ࡱ> {` XbjbjFF ,,u Fdll3D     $!!H2222222$4h7|3i!  !!3  n3&&&!  2&!2&&V,@- 8 !t"p?- #0303K-x7D#7-7-`&!!!33*&X!!!3!!!!lllllllll Appendix 3 - Specimen Collection 1. Postmortem Specimen Collection: If any body fluids, tissues or devices will be collected from animals postmortem, list them here.  FORMTEXT       2. Blood Collection. If blood is to be collected antemortem as a part of this Application and the process has not been described in Appendix 1-Antibody Production, complete the table below. TABLE 1 BLOOD COLLECTIONSite of blood collection*Amount of blood collected expressed as volume (mL)/ and % of body weight (assume 1 ml = 1 gram)Number of blood collectionsInterval between collections FORMTEXT       FORMTEXT       mL  FORMTEXT       % FORMTEXT       FORMTEXT       weeks FORMTEXT       FORMTEXT       mL  FORMTEXT       % FORMTEXT       FORMTEXT       weeks FORMTEXT       FORMTEXT       mL  FORMTEXT       % FORMTEXT       FORMTEXT       weeks * To approximate acceptable blood collection volumes, assume the total blood volume of a healthy animal as 7% of its body weight, and that 10% of the total blood volume can be collected every 2 weeks without causing significant physiological change. (Example: acceptable blood volume for a 30 g mouse ( 0.07 X 30 g X 0.10 = .21 mL.) Blood volumes in excess of 10% will be considered with scientific justification. Typically the maximum blood available for a terminal procedure is 50% of blood volume MUST be taken with the animal under anesthesia. 3. Other Tissue Collection: If other body fluids (e.g. cerebrospinal fluid, peritoneal fluid, urine) or tissues are to be collected antemortem as a part of this Application, complete the table below. TABLE 2  TISSUE COLLECTIONTissue or fluid collectedSite & method of collectionAmount (G)Volume (mL)Number of collectionsInterval between collections FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FOR@BFHPfhxz 2 V kZF&hNh6CJOJQJ]^JaJ hNhSCJOJQJ^JaJ&hdXhdX5CJOJQJ\^JaJ hdX5CJOJQJ\^JaJ&hNhS5CJOJQJ\^JaJ hNhCJOJQJ^JaJhNha :CJaJhNha CJaJh;5Fh/CJ aJ h;5FhCJ aJ h;5FCJ aJ h;5FhY4CJ aJ h;5FhsCJ aJ BHV ~ $$Ifa$gdCY (h^hgdS (h^h`gdc| 8h^hgdS 8h^h`gdNgdSgdc| (XXV X l n p z | ~ ťq`O>- hNhSCJOJQJ^JaJ hNha CJOJQJ^JaJ hNhCJOJQJ^JaJ hNh+CJOJQJ^JaJ#h>hS6B*CJ]aJphCjhb56B*CJOJQJU\]^JaJmHnHphu>h56B*CJOJQJU\]^JaJph5h>hmt56B*CJOJQJ\]^JaJph>jh>hmt56B*CJOJQJU\]^JaJph   , 0 3 F P Q d  ʹۥۗʹʅq`qRDhCJOJQJ^JaJhCYCJOJQJ^JaJ h;5F5CJOJQJ\^JaJ&hNh|5CJOJQJ\^JaJ#hNh|>*CJOJQJ^JaJh;5FCJOJQJ^JaJ&hNh/6CJOJQJ]^JaJ hNh/CJOJQJ^JaJ hNh|CJOJQJ^JaJ hNha CJOJQJ^JaJ&hNha 5CJOJQJ\^JaJ   T U _ `   $ & ( 2 4 6 : ;Ͷ͡nVnE hBhCYCJOJQJ^JaJ/fh5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu/h5CJOJQJU\^JaJ)jhCY5CJOJQJU\^JaJhCYCJaJhdXCJH*OJQJ^JaJhCYCJOJQJ^JaJ&hCYhCY5CJOJQJ\^JaJ hCY5CJOJQJ\^JaJ  6 S ~~~~ $$Ifa$gdCYtkdt$$Ifd44R&#  04 da4f4p S T  h 0$$$ $$Ifa$gdCYkdL$$Ifd44\ .R& T$   (04 da4f4p(: < > R T V ` b f h j ~ ҽҔgL4/h5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu/Vh5CJOJQJU\^JaJ)jhCY5CJOJQJU\^JaJ hCY5CJOJQJ\^JaJ.jhbCJOJQJU^JaJmHnHu)hCJOJQJU^JaJhCYCJOJQJ^JaJ#jhCYCJOJQJU^JaJhCJOJQJ^JaJ          4 ппппpпbP#jhCYCJOJQJU^JaJhCJOJQJ^JaJ/]h5CJOJQJU\^JaJ/h5CJOJQJU\^JaJhCYCJOJQJ^JaJ hBhCYCJOJQJ^JaJ hCY5CJOJQJ\^JaJ)jhCY5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu J &kdF$$Ifd4\ .R& T$  (04 da4f4p( $$Ifa$gdCY4 6 8 B D H J L ` b d n p r t زtYAY/h5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu/Mh5CJOJQJU\^JaJ)jhCY5CJOJQJU\^JaJ hCY5CJOJQJ\^JaJhCYCJOJQJ^JaJ.jhbCJOJQJU^JaJmHnHu#jhCYCJOJQJU^JaJ)hCJOJQJU^JaJJ r &kd= $$Ifd4\ .R& T$  (04 da4f4p( $$Ifa$gdCY лޣ޻pbP#jhCYCJOJQJU^JaJhCJOJQJ^JaJ/R h5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu/ h5CJOJQJU\^JaJ)jhCY5CJOJQJU\^JaJhCYCJOJQJ^JaJ hCY5CJOJQJ\^JaJ hBhCYCJOJQJ^JaJ$&*,.BDFPRTVjlnxzزtYAY/ h5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu/B h5CJOJQJU\^JaJ)jhCY5CJOJQJU\^JaJ hCY5CJOJQJ\^JaJhCYCJOJQJ^JaJ.jhbCJOJQJU^JaJmHnHu#jhCYCJOJQJU^JaJ) hCJOJQJU^JaJ ,T&kd. $$Ifd4\ .R& T$  (04 da4f4p( $$Ifa$gdCYzwx.uvwxz´ИІІuЦЦdSB hNhSCJOJQJ^JaJ hNha CJOJQJ^JaJ hNh|CJOJQJ^JaJ jhCYCJOJQJ^JaJ#hLchCY>*CJOJQJ^JaJh165CJOJQJ^JaJhdXCJOJQJ^JaJhSCJOJQJ^JaJhuXCJOJQJ^JaJhCYCJOJQJ^JaJ hCY5CJOJQJ\^JaJ hBhCYCJOJQJ^JaJuv $$Ifa$gdS ^'h^hgdS ^`gdCY h^h`gdN z 2H~:@BXʹʨʨʆxdSB4B4h-CJOJQJ^JaJ hNh-CJOJQJ^JaJ hNh.gCJOJQJ^JaJ&h.gh.g5CJOJQJ\^JaJhtCJOJQJ^JaJh;5FCJOJQJ^JaJ&hNh/6CJOJQJ]^JaJ hNh/CJOJQJ^JaJ hNh|CJOJQJ^JaJ hNha CJOJQJ^JaJ hdX5CJOJQJ\^JaJ&hNha 5CJOJQJ\^JaJ,BZ:b~~~~~~ymmmm $$Ifa$gd.gFf $$Ifa$gdStkd$$Ifd44v(*  0*4 daf4p X(*,68:<PɱږڂjږڂRږڂ/h5CJOJQJU\^JaJ/7h5CJOJQJU\^JaJ&hNh-5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu/h5CJOJQJU\^JaJ h6<5CJOJQJ\^JaJ)jh6<5CJOJQJU\^JaJ hNh-CJOJQJ^JaJPRT^`bdxz|ҷңҒzҷңҒbҷңQҒ hNh-CJOJQJ^JaJ/h5CJOJQJU\^JaJ/h5CJOJQJU\^JaJ h6<5CJOJQJ\^JaJ&hNh-5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu)jh6<5CJOJQJU\^JaJ/#h5CJOJQJU\^JaJb/kd$$Ifd44ֈ&  v( Tp0*4 daf4 $$Ifa$gd.g(*,.BDFPRTVjҷңҒzҷңҒbҷңҒJҷңҒ/Th5CJOJQJU\^JaJ/h5CJOJQJU\^JaJ/hh5CJOJQJU\^JaJ h6<5CJOJQJ\^JaJ&hNh=%<5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu)jh6<5CJOJQJU\^JaJ/h5CJOJQJU\^JaJ,T| $$Ifa$gdjlnxz|~ҷңҒzҷңiҒQҷңҒ/#h5CJOJQJU\^JaJ hNh=%<CJOJQJ^JaJ/@h5CJOJQJU\^JaJ h6<5CJOJQJ\^JaJ&hNh=%<5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu)jh6<5CJOJQJU\^JaJ/h5CJOJQJU\^JaJNFN;//// $$Ifa$gdkd$$Ifd44ֈ&  v( Tp0*4 daf4N NNNNNN N4N6N8NBNDNFNHN\N^N`NjNlNnNҷңҒxҷңҒ`ҷңҒHҷң/h5CJOJQJU\^JaJ/h5CJOJQJU\^JaJ/h5CJOJQJU\^JaJU h6<5CJOJQJ\^JaJ&hNh=%<5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu)jh6<5CJOJQJU\^JaJ/h5CJOJQJU\^JaJMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       4. Device Collection: If surgically implanted devices are to be collected antemortem as part of this Application, describe them and the collection procedure.  FORMTEXT       5. Use of Anesthetics, Tranquilizers, or Analgesics in antemortem specimen collection: Will anesthetics, tranquilizers, or analgesics be used to prevent pain or stress during collection of blood, tissue or device collection?  FORMCHECKBOX No. Justify the omission of pain-relieving agents (either scientifically or because the collection method involves no or only momentary pain) and describe the physical restraint that will be used during collection.  FORMTEXT        FORMCHECKBOX Yes. Complete the following table. TABLE 3  ANESTHETICS, TRANQUILIZERS, ANALGESICSAnesthetic, tranquilizer, or analgesic agentDoseRoute Frequencymg/kgmL FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       ADDITIONAL COMMENTS  FORMTEXT           PAGE 1 Appendix 3  Specimen Collection (Dec 2003) FNnNNN/kd$$Ifd44ֈ&  v( Tp0*4 daf4 $$Ifa$gdnNpNNNNNNNNNNNN6OJOꒁsbN=b)&hNh/6CJOJQJ]^JaJ hdX5CJOJQJ\^JaJ&hNh|5CJOJQJ\^JaJ hNh|CJOJQJ^JaJhVCJOJQJ^JaJ hNh=%<CJOJQJ^JaJ&hNh=%<5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu/qh5CJOJQJU\^JaJ h6<5CJOJQJ\^JaJ)jh6<5CJOJQJU\^JaJNNNNOP P PPPQQSSSBTDTFTT$$If^a$gdS 'z^zgdSh^hgdSgdS h^h`gda:?JOLOlOOOOOOOOPPP PP¢gE6(hG2?CJOJQJ^JaJh!h|B*CJaJphCjhb56B*CJOJQJU\]^JaJmHnHphu>T h56B*CJOJQJU\]^JaJph5h>h>56B*CJOJQJ\]^JaJph>jh>h>56B*CJOJQJU\]^JaJphha:?CJOJQJ^JaJh!CJOJQJ^JaJ hNh|CJOJQJ^JaJ hNh/CJOJQJ^JaJPPPPxPPPPPPPPnQQQQʶwfUD3U hNh1ZCJOJQJ^JaJ hNh vCJOJQJ^JaJ hNh|CJOJQJ^JaJ hdX5CJOJQJ\^JaJ&hNh/5CJOJQJ\^JaJ,hNh v56CJOJQJ\]^JaJ&hNh v5CJOJQJ\^JaJ&hNh|5CJOJQJ\^JaJ&hNhS5CJOJQJ\^JaJ hNhSCJOJQJ^JaJ hNhG2?CJOJQJ^JaJQQQQQQRR.S0SSSSSSSSϷݦ驪gL,>h>56B*CJOJQJ\]^JaJph>jh>h>56B*CJOJQJU\]^JaJphh|CJOJQJ^JaJ hNhSCJOJQJ^JaJ hNh|CJOJQJ^JaJ/ hbhbCJOJQJU^JaJhpCJOJQJ^JaJ#jhpCJOJQJU^JaJ hNh/CJOJQJ^JaJSSSSSSSSSSBTDTFTTT௞~fUG9/( hNh!h!h!5\h|CJOJQJ^JaJhBCJOJQJ^JaJ hNh|CJOJQJ^JaJ/!hbhbCJOJQJU^JaJhpCJOJQJ^JaJ#jhpCJOJQJU^JaJ hNh/CJOJQJ^JaJh!h!B*CJaJphCjhb56B*CJOJQJU\]^JaJmHnHphu>jh>h>56B*CJOJQJU\]^JaJphTTUUUU0U}md[K$$If^a$gd| $Ifgd| $IfgdS$h$If^ha$gd| h$If^hgdStkd$"$$Ifd44'$  0$4 da4f4p TUUU.U0U2U4U6UFUJULUNUbUdUfUpUrUtUvUɻlQ=5jhk(U&hdh 5CJOJQJ\^JaJ4jhb5CJOJQJU\^JaJmHnHu/Y&h5CJOJQJU\^JaJ hWt5CJOJQJ\^JaJ)jhWt5CJOJQJU\^JaJ h|h|CJOJQJ^JaJh|CJOJQJ^JaJ&hNh|5CJOJQJ\^JaJh| h|h| hNh| hNh|CJOJQJ^JaJ0U2U4U0# h$If^hgdSkd"$$Ifd44\'```$  (0$4 da4f4p(4U@UFUHUJULU8kd$$$Ifd44r '*$ 0$4 da4f4 h$If^hgdS $Ifgdk(LUtUUUUV $$Ifa$gd $h$If^ha$gd vUUUUUUUUUUUUUUUUUUUUUUVVVVVVV׷s׷[sJ hNh CJOJQJ^JaJ/5(h5CJOJQJU\^JaJ4jhb5CJOJQJU\^JaJmHnHu/'h5CJOJQJU\^JaJ hWt5CJOJQJ\^JaJ)jhWt5CJOJQJU\^JaJG'hUh jhbUmHnHujhk(U&hUhk(VV>VfVVVVNBBBBB $$Ifa$gd kd($$Ifd44r '*$ 0$4 da4f4VV,V.V0V:VV@VTVVVXVbVdVfVhV|V~VVVVVVVVVVVVVVꢚ}r}Z/+h5CJOJQJU\^JaJ+hUjhbUmHnHu*hUhk(jhk(Uh 4jhb5CJOJQJU\^JaJmHnHu/,*h5CJOJQJU\^JaJ hWt5CJOJQJ\^JaJ)jhWt5CJOJQJU\^JaJVVVVVVVVVVVWWW WW W"W,W.W0W2WFWHWJWTWVWXWZWҷҳґyҷҳqmbqTqqmIqTq.hUjhbUmHnHuY.hUhk(jhk(U/-h5CJOJQJU\^JaJ hWt5CJOJQJ\^JaJ hNh CJOJQJ^JaJh 4jhb5CJOJQJU\^JaJmHnHu)jhWt5CJOJQJU\^JaJ/,h5CJOJQJU\^JaJVVW0WXWWWNBBBBB $$Ifa$gd kd~,$$Ifd44r '*$ 0$4 da4f4ZWnWpWrW|W~WWWWWWWWWWWWW§£§£zlWE#hD5>*CJOJQJ\^JaJ)hDhD5>*CJOJQJ\^JaJh{ACJOJQJ^JaJ hNh CJOJQJ^JaJ//h5CJOJQJU\^JaJh 4jhb5CJOJQJU\^JaJmHnHu)jhWt5CJOJQJU\^JaJ/I/h5CJOJQJU\^JaJ hWt5CJOJQJ\^JaJWWWWWWXXXNIIIIIIIgdSkd50$$Ifd44r '*$ 0$4 da4f4WWWWWWWW&X(X*X.X0X4X6X:X1h56B*CJOJQJU\]^JaJph5h>h>56B*CJOJQJ\]^JaJph>jh>h>56B*CJOJQJU\]^JaJphXXX X XXXXXXXXXX X"X$X&X(X,X.X2X4X8X:X>X@XVX $&`a$gdN\gdSPXRXTXVXXXX h{Ah{ACJOJQJ^JaJh7Mhb hb0Jjhb0JUhf0JmHnHuVXXXXXgdS$a$gdN\= 0&PP/R :pS/ =!"#$% @ 00&PP/R :pS/ =!"#$% = 0&PP/R :pS/ =!"#$% @ 00&PP/R :pS/ =!"#$% = 0&PP/R :pS/ =!"#$% @ 00&PP/R :pS/ =!"#$% tDText3$$If4!vh5##v#:V d44  0,5#/  / 44 da4f4p $$If4!vh55 5T5$ #v#v #vT#v$ :V d44  (0,55 5T5$ / /  / /  / / / 44 da4f4p(xDText138xDText139xDText187xDText140xDText141$$If4!vh55 5T5$ #v#v #vT#v$ :V d4 (0,55 5T5$ / / / / / / / 44 da4f4p(xDText142xDText139xDText187xDText144xDText145$$If4!vh55 5T5$ #v#v #vT#v$ :V d4 (0,55 5T5$ / / / / / / / 44 da4f4p(vDText58xDText139xDText187vDText60vDText61$$If4!vh55 5T5$ #v#v #vT#v$ :V d4 (0,55 5T5$ / /  / / / /  / 44 da4f4p($$If!vh5*#v*:V d44  0*,5*/ / / 44 daf4p $$If!vh55 555T5p#v#v #v#v#vT#vp:V d44 <0*,55 555T5p/ /  / /  / / / 44 daf4p<kd$$Ifd44ֈ&  v( Tp <0*4 daf4p<vDText14vDText14vDText14vDText14vDText14vDText14k$$If!vh55 555T5p#v#v #v#v#vT#vp:V d440*,55 555T5p/ / / / / / / 44 daf4vDText14vDText14vDText14vDText14vDText14vDText14k$$If!vh55 555T5p#v#v #v#v#vT#vp:V d440*,55 555T5p/ / / / / / / 44 daf4vDText14vDText14vDText14vDText14vDText14vDText14k$$If!vh55 555T5p#v#v #v#v#vT#vp:V d440*,55 555T5p/ /  / / / /  / 44 daf4tDText3tDeCheck1tDText3tDeCheck2$$If4!vh5$#v$:V d44  0$,5$/ / 44 da4f4p $$If4!vh5555$ #v#v#v#v$ :V d44 (0$+++,5555$ / /  / / /  / / / 44 da4f4p($$If4!vh55*555$ #v#v*#v#v#v$ :V d440$+++,55*555$ / / /  /  / / / / / / / 44 da4f4vDText14xDText188xDText189vDText14vDText14$$If4!vh55*555$ #v#v*#v#v#v$ :V d440$,55*555$ / / /  / / /  / / / / 44 da4f4vDText14xDText188xDText188vDText14vDText14c$$If4!vh55*555$ #v#v*#v#v#v$ :V d440$,55*555$ / /  / / / / / / 44 da4f4vDText14xDText188xDText188vDText14vDText14q$$If4!vh55*555$ #v#v*#v#v#v$ :V d440$,55*555$ / /  / / / / / /  / 44 da4f4tDText3B@B Normal 1$7$8$_HmH sH tH N@N Heading 1$$@&a$CJOJQJ^JaJP@P Heading 2$h@&^hCJOJQJ^JaJDA@D Default Paragraph FontRi@R  Table Normal4 l4a (k(No List 4 @4 Footer  !.)@. 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B |~]_]g     u u w w x x z { } ~ u u w w x x z { } ~ 33Tgh{-5HI\atwBUVij}~  24GH[\opQ d L ] 7 J L ]    . / B C V W j l  ! 4 L _ t u u w w x x z { } ~ u u w w x x z { } ~  ~4 qC~PZgR@ hh^h`o(.88^8`.L^`L.  ^ `.  ^ `.xLx^x`L.HH^H`.^`.L^`L.^`o(.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.^`o(.^`.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L. qCR                            /V|!>k(BU h m< a M  /g9uGu 3 ` "7%:'Q(p(q(\*|+n,d1Y4165o5y649<=%<G2?a:?{[@pE;5F7HXHJyKMM7MS;RdX-XCY1Z@Z1\N\z\ ^6_QbLckMf.gmg himlim=nLpB*rs+tNatBvc|?+bK8otU3WIBN( ]dtcIe&{A;{$6<fV{,2bb /ySa|sEua>D v] J14iH@WtpuX03_C-&mt-OSd6STh45Iw$ABVj~ 34H\p       / C W k l ! 5 6 @pgdaaaaaa PP@P PP @PPPNUnknownGz Times New Roman5Symbol3& z Arial5& zaTahoma"hh#fˆFbyfs s !xxdo o 2X?&2 Appendix AD Lee M. DunnTimothy Staskiewicz   Oh+'0 $ D P \ ht| Appendix AD Lee M. DunnNormalTimothy Staskiewicz6Microsoft Office Word@@ ‚@ZTY@s layouts/15/DocIdRedir.aspx?ID=67Z3ZXSPZZWZ-509-5, 67Z3ZXSPZZWZ-509-5  VA Hospital ?@ABCDFGHIJKLMNOPQRSTUVWXYZ[\]^`abcdefghijklmnopqrstuvwxyz|}~Root Entry F)5@Data E21Table_7WordDocumentSummaryInformation({DocumentSummaryInformation8-LCompObjqMsoDataStore 5)5  "#$&'(*+,./0123456789:<>?@  FMicrosoft Office Word Document MSWordDocWord.Document.89qDocument ID GeneratorSynchronous100011000Microsoft.Office.DocumentManagement, Version=15.0.0.0, Culture=neutral, PublicKeyToken=71e9bce111e9429cMicrJ2X2QSAUGG0BKCTA==2 55Item  PropertiesKH535AQH3==2 55Item  !Properties%OUNE0L3A==25)5Item 'Properties)3BKGNLEC4K==25)5Item ;Properties=osoft.Office.DocumentManagement.Internal.DocIdHandlerDocument ID GeneratorSynchronous100021001Microsoft.Office.DocumentManagement, Version=15.0.0.0, Culture=neutral, PublicKeyToken=71e9bce111e9429cMicrosoft.Office.DocumentManagement.Internal.DocIdHandlerDme="_dlc_DocId" ma:index="10" nillable="true" ma:displayName="Document ID Value" ma:description="The value of the document ID assigned to this item." ma:internalName="_dlc_DocId" ma:readOnly="true"> This value indicates the number of saves or revisions. 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