In-Vivo Animal Core (IVAC) Necropsy, Histology, & Pathology Request Sample Drop-off Locations: IVAC Use Only Monday – Friday, 9:00 AM – 3:00 PM 3527 Animal Research Facility 1150 W. Medical Center Drive Ann Arbor, MI 48109-0614 ARF Phone: (734) 936-3803 IVAC Manager: (734) 763-1737 Monday – Friday, 9:00 AM – 4:00 PM North Campus Research Complex 2800 Plymouth Road B36/G157A Ann Arbor, MI 48109-2800 NCRC Phone: (734) 936-3395 Email: [email protected] Date In: Date Out: Accession #: Short Code: Investigator: Department: Lab Contact: Phone: Email: Species: Xenograft: Yes No (check one) Initial Fixative: Reagent Submitted in: Tissue Type: Special Instructions: (attach additional information as needed) If this is a mouse project, is it related to metabolic disease? ! Yes No (check one) Do you have a Mouse Metabolic Phenotyping Center (MMPC) order number? ! Yes (please include number here) ______________________ No ! Mouse projects related to metabolic disease may qualify for support from the NIH MMPC Grant. Visit mmpc.med.umich.edu to complete an MMPC order request. The MMPC order number can be added to this form or provided while work is in progress. ! (see key below) Necropsy QTY Histology (Specials) QTY IVAC Antibodies QTY Cross Reactivity Trim & Cassette Alcian Blue AE1/AE3 + 8/18 P mh Decalcification Alcian Blue-PAS Amylase PZ m Fixed Mouse Necropsy Alizarin Red ALDH1 P hx Small Animal Necropsy (Mouse, Rat) Congo Red aSMA P mrh Medium Animal Necropsy (Rabbit, Cat, Guinea Pig) Gram B220-CD45R P m Large Animal Necropsy (Sheep, Pig, Dog) Grocott Methenamine Silver CD3 P mhn NHP Necropsy Luxol Fast Blue CD4 P m Necropsy Technician Time Luxol Fast Blue-PAS CD8a P m Masson Trichrome CD31 PZ m Histology (General) QTY Oil Red O Cleaved-Caspase-3 3 P mrhxpc Paraffin Processing and Embedding Periodic Acid Schiff ER P hx Paraffin H&E Slide (prep and stain) Phosphotungstic Acid Hematoxylin F4/80 PF m Paraffin Unstained Slides (remain unstained) Picrosirius Red GFAP P mc Paraffin Unstained Slides (for IHC and/or specials) Prussian Blue GFP PF m H&E Stain (previously prepared slide) Toluidine Blue Glucagon PZ m Frozen H&E Slide (prep and stain) Verhoeff-Van Gieson HER2 P hx Frozen Unstained Slides (remain unstained) Warthin-Starry Insulin PZ m Frozen Unstained Slides (for IHC and/or specials) Other: (please describe) KI-67 P mrhxps Histology Technician Time Ly6G P m Lyve-1 P m Standard Supplies QTY Neurofilament P mrcs 5 ct. Slide Box Non-IVAC Antibodies and New Titrations QTY PR P hx 25 ct. Slide Box VWF P mrsc 50 ct. Slide Box (Previously Titrated) Cross-Reactivity Abbreviations Key 100 ct. Slide Box Mouse, Xeno Tissue Paraffin P Reagent Vials Rat Tissue Zinc Z Davinci Diluent Other Tissue Frozen F Renoir Diluent (New Titer) Cat c Van Gogh Diluent Mouse, Xeno Tissue Human h Sucrose Rat Tissue Mouse m OCT Other Tissue Non-Human Primate n Negative Control Slides Pig p Pathology Slide Interpretation (select one) Mouse, Xeno Tissue Rat r Dr. Robert Sigler Dr. Mark Hoenerhoff TBD Rat Tissue Sheep s Dr. Ingrid Bergin Dr. Kate Eaton Other Tissue Xenograft x View ULAM Rates * IVAC may not always have positive control for IHC. It is up to the requestor to provide positive controls if not available in our lab. Rev. 09/19/2018