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  • Assistant Professor of Medicine, Divisions of Emergency Medicine and Critical Care Medicine, Western University, London Health Sciences Centre, London, Ontario, Canada

The neurocognitive deficits can be significant spasms in legs buy robaxin amex, particularly in infants and young children spasms spinal cord injury generic robaxin 500mg overnight delivery, and are the primary reason for the continued search for the lowest efficacious radiation therapy dose and the most conformal delivery methods for the radiation therapy boosts muscle relaxant bruxism robaxin 500mg mastercard. Cerebellar mutism syndrome occurs in 25% of patients after resection of a posterior fossa tumor and is characterized by an acute decrease in speech (often mutism) quadricep spasms order discount robaxin online, behavioral changes (e. It may begin within hours to days of surgery and is usually self-resolving within weeks to months; cerebellar ataxia and dysmetria often persist. Somnolence syndrome, which is characterized by excessive fatigue and sleepiness, may occur in the months after completion of radiation therapy and is self-limited. Posterior fossa syndrome manifests as headache and aseptic meningitis days to weeks after surgery in this area. The tumor usually occurs sporadically, but, in 1% to 2% of cases, there is a family history of neuroblastoma. Children with localized disease are often asymptomatic at diagnosis, whereas children with metastases often appear ill and have systemic complaints, such as fever, weight loss, and pain. In the abdomen, 45% of tumors arise in the adrenal gland, and 25% arise in the retroperitoneal sympathetic ganglia. Paraspinal tumors may invade through the neural foramina and cause spinal cord compression. Several paraneoplastic syndromes, including secretory diarrhea, profuse sweating, and opsomyoclonus (dancing eyes and dancing feet), are associated with neuroblastoma. Neuroblastoma may metastasize to multiple organs, including the liver, bone, bone marrow, and lymph nodes. A unique category of neuroblastoma, stage 4S, is defined in infants (<1 year old) with a small primary tumor and metastasis limited to skin, liver, or bone marrow. Intrinsic brainstem gliomas and glioblastoma multiforme have extremely poor prognoses. Most cases occur in young children, thus it is likely that neuroblastoma results from prenatal and perinatal events. Calcification within abdominal neuroblastoma tumors is often observed on plain films of the abdomen. About 90% of neuroblastomas produce catecholamines (Vanillylmandelic acid; Homovanillic acid) that can be detected in the urine. Definitive diagnosis of neuroblastoma requires tissue for light microscopic, electron microscopic, and immunohistologic examination. Neuroblastoma is the most common extracranial solid tumor of childhood and the most common malignancy in infancy. Periorbital ecchymoses from orbital metastases sometimes are mistaken for child abuse. Because children with bone marrow involvement may have anemia, thrombocytopenia, or neutropenia, leukemia is often considered in the differential. Complete surgical excision is the initial treatment of choice for localized neuroblastoma. Children with favorable biology who undergo a gross total resection require no further therapy. In patients with advanced disease, combination chemotherapy usually is given after confirmation of the diagnosis. The most commonly used agents are vincristine, cyclophosphamide, doxorubicin, cisplatin, and etoposide. Delayed resection of the primary tumor is undertaken after numerous courses of chemotherapy. Radiation therapy often is administered to the primary tumor bed and areas of metastatic disease. High-dose chemotherapy with autologous stem cell rescue has improved the outcome for patients with high-risk neuroblastoma. Children with the opsomyoclonus syndrome may suffer from developmental delay or mental retardation. The aggressive chemotherapy and radiation therapies currently used to treat high-risk neuroblastoma may result in complications such as ototoxicity, nephrotoxicity, growth problems, and second malignancies. Currently children with neuroblastoma can be divided into three groups: low, average, and high risk. Patients with favorable biology tend to be younger and often have localized disease. Patients under 1 year of age generally have a better prognosis than older patients. Older patients with stage 4 disease most commonly have unfavorable biology, and more than 50% will relapse due to drug-resistant residual disease. Although neuroblastoma represents only 8% of cases of childhood cancer, it is responsible for 15% of cancer deaths in children. Evaluation of the inferior vena cava is crucial because the tumor may extend from the kidney into the vena cava. A complete blood count, urinalysis, liver and renal function studies, and a chest radiograph (to identify pulmonary metastases) should be obtained. Although most cases of Wilms tumor are classified as favorable histology, the presence of anaplasia is predictive of a worse prognosis and is considered unfavorable. Nephrogenic rests are foci of embryonal cells that may be rarely (<1%) found in normal infant kidneys and are commonly (25% to 40%) found in Wilms tumor-bearing kidneys. They may be perilobar, intralobar, or both, and are widely considered to be precursors to Wilms tumors. Although the cause of Wilms tumor is unknown, children with certain congenital anomalies or genetic conditions are at increased risk of developing the disease. A hereditary form of Wilms tumor may be associated with bilateral presentation and younger age at onset. Many congenital anomalies are associated with Wilms tumor, including sporadic aniridia, hemihypertrophy, and genitourinary abnormalities. Patients with Beckwith-Wiedemann syndrome and some other overgrowth syndromes are at increased risk for developing Wilms tumor and should be screened with periodic renal imaging. The timing of nephrectomy for unilateral, resectable Wilms tumor remains controversial. The North American approach is for immediate nephrectomy followed by adjuvant chemotherapy, whereas the European approach is to make a diagnosis by imaging and sometimes a biopsy, give neoadjuvant chemotherapy followed by surgery and then adjuvant chemotherapy (plus radiation therapy, as indicated). Bilateral Wilms tumor is present in about 5% of children on initial presentation, whereas recurrent disease affects the opposite kidney in 4% to 5% of patients. Treatment for patients with bilateral Wilms tumor should be individualized to retain as much normal kidney as possible. Although many children do not have complaints at the time that the mass is first noted, associated symptoms may include abdominal pain, fever, hypertension, and hematuria. Survivors of Wilms tumor are at risk for several late effects, including cardiomyopathy, scoliosis, hypertension and prehypertension, renal and bladder insufficiency, pulmonary dysfunction, hepatic dysfunction, infertility, and second malignancies. Patients with bilateral Wilms tumor are sometimes left with renal insufficiency or failure. Anaplastic variants of Wilms tumor have a significantly worse outcome than classic Wilms tumor. Chapter 160 the 4-year relapse-free survival of patients with tumors of favorable histologic picture is directly related to stage. Cure rates for patients with localized Wilms tumor at diagnosis are greater than 85%, whereas patients with pulmonary metastases have event-free survival rates of approximately 70% to 80%. Periorbital swelling, proptosis, and limitation of extraocular motion may be seen with an orbital tumor. Nasal mass, chronic otitis media, ear discharge, dysphagia, neck mass, and cranial nerve involvement may be noted with tumors in other head and neck sites. Urethral or vaginal masses, paratesticular swelling, hematuria, and urinary frequency or retention may be noted with tumors in the genitourinary tract. Trunk or extremity lesions tend to present as rapidly growing masses that may or may not be painful. If there is metastatic disease to bone or bone marrow, limb pain and evidence of marrow failure may be present. Osteosarcoma often is located at the epiphysis or metaphysis of anatomic sites that are associated with maximum growth velocity (distal femur, proximal tibia, proximal humerus), but any bone may be involved. Because the pain and swelling often are initially thought to be related to trauma, radiographs of the affected region frequently are obtained, which usually reveal a lytic lesion, often associated with calcification in the soft tissue surrounding the lesion. While 75% to 80% of patients with osteosarcoma have apparently localized disease at diagnosis, the majority of patients are believed to have micrometastatic disease as well. Although Ewing sarcoma can occur in almost any bone in the body, the femur and pelvis are the most common sites.

The clinical symptoms depend on the localization and degree of pathological changes and include nonspecific and varied conditions such as eosinophilia muscle relaxer kidney pain discount robaxin express, leukocytosis muscle relaxant used during surgery buy cheap robaxin 500 mg line, hepatomegaly muscle relaxant 2632 order robaxin master card, brief febrile episodes spasms just before falling asleep purchase robaxin pills in toronto, mild gastrointestinal disorders, asthmatic attacks, pneumonic symptoms, lymphadenopathy, urticarial skin changes, central nervous disorders with paralyses, or epileptiform convulsions. Eye infections are seen in all age groups and present as granulomatous chorioretinitis, clouding of the vitreous body and other changes. Persistent eosinophilia and the other symptoms described above justify a tentative diagnosis. Anisakis Causative agent of anisakiosis Anisakis and related roundworm genera (Phocanema [= Pseudoterranova], Contracecum), live in the intestines of marine mammals or birds. The larvae of these parasites, which are ingested by humans with raw sea fish, are known as the causative agents of eosinophilic granulomas in the gastrointestinal tract ("herring worm disease"). Reliable prophylactic practices include heating or deep-freezing of fish (­20 8C for at least 12­24 hours). Angiostrongylus Causative agent angiostrongylosis 10 Angiostrongylus cantonensis (syn. Parastrongylus cantonensis) occurs in the southern Asian and Pacific area, where it inhabits the lungs of rats. This parasite has been identified as the cause of an eosinophilic meningoencephalitis in humans. Larval stages of the parasite have been found in the brain, spinal cord, and eyes of persons who had previously fallen ill. Infection results from ingestion of raw intermediate hosts (snails) and transport hosts (crustaceans) containing infective larvae of A. Human infections are caused by accidental ingestion of intermediate hosts (snails) containing larvae, resulting in the invasion of mesenteric vessels by parasites and development of inflammatory intestinal wall granulomas. Larvae are not shed in stool because, although the parasites produce eggs, no larvae hatch out of them. Nematoda (Roundworms) Dirofilaria Causative agent of dirofilariosis 605 the larvae of Dirofilaria immitis and Dirofilaria repens, which in the adult stages are parasites of dogs, cats, and wild carnivores, are occasionally transmitted to humans by mosquitoes: immature stages of D. In Europe, the majority of autochthonous cases are reported from Italy, France, and Greece. Imported infections are reported from other countries as well (Germany, Austria, Switzerland, etc. Eckert Parasitic arthropods are ectoparasites that have a temporary or permanent association with their hosts. Their considerable medical significance is due to their capability to cause nuisance or skin diseases in humans and to act Table 11. Some species or stages of arthropods are capable of penetrating to deeper skin layers or into body openings or wounds, where their effect is similar to that of endoparasites. Only a small selection of medically important arthropods will be described in the following chapter (see Table 11. The order Ixodida includes two important families, the Argasidae (soft ticks) and Ixodidae (hard ticks). Approximately 20 hard tick species are indigenous to western and central Europe, belonging to the genera Ixodes, Rhipicephalus, Dermacentor, and Haemaphysalis. The most important species is Ixodes ricinus that accounts for about 90 % of the tick fauna in this region. For this reason, human tick bites in central Europe are in most cases caused by I. Ixodes ricinus Vector of the causative agents of Lyme borreliosis and tickborne encephalitis & Ixodes ricinus, (common sheep tick, castor bean tick) is the most frequent hard tick species in central Europe. Ticks that have attached to the skin should be mechanically removed as soon as possible to reduce the risk of & infection. Male: about 2­3 mm long with a highly chitinized scutum covering the entire dorsal surface. Female: 3­4 mm, up to 12 mm when fully engorged after a blood meal; the scutum covers only the anterior portion of the body. Adults and nymphs (the latter about 1 mm long) have four pairs of legs, the smaller larvae (about 0. Having selected a suitable location on a host, a female tick inserts her piercing mouthparts into the skin within about 10 minutes. Using clawlike organs at the tip of stylettelike mouthparts, the chelicerae, the tick cuts a wound into which the unpaired, barbed, pinecone-shaped hypostome is then inserted to anchor the parasite in the skin. While sucking blood, ticks secrete large amounts of saliva, containing cytolytic, anticoagulative, and other types of substances. Female ticks even transmit certain pathogens by the transovarial route to the next generation of ticks (vertical transmission). The overall development period may be interrupted by periods of inactivity and starvation (maximum starvation capacity 13­37 months, depending on the stage) and can therefore take from one to three years. The habitats preferred by this species include coniferous, deciduous, and mixed forests with plentiful underbrush and a dense green belt. Birds, mammals2, humans Imago Domestic and wild ruminants, dogs, cats, horses, and other animal species2, humans 5­14 Duration of bloodsucking, in days: Tick habitat when not attached to a host: 1 ­ 2­6 3­7 11 Humid soil, low vegetation, areas of woodland with underbush, meadows with high grass, gardens etc. When hosts approach, the ticks either let themselves drop onto them or cling to the skin on contact. Skin reactions, in particular the erythema chronicum migrans resulting from a borreliosis infection, often provide indirect evidence of an earlier tick bite. Tick habitats with dense undergrowth, ferns, and high grasses should be avoided as far as possible. If this is unavoidable, proper clothing must be worn: shoes, long socks, long trousers (tuck legs of trousers into socks), long sleeves that fit closely around the wrists. Additional protection is provided by spraying the clothes with acaricides, especially pyrethroids, which have a certain repellent effect (e. The effect of repellents applied to the skin (see malaria) is in most cases insufficient to protect against ticks. After staying in a tick habitat persons should search their entire body for ticks and remove any found attached to the skin as quickly as possible by mechanical means (do not apply oil or other substances to attached ticks! Any bites should be watched during the following four weeks for signs of reddening (erythema), swelling, and inflammation. Mites Sarcoptes scabiei Causative agent of scabies ("the itch," "sarcoptic itch") 11 & Infestation with Sarcoptes scabiei var. Various mite species that parasitize animals may also infest the human skin without reproducing, & causing the symptoms of "pseudoscabies. Following transmission to a human host the female mites penetrate into the epidermis and begin to tunnel. Transmission is by close contact (sexual partners, family members, school children, healthcare staff) from person to person, whereby female mites translocate to the skin of a new host. Mite infections can also be acquired from animals to which humans have close skin contact. An early sign of an initial infestation with Sarcoptes mites is the primary efflorescence with mite tunnels up to 2­4 mm and sometimes 10 mm long-threadlike, irregularly winding burrows reminiscent of pencil markings. Following an inapparent period of about four to five weeks, during which time a hypersensitivity response to mite antigens develops, the scabies exanthema manifests in the form of local or generalized pruritus, which is particularly bothersome in the evening when body heat is retained under the bedcovers. The evolving skin lesions are papulous or papulovesicular exanthema and reactions due to scratching. In adults, these lesions are seen mainly in the interdigital spaces and on the sides of the fingers, on the wrists and ankles and in the genital region. A special form of the infestation may develop in immunocompromised patients: scabies crustosa (formerly scabies norvegica). This type is characterized by pronounced crusted, flaking lesions, particularly in the head and neck region. Case history and clinical manifestations provide important diagnostic hints that require etiological confirmation by identification of the parasites. Mites can also be isolated from skin tunnels after scarification with a needle or by pressing adhesive tape onto the skin. On human hosts the mites remain temporarily on or in the skin without reproducing, causing a variety of skin lesions involving pruritus, most of which abate spontaneously if reinfestation can be prevented. It is important to prevent such infestations by treating of mite-infested animals and-if needed-by decontaminating their surroundings. Widespread and frequent in human dwellings are several species of house-dust mites (above all Dermatophagoides pteronyssinus) that are an important cause of "house-dust allergy" (dermatitis, inhalation allergy). Insects Lice (Anoplura) 11 Causative agents of pediculosis and phthiriosis (louse infestations) & Head lice and crab lice occur more frequently in central Europe and else- where than is generally assumed and must therefore always be taken into & consideration when diagnosing skin diseases. Two species of lice infest humans, one of which is divided into two subspecies (Table 11.

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It is the diagnostic classification standard for all clinical and research purposes spasms near anus order 500 mg robaxin overnight delivery. Uses include monitoring of the incidence and prevalence of diseases muscle relaxant alcohol addiction order genuine robaxin online, observing reimbursements and resource allocation trends spasms upper left quadrant buy cheap robaxin on line, and keeping track of safety and quality guidelines muscle relaxant hydrochloride buy generic robaxin 500 mg. They also include the counting of deaths as well as diseases, injuries, symptoms, reasons for encounter, factors that influence health status, and external causes of disease. Median A value or quantity lying at the midpoint of a frequency distribution of observed values or quantities, such that there is an equal probability of falling above or below it. Needs assessment the purpose of needs assessment in healthcare is to gather the information required to bring about change beneficial to the health of the population. It is generally, but not universally, accepted that this takes place within the context of finite resources. Quartiles divide a rank-ordered data set into four equal parts (numbers of observations). Overuse See also Underuse Overuse describes a process of care in circumstances where the potential for harm exceeds the potential for benefit. Prescribing an antibiotic for a viral infection like a cold, for which antibiotics are ineffective, constitutes overuse. The potential for harm includes adverse reactions to the antibiotics and increases in antibiotic resistance among bacteria in the community. I argue that this can result in a serious but commonly overlooked medical error: operating on the wrong patients ­ on those who, were they fully informed, would not have wanted the operation they received. Preference-sensitive treatment decisions Preference-sensitive treatment decisions involve making value trade-offs between benefits and harms that should depend on informed patient choice. Prevalence Prevalence refers to the total number of individuals in a population who have a disease or health condition at a specific period of time, usually expressed as a percentage of the population. Patients may use them to prepare for talking with a clinician, or a clinician may provide them at the time of the visit to facilitate decision making. At a minimum, patient decision aids provide information about the options and their associated relevant outcomes. Developing a quality criteria framework for patient decision aids; online international Delphi Consensus process. Productivity See also Efficiency Productivity is the relationship between inputs and outputs, such as the number of operations per theatre per year; efficiency is the relationship between outcomes and inputs, such as the number of successful operations per theatre per year. Protocol An agreed framework outlining the care that will be provided to patients in a designated area of practice. They do not describe how a procedure is performed, but why, when, where and by whom the care is given. Population medicine Population medicine is a style of clinical practice in which the clinician is focused not only on the individual patients referred but also on the whole population in need. Public health the science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society. Any of the 100 equal parts into which the range of the values of a set of data can be divided in order to show the distribution of those values. The percentile of a given value is determined by the percentage of the values that are equal to or smaller than that value. The values that divide each part are called the first, second, third, fourth and fifth quintiles. Standard deviation See also Variance the standard deviation is a measure of spread, and is the square root of the variance. The concept is to estimate the length of time a person would have lived if they had not died prematurely. By inherently including the age at which death occurs, rather than just the fact of its occurrence, the calculation is an attempt to better quantify the burden, or impact, on society from the specified cause of mortality. Safety Patient safety can, at its simplest, be defined as: the avoidance, prevention and amelioration of adverse outcomes or injuries stemming from the 1 Examples of other quality of life definitions can be found at: Transformation Plans which the public can feedback on before they are implemented. Structure Structure comprises the inter-relation of healthcare facilities through which health services are provided. Underuse See also Overuse Underuse refers to the failure to provide a healthcare service or for patients to accept and take up such a service when it would have produced a favourable outcome for a patient. Standard examples include failure to provide or low uptake of, appropriate preventive services to eligible patients (eg cervical smears, influenza vaccinations for older people, screening for hypertension) and proven medications for longterm illnesses (steroid inhalers for people with asthma; aspirin, beta-blockers and lipidlowering agents for people who have had a recent myocardial infarction). Supplysensitive care is not about a specific treatment per se; rather, it is about the frequency with which everyday medical care is used in treating patients with acute and chronic illnesses. Unwarranted variation Variation in the utilisation of health care services that cannot be explained by variation in patient illness or patient preferences. Surgical signature Surgical signatures reflect the practice patterns of individual physicians and local medical culture, rather than differences in need ­ or even differences in the local supply of surgeons. Each area has developed proposals built around the needs of the whole population in the area, not just those of individual organisations. Some variation in healthcare is desirable, even essential, since each patient and population is different and should be cared for uniquely. New and better treatments and improvements in care processes result in variation during the early phases of their introduction. The meaning of variation to healthcare managers, clinical and health-services researchers, and individual patients. It is the average of the squared differences from the mean and is a better measure of spread than the range. Mean Mean Spread Spread this figure illustrates how two populations may have the same mean value but different degrees of variation or spread: the graph on the right shows greater variation than that on the right. Over time persistent inflammation causes damage to the liver and can lead to cirrhosis. Autoimmune hepatitis is thought to arise from a combination of genetic predisposition and environmental triggers. Acute liver failure Acute liver failure is the appearance of severe complications rapidly after the first signs of liver disease (such as jaundice), and indicates that the liver has sustained severe damage (loss of function of 80­90% of liver cells). Alagille syndrome Alagille syndrome is a disorder that can affect the liver, heart and other parts of the body. A major feature of this syndrome is damage to the liver caused by abnormalities in the bile ducts, which may be narrowed, malformed or reduced in number. Barcelona Clinic Liver Cancer staging system the Barcelona Clinic Liver Cancer staging system links the stage of liver cancer to a specific treatment strategy. There are five stages: stage 0 where patients have very early hepatocellular carcinoma and are optimal candidates for resection; stage A where patients have early hepatocellular carcinoma and are candidates for radical therapies (resection, transplantation or percutaneous treatments); stage B where patients have intermediate hepatocellular carcinoma and may benefit from chemoembolisation; stage C where patients have advanced hepatocellular carcinoma and may receive new therapeutic agents in the setting of a randomised controlled trial; stage D where patients have end-stage disease and will receive symptomatic therapy. Alcohol-related admissions to hospital Alcohol-related admissions to hospital are those for which an alcohol-related disease, injury or condition is the primary reason for admission or a secondary diagnosis. Alcohol-specific admissions to hospital Alcohol-specific admissions to hospital are those for conditions where alcohol is the sole cause, eg alcoholic liver disease, and thus the reason for admission is wholly attributable to alcohol. Biliary atresia Alpha-1 antitrypsin deficiency Alpha-1 antitrypsin deficiency is a rare inherited condition that may cause lung disease and liver disease. In some affected individuals this damage can lead to cirrhosis; individuals are also at risk of developing hepatocellular carcinoma. Biliary atresia is a rare disease in infants in which one or more bile ducts are narrowed, blocked or missing, leading to biliary obstruction. Owing to obstruction bile builds up in the liver causing damage, which can lead to cirrhosis and eventually liver failure. An alternative measure is visceral fat storage, which can be ascertained by measuring waist circumference. There is a build-up of bile in the liver, which may lead to inflammation and scarring of the liver tissue. A small percentage of children and young people develop severe cystic fibrosis-related liver disease or cirrhosis. Choledochal cyst Choledochal cyst is a rare congenital condition in which part or all of the bile duct is dilated or cysts form on the ducts, affecting the flow of bile from the liver to the gallbladder, and thence to the small intestine. The bile ducts can become inflamed or infected, known as cholangitis; over time there can be damage to the liver tissue, which can lead to cirrhosis. Decompensated liver disease Decompensation is the failure of an organ, particularly the liver or the heart, to compensate for the functional overload that results from disease.


Catalog Number A00102-0002 A00102-0007 A00102-0025 Volume 2 ml 7 ml 25 ml Kappa; Clone L1C1 (Ready-To-Use) Species: Mouse Clone: L1C1 Isotype: Mouse IgG1 spasms under left breastbone order robaxin 500 mg fast delivery, Kappa Species Reactivity: Human spasms constipation buy robaxin 500mg overnight delivery. Specificity: the kappa light chain antibody recognizes the kappa light chain of immunoglobulin spasms hands purchase robaxin 500 mg amex. Catalog Number A00113-0002 A00113-0007 A00113-0025 Volume 2 ml 7 ml 25 ml Lambda Light Chain; Clone LcN-2 (Ready-To-Use) Species: Mouse Immunogen: Purified human IgG Clone: LcN-2 Isotype: IgG2a spasms left side order robaxin 500mg line, kappa Species Reactivity: Human. It reacts with B lymphocytes, cells of mantle zone and immunoblasts outside the lymphoid tissues. Laminin is synthesized by fibroblasts in epithelial and endothelial cells, as well as smooth muscle cells. Extensive studies of a variety of invasive and noninvasive carcinomas, including their benign counterparts, demonstrated a lack of immunoreactivity for laminin in the majority of invasive carcinomas. Specificity: this monoclonal antibody is specific to the kappa light chain of immunoglobulins and shows no cross-reaction with the lambda light chain or any of the five heavy chains. Catalog Number A00156-0002 A00156-0007 A00156-0025 Volume 2 ml 7 ml 25 ml ScyTek Laboratories, Inc. Positive Control: Melanoma Specificity: By immunohistochemistry, it specifically recognizes a protein in melanocytes and melanomas. Positive Control: Human Melanoma Specificity: Melanoma; Pan is a broad spectrum marker for metastatic melanoma. Catalog Number A00134-0002 A00134-0007 A00134-0025 Volume 2 ml 7 ml 25 ml ScyTek Laboratories, Inc. Catalog Number A00131-0002 A00131-0007 A00131-0025 Volume 2 ml 7 ml 25 ml Neurofilament; Clone 2F11 (Ready-To-Use) Species: Mouse Clone: 2F11 Isotype: IgG1, Kappa Species Reactivity: Human, Rabbit, Cat, Mouse and Rat. Specificity: the antibody is highly specific to p21; it does not cross-react with other closely related mitotic inhibitors. Catalog Number A00125-0002 A00125-0007 A00125-0025 Volume 2 ml 7 ml 25 ml ScyTek Laboratories, Inc. Specificity: this antibody reacts with wild as well as mutant types of p53 protein. About 50% of breast carcinomas are positive for p53 especially those lacking estrogen and/or progesterone receptors. This antibody can be demonstrated in 22-76% of colon, stomach, bladder, breast, lung and testes cancers. About 50% of breast carcinomas are positive for p53, especially those lacking estrogen and/or progesterone receptor, or with high proliferation index. Specificity: Recognizes a 53kDa protein, which is identified as p53 suppressor gene product. The antibody reacts with the mutant as well as the wild form of p53 under denaturing and non-denaturing conditions. Positive Control: About 50% of breast carcinomas are positive for p53, especially those lacking estrogen and/or progesterone receptor, or with high proliferation index. Specificity: Recognizes a 53kDa phosphoprotein, identified as p53 suppressor gene product. Catalog Number A00154-0002 A00154-0007 A00154-0025 Volume 2 ml 7 ml 25 ml ScyTek Laboratories, Inc. This antibody reacts with non-neoplastic adult and fetal prostatic glands, primary and metastatic prostatic carcinomas. S100 belongs to the family of calcium binding proteins such as calmodulin and troponin C. S100A is composed of an alpha and beta chain whereas S100B is composed of two beta chains. S100 protein is highly soluble and may be eluted from frozen tissue during staining. However because of the reported high expression of gp200 in renal cell carcinoma, gp200 is most commonly referred to as Renal Cell Carcinoma Marker. Catalog Number A00161-0002 A00161-0007 A00161-0025 Volume 2 ml 7 ml 25 ml ScyTek Laboratories, Inc. Thyroglobulin defects resulting from defective dimer formation and export to the Golgi is thought to cause some types of goiter. An body to thyroglobulin has been shown to be useful for the identification of papillary and follicular thyroid carcinoma; thyroglobulin antibody positive lesions are of thyroidal origin. Carcinomas of nonthyroidal origin do not express thyroglobulin and hence are thyroglobulin antibody negative. It is important to note though that not every type of thyroidal lesion is thyroglobulin antibody positive, a number of forms are negative. Hence a negative result does not necessarily rule out that a given lesion or metastasis originated from the thyroid gland. Catalog Number A00108-0002 A00108-0007 A00108-0025 Volume 2 ml 7 ml 25 ml Tyrosinase; Clone T311 (Ready-To-Use) Species: Mouse Clone: T311 Isotype: Mouse IgG1 Species Reactivity: Human. Positive Control: Human Melanoma Specificity: Tyrosinase has been shown to be a very specific marker for melanomas. Cross reactivity with other tumors or normal tissues tested has not been reported. Specificity: the UchL1 clone 31A3 antibody stains neuronal cell bodies and axons in the central and peripheral nervous systems as well as small nerve fibers in peripheral tissues, including epidermal tissues (Day & Thompson, 2010). This antibody has also identified UchL1 expression in renal tubule spermatogonia, testis, ovary, and both pregnant and non-pregnant corpus luteum. Vimentin is the main intermediate filament in mesenchymal cells and is therefore of value in the differential diagnosis of undifferentiated neoplasms. Positive Control: Blood vessels Specificity: this antibody recognizes the a-smooth muscle form of actin. Its epitope is composed of the acetyl group and the first 4 amino acids on the N-terminal end of the peptidic chain of a-smooth actin. Myoepithelial cells in breast and salivary gland are also stained as they also contain this actin. In normal tissues, sialyl Lewisa antigen is present in ductal epithelium of the breast, kidney, salivary gland, and sweat glands. Catalog Number A00135-C Volume 1 ml Bcl-2; Clone 100/D5 (Concentrate) Species: Mouse Clone: 100/D5 Isotype: Mouse IgG1, Kappa Species Reactivity: Human, Monkey. The 100/D5 antibody [also known as clone Bcl-2/100 (Kren, 2004, Kaur, 2004)] recognizes both Bcl-2 isoforms (Pezzela et al, 1990). This Mab distinguishes large cell lymphomas derived from activated lymphoid cells from histiocytic malignancies and lymphomas derived from resting and precursor lymphoid cells or from anaplastic carcinomas. Though this antibody is useful to identify T-cell lymphomas and leukemia, rare staining with B cell lymphomas reported. It is also expressed on some mesodermally derived tumors such as rhabdomyosarcoma and also on natural killer cells. Specificity: Cytokeratin 6 is expressed in many non-keratinizing stratified squamous epithelia of large cell carcinoma and pulmonary squamous cell carcinomas. It can also be found on stratified epithelia including: basal layer of epidermis, the outer root sheath of hair follicles, esophagus, oral mucosa, as well as basal cells in prostate glands and myoepithelial cells in mammary glands. Twenty human keratins are resolved with two-dimensional gel electrophoresis into acidic (pI<5. Specificity: Cytokeratin 7 expression is restricted to most glandular and transitional epithelia including lung, breast, bladder and female genital tract and their adenocarcinomas, but not in most gastrointerstinal epithelium, prostate, hepatocyte and squamous epithelium. Cytokeratin 8 is primarily found in the non-squamous epithelia and is present in a majority of adenocarcinomas and ductal carcinomas. This antibody reacts with leiomyomas, leiomyosarcoma, rhabdomyomas, rhabdomyosarcoma, and perivascular cells of glomus tumors of the skin. This antibody can be used for gel shift assay, immunoprecipitation, immunohistochemistry and western blotting. Catalog Number A00106-C Volume 1 ml Kappa; Clone L1C1 (Concentrate) Species: Mouse Clone: L1C1 Isotype: Mouse IgG1, Kappa Species Reactivity: Human. Specificity: this monoclonal antibody is specific to the lambda light chain of immunoglobulins and shows no cross-reaction with the kappa light chain or any of the five heavy chains.

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