HOSPITALS IN-COMMON LABORATORY INC.

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1 Immunoglobulin E Ab., Single Allergen: Allergens are now searchable and viewable in the web test manual database but are not listed individually in the printable pdf-format documents. Trace Metals: Trace Metals services have been revised; refer to individual test listings. Further information and details are available at Eight metals (various specimen types) are now available by Atomic Absorption technology ICP-MS reports include SI and traditional units and the comment Ref. Range based on Non-Occupationally exposed population ICP-MS test panels are available Lead (Whole Blood) no longer includes Zinc Protoporphyrin unless it is specifically requested Mercury, Urine: Avoid seafood consumption for 5 days Urine Collection Instructions: Revised for all Essential Trace Elements to include advisory to avoid mineral supplements for 5 days Whole Blood: Store and send cold Stability Information: Specimen stability information has been added or revised for the following tests but is not included in this table: α-1-antitrypsin: Total C3 Complement C4 Complement Ceruloplasmin C-Reactive Protein Haptoglobin Transferrin Page 1 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

2 Unavailable Tests. The following tests are no longer available for routine analytical service. Service may be available for research studies. Contact HICL Customer Service at ( Ext. 300 or Glucose (24h urine) Lorazepam - Urine Web Documents Update: List of Allergens (Testing for IgE-Specific Antibodies) available under Data Tables on the Resources page has been updated to version Flucytosine *** New Test 1 ml Serum. Avoid gel-separator tube and separate serum within 2 hours. Peak level specimen should be drawn 1 to 2 hours after oral dose or 30 minutes after intravenous infusion. Trough specimens should be drawn immediately prior to next dose. Store and send frozen. Ambient: 72 hours Refrigerated: 7 days Frozen: 14 days Reference Range: Therapeutic Peak: > 25.0 µg/ml (difficult infections may require higher concentrations) Toxic Peak: > µg/ml Method: LC-MS/MS TAT: 15 days Fee: $ Mnemonic: 5FLUC Test site: USA Page 2 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

3 Alkaline Phosphatase: Isoenzymes ***New Test Site 3 ml serum. Reference Ranges: Alkaline Phosphatase (ALP) Total: 19y and over: U/L ALP Isoenzymes (20y and over): Total Liver U/L Bone U/L Intestinal 1-13 U/L Method: Colorimetry/Electrophoresis TAT: 10 days Fee: $ Mnemonic: ALPISO Test Site: Ontario Allergic Lung Serology *** New Test Site 1 ml Serum. This test panel includes both Aspergillus Precipitins and Farmer's Lung Precipitins which may be ordered separately if desired - see separate listings. Reference Ranges: Aspergillus 1 PPT: Negative Aspergillus 2 PPT: Negative Aspergillus 3 PPT: Negative M. faeni 3 PPT: Negative T. vulgaris 1 PPT: Negative T. vulgaris 2 PPT: Negative Method: CIEP & Immunodiffusion TAT: 15 days Fee: $ Mnemonic: ALS Test site: Ontario Page 3 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

4 Aspergillus Precipitins *** New Test Site 1 ml Serum. This test is included in Allergic Lung Serology Panel. See separate listing. Reference Ranges: Aspergillus 1 PPT: Negative Aspergillus 2 PPT: Negative Aspergillus 3 PPT: Negative Method: CIEP TAT: 10 days Fee: $ Mnemonic: ASPPT Test site: Ontario Amitriptyline Reference ranges revised Amitriptyline: No therapeutic range for Amitriptyline alone Nortriptyline: No therapeutic range for Nortriptyline alone Combined (A+N): Therapeutic: µmol/l Toxic: > 1.80 µmol/l C1 Esterase Inhibitor: Functional Separate and freeze as soon as possible. Store and send frozen. Specify "Functional" on requisition. Page 4 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

5 C2 Complement Separate within 1 hour of collection and freeze as soon as possible. Submission of duplicate aliquots is recommended in case repeat analysis is required, avoiding multiple freeze/thaw. If the specimen thaws it is unsuitable for analysis. CA 15-3 Reference ranges revised CA 15-3 (Architect): >= 10y: <= 30 ku/l Method: Immunoassay by Abbott Architect. Calprotectin - Fecal 10g faeces. Do not add preservative. Send Reference Range: <= 50 µg/g *** New Test specimen in a screw-capped, plastic Method: ELISA TAT: 21 days container. Provide collection date and time. Fee: $ Mnemonic: CALP F Store and send frozen. This test is for "Research Use Only". Test site: USA Ambient: 5 Days Refrigerated: 8 Days Frozen: 30 Days Page 5 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

6 Dihydrotestosterone Testosterone Reference ranges revised: Testosterone - Total (nmol/l): Male, 20y to 49y: Male, 50y and over: Female, Ovulating: Female, Postmenopausal: <= 1.4 Children, 9m to puberty: <= 1.8 Dihydrotestosterone: Reference ranges unchanged Diphenhydramine Reference ranges revised Diphenhydramine: Therapeutic: µmol/l Toxic: > 4.00 µmol/l DNA Antibodies 1 ml Serum or Plasma (EDTA or Citrate). This assay assesses antibodies against doublestranded DNA only. Page 6 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

7 Dopamine - 24h urine ***New Test Site Drug Screen - Nasal Swab *** New Listing 20 ml urine. Collect urine in a container with 25 ml 6N HCl acid. The final ph must be maintained between 2-4. Restrict caffeine, nicotine, and alcohol 24h prior to collection. Discontinue Methyldopa (Aldomet) at least 5 days prior to collection. Other drugs do not interfere with this assay. State 24h volume and collection date. Submit nasal swab in plastic pouch labelled with at least two unique identifiers matching the requisition/order. Reference Range: Dopamine (nmol/l): Not available Dopamine (nmol/d): Less than 4000 Dopamine/Creatinine Ratio: >20y: Less than 320 nmol/mmol cr 10y - 20y: Less than 320 nmol/mmol cr 5y - 9y: Less than 620 nmol/mmol cr 2y - 4y: Less than 900 nmol/mmol cr Up to 2y: Less than 1760 nmol/mmol cr Method: HPLC TAT: 10 days Fee: $ Mnemonic: DOPA U Test Site: Ontario Reference Range: Not Available Method: GC-MS TAT: 7 days Fee: $ Mnemonic: DS NS Test site: Ontario Page 7 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

8 Extractable Nuclear Antigen Antibodies ***New Test Site and Method 1 ml Serum. Specimen will be tested for antibodies to 13 nuclear antigens and the results compared to pre-established cutoffs for systemic autoimmune disease. Numeric results for the antibodies will only be reported when one antibody or more exceed the cutoff. Every report will include an interpretive Medical Decision-Support System (MDSS) comment. Refrigerated: 7 days Frozen: >7 days Reference Ranges: ANA/ENA Screen: Negative dsdna Antibodies (IU/mL): Negative: <= 4; Indeterminate: 5 9; Positive: >= 10 Chromatin Antibodies: < 1.0 AI Ribosomal Protein Antibodies: < 1.0 AI SS-A 52 Antibodies: < 1.0 AI SS-A 60 Antibodies: < 1.0 AI SS-B Antibodies: < 1.0 AI Centromere-B Antibodies: < 1.0 AI Sm Antibodies: < 1.0 AI SmRNP Antibodies: < 1.0 AI RNP 68 Antibodies: < 1.0 AI RNP A Antibodies: < 1.0 AI Scl-70 Antibodies: < 1.0 AI Jo-1 Antibodies: < 1.0 AI Page 8 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

9 Farmer's Lung Precipitins *** New Test Site Fat Quantitation (Faeces) ***New Test Site 1 ml Serum. This test is included in Allergic Lung Serology Panel. See separate listing. Faeces (48 or 72 h collection). Specimens must be collected in approved containers obtained from HICL - contact Customer Service for the containers and instructions. Note: Other containers (such as metal cans) are not acceptable. Refrigerated: 180 days Frozen: 180 days (preferred) Reference Ranges: M. faeni 3 PPT: Negative T. vulgaris 1 PPT: Negative T. vulgaris 2 PPT: Negative Method: Ouchterlony Double Diffusion TAT: 10 days Fee: $ Mnemonic: FLPPT Test site: Ontario Reference Ranges: >= 18y: 2-7 g fat/24h < 18y: Reference values not established. Method: NMR Spectroscopy TAT: 10 days Fee: $ Mnemonic: FATQ Test site: USA Page 9 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

10 Fructosamine Reference Ranges: Female: µmol/l Male: µmol/l Fructosamine concentrations reflect glucose status over the previous 3 weeks. Dysproteinemic states may produce erroneous fructosamine values. Method: Photometry-Reaction Rate Galactomannan *** New Test 2 ml Serum or 2 ml Broncheoalveolar lavage (BAL). BAL has demonstrated improved sensitivity over serum. Store and send frozen. Assay requires minimum 1 ml - submit two 1 ml aliquots of Serum or BAL if possible to allow confirmatory repeats on frozen aliquot. Refrigerated: Serum: 48h, BAL: 24h Frozen: Serum: >48h, BAL: >24h Additional: Avoid repeat freeze/thaw Reference Range: Serum or BAL: Non-Reactive: Index < 0.5 Reactive: Index > = 0.5 Method: EIA (Microplate) TAT: 7 days Fee: $ Mnemonic: GALMAN Test site: Ontario Page 10 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

11 HPV - Detection and Genotyping ***New Test Refer to HPV Collection Instructions. Collection supplies (with instructions and requisitions) may be obtained by contacting HICL Customer Service at info@hicl.on.ca or (416) Ext This assay specifically identifies HPV 16 and HPV 18 while concurrently detecting the rest of the high risk types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68) at clinically relevant infection levels. Reference Range: Negative Method: PCR (Roche) TAT: 10 days Fee: $ Mnemonic: HPV Test Site: Ontario Immunoglobulin G - CSF Reference range revised IgG-CSF: mg/l Page 11 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

12 Interleukin-10 - Plasma 1 ml Plasma (EDTA). Separate as soon as possible. Store and send frozen. If the Reference Range: < 4.6 pg/ml Method: ELISA specimen thaws it is unsuitable for analysis. TAT: 30 days Fee: $ Analysis also available on serum - see separate listing. Indicate clearly specimen type submitted. This test is for "Research Use Only". Mnemonic: IL10 P Test site: USA Frozen: 1 year Interleukin-10 - Serum 1 ml Serum. Avoid gel-separator tube. Store and send frozen. If the specimen thaws it is unsuitable for analysis. Analysis also available on plasma - see separate listing. Indicate clearly specimen type submitted. This test is for "Research Use Only". Frozen: 1 year Reference Range: pg/ml Method: ELISA TAT: 30 days Fee: $ Mnemonic: IL10 S Test site: USA Page 12 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

13 LDH Isoenzymes *** New Test 2 ml Serum. Gel-separator tube preferred. Hemolyzed specimens are unacceptable due to high concentration of LD in erythrocytes. Prepare two 1 ml aliquots in transfer vials. Date of birth must be provided. Store and send at controlled ambient temperature. Freezing or prolonged storage at 4 C (> 12 hours) causes LD-V to be lost. Ambient: 7 days (preferred) Refrigerated: 48 hours Reference Range: LD (Total) 1-30 days: U/L 31 days - 11 months: U/L 1-3y: U/L 4-6y: U/L 7-9y: U/L 10-12y: U/L 13-15y: U/L 16-17y: U/L >= 18y: U/L LD Isoenzymes I (Heart): % II: % III: % IV: % V (Liver): % Method: Electrophoresis TAT: 7days Fee: $ Mnemonic: LDISO Test site: USA Page 13 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

14 Metanephrines - Plasma Reference range revised Normetanephrine: Less than or equal to 0.89 nmol/l Metanephrine: Less than or equal to 0.49 nmol/l Mitotane *** New Test Mucopolysaccharides: Screen 1 ml Serum or Plasma (EDTA or Heparin). Do not use gel-separator tubes. Store and send frozen. Refrigerated: 7 days Frozen: 6 months Specimen volume revised 1 ml urine Reference Range: µg/ml; Toxic: > 20 Method: HPLC-UV TAT: 20 days Fee: $ Mnemonic: MITOTANE Test site: Quebec Nortriptyline Therapeutic Range µmol/l Toxic: Greater than 1.80 µmol/l Oligosaccharides Specimen volume revised 1 ml urine Page 14 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

15 Protriptyline Therapeutic Range: µmol/l Toxic: than 1.90 µmol/l Sugar Chromatography *** New Listing Renin (Activity Assay) *** New Test 1 ml Urine (Random). Store and send frozen. Reference Range: Descriptive Report Method: TLC TAT: 15 days Fee: $ Mnemonic: SCHROM Test site: Ontario 3 ml Plasma (EDTA). Collect prior to 10 a.m. as Renin fluctuates throughout the day. Collect in pre-chilled tube without tourniquet. Separate as soon as possible (at 4 C if possible) and prepare two 1.5 ml aliquots in pre-chilled transfer vials. Store and send frozen. If the specimen thaws, it is unsuitable for analysis. Reference Range: < 3.3 ng/ml/hr (Random ambulatory individuals with normal salt intake) Method: Coated tube immunoassay TAT: 10 days Fee: $ Mnemonic: RENACT Test site: Alberta Sulfatides - urine 5 ml urine Reference range revised Sulfatide: µg/l Page 15 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

16 Testosterone: Total Reference Ranges: Males ( 18y): nmol/l Females (( 18y): nmol/l Trimipramine Therapeutic Range: µmol/l Toxic: > 1.70 µmol/l (unchanged) Transferrin Receptor Soluble *** New Test Tumor Necrosis Factor Alpha *** New Test 0.5 ml Serum. Gel-separator tube preferred. Store and send frozen. Ambient: 72 hours Refrigerated: 7 days Frozen: 90 days 1 ml Plasma (EDTA). Separate as soon as possible. Store and send frozen. If the specimen thaws it is unsuitable for analysis. This test is for " Research Use Only". Frozen: 1 Year Reference Range: mg/l Method: Immunoturbidimetry TAT: 10 days Fee: $ Mnemonic: STFREC Test site: USA Reference Range: < 3.4 pg/ml Method: ELISA TAT: 30 days Fee: $ Mnemonic: TNFAL Test site: USA Page 16 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

17 This update and future updates are available via in Adobe pdf format - Contact HICL Customer Service info@hicl.on.ca Page 17 of Wynford Drive, Suite 600, Toronto, ON. M3C 3S2, Canada. Phone: FAX: info@hicl.on.ca

In-Common Laboratories

In-Common Laboratories Stability Information: Specimen stability information has been added or revised for the following tests: Vitamin B6, Dehydroepiandrosterone, Thyroid Antibodies (Thyroid Peroxidase Ab & Thyroglobulin Ab)