the process and before the end of the stage in progress, the information on the stage in progress and the schematic depiction of the positions of PRESTO PRO’s reagents.

The following screen is shown at the end of the first cycle and there is an audio alarm. Remove the rack to end cycle 1 and continue cycle 2.

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Once the rack is removed from the standard position (BLUE) and the cover of the PRESTO PRO is closed again, stage 2 (yellow) continues and the time remaining to the option of starting the third cycle, using the standard position again, is shown in the left section of the screen.

When the second cycle is in the Ethanol stage, the standard position (BLUE) of the arm is in the rack loading position and a third cycle can thus be started while the second is still in progress. The option of starting a third cycle is available when the ethanol stage of the second cycle is in progress (10 seconds). There is an audio alarm during this period of time and the time remaining to start the third cycle and the button for starting it are shown in the left section of the page.

There are two courses of action:

A) If the third cycle does not need to be started, simply ignore the start button and the current cycle continues as normal. In this case, the audio alarm can be silenced by pressing the relevant button in the bar on the right

side . The following screen appears at the end of the second cycle and there is an audio alarm. Remove the rack to end the cycle.

Once the rack with slides is removed, the software goes back to the main screen.

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Cycles can be run continuously one after the other until the reagents have expired.

It is recommended to close the reagent containers with the relevant caps after using

During a process, if required, press “Abort” to stop the process and remove the rack with

B) If other sections need to be processed/stained, press the start button to run the third cycle that uses the

standard position with blue reference colour.

Open the PRESTO PRO cover and load the rack on the support, in position 1DOWN. Once closed, the START button is displayed at bottom right: press this button to start a process.

The third cycle starts and the second one continues only when the START button is pressed.

PRESTO PRO if it is not going to be used for a long time (more than 24 hours). Refer to chapter 2.7.5

slides. If two cycles are in progress, both are stopped.

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Before starting a process ensure

the reagent vessels do not have the cap (see

chapter

3.2.3. Press the start button to run a standard protocol

For reasons of safety, if the cover of the work area is opened while the arm is moving, the arm stops immediately.

Press “Start run” from the MAIN FUNCTIONS screen. The standard loading position (BLUE) of the slide rack goes in the loading position above the container in position 1DOWN, ready to load the rack in the FineFIX container. Refer to chapter 2.7.7 for the positions in the PRESTO PRO.

At the start of each process the software performs a water flow check which lasts few seconds.

The screen to enter process data and to start it is displayed. Enter the number of slides in the rack, pressing the number keys from 1 to 6, then enter “Case ID” and “Run ID” (process identification code) data. It is not mandatory to enter any of this data. Press the arrow under the word “Protocol” to bring up the list of protocols in the software, if any have been created (refer to chapter 3.3 Editing a program). By pressing the start button, you can select the desired program from among the standard ones. The software always suggests the last selected standard process.

Open the PRESTO PRO cover and load the rack on the support, in position 1DOWN. Once closed, the START button is displayed at bottom right: press this button to start a process.

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During a process, if required, press “Abort” to stop the process and remove the rack with

The cycle starts only when the START button is pressed.

Below are two examples of screens during processing: on the left during the FineFIX stage and on the right while moving to the water cleaning stage after haematoxylin:

Once the rack with slides is removed, the software goes back to the main screen.

It is recommended to close the reagent vessels with the relevant caps after using PRESTO PRO if it is not going to be used for a long time (more than 12 hours). Refer to chapter 2.7.5.

slides.

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Before starting a process ensure the reagent containers do not have the cap (see

chapter

3.2.4. Press the start button to run a “Continuous” protocol

For reasons of safety, if the cover of the work area is opened while the arm is moving, the arm stops immediately.

Press “Start continuous” from the MAIN FUNCTIONS screen. The standard loading position of the slide rack goes in the loading position above the container in position 1DOWN, ready to load the rack in the FineFIX container. Refer to chapter 2.7.7 for the positions in the PRESTO PRO.

At the start of each process the software performs a water flow check which lasts few seconds.

The screen to enter the data of cycle 1 and to start it is displayed. Enter the number of slides in the rack, pressing the number keys from 1 to 6, then enter “Case ID” and “Run ID” (process identification code) data. It is not mandatory to enter any of this data. Press the arrow under the word “Protocol” to bring up the list of “Continuous” protocols in the software, if any have been created (refer to chapter 3.3). The desired protocol can be selected from among the “Continuous” ones.

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The protocol selected for the first cycle is the same for all consecutive continuous ones.

The software always suggests the last selected “Continuous” process.

Proceed as described in chapter 3.2.2.

3.3. Editing a program

3.3.1. Modify a standard protocol

The Standard protocols (HIGH and ULTRA QUALITY) require the first cycle to end before the second one can start and cannot have the word “Continuous” in the title

Select the “Set protocols” button from the MAIN FUNCTIONS screen.

There are two categories of protocols:

 DEFAULT PROTOCOLS (for example HIGH QUALITY): the owner is Milestone and the user can only

copy them.

 USER PROTOCOLS: the user is the owner and they may be edited, deleted and copied.

To create a new protocol:

1. Select the program to be copied, then press “Copy”.

To create a standard protocol, you need to start with an existing standard one (without the word “Continuous” in the title).

2. The copied program screen opens.

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The first two stages of each protocol (FineFIX and rinsing water of the FineFIX) cannot be

The new protocol you have created will be shown in the drop

down menu in the pr

ocess

3. By default, the new program is called “Copy of…”: if preferable, rename the program using the keypad

and press “Enter”.

Standard protocols must not have the word “Continuous” in the title. The software prevents it from being entered.

4. To edit a stage, select it and press “Modify” after which it is possible to edit “Vessel” (Position) and

“Reagent”, selecting from the options in the drop-down menu.

eliminated or moved.

5. Edit the stage time, clicking in the relevant box, to bring up a number keypad, then click “OK”. Modify

the arm’s movement, adding “dipping” and/or “dripping”.

6. To add a step press “Add”: the new step will be added last. To change its position select it and move

it with the arrows on the right. To remove a step, select it then press “Delete”.

7. Press the HOME icon and “Yes” to save the changes.

1 2

3 4

5 6

start page, under the icon .

Changes to a user protocol do NOT require to copy it before making changes.

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A program may only be run if the reagents in the protocol are loaded in the “Reagents”

section and their positions match those indicated in the protocol. Refer to chapter 4.

3.3.2. Modify a “Continuous” protocol

The Continuous protocols let you run an additional cycle even when the previous one is still in progress, saving time as a result, and must have the word “Continuous” in the title.

Select the “Set protocols” button from the MAIN FUNCTIONS screen.

There are two categories of protocols:

 DEFAULT PROTOCOLS (for example HIGH QUALITY): the owner is Milestone and the user can only

copy them.

 USER PROTOCOLS: the user is the owner and they may be edited, deleted and copied.

A new “Continuous” protocol can be modified or created only by starting with a protocol of the same type, and the new protocol must have the word “Continuous” in the title.

The procedure for creating a new “Continuous” protocol is the same as that described in chapter 3.3.1 but:

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- The word “Continuous” must be retained in the name of the protocol

- A new stage cannot be added and the order of the stages cannot be changed

- The stage time can be modified only for the Haematoxylin and Eosin stages

- Changing the time of the Haematoxylin stage causes the Isopropanol stage to change in the same way, and the following message is displayed:

3.3.3. Modify the temperature of the fixation reagent

The FineFIX reagent is maintained at such a temperature that when it comes in contact with the slides, it is between 35°C and 40°C (95—104°F). If the FineFIX temperature needs to be changed, it is required to change the maintenance temperature in the

“FineFIX heater” section . Refer to chapter 2.15.3.

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Handle reagents with care and store in a cold dry space using a tightly closed container.

Sheet) provided by the reagent’s

4. REAGENT MANAGEMENT

Reagents in the PRESTO PRO are divided into three types:

• Fixation/processing reagents (FineFIX)

• Staining reagents

• Cleaning reagents

The three types of reagents are managed in the “Reagents” section. See chapter 2.15. The fixation/processing reagent is considered a consumable and it is managed as such. See chapter 2.14.

4.1. Use of FineFIX

FineFIX is managed as number of changes that can be made. The available changes are loaded by means of a bar code system (see chapter 2.14). Each tank of concentrated FineFIX has an unambiguous bar code that enables the PRESTO PRO for the number of changes that can be made with that tank:

- The barcode of a 5L tank (REF 70148) fills about 100 changes.

- The barcode of a 10L tank (REF 70149) fills about 200 changes.

The number of loaded changes decreases every time the reagent is changed and turns the icon of the FineFIX code page from GREEN to YELLOW to RED, based on the set threshold (10 changes by default, as described in chapter 2.17). For example, if a 5L tank of concentrated FineFIX is loaded and the threshold of consumables is 10, the icon of the FineFIX code is green up to the first 89 changes, then it becomes yellow from 90 to 99 changes made and red when 100 changes have been made. When RED, changes cannot be made and it is not possible to start a process.

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Reagent st

atus

Icon

“FineFIX code” page

Number of available changes above the “Consumable alert threshold”.

Number of available changes below the “Consumable alert threshold”.

0 available changes.

In order to load consumables, select the “FineFIX code” icon from the FineFIX heater page and follow the procedure illustrated in the chapter 2.14.1.

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The fixation/processing reagent expires after 1 day and the expiration cannot be either

4.2. Reuse of reagents

Select “Reagents” from the MAIN FUNCTIONS screen (picture below left). The standard position (BLUE) of the slide rack goes into position 5DOWN (see chapter 2.7.7), and the reagent management screen is displayed (picture at bottom right).

The time of reagents use may be controlled through:

1. “Check the expiration date”: this field automatically displays “Loaded date” and “Expiration date” of the

reagent, according to “Max days” of use set.

modified or deselected. The fixation/processing reagent evaporates more quickly as it is heated and must therefore be changed on a daily basis.

2. “Check the performed cycles”: this field automatically displays the “Performed cycles” and “Max cycles” set.

By default, 10 performed cycles are set before the expiration date.

For the reagents (except on the days of expiration of the fixation reagent) it is possible to change the type of control by selecting the relevant boxes to activate the settings described above. Settings for reagents turn the “Reagents” icon from GREEN to YELLOW to RED, based on the remaining reuse of reagents (1 day and/or 1 cycle). For example, if 10 cycles are set as maximum limit, the reagent icon is green for the first 8 cycles (up to 1 cycle before the limit is reached); it then turns yellow if 9 cycles have been performed and red once 10 cycles have been performed. When RED, processes cannot be started.

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Reagent status

Icon

Only users

authorized

to edit the reagents' parameters are allowed to

perform these

Staining and/or cleaning reagent at least 2 cycles/days from the threshold. Fixation reagent at least 2 cycles from the limit.

Staining and/or cleaning reagent at 1 cycle/day from the threshold. Fixation reagent at 1 cycle from the limit.

At least one threshold reached.

For each of the three types of reagents it is possible to change the number of days (except for the fixation reagent, see above) and number of cycles before expiry, by clicking in the suitable box and using the keypad displayed.

changes. It is always possible for SERVICE and ADMINISTRATOR users. Refer to chapter 2.11.

By default, both staining and cleaning reagents are checked by date of expiry, with a period of use of 7 days, and by number of cycles performed, with a maximum number of 10 cycles. The default maximum life of the fixation reagent is one day and is controlled according to the number of cycles carried out, with a maximum number of 10 cycles.

Milestone recommends checking the staining reagents by days (7 days) and the cleaning reagents by number of cycles (10 cycles).

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POSITION

REAGENT

CATEGORY

4.3. Setting the configuration of reagents

Enter the reagents management page “Reagents”. On the left is the schematic depiction of the reagents' positions in the PRESTO PRO.

The reagents configuration is as follows by default:

1 FineFIX Processing 2 Haematoxylin Staining 3 Water Cleaning 4 2% acetic acid in water Cleaning 5 Alcohol eosin Staining 6 Ethanol 1 Cleaning 7 Isopropanol Cleaning 8 Ethanol 2 Cleaning

To change the reagent in a position, tap on the relevant position in the diagram. For example, to change the reagent Eosin in position 5, tap the relevant circle (see above). The following page is displayed, which lets you choose one of the reagents from the reagents' list:

Select the desired reagent, for instance ethanol and press “OK”. The reagent in position 5 will be changed.

Reagents FineFIX in position 1 and Water in position 3 are fixed and cannot be changed.

It is always possible to go back to the default set-up by pressing the button and clicking on YES when asked to confirm.

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4.4. Edit reagents list

To access the list of reagents, press the icon “Vessels Reagents” in the main page, then “Reagent list” The following page is displayed with the list of reagents set by default:

Default reagents cannot be deleted.

Default reagents settings cannot be edited.

To add a reagent, press the “Add” key. Then enter the new reagent name and press “ENTER”. The new reagent has been created and the following may be selected: Short name (three letters or figures), colour and category: whether fixative, staining or cleaning reagent (example below).

The reagents created by the user may be deleted.

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The safety procedure should be considered as an em

ergency procedure to be used once

5. SAFETY PROCEDURE

The safety procedure is triggered in the event of PRESTO PRO operation lock-down and consists of guided manual staining using PRESTO PRO reagents.

only to save ready slides. Upon completing the procedure contact technical support to solve the problem in the unit.

5.1. Water error

At the start of each process the software performs a water flow check which lasts a few seconds.

Two problems linked to water may trigger the safety procedure:

• Water is missing during a process. In this case, slide cleaning would not be optimal and the safety

procedure is required.

• Water overflow the water drain is clogged, flow is to be stopped and slide staining is to be performed under

a safety procedure.

The rack is brought back into the FineFIX vessel to maintain the slides secure until the safety procedure starts.

A sound alarm advises the user: it is possible to silence the alarm by pressing the icon (image below).

A screen is displayed with the instructions to use the PRESTO PRO reagents for manual staining:

- Obtain a container with clean water

- Open the work area cover

- Remove the screw from the cover disc

- Remove the reagent cover disc (see section 2.7.1)

- Open the protocol to be followed

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After that, the screen of the protocol that had been selected at the start of the process is displayed, indicating the stage at which the process was interrupted, so it may resume from that stage (for example, in the case of the image below, from the first water cleaning). For each stage, the reagent, its position in the PRESTO PRO and the stage duration are indicated: use the reagents in the PRESTO PRO to manually stain the specimens. To perform the protocol, the screen provides a timer already set with the time for each stage.

At the end of the procedure press the HOME icon to go back to the main page.

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In the case of a safety procedure during a “Continuous” cycle, the slides are not returned to the FineFIX container and the procedure to be followed is slightly different:

- Obtain a container with clean water

- Open the work area cover

- Remove the rack/two racks

- Remove the screw from the covering disc

- Remove the reagent covering disc (see section 2.7.1)

- Open the protocol to be followed

If only one cycle was in progress, the screen of the protocol that had been selected at the start of the process is displayed, indicating the stage at which the process was interrupted, so it may resume from that stage (for example, in the case of the image below, from the first water rinsing). If two processes were in progress, the protocol to be followed and the stage during which it was interrupted is shown for each process. For each stage, the reagent, its position in the PRESTO PRO and the stage duration are indicated: use the reagents in the PRESTO PRO to manually stain the specimens. To perform the protocol, the screen provides a timer already set with the time for each stage.

At the end of the procedure press the HOME icon to go back to the main page.

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5.2. Arm position lost error

Either in the event the arm position should be lost during a process or the arm should be unable to reach a position (Arm positioning time-out), the software initiates the safety procedure.

A sound alarm advises the user: it is possible to silence the alarm by pressing the icon (image below).

A screen is displayed with the instructions to use the PRESTO PRO reagents for manual staining:

- Open the work area cover

- Remove the screw from the cover disc

- Remove the reagent cover disc (see section 2.7.1)

- Open the water flow for the rinse stage, by pressing .

- Open the protocol to be followed

The screen of the protocol that had been selected at the start of the process is displayed, indicating the stage at which the process has been interrupted, so it may resume from that stage (for example in the image below, from the step in acetic acid).

For each stage, the reagent, its position in the PRESTO PRO and the stage duration are indicated: use the reagents in the PRESTO PRO to manually stain the specimens. To perform the protocol, the screen provides a timer already set with the time for each stage.

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At the end of the procedure press the HOME icon to go back to the main page.

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In the case of a safety procedure during a “Continuous” cycle, the procedure to be followed is slightly different:

- Open the work area cover

- Remove the rack/two racks

- Remove the screw from the covering disc

- Remove the reagent covering disc (see section 2.7.1)

- Open the water flux for the rinse stage, by pressing .

- Open the protocol to be followed

If a single cycle was in progress, the screen of the protocol that had been selected at the start of the process is displayed, indicating the stage at which the process has been interrupted, so it may resume from that stage. If two processes were in progress, the protocol to be followed and the stage from which to restart manual staining is shown for each process. For each stage, the reagent, its position in the PRESTO PRO and the stage duration are indicated: use the reagents in the PRESTO PRO to manually stain the specimens. To perform the protocol, the screen provides a timer already set with the time for each stage.

At the end of the procedure press the HOME icon to go back to the main page.

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Contact annually your local distributor or Milestone offices directly:

6. MAINTENANCE

6.1. Introduction

PRESTO PRO maintenance is performed at 2 levels:

The FIRST is at laboratory level: a simple routine maintenance that prevents the likelihood of more serious problems. Minimum routine maintenance is required by the laboratory personnel using the PRESTO PRO. The following procedure is required to assure optimal PRESTO PRO performance.

The SECOND level of maintenance is technically more detailed and is not the responsibility of laboratory personnel. The unit requires technical preventive maintenance once a year to maintain the high performance and prevent any malfunctions.

customersupport@milestonemedsrl.com, for how to perform Preventive Maintenance and

regular inspections in order to maintain your PRESTO PRO within safe operative standards.

6.2. Before/after every process

Ensure PRESTO PRO is generally kept clean after each use. Do not use abrasive or sharp material in order not to damage the casing. Before starting a process ensure the reagent vessels do not have the cap on and if so, remove it (refer to chapter 2.7.5) and check proper reagent level, as they are subject to evaporation. The correct level of reagents is between the two lines etched inside the vessel. Milestone recommends keeping the staining reagents level to the minimum and the cleaning reagents to the maximum.

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6.3. Daily

It is required to check reagent level inside the vessels every day. The level of reagents must be between the two etched lines inside the vessel. Milestone recommends keeping the staining reagents level to the minimum and the cleaning reagents to the maximum. Replace the fixation/processing reagent every day since it is heated hence it evaporates more quickly. Ensure the staining agents do not show an oxidized reagent film, if so filter or replace them. Check the general cleanliness of the equipment and, if necessary, follow the procedures described in chapter

6.4. Weekly

It is required to check for any residual reagent in the drawer (Code 100360). In this case: remove it from its seat under the unit by extracting it from the front of the unit and empty it. It is recommended to change the staining reagents and check the level of cleanliness of cleaning reagents, if required replace them. It is advisable to check the FineFIX reagent near the cryostat. Change the reagent and clean the container if necessary.

6.5. Yearly

Contact your technical support for a preventive maintenance contract.

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For reasons of safety, any operation without the required pe

rsonal protection equipment is

PRESTO PRO decontamination is mandatory due to the biological hazard, arising from use

Do NOT remove the side panels of the unit during the cleaning operations.

For decontamination and cleaning do not use procedures other than explaine

d in this

Before every operation disconnect the power supply. Do not use direct or high

pressure

It is recommended to use polyphenol

based disinfectants.

7. DECONTAMINATION AND CLEANING

The procedure described in this chapter must be performed on a daily basis.

to be avoided.

of fresh specimens.

7.1. Safety precautions

The personnel involved in decontamination of PRESTO PRO and its optional parts (if any) must wear personal protection equipment, specifically:

• HI-RISK type single-use protection gloves (100% latex or equivalent material). Personal protection system

compliant with the EN 374 standard and the 89/686/EEC Directive.

• Antibacterial mask for surgical/operating theatre use and white coat. Personal protection system

compliant with the EN 149 standard Grade FFP3D and the 89/686/EEC Directive.

7.2. Procedure for PRESTO PRO decontamination and cleaning

7.2.1. Detergents

It is required to strictly follow the instructions below to carry out a correct cleaning and decontamination procedure.

chapter.

water to clean the instrument.

For further information, please contact our specialists at: application@milestonemedsrl.com.

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Germicidal efficacy of polyphenol-based disinfectant agents:

5 minutes: Human Immunodeficiency Virus Type 1 (HIV-1), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Rotavirus, Coronavirus SARS. 15 minutes: Staphylococcus Aureus, Candida Albicans. 30 minutes: Pseudomonas Aeruginosa, Mycobacterium Bovis (TB).

7.2.2. Procedure

1. Move the arm to position 5DOWN, by pressing the icon . For PRESTO PRO's arm positions refer to chapter 2.7.7

2. Switch off the unit and disconnect the power supply.

3. Open the work area lid, remove the cover disc as explained in chapter 2.7.1, remove all reagent vessels except the fixed one in position 3, paying attention not to overturn them.

4. Remove the vessel support tray, by lifting it and extracting it from PRESTO PRO's arm, as explained in chapter 2.7.6

5. Then clean all parts according to the rules set out below.

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Surface underneath the reagent vessels

• Clean the PRESTO PRO surface with a cloth

moistened with alcohol and, if required, remove any reagent residues with a non-abrasive tool.

• Dry with adsorbent paper or a clean cloth.

Fixed vessel for water, and rack

• Spray the disinfectant (see section 7.2.1) and

let sit for at least 30 minutes.

• Rinse with water to remove the disinfectant.

• Clean the inside of the fixed vessels with paper

tissue or with a clean cloth.

• Wash the outside with a cloth moistened with

alcohol and, if required, remove any reagent residues with a non-abrasive tool.

• Dry with adsorbent paper or a clean cloth.

Support tray, reagent vessels cover disc and rack support

• Wash these parts with a cloth moistened with

alcohol and, if required, remove any reagent residues with a non-abrasive tool.

• Dry with adsorbent paper or a clean cloth.

Steel and aluminum vessels

• After removing the waste reagent, clean inside

the vessels using paper or a clean cloth. Ensure there are no pieces of paper or residues of specimens in the vessels.

Work area cover

• Clean the PRESTO PRO cover with a damp

cloth.

• Dry the surface with paper or with a clean

cloth.

6. Place back in position:

- the reagent vessel positioning tray,

- the vessels, with caution in order not to spill the contents and paying attention to fit them in the previous positions,

- the reagents cover disc, according to the instructions in chapter 2.7.1.

7. Close the work area cover.

On completion of the cleaning operations, wait at least 5 minutes before connecting the power supply cable.

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8. REPORTING

PRESTO PRO provides the required documentation for the Laboratory's reporting activity. It is in fact possible to export a document including all the process information and the “Events log”.

8.1. Exporting saved process data

Access the “Settings” screen by pressing the icon on the status bar on the left, then select the “Log book” button in the new screen, finally select the “Saved runs” icon.

The following screen is displayed, which shows all saved processing files on the right, listed by date (on the left). The dates are automatically created by the software. Select a date (in the example below 17-Aug-2017) and the cycle(s) saved that day will be displayed on the right.

Press the file name to see the program run. Press “Open” (picture above) to view the data of the highlighted file (picture below).

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Press the icon to go back to the screen of saved processes.

To export the data, insert the USB drive in one of the slots on the right side of the unit. Then select the process

of interest and press (Export) or (Export all) to copy all cycles performed.

A folder is created in the USB drive, called PRESTO PRO_SN, containing the "Saved “sub-folder and the processes sorted by date and named with the end time, as in the example below:

8.1.1. How to delete a saved process

Select a date and press “Delete” to delete all processes saved on that day (picture below left). Then confirm. Select a Process and press “Delete” to delete ONLY the highlighted process (picture below right). Then confirm.

Alternatively, press “Delete All” to delete ALL programs saved on the PRESTO PRO.

Press to go back to the MAIN MENU.

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8.2. Exporting the events log

These functions are available only for SERVICE and ADMINISTRATOR personnel.

Access the “Settings” screen by pressing the icon which is on the status bar on the left, then in the new screen select the “Log book” button and select the “Events log” icon.

The following screen is displayed, which shows the list of all actions, alarms and reagent movements performed.

The list may be saved on a USB drive, inserting it in one of the slots on the side of the unit and pressing “Export to USB”.

A folder is created on the USB drive, called PRESTO PRO_SN, containing the LogEvents file.

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9. OPTIONALS

Not included, to be ordered separately:

9.1. External exhaust fume filter kit (Code 61550/F)

The external exhaust fume filter kit includes a spare cartridge.

The filter is required if PRESTO PRO is NOT connected to the laboratory fume extraction system.

Below a picture of the filter:

Airflow range of 28-32m3/h (cubic meters per hour).

The external fume filter must be installed in a proper manner every time, in compliance with the regulations in force on laboratory safety.

If PRESTO PRO is connected to a laboratory fume extraction system, the filter is to be changed ONCE PER YEAR. Otherwise, without external extraction, it must be changed EVERY 6 MONTHS.

Please refer to manual MM109 - Installation of the external exhaust fume filter kit - Operation Manual, for further details on how to install or change the external exhaust fume filter kit.

9.2. FineFIX tanks

• 5L tank REF 70148

• 10L tank REF 70149

Refer to MM029 - FineFIX - Operator Manual for how to prepare the FineFIX working solution and its use.

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A. Appendix – Hints and tips

A.1. Fatty tissues

A problem arising from fatty specimens is that they tend to adhere less to the slide and to detach during staining. In this case, it is recommended to heat the slide before taking the section and/or cut a thinner slice.

A.2. Tips to modify the staining protocol

Improvement of slide cleaning

Reduction of Haematoxylin non-specific

- Increase the time of the 2% Acetic Acid step.

- Set the time of water rinsing step after Acetic Acid by the same duration.

- Do not increase the water rinsing time after Haematoxylin, 10 seconds are sufficient to remove the excess stain.

Reduction of Haematoxylin non-specific

- Add a third cleaning in alcohol after the Eosin step, in addition to the two existing ones.

- Add a cleaning step in 95% ethanol after the Eosin step: 5% water increases removal of Eosin nonspecific.

Modification of staining

Reduction of Eosin intensity

- Reduce the step in Eosin up to 2 seconds. A shorter step is not recommended as the dipping movement would not occur, which makes the stain consistent.

- Add a third cleaning in alcohol after the Eosin step, in addition to the two existing ones.

- Add a cleaning step in 95% ethanol after the Eosin step: 5% water increases removal of Eosin nonspecific.

Increase the intensity of Haematoxylin

- Lengthen the Haematoxylin step up to 60 seconds.

- Eliminate the Acetic Acid step

- Do not reduce the water rinsing time after Haematoxylin

Increase the Haematoxylin/Eosin contrast

- Lengthen the Haematoxylin step up to 60 seconds.

- Add a Lithium Carbonate step, after the Acetic Acid step and water rinsing.

- Reduce the step in Eosin up to 2 seconds. A shorter step is not recommended as the dipping movement would not occur, which makes the stain consistent.

- Add a cleaning step in 95% ethanol after the Eosin step: 5% water increases removal of Eosin nonspecific.

- Use a solution of 50% Eosin diluted in ethanol.

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Code

DESCRIPTION

WHAT TO DO

B. Appendix – Alarm management

B.1. Alarm management

1 Serial communication

fault

2 Arm positioning time-out 1. Ensure nothing is blocking the arm movement. Then press

3 Arm position lost

(Lost position error)

4 Fan not running

6 Cover Open

1. Press 'Clear' to reset the alarm.

2. Reboot the system (wait 2 minutes before the rebooting).

3. Call your customer service if the issue cannot be fixed.

1. Press 'Clear' to reset the alarm.

2. Reboot the system (wait 2 minutes before rebooting).

3. Contact support if the problem cannot be solved.

'Clear' to reset the alarm.

2. Press 'Silent' to hide the alarm.

3. Call your customer service if the issue cannot be fixed.

1. Ensure nothing prevents the arm’s movement. Then press 'Cancel' to reset the alarm.

2. Press 'Silent' to acknowledge the alarm.

3. Call support if the problem cannot be solved.

1. Press 'Clear' to reset the alarm.

2. Press 'Silent' to hide the alarm.

3. Call your customer service if the issue cannot be fixed.

1. Press 'Clear' to reset the alarm.

2. Press “Silent” to acknowledge the alarm.

3. Contact support if the problem cannot be solved.

1. Close the cover to reset the alarm.

2. Press 'Silent' to hide the alarm.

3. Call your customer service if the issue cannot be fixed.

1. Close the cover to clear the alarm.

2. Press “Silent” to acknowledge the alarm.

3. Contact support if the problem cannot be solved.

14 Water is missing

15 Water overflow

1. Check if outside taps are open. Press 'Clear' to reset the alarm.

2. Check that the water hoses are not bent or obstructed by anything. Then press 'Clear' to reset the alarm.

3. Press 'Silent' to hide the alarm.

4. Call your customer service if the issue cannot be fixed.

1. Check if external taps are open. Press 'Clear' to reset the alarm.

2. Check that the hoses are not bent or occluded by anything. Press 'Clear' to reset the alarm.

3. Press “Silent” to acknowledge the alarm.

4. Contact support if the problem cannot be solved.

1. Check that the water hoses are not bent or obstructed by anything. Then press 'Clear' to reset the alarm.

2. Press 'Silent' to hide the alarm.

3. Call your customer service if the issue cannot be fixed.

1. Check that the water hoses are not bent or occluded by anything. Then press 'Clear' to reset the alarm.

2. Press “Silent” to acknowledge the alarm.

3. Contact support if the problem cannot be solved.

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Code

DESCRIPTION

WHAT TO DO

18 Fixative temperature too

low

17 Fixative temperature too

high

1. Press 'Clear' to reset the alarm.

2. Reboot the system.

3. Call your customer service if the issue cannot be fixed.

1. Press 'Clear' to reset the alarm.

2. Restart the system.

3. Contact support if the problem cannot be solved.

1. Press 'Silent' to hide the alarm.

2. Wait 10 minutes and then press 'Clear' to reset the alarm.

3. Call your customer service if the issue cannot be fixed.

1. Press “Silent” to acknowledge the alarm.

2. Wait 10 minutes and press 'Cancel' to reset the alarm.

3. Contact support if the problem cannot be solved.

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Milestone Srl

Via Fatebenefratelli, 1/5 - 24010 Sorisole (BG) - Italy Tel +39 035 4128264 - Fax +39 035 575498

marketing@milestonemedsrl.com www.milestonemed.com

Milestone PRESTO PRO Operator's Manual

Specifications and Main Features

Frequently Asked Questions

User Manual