'l,StJ;L1s3.amazonaws.com/janus-cloud2/www/lovelace/dcr/935U.pdf · PHYSICAL EXAMINATION (AN)...

PHYSICAL EXAMINATION (AN) (Short Form) 1' . o ._-"'.J..o.?-"i,CJ.I...:3L-__ _

Tattoo Number 9, o SLA_ (N-Normal) (A-Abnormal) A. Date 'l,StJ;L1 1. Attitude B. Weight�gm 2. Conformation

3. Hydration c. Height (Shoulder)�

. .Q- 4. Nutritional status

D. Body Temp. (rectal lEll...-..L 5. Superficial lymph nodes 6. Membrane color

E. Pul<e Rate (femoral)� 7. Sk·in and ears f·. Respiration (rate/min. )2.Q._ 8. Eyes

9. Musculoskeletal system G. Genera 1 Condition: 10. Respiratory system

1. Comatose 11. Cardiovascular system 2. Poor 12. A1 imentary system 3. Fair 13. Urinary system 4. G� 14. Genital system S c- Excell.eOV 15. Nervous system

16. Endocrine sys tern 17. Teeth and gums

Techniciun

��,_J Clinician

----------�------------�---------

CHEMISTRY REPORT

TATTOO 935U

PATH #

SAMPLE DATE 84237

ENZYMES

ALKALINE PHOSPHATASE

S.G.P.T.

C.P.K.

L.D.H.L.

G.G.T.P.

S.G.O.T.

BIOCHEMISTRY

CALCIUM

B. U.N.

CHOLESTROL

INORGANIC PHOSPHOROUS

TOTAL PROTEIN

ALBUMIN

TOTAL BILIRUBIN

DIRECT BILIRUBIN

CREATININE

GLUCOSE

SODIUM

POTASSIUM

CHLORIDE

A/G RATIO

1/ET

RUN DATE 8423 7

'16. 00 IU/L AT 30 DEGREES C

56.00 IU/L AT 30 DEGREES C

IU/L AT 30 DEGREES C


IU/L AT 3 0 DEGREES C

IU/L AT 3 0 DEGREES C

MGS.% AT 30 DEGREES C

17.00 MGS.% AT 30 DEGREES C



GS.% AT 30 DEGREES C



MGS . % AT 3 0 DEGREES C

0. 70 MGS.% AT 30 DEGREES C

76.00 MGS.% AT 30 DEGREES C

MMIL

MM/L

MM/L

HEMATOLOGY

TATTOO 935U

EXP.NO.

P ARAME.!'ERS :

PLASMA PROTEIN

RED BLOOD COUNT

HEMATOCRIT

HEMOGLOBIN

PLATELETTS

PATH #

WHITE BLOOD COUNT

REPORT

EX PDT

7.2

7. 35

48.0

16.8

H

109

NUCLEATED RED BLOOD CELL COUNT

DIFFERENTIAL ABSOLUTE NUMBERS

SEGMENTERS

BANDS

METAMYELOCYTES

BLASTS

EOSINOPHILS

BASOPHILS

MONONUCLEAR LYMPHOCYTES

MONOCYTES

INDICES

6540

654

327

2943

436

DATE 84237 DPE

GMS./DL.

MILLION CU.M.M.

%

GMS/DL

THOUSANDS /CU.M.M.

HUNDREDS I CU.M.M.

MEAN CORPUSCULAR VOLUME 65. 3 CU. MICRON

MEAN CORPUSCULAR HEMOGLOBIN 22.8 MICRO-MICROGRAMS

MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.0 %

REMARKS:

OTHERS:

KEYS:

ANISOCYTOSIS

POLYCHROMASIA +

GIANT PLATELETTS +

POIKILOCYTOSIS +

HYPOCHROMAS IA +

RETICULOCYTE COUNT % RBC

1 - 5 % l+

6 - 10 % 2+

11 - 30 % 3+

31 - 70 % 4+

EXPER IMENTAL R E LEASE

ANIMAL I DENT! F1 CATION : _ ___:9c::3_::_5:_:_U:_ _______________ _

STUDY : __ B:cR:: Oc.cN C::H::I:_:_A=-L _:L:::A_:_V Ac:G:.:E _Ac_N--A:.:L_:_Y S::.: Ic:S__:cl N----NO.:cR_:_ M;_cA_::_L _:D_:O_:cGS :_A:_ N::_D -'0-'D-"GS:_W _IT_H ____ _

LUNG CANCER OR RADIATION PNEUMONITIS

PROTOCOL NUMBER : __ F:_:_Yc:8_4---'0"-7-"2 -------------------

This animal has satisfactorily completed the pre-experimental workup as

defined in the protocol for this study and meets its minimum requirements for

an experimental animal.

Date of Release

This release sent to : __ D_R_. _B_._A_. _M_U.:._GG:_E_N_BU_ R..;_G ___________ _

Date: __ �-"----

INHALATION TOXICOLOGY RESEARCH INSTITUTE

��·")JQ H. :. 4

1�21 1

� Z.vif aa.:.'J?y

Preparation:

5(/;:}d� t?&1-r?�v;

�tMP fJJc;-47/t (jl

RADIOLOGY

Type of Exam:

�st

0 Abdomen

D Survey

0 Extremity

0 Othec ____ _

Anesthesia:

�ow-,et / 1{: �tcopine I /-vk

0 Oiabutal

�cital }- (� 0 Halothane

0 Othec -------

Special Instructions:-----------------------------

lntecpcetation. _ _::r.;=-:'l,e>(__�------ ----------------

Cl1nician'-+---�----------- -- Date _ __:_c..!__�-- ---------

CENTRAL RECORDS

Procedures

RIJid Bronchoscope

Fle.xible Bronchoscope

Photographs

Vlsull' FlndlnltS

RIGHT

Diagnosis

Oiniciill


BRONCHOSCOPY REPORT

Anesthesia:

Jnnovar-Vet & Atropine

Diabutal

Surital

Halothane

Other

LEFT

D•te

WHITE- CENTRAL RECORDS CANARY- CLINICAL PINK- PATHOLOGIST

Dosage Route


BRONCHOSCOPY REPORT

Dosage Route

Anesthesia:

Cf35JL{ lnnovar-Vet & Atropine

'fC•,J )�ll 7 Diabutal

.--aao Surital "� 'l04

Halothane

Other

Procedures

RIJid Bronchoscope

Flexible Bronchoscope 1------L--

Photographs

Visual' FJndlnKS Luttdl ,')o,_,J} 5 aL:.. ( I

fcL r?\,;f =- "f/ c t:.._L (':x,i "13

RIGHT LEFT

Diagnosis

Oinician D•te


CHEMISTRY REPORT

TATTOO 935U

PATH #

SAMPLE DATE 84195

ENZYMES


S.G.P.T.

C.P.K.

L.D.H.L.

G.G.T.P.

S.G.O.T.

BIOCHEMISTRY ------------

CALCIUM

B. U.N.

CHOLESTROL


TOTAL PROTEIN

ALBUMIN

TOTAL BILIRUBIN

DIRECT BILIRUBIN

CREATININE

GLUCOSE

SODIUM

POTASSIUM

CHLORIDE

A/G RATIO

50.00

32.00

16.00

0. 70

o. 90

65.00

VET

RUN DATE 84195

IU/L AT 30 DEGREES c






MGS.% AT 30 DEGREES c










MM/L

MM/L

MM/L

'135\J )�ll) 0.·000 •• >04

Procedures

Rlsld Bronchoscope

Flexi�e Bronchoscope

Photographs

Visu.r FindinG

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

.r Anesthesia:

lnnovar-Vet & Atropine

Diabutal

Surital

Other

LEFT

O•te


Dosage Route

PHYSICAL EXAMINATION (AN} (Short Form} H.O. ________ _

Tattoo Number 1 �G"U (N-Nonnal) (A-Abnonnal) A. Date ?'-1 I 7 'i

B. Weight�_...,. c. Height (Shoulder}.3...£L . .2.

D. Body Temp. (rectal}Lill.·.J,<.!..

1. Attitude ....k:. 2. Conformation --""-3. Hydration _J_ 4. Nutritional status 5. Superficial lymph nodes :::=. 6. Membrane co 1 or

E. Pul'e Rate (femoral }.LQ...,h_ F. Respiration (ratc/r:',in.)�

7. Skin and ears .:.c B. Eyes

9. Musculoskeletal system V" G. General Condition: 10. Respiratory sys•em ...!£

1. Comatose 2. Poor 3. rair

�: ��llent -)

11. Cardiovascular system 12. Alimentary system � 13. Urinary system ...J<:... 14. Genita 1 system � 15. Nervous system .J:_ 16. Endocrine system / 17. Teeth and gums R �

----------------------------

--------------------------------· --------------------------·--

--------·-----------------------

Technician Clinician

13'>Li • ' 7UI7

··- ,,

••>04

Procedures

Rigid Bronchoscope

Flexible Bronchoscope

Photographs

Visual Findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

Anesthesia·

lnnovar.Vct & Atropine

Diabuul

Surital

llatothanc

Other

LEFT

D.rt.·

Dosage Route

WHITE- CENTRAL RECOIU>S CANARY LUNil'AL 1'11\.t. - I'ATH•U <ILI!'>r l,tlLIJENKOD- lli.L

...... 1!>111 ••-?00 N/S04

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

, Anesthesia

lnnovar·Vct & Atropine

Oiabutal

Surital

llalothanc

Other

LEFT

O,n,·

Dosage Route

WHITE- CENTRAL RECOIUJS CANARY CLINICAl 1'1'\t- -l'A11hll <)l,l�r <.tlLllENKOI> -I ILL

"''" ISll 1

.,_.)1}0

"� '))4

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

, Anesthesia:

lnnovar.Vct & Atropine

Diabutal

Suriu.l

llalothanc

Other

LEFT

Dosage Route

WHITE-CENTRALRECORDS CANARY Ll.INICAI. 1'1!\K -I'ATIH)IIK_,l!-,1 I,<)LJ>CNROD -II!.L

1')/17

Procedures

Rigid Bronchoscope


Photographs

Visual findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

\ (, /).L.

LEFT

D.n.·

Dosage

WHITE� CENTRAL RECOIU>S CANARY l'lt-.t-. ·-I'ATil<II<X..I�l <,tJLP(.NKOD �·IIIL

Route

t ,�, J •slt r J.'lll- j�· W:�Q4

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia·


Diabutal

Surital

Halothane

Other

LEFT

Dosage Route

WHITE- CENTRAL RECOKU!> CANARY CLINICAl I'lL\ I\- I'AHhll4)l,l:0.1 t,tlLIJI:NKtlll- I ILL

.. ( �. �

··- ,,

Ml5J4

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY R[PORT

, Anesthesia·

lnnovar-Vc1 & Atropine

Oiabutal

Surital

llalothanc

Other

LEFT

Dosage Route

I ---

WHITE- CENTRAL RECOK.[)S CANARY CLJN!CA1 I'll'> 1\ -PATH' >I< K.-1� 1 L< lLD(NkOD - 1 ILL

C H E M I S T R Y R E P O R T

TATTOO 935U

PATH # AN-000

SAMPLE DATE 83117

ENZYMES


S.G.P. T.

C.P.K.

L.D.H.L.

BIOCHEMISTRY

65.6

18.7

-1

-1

VET

RUN DATE 83117





CALCIUM

B. U.N.

CHOLESTROL

�MGS.'l. AT

MGS.% AT

30 DEGREES c

30 DEGREES c


TOTAL PROTEIN <SERUM>

ALBUMIN

TOTAL BILIRUBIN

DIRECT BILIRUBIN

CREATININE

GLUCOSE

SODIUM

POTASSIUM

CHLORIDE

A/G RATIO

251.00

5.88

7.19

4.16

0.24

-1.00

0. 70

95.40

-1.00

-1.00

-1.00

1. 37

MGS.'l. AT 30 DEGREES c

MGS. 'l. AT 30 DEGREES c

GMS.% AT 30 DEGREES c

GMS.'l. AT 30 DEGREES c





MEQ/L

MEQ/L

MEQ/L

f]JZI.f '6 c; ;r '6 '1·�?-U�

EXP.NO. 9999

F'ARAMETERS:

PLASMA PROTEIN

RED BLOOD COUNT

HEMATOCRIT

HEMOGLOBIN

H E M A T 0 L 0 G Y

TATTOO 935U

PATH. # AN-000

GRP 0

R E POR T

EXPDT -1

GMS. /DL.

MILLION CU. M. M.

7. GMS/DL.

DAlE 83117 DPE 0

PLATELETTS N

WHITE BLOOD COUNT 104. 0

NUCLEATED RED BLOOD CELL COUNT 0

THOUSANDS I CU. M. M.

HUNDREDS I CU. M. M.

'l. WBC


GRANULOCYTES - SEGMENTER$

BANDS

7800

104

0 METAMYELOCYTE$

BLASTS 0

EOSJNOPHILS

BASOPHJLS

MONONUCLEAR LYMPHOCYTES

MONOCYTES

104

0

2080

312

INDICES

MEAN CORF'USCULAR VOLUME 65. 9 CU. MICRON


MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.2 'l.

REMARKS:

OTHERS:

KEY:

AN I SOCYTOS IS 2+

POLYCHROMASIA 0+

GIANT PLATELETTS 1+

POIKILOCYTOSIS 0+

HYPOCHROMAS: I A 1 +

RETICULOCYTE COUNT -1 'l. RBC

1 - 5 'l. 1+

6 - 10 'l. 2+

11 - 30 'l. 3+

31 - 70 % 4+

g) J/ 't �.;�q-Z!�

.. 1�.' 1\117

"-010

H2>04

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

Anesthesia·

lnnovar-Vct & Atropine

Diabutal

Surital

Halothane

Other

LEFT

D.tk

Dosage Route

1.'

WHITE -CENTRAL RECOIU.lS CANARY CLINICAl r•r,-...>. I'AlH\)1 lk,,l�f I.•IU)£NIUII> -I ILL

INHALATION TOXICOLOGY RESEARCH INSTITUTE-HEMATOLOGY /CLINICAL CHEMISTRY REPORT

REQUESTED BY

1'><1• ,

_ _:&:_·,_J'_--: gm/dl D RBCf-".-""-""'r----xl0 6/mm3

OHCT r % D HGB /9. gm/dl D Platelets N!,f >'Vld 1.. xl03/mm3

D WBC c, xl03/mm3

D NRBC %WBC D MCV c , · "3

D MCH ·2 '5. ;._ pgms OMCHC �s ;2. % oRetlculocytes % DOth� ---------

ENZYMES

J ASAP [ STAT D{BC 0 OTHER CHEM .SEE BELOW g!IOSPITAL PROFILE

ISAP. SGPT, TP. ALB. BUN TB. CHOL GLU. CA. Pi

COLLECTION DATE 1?2\Ji HEMA!OLOGY

Abs Dlfferent1al

Segmmters Bands Metamyelocytes

\ No.imm3

Eosmoph1ls Basoph•ls Lymphocytes Monocytes

Red Blood c.lls AnisocytOSIS Rellculocytes Po•k•locytos•s Polychromasia

--2£:_ 7!tcc -----L-- �

_I __ --L.Q..<L

� .2o5c

__ 3 __ ----'--2:::.._

Hypochromas•a -�-�--

Giant Platelets --L.:t:__ SERUM CHEMISTRY

BIOCHEMISTRY

D Total Protem _7'--'·-9:_ ___ gm/dl OAc•d Phos ______ IUlL 30 OAibum1n /f . . 'roo gm/dl DAik Phos �.;· C. IU/L 30 oA G RatiO / . .17 DAmylase ______ IU/L30 Dlotai Bihrubm t).,'" mg/dl D CPK IU/L 30 D Indirect Blhrubtn _____ mg/dl 0 Gamma GTP IU/L 30 D BSP ________ %ret. D G6PDIRBC) IU/L 30" D BUN ___ ;..fL;j .. _,_ C, ___ mgidl D HBDH _______ IU/l 30 D Cholesterol ol,s·l _) mg/dl DLDH·L 1Uil30 OCreatmme _______ mgidl DL1pase _______ IU/L 30 OGiuoose �· "- mg/dl oSGOf _______ IUil30 oCale�um :.7. mg/dl OSGPT __ J./,.a.'f�·..:"c_ __ IU/l30 D Phosphorous � mgidl D Thyro�1ne ____ _ _

DISH Stirn _____ _

OOther

"g/dl OChlollde _______ mEqiL lJg/dl oPotass•um mEq/L

f'JSod1um mEq/l CENTRAL RECORDS

HISTORY

Addttlonal Comments

Tech/Path Date "/-.22/C

Add•t•onal Comments

Teth/Path brJ<-

15J'I1

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia

, lnnovar·Vct & Atropine

Diabutal

Surital

Halothane

Other

R.

C: L

LEFT

Dosage Route

WHIT£- CENTRAL RECORlJS CANARY CLINICAL I' I!'> I\ - I'ATH<JUJ01�'l t,tlU)(NKOD -I'ILE

INTEROFFICE MEMORANDUI'I

TO: R. K. Wolff

B. A. Mu�9enburs

FROM: D. E. Bico Of$

May 1€:. 1983

�3101>

SUBJECT: Use of doss 94'=�4. 935U, o:;o35T. 938T

Do�s 949A. 935U. Q35T and 938T wEorfo used as unexPosed

control doss in a study to evaluat� the effects of inhaled PuO?

on anti !':liens dePosited irr the l uns. Each do� was 1mmun12E-d bY

dePos i t ion of SRBC lfr the left cardiac. lung lob.;-. Th<2 riSht

cardiac and risht int�rmediate lung lobes rec�ived 1 ml saline.

Thes"' lurr� lobes wer·e lavased with five tLash,:,os of 10 rrrl saline a

total of 8 times. These exPeriments will finish .)r.me 1. JCI83.

V coPY to: A. D. Mur·r·in

•

D

0

....----"

if EMU

'6 ) ... J'ii ,,.,., RONALD K. WOLFF, Ph.D.

Jd;/3-�2__ '""

l....arks: -� 0 Ur 134-5 S:Jb

'13:S T so"\ 13.5(.(

\�'0-'T3�t7 9;)7X 93713 erne fj"'-f-'( A-

�;;;p�� - ). '

�w:J)� - � "'--"-d-�

��}J_-� r � iJ_.:.} 41A �

D

7Jj-2f

[

[

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

LEFT

Date

Dosage Route

r/

1-

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLO<.;!ST GOLDENROD FILE

'"' ' , U(tLUif

NUCLEAR MEDICINE

Clinician

Scan Type

D V/Q

0 Liver

0 Tumor

� 0 Bone

c

0 Other -----

Calibration Time: oro 0 Scan Time: fJL/1( •I

Injection Time: _____ __ �

Radioisotope

G<MAA o:,� mCi D x,

D KS mCi D 67G,

D To04 mCi 0 Other

D To-MOP mCi

Dose (RAD)

Wholo Body ___ _:0�(1:_,2__�---- ---

Organ of Greatest Localization

Summary

·Of

mCi

mCi

mCi

Cross Reference in Nuclear Medicine Log Book: .!J -:._3

D D-V

D V-D

0 L.Latcral

kg

Anesthetist: _ _!_1 A_'-:_· __ _ _

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetamc 0 Diabutal 0 Surital

�thane

0 None

D Othec, _____ _ _

Views:

�teral

D L. Oblique

D R. Oblique

Scan performed by: __ p.cL:_,.oy�-- ------ Read· -------- Date:

1115'&

1·/s·b'l 7 7 WHITE CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD fiLE

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia·


Diabutal

Surital

Halothane

Other

LEFT

Date

Dosage Route

CENTRAL. RECORDS CANARY CLINICAL PINK PATHOL<XOIST GOLDENROD FILf

Calibration Time:

Scan Time:

'lr o

,

Injection Time: _______ _

Radioisotope

[0'(MAA ,1) .':, -

mCi D x, D TC-S mCi D 67G, D Tc04 mCi O othcr

D Tc-MOP mCi

Dose (RAD)

Whole Body L

Organ of Greatest LocaliLation ,D

Summary·

NUCLEAR MEDICINE

Clinici.m

Scan Type

D V/Q

D Liver

0 Tumor

�MC

0 Bone

0 Other _

___ _

_____ mCi

_____ mCi

_____ mCi

D 0-V

D V-0

0 L.lateral

Cross Reference in Nuclear Medicine Log Book: J"]f � Scan performed by _.f.�'-::'..L-,J<::..L ____

___

__ Read·

Wt kg

Anesthetist: _ _;_K;_L'-'Li=_ __ _

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

0 Halothane

0 None

O Other· ______ _

View�·

a C f j-v

�.Lateral

D L.Oblique

0 R.Oblique

WHITE· CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD FILE

NUCLEAR MEDICINE

Clinician

Scan Type

D V/Q

D Liver

0 Tumor

� 0 Bone

0 Other ____ _

Wt

Anesthetist: £, �7_� Anesthesia:

0 lnnovar-Vet

0 Atropine

D Vetame

D Diabutal

O surital

�othane

0 None

kg

D Other ______ _

Calibration Time:

Scan Time: '�� ( �

Injection Time· _______ _

Radioisotope·

�AA ,Ot; mCi D x, _____ mCi

D TC�S mCi D 67G, _____ mCl

D Tc04 mCi D other _____ mCi

D Tc·MDP mCi

Dose (RAD)

Whole Body: ' o-:<

Organ of Greatest ·0 I

(�) Localization

Summary:

Reason for Scan:

D o.v

D V·D

0 L.Lateral

View�

�Lateral

D L.Oblique

0 R.Oblique

Ceo" Rdecoooe io Nod"' Medicioe Log Book·�--J._.Q;:{l.-"5 ____ _

Scan performed by: (? 'Y.J /.;..).J Kl _. Read· ---'�_,·_v_1 ____ 0ate·

WHITE- CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD- FILE

"ltLLlH

Procedures

Rigid Broncho�ope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

:JyL,,

+

LEFT

Date

Dosage Route

7 1.1�

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD FILE

''�" ?UIJ ,

I•CILUif

NUCLEAR MEDICINE

Clinician

Scan Type D V/Q 0 Liver 0 Tumor

u::rfMc

0 Bone

0 Othcc ____ _

Wt

Anesthetist: l?�v�,t Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

�thane

0 None

kg

s /;; b_� D Othcc ______ _

Calibration Time: 9oo I

Scan Time:

Injection Time: /;

Radioisotope

l}}'l(MAA ' ul) mCi D x, _____ mCi

0TC·S mCi D 67G, _____ mCi

D Tco4 mCi 0 Other _____ mCi 0 Tc-MDP mCi

Dose (RAO) Whole Body· ____ .c.:<>:..:U'---�'-----------Organ of Greatest Localization

Summary:

Cross Reference in Nuclear Mcm,

'l�ook: � 1 I Scan performed by: --J,� l (

Reason for Scan:

D D·V

D V-0

0 L.Latcral

View�

�lateral

0 L.Oblique

0 R.Oblique

Read __ _...z£:-.....:\l.__ _ __

D>t" s/JI> f I WHITE CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD FILE

JUI7

hC ILL•n

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:

, lnnovar-Vet & Atropine

Diabutal

Surital

Halothane

Other

Date

Dosage Route

WHITE -CENTR.AL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia·

lnnovar.Yet & Atropine

Diabutal

Surital

Halothane

Other

LEFT

12..

Date

Dosage Route


Calibration Time Z'_() !.2

Scan Time: !4<uu

lniection Time·

�MAA ,o;;-O TC-5

D T<04 D T<-MDP

Dose {RAD)

,

�4bt

Radioisotope

mCi D x,

mCi D 67G,

mCi 0 Other mCi

NUCLEAR MEDICINE

Clinician

Scan Type

D V/Q 0 Liver 0 Tumor

[!}'fMc 0 Bone

0 Other ____ _

mCi D D-V

mCi D V-D

mCi 0 l.Lateral

Whole Body: _ ___ �""-'C,_:l_::).,_ ____ _


Summary:

Cross Reference in Nuclear Medicine Log �--}--:-.7�'-;3=--------r Scan performed by: £. 1h {::0. ZL- Read: £�

Wt

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

Osurital

�thane

0 None

kg

0 Othec· __ ____ _

View�:

�Lateral

D L.Oblique

D R. Oblique

WHITE· CENTRAL. RECORDS CANARY CLINICIAN PINK PRINCIPAL. JNVESTIGATOil. GOLDENROD FILE

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Ane sthesia:


Diabutal

Surital

Halothane

Other

Dosage Route

t c "-- ' ./_, " l (

LEFT

I

Date

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK- PATHOLOGIST GOLDENROD- FILE

NUCLEAR MEDICINE

'" " ,

l ''ILL I If

Calibration Time:

Scan Time:

Injection Time: _ ______ _

�AA __ --'-'"-'--

D TC-S

D Tc04 D Tc-MDP -----

Dose {RAD)

Radioisotope:

Whole Body: ____ '--"--'--"-------

Organ of Greatest Localilation

Summary:

Clinician

Scan Type

D V/Q

D Liver

0 Tumor

(B"'TMC

0 Bone

<.__"

D Other ___ _ _

/rL,�!L Wt

Anesthetist: '':+L' /. .l Anesthesia:

D lnnovar-Vet

D Atropine

0 Vetame

D Diabutal

0 Surital

�alothanc

D None

0 Other

Reason for Scan: / 4 :c-«.J n. p (). �. 6o• II.; C::!/y I �(} /-.. I

7

View;

0 L.Oblique

D R. Oblique

/ 1 114 Cross Reference in Nuc lear �dicinc log Book:_�Z'--"0'--"')L_ _____ � : ; /_ .I 7 r Scanpocfotmedbyo t:;_'/1/U, KL Road· --lf!)."'- L!./L_ _____ Daw· �

WHITE CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD FILE

kg

75ll7

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:

lnnovar.Vet & Atropine

Diabutal

Surital

Halothane

Other

LEFT

Date

Dosage Route

v

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLtX;tST GOLDENROD FILE

NUCLEAR MEDICINE

Clinician

t 1\U JUI1 ,

Scan Type

0 V/Q 0 Liver

··� ILUif 0 Tumor

� 0 Bone

0 Other-----

Calibration Time:

Scan Time

Injection Time: ___ ____ _

Radioisotope·

[0'("MAA ---�""�---�mCi 0 Xe _____ mCi

0 TC-S mCi 0 67Ga _____ mCi

0Tc04 mCi 0 Other _____ mCi 0 Tc-MDP ----- mCi

Dose (RAD) Whole Body:'-----''-'0=-u=--'--'--------Organ of Greatest Localil.ation

Summary:

.of

0 D-V

0 V-0

0 L.Lateral

Cross Reference in Nuclear Medi� Log poo k :._=�{:--;y_:(:__ _ _____ �

Scan performed by: f:..Ljv �-.iJ .fS.Q.,J Read: ,R g..�_..

Wt

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

�hane

0 None

kg

0 Oth"-------

�-Lateral

0 L.Oblique

0 R.Oblique


'"" - ,

NUCLEAR MEDICINE

Clinician

Scan Type

0 V/Q 0 Liver

0 �m u;y'TMC

0 Bone

0 Othoc ____ _

Wt

Anesthetist: l! ==-:l -L:1_ Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0Surital

�hane

0 None

kg

Col;bcotiooT;m" ,fOil �/(.,by Scan Time: --1/..L/-'00'-"'------

0 Other, ______ _


Radioisotope

�-MAA ___ -""� ;..J: mCi

Orc-s

0 To04 0 To-MDP -----

Dose {RAD)

mCi

mCi mCi

0 x,

0 67G,

Oother

_____ mCi

_____ mCi

_____ mCi

Whole Body: _____ ·_:U=(J'-=-'�-----Organ of Greatest Localilation

Summary:

ReasonforScan: "S �_}y., 7c.,h:f 0,}54

0 D-V

0 V-D

0 L.Lateral

View�

�ateral

0 L.Oblique

0 R.Oblique

/ 7'1 otP

Cross Reference in Nuclear :/-V.Q.c Log Book:___;0�/r>/Y::________ ·7/, L, Scan performcdby: ��-1.,-Jy ROt.../ Read: -�/2'-\._Q:.Jlc./""-. ___ Date : � WHITE -CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD- FILE

Cf35V'-t�su 1�217

aoc ILUU

Procedures

Rigid Bronchoscope

Flexible Broochoscope

Photographs

Visual Findings


BRONCHOSCOPY REPORT

Anesthesia:

lnnovar.Vet & Atropine

Diabutal

Surital

Halothane

Other

RIGHT LEFT

Diagnosis

Clinician Date

Dosage Route

v

rnl4-d--

CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD

7Uif

1�; llLIRI

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician

WHITE


BRONCHOSCOPY REPORT

Anesthesia:


, Diabutal

Surital

Halothane

Other

LEFT

Date

Dosage Route

CANARY CLINICAL PINK PATHOU)GIST GOLDENROD FILE

ti\U 7U17 � r ••< I�LUY

NUCLEAR MEDICINE

Clinician c. 14.,: L Scan Type

0 V/Q

D Liver 0 T

7 [!YTMc

0 Bone

0 Othec ____ _

Wt

Anesthetist: .$-.� i..�f:..t Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 S�a \

[]�a lothane

0 None

kg

0 Other, ______ _ Calibration Time:

Scan Time:

I( Injection Time: _______ _

�MAA __ ---'--.:__:_-6<;"

0 TC-5

0Tc04 0 Tc-MDP -----

Radioisotope:

mCi 0 x, mCi 0 67G,

mCi D Other mCi

Reason for Scan:

_____ mCi

_____ mCi

_____ mCi

0 D-V

0 V-D

0 L.Latcral

Dose (RAD) Whole Body'-----�-''" -'= -':..:o:__o::__l.e:.._ __ _ Organ of Greatest Localization

Summary:

'";4r •u I

View�-

�ateral

0 L.Oblique

0 R.Oblique

Cross Reference in Nuclear Mcd�c � �ook:_----,;;-;'(;'-..-7'-;-'£-"-------

Scan performedby: '--. ��;Lly ,1 fZV Read· ----,f:?v"'---'-'----- Date·

WHITE- CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD- FILE

7Sll 1

• ._ILLUT

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia·


Diabutal

Surital

Halothane

Other

LEFT

Dosage Route

Date 2-!'-/- 7q

WHITE- CENTR.AL RECORDS CANARY CLINICAL PINK PATHOLCX;JST GOLDENROD FILE

NUCLEAR MEDICINE

Clinician

Scan Type 0 V/Q

D Liver 0 Tumor

� 0 Bone

D Other ____ _

c. ACJU Wt

Anesthetist: _LS -��..:6:L Anesthesia:

D lnnovar·Vet

D Atropine

0 Vetame

0 Diabutal

0 Surital

CZJ�othane

0 None

kg

;;,_,LJ'rjir 0 Oth"-------

Calibration Time: 9ou

Scan Time I �r<>to

Injection Time:

Radioisotope

�AA ,6r- mCi 0 x, _____ mCi

Orc-s mCi 0 67G, _____ mCi

0Tc04 mCi Dother _____ mCi 0 Tc-MDP mCi

Dose (RAO) ..A'-.? ,ou� Whole Body: _ __ ----:-.u-r-=�----,----tO/�/�) Organ of Greatest

localization

Summary:

Reason for Scan:

0 0-V

0 V-D

0 Llateral

View�·

�teral

0 LOblique

0 R.Oblique

_, q o �; Cross Reference in Nuclear Medicine log l}ooj:_-z,i:L-70�(,______ 1 / ·/�}, Sc.o P"fo•mod byo J:' :-v k:A.; ;;:J!+ Rood· ---+-/!?""--.,___-=--/----- o'" �1/r

WHITE -CENTRAL RECORDS CANARY CLINICIAN PINK I'RINCIPAL INVESTIGATOR GOLDENROD FILE

7UI7

l'C lllUI

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

LEFT

Date

Dosage Route

WHITE CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD FILE

'"" , AOLI�lUY

Calibration Time:

Scan Time /d. 'f(,

NUCLEAR MEDICINE

Clinician

Scan Type

D V/Q

0 Liver 0 Tumor

� 0 Bone

DOth" -----

Reason for Scan:

Injection Timc: __ L/ J"'-'$"'-l.t"---'f'-----Radiois01ope

�-----"=-,o )mc; D x, _____ mCi

Orc-s D Tc04 D Tc-MDP -----

mCi

mCi mCi

D 67G, _____ mCi

0 Other _____ mCi

Dose (RAD)

Whole Body ''-----'-.-df="'--+--'-()0_:<_ __


Summary:

� .of

D 0-V

D V-0

0 L.Lateral

c jL.:_L, Wt kg

Anesthetist: ------

Anesthesia·

0 lnnovar·Vet

0 Atropine

D Vetamc

0 Oiabutal

D Surital

0 Halothane

0 None

D Oth"-------

View�

�a I

0 L.Obliquc

0 R.Oblique

Cross Reference in Nuclear Medicine Log Book:_;;v�G'"-:'C"-·-'-j _ _ ---::---::--Scoo p"fo•med by' &.;!.. 4.

1 f('k/ R"d' --+1)-''-9---'-�----- Om [EIJ / 0 /'l7y WHITE· CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD FILE


BRONCHOSCOPY REPORT

Anesthesia:


fi\U "'" Diabutal

UCIUIU Surital

Halothane

Other

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT LEFT

Diagnosis

Clinician Date

Dosage Route


' ''" 1UI1 ,

••nu.ur

NUCLEAR MEDICINE

Clinician

Scan Type

0 V/Q

0 liver

0 Tumor

W'c 0 Bone

0 Other _ __ _ _

Wt

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vctame

0 Diabutal

0 Surital

[l}'fGtothane

0 None

kg

Calibration Time· -�Z._,o,_, <J"-'--'.;,"'+(�5"f/_._7y D Other _ _____ _

I Scan Time: _ _uft.,� ,_,\>.__ __

_ 1 __


�AA

Orc-s 0 To04 0 To-MOP

Radioisotope

(J, 0S me;

mCi

mCi

mCi

0 x,

0 67G,

O othcr

_____ mCi

_____ mCi

_____ mCi

Do� (RAD) �

Whole Body ------w+=�'-+ --•_0_0 ____ _ Organ of Greatest Localization

Summary:

.V\ N/�j

Reason for Scan:

0 D·V

0 V-0

0 L.Lateral

View�:

�ateral

0 L. Oblique

0 R.Oblique

1q {)�lt 'ff -S Cross Reference in Nuclear Medicine Log BooJc _�� -lt,.;._-- ----� ') /, 7 0 Scan performed by: (':it..�� . Read· �C.....,._'h--'-'< �----- Date c:/' -if- J

WHITE· CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD FILE

.�\11 ""'

a�c ILUtf

Calibration Time:

Scan Time

,

lojoctioo Timo· _______ '1�

�AA_..,C c_· ·-1-/�

OTC-5

0 Tc04

0T<-MDP -----

Dose (RAD)

Radioisotope:

mCi 0 x,

mCi 0 67G,

mCi Oothcr mCi

NUCLEAR MEDICINE

Clinician

Scan Type

0 V/Q

D Liver

0 T/

[]/fMc

0 Bone

0 Othoc ____ _

Reason for Scan:

mCi 0 D-V

mCi 0 V-D

mCi �ateral

Whole Body·----��0"-"'··i:_L_ _____ _


Summary:

Wt kg

Anesthetist: ------

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

�othane

0 None

O Othec ______ _

Views

0 R. Lateral

0 L.Oblique

0 R. Oblique

7� 3�1

Dm J-y�;6'\. WHITE- CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD fiLE

•l�U 1�111

PROFILE REfWEBTE:n: __ LIVER RFNAL

__ TUMOR _ FN!IOC:RINE _OTHER _ 1-LUI[f TYPE

JULIAN DATE 7-t . .. :Z. L:i

... ... TOT PROT PLASMA __ _,{,;,_i _ _ _ _ RBC. _'Z ..... <e<2- .... ---- ----·

...... HCT .dfl,(!_ .... _HGB ... ... J .. tc ... �'-·--· -·--· -- --·

... -PLATELET s'h·<.'J.c,n,.;._(. ... _ .... .. ..

... -WBC .. JI..:> .. : .... . _ -- -·-·--· .. ---· .. .. NRBC .. ... ... _,_____ .. _ -·-- ..... ..

... ... Mcv __ «:..t<.� ....... MCH . ... -<62-Y!

___ MCHC __ j_?__�':L. .. ____________ .. __ _

....... RET!CULOCYTES ___ _____ ----

GIANT PLATELETS ____ _

ENZYMES

SEGS __ 0_ BAND

��A

-�z:= BASO

LYMPH MONO ANISOCYTOSIS ..

POIKILOCYTOSIS ...

POLYCHROMASIA -

HYPOCHROMAS I A .........

BIOCHEMISTRY

.... ALK PHOS .. HI/L 37 TOTAL PROTEIN ... . _ LDH·-P KAU 37 . ALBUMIN

_ SGPT __ UNIT /Dl _ .... CPK. ·--.. - ... IU/1 37 ____ GAMMA GTP____ _IU/l. 30 .... G6PD _ __ ____________ IU/L 37 .... HBDH ___ ____________ IU/L 37

_LDH-L .... __ .... ........ _ ILI/I 37 ...... ACID PHOS IU/L 37

LIPASE _____ UNIT /Ml

A!G RATIO

TOTAL BILI

_[ITRECT fl!LJ __

BSP BUN ---·-·

_ CHOLESTEROL ...... CREATININE. ---

- .JlUJCOSE ____ ________ ..

....... AMYLASE.......... . . ... UN !TS/DI ... ... SGOT _ .... KU/ML

ELECTROPHORESIS

OTHEf< CHEMISTRIES REQUIRED?

I'ECH/F'ATH

. CALCIUM ·-

. PHOSPHORUS

SODIUM ...... -POTASSII.JM

CHLORIDE_

THYROXINE.

TSH STIM

.. . . DATE

ABS.NU.

..1..!.2:

_GM/.

.GMZ

MD%

MG%

MGZ MD%

MF0/1 MF!UI

MEC>/1.

. MF;%

MGZ

INTERPRETATIIJN

ADDITIONAl

COMMFNTS

NUCLEAR MEDICINE

Clinician Wt kg

Scan Type

D V/Q

Anesthetist: --"'--'{_C::/=-f--={,'-Anesthesia:

"'"

UCILUU

Calibration Time·

Scan Time:

•I Injection Time: _______ _

�A L>,/ Orc-s 0 T<04 0 T<-MDP -----

Dose (RAD)

Radioisotope:

mCi D x,

mCi D 67G,

mCi O other mCi

Whole Body: _ __ __ --'-".c_"L_ ___ _ _

Organ of Greatest Locali;ation

Summary ·

0 Liver 0 Tumor

(]/f'M c 0 Bone

D Oth" -----

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

c::zvCalothane

0 None

O Otherc ______ _

Reason for Scan: {�,: 1-a-L.v.••

View�:

mCi D D-V D R. Lateral

mCi D V-0 D L. Oblique

mCi Wc.Latcral D R. Oblique

lP3'l> Cross Reference in Nuclear Medicine Log Book:��-"'-L(-"-------- /._ Scanperformedby: .;('',h. '"1.- Read· ----'R'c:'-:__:-1,_"------Da te : ��//{ WHITE· CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD FILE

ti\U 7UI7

a.CILLIU

Procedures

Rigid Bronchoscope


Photographs

Visual Findings


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

, Surital

Halothane

Other

Dosage Route

L /

� L ---r:u. Z

RIGHT LEFT

Diagnosis

Clinician Date 115 X 38 WHITE-CENTRALRECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD FILE


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal ntlf

Surital

I•C ILLUY Halothane

Other

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT LEFT

Diagnosis

Clinician Date

Dosage Route

t/

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOL(:K;IST GOLDENROD FILE

UCILLUY

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


f Diabutal

Surital

Halothane

Other

LEFT

Date

Dosage Route

WHITE� CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD fiLE

,

NUCLEAR MEDICINE

Clinician

Scan Type D V/Q D Liver 0 Tumor

� 0 Bone 0 Other ___ _ _

C, 14.;:_;" Wt kg

Anesthetist: ----"--V--"'(.'--1 = l'=t-Anesthesia:

0 lnnovar-Vet

D Atropine

D Vetame

0 Diabutal 0/ital

[!) Halothane

0 None 0 Othec. ______ _

Calibration Time

Scan Time:

Injection Time --------

Radioisotope·

�AA _ _,Q'--.Lf __ mCi 0 X0

0 TC-S mCi 0 67G, ____ _

D Tc04 mCi D Other ____ _

0 Tc-MDP _____ mCi

Dose (RAD) Whole Body -------''-'C)(.)'-"--1-------Organ of Greatest Localization

Summary

Views

mCi D D-V D R. lateral mCi D V-D D L. Oblique mCi �-Lateral D R. Oblique

Cross Reference in Nuclear Medic�<.,;Lor-Book : 71 _,___,_h;_jlc_ ____ _ Scan performed by: (5;_ 1'., l t.v Read: -----"t(C.>..·_- >-"�----- Date

WHITE- CENTRAL RECORDS CANARY CLINICIAN PINK- PRINCIPAL INVESTIGATOR GOLDENROD rtLE

7UI1

.. CILLAU

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

LEFT

Anesthesia:


Diabutal

Surital

Halothane

Other

<t,;' L <> . .c f_.,o

Date

Dosage Route

WHITE CENTRAL RECORDS CANARY CLINICAL PINK PATHOUXi!ST GOLDENROD FILE

UCILUIY

NUCLEAR MEDICINE

Clinician

Scan Type

D V/Q

0 Liver 0 Tumor

[t}--1'MC D Bone

0 Other -��-

Wt

Anesthetist: L/ UJ .t� A Anesthesia:

D lnnovar-Vet

0 Atropine

D Vetame

0 Diabutal

0 Surital

�hane

0 None

kg

D Othoc•_�� Calibration Time·

Scan Time

Injection Time:��-'C''�-

�MAA _�--'L'-L--o. I Orc.s 0 Tc04 0 To-MOP-��-

Dose (RAD)

Radioisotope·

mCi D x, -��mCi

mCi D 67G, -�� mCi

mCi 0 Other -��mCi

mCi

Whole Body·-��-"' .LU"-L��-

Organ of Greatest / Locali?ation -��·&u<,..ly/'-'-d:;;z.u.• --;'r-f��-

Summary: 1 J J

D 0-V

D V-0

�eral

Views·

1 I I

0 R. Lateral

0 L.Oblique

D R. Oblique

I a

1�9-'� Cross Reference in Nuclear Mcdicine l� Book : _�,&:=----:9--L/�� - 1 Scan performed by: !::::::_ V L-t./ Read:

�--1-R_,_'It/_:_::_��- Date: ) 7/<)�,;, r

WHITE· CENTRAL RECORDS CANARY CLINICIAN PRINCIPAL INVESTIGATOR GOLDENROD fiLE

UCILUU

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

LEFT

Date

Do�ge Route

v


NUCLEAR MEDICINE

Clinician Wt kg

Scan Type

ntu "'!" '' D V/Q

Anesthetist: ------Anesthesia:

10( IL�liY

Calibration Time:

Scan Time:

Injection Time· __ ____ __:4'-----

Radioisotope:

�AA __ J.6t_-:__j__ mCi 0 Xe Orc-s me; D 67G, -----

0 Tc04 mCi 0 Other -----

0 Tc-MDP _____ mCi

Dose (RAD) Whole Body: ____ __,_j..il,i_I_ _____ _


Summary:

,Q;) !:Z. )

D D D D D

mCi

mCi

mCi

Liver Tumor

TMC

Bone

Other

Reason for Scan:

D 0-V

D V-0

�teral

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

O surital

0 Halothane

0 None

D Other, ______ _

Views

D R. Lateral

D L. Oblique

D R. Oblique

/ 7� ?,O':J Cross Reference in Nuclear Medicine Log Book · -,---�L.!>_L______ JJ J_ Scan performed by· R\:v· \; "0 Read: __ Aeo__:"L-"'--/---- Date t)o/7b'-

WHITE ·CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD FILE

''�u

HC ILLAU

Calibration Time· /"<...:.:; !_o/_}/_IS I

Scan Time ,) .,

Injection Time

Radioisotope

G--r;:MAA {). / mCi 0 x, ) 0 rc.s mCi 0 67Ga

0 To04 mCi Oother

Oro.MOP mCi

NUCLEAR MEDICINE

Clinician

Scan Type 0 V/Q

D Liver 0 Tumor

[9/i'Mc

0 Bone

0 Oth" -----

Reason for Scan:

I L >=""'

mCi 0 0-V

mCi 0 V-0

mCi ��ateral

Dose (RAD) Wholo Body _____ ._:U'-'G:__"-______ _

Organ of Greatest Locali1ation

Summary·

Wt kg

Anesthetist: '-C-1.. _)..; Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Soy<at

cb �alothane

0 None

D Other ______ _

View�:

0 R.lateral

0 l.Obliquc

0 R.Oblique

7�).1)o Cross Reference in Nuclear Medi� Book:.�-------'">::ui_S ____ �""' Scan performed by: Z:;.,..._!. 1 Read· -"-X-�----- Date: ,lj.


Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

"

LEFT

Date

Dosage Route

CENTRAL RECORDS CANARY CLINICAL PINK PATHOUX;IST GOLDENROD FILE

NUCLEAR MEDICINE

tnu 7Ut7 ........ lD

Calibtion Time

Scan me

,

lnjecti(Time: _______ _

Radioisotope:

mCi 0 x, Orc-s ___ _ mCi 0 67Ga 0Tc04 ----- mCi Dother

0 Tc-MDP ___ _ mCi

Dose (RAD) Whole Bod ______ '_:'' ------Orga.nofGrltcst Localization -----�·-'-/-�----

Summary

Clinician

Scan Type

0 V/Q

0 Liver 0 Tumor

1]1/tMC

D Bone

0 Other ____ _

Reason for Scan:

mCi 0 D-V

mCi 0 V-0

mCi [],-{[_""''

Wt kg

Anesthetist: ---'''---''�L''---'/ __

Anesthesia:

D lnnovar-Vet

D Atropine

D Vetamc

D Diabutal

D Surital

O·'Halothane

0 None

0 Other ______ _

. . j

View�:

0 R. Lateral

0 L. Oblique

0 R. Oblique

Cross Reference in Nuclear Medicine_Log Book:�--,.-'c-·--";--_____ 7, > , Scan performed by· ___ L,__· -----��-�'-'--- - Read· -�-------Date

WHITE· CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL. INVESTIGATOR GOLDENROD rJLE

USU 7UI1 r

NUCLEAR MEDICINE

Clinician

Wt kg

.. UIIIIlG Scan Type

0 V/Q

D Liver

0 Tumor

Anesthetist: ___ '_.t_lc.'-'' --

Calibration Time:

Scan Time·

Injection Time : _______ _

[] To-MAA ---�

OTC-5

0 To04

0 To-MOP -----

Dose (RAD)

Radioisotope:

mCi 0 X ' mCi 0 67G,

mCi 0 Other

mCi

Whole Body: __ ___ ,__ ______ _

Organ of Greatest

Localization

Summary:

-.�

Anesthesia:

0 lnnovar-Vct

0 Atropine

[]j� 0 Bone

0 Vetame

0 Othec ____ _ 0 Diabutal

0 Surital

�thane

0 None

0 Othec _ _____ _

Reason for Scan·

Views:

mCi 0 0-V 0 R. Lateral

mCi 0 V-0 0 L. Oblique

mCi �Lateral 0 R. Oblique

c' j

Cross Reference in Nuclear Medicine Log Book.: _ _ �"'-------� Scan performed by: / · �· Read _£____:____ _____ Date: ---"----:L--


u�u 7UI1

UUUIUlD

Procedures

Rigid Bronchoscope


Photographs

Visual Findings


BRONCHOSCOPY REPORT

Anesthesia·


, Diabutal

Surital

Halothane

Other

.. :17 �d

Dosage Route

RIGHT LEFT

Diagnosis

Clinician Date 28 210

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOUX;IST (;OLDEN ROD FILE

UIU 1Uif

UUIIIIll

Procedures

Rigid Bronchoscope


Photographs

Visual Findings


BRONCHOSCOPY REPORT

Anesthesia:


, Diabutal

Surital

Halothane

Other

) • 3 ,,

RIGHT LEFT

Diagnosis

Clinician Date

Dosage Route

v


HSU na11

VUUIUEO

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:

lnnovar-Vct & Atropine

, Diabutal

Surital

Halothane

Other

� :2 78

v

Date

Dosage Route

,111 tUt

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOUX;IST GOLDENROD FILE

, v•antllll

'f 111 .,.

Calibration Time: 'loy

NUCLEAR MEDICINE

Clinician

Scan Type

0 V/Q

D Uver

0 Tumor

[if TMC

0 Bone

c

0 Other ____ _

1./n�!g?,. Wt kg

Anesthetist: Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

�alothane

0 None

O Other

Scan Time i/0<, Injection Timc: __ 1'_1_• ___ 11

_1_:_• _1 '_

Reason for Scan: _...!1!.!1-<<-S:,_' (�' �- �Jd.Odl..<:ccju, t-"'-'C:.!' "-'"�-UXf PL pcaf -"� p """ 1>

Radioisotope

[}(-MAA .0'>- mCi 0 x, 0TC·S mCi 0 67G, 0T<04 mCi Oother

0 T<·MDP mCi

Dose (RAD)

Whole Body: __ _,_, _c("'>O c_0,;,- �--------Organ of Greatest Locali1ation

Summary

0 I I.(,,.,.&)

View�·

mCi 0 D·V 0 R. Lateral

mCi 0 V-D 0 L. Oblique

mCi 0 l. Lateral 0 R.Oblique

1S I�� Cross Reference in Nuclear Medicine Log Book: __ 4-'---.!1c.3-"C ______ � Scan performed by: S. ltVc:f.[{ ( Lt'm{"..<, ;.;t- Read: --''-'->!'<..' ____ __ Date· 1,/t :,frs

WHITE CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOI.OENROO FILE

tHU 7UI7

UUUIIIID

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

Anesthesia:

, lnnovar-Vet & Atropine

Diabutal

Surital

Halothane

Other

., 13 111

LEFT

Date

Do�ge Route


9lSU 1S217

UNASIIUlD

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Oinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

";?, y Z----en. , ·'<�

LEFT

Date

Dosage Route

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDENROD· FILE

135'-' NUCLEAR MEDICINE

Clinician Wt kg

""" '""

uMUIIUU

, Scan Type

D V/Q

D Liver 0 Tumor

GfTMC

0 Bone

Anesthetist: _<L�£=.;f».=''I'/K+'"'->,;t;:L_ Anesthesia:

., 7"M

Calibration Time: Ctoo tl 7-L1 '1. r 1 Scan Time: , ,- -, ,,

Injection Time : " ,, 1-

Radioisotope:

�c·MAA D{ mCi D x,

0 TC-S mCi D 67G,

0 To04 mCi 0 Other

0 To-MOP mCi

Dose (RAD)

Whole Body: _ _i,0!_,.;:0.>0!_,-"-0 ---------

Organ ofGreatest '\ Localization ---''-"0'-i'--l{-"{:"=""'J"";j-;)1------

Summary: Mt"'V-lcl .::tA �-r

D lnnovar·Yet

0 Atropine

0 Other ____ _

0 Vetame

0 Diabutal

osurital

[kJ Halothane

0 None

D Oth"-------

ReasonforScan: H2SOt, d1.r� cv..x...

cl-110 r .. :r , ., ?"""'-'-

Views:

mCi D 0-V D R. Lateral

mCi D V-0 D LOblique

mCi [S?' L Lateral D R. Oblique

Cross Reference in Nuclear Medicine Log Book:_.I_-'.b _!<fc_ ______ _ 7� \�t

Scanperformedby· f\cnVck.{( C Efw'/"""w-t: Read : _ck_,_' L>L ______ Date: T/7-hf< WHITE CENTRAL RECORDS CANARY CLINICIAN PINK PRINCIPAL INVESTIGATOR GOLDENROD PILE

9lSU 75111

UUUICUO

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician

,


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

Dosage Route

1 1;- f0-..-.2 ,, 1 j, d1 a

LEFT

Date

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST GOLDC:NROD FILE

'ISU 1,111 r .AUIUID � � II_Jv4 �

7 e..,.

Calibration Time·

Scan Time

RJdioi�otopc

�-MAA (, mCi D x, OKS mCi D 67G,

0 To04 mCi Dother

Oro.MDP mCi

Dose (RAD)

Whole Body: c )

Organ of Greatest l-&.i I Localilation l/ I , I

Summary:

Cross Reference in Nuclear

NUCLEAR MEDICINE

Clinician

Scan Type D V/Q

D Liver 0 Tumor

[]j/fMC

D Bone

0 Other -----

Reason for Scan:

l;..:o L

mCi D D·V

mCi D V-D

mCi �Lateral

Wt kg

Anesthetist: __,( __,U,_.,"�7., __ a"--Anesthesia: (;

0 lnnovar-Vet

0 Atropine

0 Vctame

0 Diabuta\

osurital

�lothanc

D None

D Other ______ _

View�

D R. Lateral

D L Oblique

D R. Oblique

Scan performed by:_--"'""--'-""-"'iif'-,--'-�c'."'�""""T'�..L!.- Read:

PINK PRINCII'AL INVESTIGATOR GOLDENROD FILE

tHU JSIIJ ,

NUCLEAR MEDICINE

Clinician Wt kg

UUUIIIII Scan Type Anesthetist: ______ _

0 V/Q

0 liver

0 Tumor

0 TMC

0 Bone

rn----bther INC

Anesthesia:

0 lnnovar-Vet

0 Atropine

0 Vetame

0 Diabutal

0 Surital

[ZYfGiothane

0 None

D Other ______ _

Calibration Time:

Scan Time:


Radioisotope

�-MAA __ __c_:• tJ:=S_mCi D xe 0 TC-5

0 Tc04

_____ mCi 0 67Ga ----

_____ mCi D Other -----

D Tc·MDP _____ mCi

Dose (RAO)

Whole Body: _____ ��------


Summary:

Reason for Scan: /bSQ � '[! ?lr C

View!>

mCi 0 0-V 0 R. Lateral

mCi 0 V-0 0 L. Oblique

mCi rn-<.Lateral 0 R.Oblique

Cross Reference in Nuclear Medicine Lo1._Book ----:--------Scan performed by: .R �--) 1,·C:ft!, ..:._ 'Read: _ ___, __ r_,_) _._ ____ Date


I>\

9HU 7SII7

UNASSIUED

Procedures

r Rigid Bronchoscope

I Flexible BronchOSGope

f Photographs

Visual Findings

RIGHT

Diagnosis

Clinician

,


BRONCHOSCOPY REPORT

I /

I v I

Anesthesia:


Diabutal

Surital

Halothane

Other

I Cytology, Brush I [ Cytology, Wash I I Biopsy I

LEFT

Dosage Route

Da" 7 q / (:; j WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLCK;!ST GOLDENROD F!LF

SPECIAL RADIOGRAPHIC SURVEY

Tattoo 10 / Oete

I Posit1on R•llon B G NS Thick OIST (Cm) (In) KVP Ml SEC Comments

I {} I ),u I II /y

''1 <;, (J-� (, /l !; /f 1tr1 l';

I

-----·-- -+----+-1-1--1----l--l---l-_.)_--+---- --

A lc ", _l /U - ;;l

�----�----_L��L__J __ l__L�L_�-----� Rad•oeraph•c Ft,dln .. : ___ -�,...1 __;L__:L_=------- -,�---------------

(

HEMATOLOGY

TATTOO 935U

PATH •

EXP.NO.

PARAMETERS:

REPORT

EX PDT DATE 86211

GMS./OL.

OPE

PLASMA PROTEIN

REO BLOOD COUNT

HEMATOCRIT

HEMOGLOBIN

PLATE LETTS

6.5

.B...2..1

52.4

18.5

Mil LION CU.M.M. 1' "

WHITE BLOOD COUNT

NUCLEATED RED BLOOD CELL COUNT


N

95

SEGMENTER$ 6365

BANOS

METAMYELOCYTE$

BLASTS

EOSINOPHIL$ 285

BASOPH I LS 95

MONONUCLEAR LYMPHOCYTES 2565

MONOCYTE$ 190

INDICES

GMS/OL

THOUSANDS /CU.M M.

HUNDREDS I CU.M.M.

MEAN CORPUSCULAR VOLUME 63.8 CU.MICRON


MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.3 %

REMARKS:

OTHERS:

KEYS:

ANISOCYTOSIS

POLYCHROMASIA

GIANT PLATELETTS

POIKILOCYTOSIS

HYPOCHROMASIA

RETICULOCYTE COUNT

1 - 5 " � 1 +

6 - 10 " - 2+

11 - 30 % . 3+

31 - 70 " . 4+

% RBC

pz__

CHEMISTRY REPORT

? PATH *

SAMPLE DATE 86211 86211

ENZYMES

ALKALINE PHOSPHATASE 74 .20 IU/L AT 30 DEGREES C

S .G .P. T. 29. 40 IU/L AT 30 DEGREES C

c. P.K. IU/L AT 30 DEGREES C

L.O H. L. IU/L AT 30 DEGREES C

G.G. T. p. IU/L AT 30 DEGREES C

S.G 0. T. IU/L AT 30 DEGREES C

BIOCHEMISTRY

------------

CALCIUM MGS .% AT 30 DEGREES c

B.U.N. 14.30 MGS .% AT 30 DEGREES c

CHOLESTROL MGS .% AT 30 DEGREES c

INORGANIC PHOSPHOROUS MGS .% AT 30 DEGREES c

TOTAL PROTEIN GS .% AT 30 DEGREES c

ALBUMIN GS .% AT 30 DEGREES c

TOTAL BILIRUBIN MGS .% AT 30 DEGREES c

DIRECT BILIRUBIN MGS.% AT 30 DEGREES c

CREATININE MGS.% AT 30 DEGREES c

GLUCOSE 78. 10 MGS.% AT 30 DEGREES c

SODIUM MM/L

POTASSIUM MM/L

CHLORIDE MM/L

A/G RAT 10

HEI'1ATOLOGY

i'"tJ.:I1A F"rwn:rr. I;( ED D: __ O(Il) O::OI.JN 1

1[ I<

1"11">·11':":

OF!f·:·t .. !::::.r·J.Jl VOLI.Ji'1F i'·r�··:·u::: -, HFIV:Cii3LOBIN

I,I!,J, HFMCIGIJ1BIN

I_·_ (

l-+ 1·

REF'OPT

EX PDT

1,:: • • ·:) ''�.Ol

,.

:.6()

D?'iTE

C.it·1::::. /DL.

f 1'1Tl ... Lim,J CIJ.I'1,

THOU::':::AND:�

11Ui'-IDHED'3 I

(::I.J.I'1JCRO!'>!

' T

I �I ' !- �� !;;1 I'

' fol :n

1-11 " �( (.' "T ., '

D I ��· I

' • ·.� r'-'

'L

PHYSICAL EXAMINATION (AN)

(Short Form)

Tattoo Number j "l vU.. H.O. _ ___,:J__.q_,;<�q�<j+-

(N-Nonnal) (A-Abnormal)

A. Date ZS??il �-'> � '> B. Weight��

C. Height (Shoullor)_2_L._Q_ D. Body Temp. (rectal )JQ.L.__Q

I. Attitude 2. Conformation 3. Hydration 4. Nutritional status _ 5. Superficial lynph nodes _

6. Membrane color E. Pulse Rate (femoral)_l:i!Q_ F. Respiration (rate/�in.)0.:i._

7. Skin and ears 8. Eyes 9. Musculoskeletal system

G. General Condition: 10. Respiratory system

1. Comatose 2. Poor 3. Fair 4. Good

5. �

11. Cardiovascular system 12. Alimentary system 13. Urinary system 14. Genital system 15. Nervous system 16. Endocrine system 17. Teeth and gums

C01·11�UHS:

Technician \J;V Clinician

INTEROFFICE MEMORANDUM

TO: D<.8.A.Muggenbu<g

FROM: D<.S.L.Whaley � RE: Reassignment of Dogs

Ap<i1 30,1985

SS"i<o

The following dogs were used for the experiment THE EFFECTS OF AGING ON TRACHEAL MUCOUS CLEARANCE. As desc<ibed in the p<otocol, these dogs are to be returned to their oricpnal colonies at the end of the experiment. Please remove the upkeep and maintenance costs of these animals t rom cost code 4011.

UNASSIGNED DOGS 1437A 143BT l441S l441U l442T 144.>T l445A 14458

ANCILLARY DOGS 9345 935T 935U 938T 927X

9378 937C

AGED DOGS 367T 395S 406S 419S 4378 441C 544A 5668

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital

Halothane

Other

LEFT

Date f�7u/

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK PATHOLOGIST

Dosage Route

I

MEDICAL RECORDS

EXPOSURE RECORD FOR ANIMAL

TATrOO: 9,3�-U

PROTOCOL NUMBER:�fLV�r��- ---�� -- ------

COST ACCOUNT:��Y£07�/�-----------

STUDY: ..,J,F t.(fu-tl i<(''><- 'IM.G

INVESTIGATOR: IJ�r

RADIOBIOLOGY NUMBER''------------------

EXPO ;uRE DATE :. _ _:Y:_::':.:_-_:_1 tr!::_:_ __________ _

EXPOSURE AGE''------------------

BURDEN/UCI /1!110:• ___ 2.£!�-'-f"O!'L&_""=�--------

PATH INDEX NUMBER:: ____________ ______ _

DEA'l'H

TOXICANT

Inhalation: ___ __ ______ __

Intravenous: ___ _______ _ __

Instillation: t?'l� 1i: - �tA-:4 -!<-"--"'�

OTHE .l : __________ __

CONTROL: -----------

DATE: ______________________ ___

DAYS POST EXPOSURE: ________________________ _ __

AGE AT DEATH: _________________________ __

xc: CLINICAL PATHOLOGY

Procedures

Rigid Bronchoscope


Photographs

Visual Findings

RIGHT

Diagnosis

Clinician


BRONCHOSCOPY REPORT

Anesthesia:


Diabutal

Surital I Halothane

Other

LEFT

Date

WHITE- CENTRAL RECORDS CANARY CLINICAL PINK- PATHOLOGIST

Dosage Route

MEDICAL RECORDS

EXPOSURE RECORD FOR ANIMAL

TAlTOO: 93 � U

PROTOCOL NUMBER :_(Lli.(_,_�.::�-_-_.:::07_.:_/L_ _ __ _

COST ACCOUNT:_�J7�/ _____ ___

STUDY: .,J1g Cffu-tl !¢{''"- 'IM.(,

INVESTIGATOR :_�LiJ,c' LvJ.!':'�,�r';F=----RADIOBIOLOGY NUMBER: __ ______ _

EXPO mRE DATE ,_____,J>;;=-0'-'8'-'1 __ _ __ _

EXPOSURE AGE:, ___ _ ____ _ _

TOXICANT

Inhalation: ____ __ _

BURDEN/UCI/�:,_-=£0�,�L'�d_�--

--- Intravenous: _____ _ _

Instillation: c?9/)( 72" · l-1tJA PA1'H INDEX NUMBER •---------- --�>-��

OTHE_,, _____ _

CONTROL: -------

DEATH

DATE: ___ __ ___ __ __ _

DAYS POST EXPOSURE: __ __ _____ ___ _

AGE AT DEATH: _________ ___ _ _

xc: CLINICAL PATHOLOGY

INTEROFFICE MEMORAND�M TO: Dr.B.A.Muggenburg

FROM: Dr. S. L. Whaley.g?.J March 18.1985

RE:Radiation dose from 99m-Tc to dogs in the study EFFECTS OF AGING ON TRACHEAL �CO�S CLEARANCE

Of the 23 dogs assJ.gned to this study, 16 are from either the aged or immature colonies and as such have no previous exposure history. At the end of this experiment these an1mals will be returned to their respective colonies for further use. Ourinq the experiment each dog w1ll be instilled with 20 uCi of 99m-Tc in a 10 ul drop at the tracheal bifurcation twice. The instillations will be 3 weeks apart for each dog. Estimated whole body dose to each dog from 20 uCi 99m-Tc is 0.8 mrads and estimated tracheal dose to each dog is 120 mrads. This information is provided should any question of previous exposure history ar1.se during consideration of future use with these an1.mals. The animals are listed below by colony.

IMMATURE DOGS 1437A 1438T 1441S 1441U 1442T 1443T l445A 14455

xc: File

ADULT DOGS 934S 935T 935U 938T 927X 937B 937C

AGED DOGS 367T 395S 406S 419S 4378 441C 544A 566B

EXPERIMENTAL RELEASE

ANIMAL I DENT! F1 CATIDN: _ _,c_..:_ ________________ _

(' ' I STUDY: I It.(' ,c l

lc ,,

PROTOCOL NUMBER: __ -'--�------------------

This animal has satisfactorily completed the pre-experimental workup as

defined in the protocol for this study and meets its minimum requirements for

an experimental animal.

Experimehtal Clinician

,t J Date of Release

This release sent to : _rul-A--'-'-' "'L-"�-'h"-'-11"'/'-'-t-'--j.JL-___________ _

Date: f=:)!/r,.j I

INTEROFFICE MEMORANDUM January 21, 1985

TO: Or. S. L. Whaley

FROM: Dr. B. A. Muggenburg

SUBJECT: Assignment of Animals to Study "Effects of Aging on Tracheal Mucociliary Clearance"/Deposition and Clearance: Re: Protocol # FY85-011 Project Cost Code/4011

The following Beagle dogs have been selected in the above named study.

They will receive the following clinical workup: 1) Chest radiograph,

2) Physical examination, 3) Standard Hemogram, 4) Clinical chemistry consisting

of BUN, SGPT, SAP and creatinine, and also 5) Work-up summary.

Work orders have been scheduled accordingly.

TATTOO RADIOLOGY HEMATOLOGY/CLINICAL CHEMISTRY

348 A COMPLETED January 23, 1985 367 T COMPLETED January 23, 1985 395 s January 30, 1985 January 23, 1985 406 s t

January 25, 1985 419 s January 25, 1985 437 B COMPLETED January 25, 1985 544 A January 30, 1985 January 28, 1985 566 B January 28, 1985 934 s January 28, 1985 935 T January 30, 1985 935 u January 30, 1985 938 T January 30, 1985 927 X February 1, 1985 937 B February 1, 1985 937 c February 1, 1985 1430 A February 4, 1985 1431 A February 4, 1985 1433 A February 4, 1985 1433 s February 6, 1985 1433 T February 6, 1985 1436 B February 6, 1985 1436 v February 8, 1985 1441 s February 8, 1985

After the pre-experimental workup has been completed, the clinician on duty

will sign an experimental release form for each dog stating that each animal has

satisfactorily completed the experimental workup.

plg

xc: distribution list (reverse)

CHEMISTRY REPORT

TATTOO 935U

PATH # VET

SAMPLE DATE 85030 RUN DATE 85030

ENZYMES

ALKALINE PHOSPHATASE 63.00 IU/L AT 30 DEGREES c

S.G.P.T. 30.00 IU/L AT 30 DEGREES c

C.P.K. IU/L AT 30 DEGREES c

L.D.H.L. IU/L AT 30 DEGREES c

G.G.T.P. IU/L AT 30 DEGREES c

S.G.O.T. IU/L AT 30 DEGREES c

BIOCHEMISTRY ------------

CALCIUM 10.40 MGS.% AT 30 DEGREES c

B. U.N. 16.00 MGS.% AT 30 DEGREES c

CHOLESTROL 267.00 MGS.% AT 30 DEGREES c

INORGANIC PHOSPHOROUS 4.30 MGS.% AT 30 DEGREES c

TOTAL PROTEIN 6. 80 GS.% AT 30 DEGREES c

ALBUMIN 3.60 GS.% AT 30 DEGREES c

TOTAL BILIRUBIN 0.70 MGS.% AT 30 DEGREES c

DIRECT BILIRUBIN MGS.% AT 30 DEGREES c

CREATININE 0. 70 MGS.% AT 30 DEGREES c

GLUCOSE 76.00 MGS.% AT 30 DEGREES c

SODIUM MM/L

POTASSIUM MM/L CHLORIDE MM/L

A/G RATIO L 13

�;ff'

� :-r·z�·tf, ¥

HEMATOLOGY REPORT

TATTOO 935U

fATH #

EXF.NO. EX PDT DATE 85030

PARAMETERS ' PLASMA PROTEIN RED BLOOD COUNT HEMATOCRIT HEMOGLOBIN PLATELETTS WHITE BLOOD COUNT NUCLEATED RED BLOOD CELL COUNT

DifFERENTIAL ABSOLUTE I;DMBEE2

SEGMEI<TERS BANDS METAMYELOCYTES BLASTS £(JS INOPHILS BASOPHILS MONONUCLEAR LYMPHOCYTES MONOCYTES

INDICES

7.0 GMS./DL. 8.31 1' MILLION CU.M.M. 54.3 ") %

19 .y GMS/DL -H THOUSANDS /CU.M.M.

114 HUNDREDS I CU.M.M.

8094

114

114

2736

342

MEAN CORPUSCULAR VOLUME 65. 3 CU. MICRON MEAN CORPUSCULAR HEMOGLOBIN 23.4 MICRO-MICROGRAMS MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION 35.9 %

REMARKS:

OTHERS:

KEYS:

ANISOCYTOSIS POLYCHROMASIA GIANT PLATELETTS FOlKILGCYTOSIS H.:lPOCHROMAS IA +

RETICULOCYTE COUNT

5 % h

6 - lO % 2+ - 30 % 3+

70 4+

% RBC

DPE

NHALATION TOXICOLOGY RESEARCH INSTITUTE

RADIOLOGY

Type of Exam:

�est

0 Abdomen

D Survey

0 Extremity

0 Othec ____ _

Anesthesia:

D lnnovar-vet

0 Atropine

0 Diabutal

�cital ;;;2._ �

0 Halothane

@--6thec ?f.o@

Pcepacation, _ __,/},:t:.e�:c�e:- ·::.:._.:_:· :1/o:___· --------------------------

Special Instructions·-----------------------------

Clinician_-=!""-'------------- Date �p-"'iV:..:_c;iJ=---------CENTRAL RECORDS

'I'll I

I II

11!\

I"

I

I

Ill

F I II , �

!'Ill

PHYSICAL EXAMINATION (AN)

(Short Form)

Tattoo Number 9 3 5 v{ A. Date /7 8<" S-'1 B. Weight�gm

C. Height (Shoulder)3t'f .6� Body Temp. (rectal )/.QL . .J:z. D.

E. Pulse Rate (femoral) 100 F. Respiration (rate/min. )lie_ G. Genera 1 Condition:

1. Comatose 2. Poor 3. Fair 4. Good

c§./ Excellent

COMMENTS:

Technician /:l__/

(N-Norrr:al)

I. Attitude 2. Conformation 3. Hydration 4. Nutritional status 5. Superficial lymph nodes 6. Membrane color 7. Skin and ears 8. Eyes 9. Musculoskeletal system

10. Respiratory system 11. Cardiovascular system 12. Alimentary system 13. Urinary system 14. Genital system 15. Nervous system 16. Endocrine system 17. Teeth and gums

(A-Abnormal)

l�BORATORY REPORT

+

0 SEMEN L.J URINALYSIS

COllECTION MET);00 I >mple Volum� Crmpre,.oon

Torbodoty Cot�etenzohon

,,.

Other·---

Temp

Voobo!1ty% 2 2 CHEMISTRY

Sugar

Morphology

Motdity o-• Acetone

0< It Blood

""ICWSCOPE

WhoteBI >d(et'

Red 8to � :et 3 3 3 3

,,

N6C "RBI

)the•--

2 2 2

----

... � )'

,..,�04

Appe tite

1�21 1

Bowels Urine I T

IL'C�

R

CLINICAL CHART

General Comments: 1

COMMENTS

ABBREVIATIONS: Appetite: F'"'fair, G-good, P-poor, 0-none. Bowels: N-normal, D-diarrhea, DB-diarrhea with blood, o-no feces. Urine: N-normal, A-abnormal, Q-none.

��: l �i�: Bowel-.. J Urine I T p a COMM!N'I'�

I I I

f9n�.s ll (u_) i\' '·. ' \.\ \ ,r \·

.. + 'c'(' T +,- r1. ''-'L \ '' I " .1 i-- I � .,.. /'

(1 ( I. I� (_; k}, A..�/ . . ( J . f /. .r <

ilL, ( .?)"""' I :ffc<;J c ,t c-.-! I �;;;- � (1(_ I h4h'll r� {l bh \\\ ( ru cc\ (\ .� ( \ (,_, '<.( r<i\ (21

,, ,r\ r h ,J cc'< ll !l1.i.l. L ) I \

I I I I I I

I I I I I I I I

I I

�· I ' I

I I I I I

I I

/ I ABBREVIAtiONS: Appetite: F•iair, G-good, P-po ..... ·, 0-none. Bowels: N-normal, 0-diarrhea, DB-diarrhea with blood, 0-no feces. Urin•: N-nor.al, A-abnormal. o-none.

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