Get University Of California Irvine Form S-65 2017-2024

Edu jbkim uci. edu fakhtar uci. edu ETR Director Research Histopathology Special stains Congo Red Amyloid AFB Alcian Blue pH 2. 2 CD1a CD2 CD3 CD4 CD5 CD7 CD8 CD10 CD15 Leu M1 CD20 L26 RTU CD30 Ki-1 CD45 LCA CD123 Cost/ Class A B C CD79a CD117 CD138 CD163 CEA-polyclonal CEA-monoclonal c-erbB-2 Her-2-IHC Chromogranin A CMV Cytokeratin 5/6 Cyclin D1 bcl-1 HMW keratin 34BE12 Podoplanin D2-40 Desmin DOG1 EBV-ISH EBV-LMP E-cadherin ERG EMA ER Factor VIII Von Willebrand FSH Gastrin GFAP Gata3 Glucagon Glypican-3 Helicobacter pylori HHF-35 HHV-8 HCC Hepatocyte Herpes Simplex Virus 1 HMB-45 HER2 Dual ISH DNA Probe IDH1 IgA IgD D IgG IgM IMP 3 Inhibin Kappa-IHC Ki-67 Lambda-IHC LH Lysozyme Melan-A Red MLH-1 MOC-31 MSH-2 MSH-6 MUM1 Myeloperoxidase MPO MYO D1 Myogenin Napsin A Neu N Neurofilament Pro NFP NKX 3. 1 NSE O13 CD99 P504S p16 p53 p63 Parvovirus PAX-5 PAX-8 PD-1 PIN-4 PLAP PMS2 RTU PR Prolactin PSA RCC S100 SMA SM Myosin Sall 4 SP-A Simian Virus SV-40 Sox 10 Synaptophysin Tau TDP-43 TdT Thyroglobulin Tryptase TSH TTF-1 Ubiquitin Uroplakin III Vimentin WT-1 34BE12 p63 FITC IgG FITC Kappa FITC Lambda FITC Fibrinogen FITC C3 FITC C1Q FITC Albumin. 3 bcl-2 bcl-6 B-amyloid -HCG Ber-EP4 BRST-2 C4d CA 19-9 CA125 Calcitonin Caldesmon Calretinin CAM 5. Edwards Anne Sawyers Jeffrey Kim Farah Akhtar 949-824-8576 714-456-8975 714-456-5022 redwards uci. edu asawyers uci. 01/30/2017 Cut Unstained Slide from Tissue Blocks J Cut first slide 1 or 2 sections/slide on Superfrost slide /slide J1 Re-cut additional slide per block J2 Cut tissue into eppendorf tube curls 1-6 thickness m K Cut first frozen section 1 or 2 sections/slide on Superfrost slide /slide Stain Unstained Slides L H E stain M Special histochemical stains See list on page 3 Immunostain Slides human tissues only contact research histologist on page 3 prior to all initial requests N1 Class A antibody antibody N4 Class D Special antibody antibody P Immunostain optimization For user supplied antibodies 17. Received Date Sent Out Date Reference No. Specimen No. RESEARCH HISTOLOGY and BIO-REPOSITORY SERVICES REQUEST FORM UCI DEPARTMENT OF PATHOLOGY EXPERIMENTAL TISSUE RESOURCE USER INFORMATION ALL sections must be filled in Today s Date Principal Investigator CRC or Lab Manager Name Recharge Account Number Protocol No / Title of Study End User or Contact Person End User s Phone Number Department PI s E-mail CRC or Manager s E-mail CRC or Manager Phone No End User s E-mail COMPLIANCE INFORMATION services will NOT be performed without this information Do requested services involve use of human tissue YES NO If YES attach IRB approval letter if previously attached list IRB No. If YES attach IACUC approval letter if previously attached list IACUC No. Indicate end use of this service check the one that most applies Research Clinical Teaching Check here if this is a RUSH clinical trials sample turnaround time is 1-3 calendar days. 00 Request an Existing FFPE Block to be Cored e.g. - for TMA T Case and Block Number s Core s Diameter 1 2 3mm UCI investigators / Subtotal Outside Non-profits Total 150 of subtotal for orders not picked-up at UCI or UCIMC Shipping packaging charge 5 dry 25 dry ice or TBD your FedEx Usual turnaround time is 5-10 working days Provide specific information about tissues/diagnoses required up to 10 blocks Append list of blocks/cases Double immunostaining available unit cost is sum of the two antibodies Indicate specific antibody and conditions/dilutions optimization may still be needed for core processing If there are more specific instructions please describes below and copy your specific instructions with the cover email or fax when submitting this form. If special embedding is required please state exact orientation of the tissue.