Aortic Stenosis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

AORTIC STENOSIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Aortic Stenosis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83739-2 1. Aortic Stenosis-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on aortic stenosis. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON AORTIC STENOSIS ..................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Aortic Stenosis .............................................................................. 4 E-Journals: PubMed Central ....................................................................................................... 20 The National Library of Medicine: PubMed ................................................................................ 20 CHAPTER 2. NUTRITION AND AORTIC STENOSIS ........................................................................... 65 Overview...................................................................................................................................... 65 Finding Nutrition Studies on Aortic Stenosis............................................................................. 65 Federal Resources on Nutrition ................................................................................................... 67 Additional Web Resources ........................................................................................................... 67 CHAPTER 3. ALTERNATIVE MEDICINE AND AORTIC STENOSIS ..................................................... 69 Overview...................................................................................................................................... 69 National Center for Complementary and Alternative Medicine.................................................. 69 Additional Web Resources ........................................................................................................... 73 General References ....................................................................................................................... 74 CHAPTER 4. DISSERTATIONS ON AORTIC STENOSIS ....................................................................... 75 Overview...................................................................................................................................... 75 Dissertations on Aortic Stenosis.................................................................................................. 75 Keeping Current .......................................................................................................................... 75 CHAPTER 5. PATENTS ON AORTIC STENOSIS .................................................................................. 77 Overview...................................................................................................................................... 77 Patents on Aortic Stenosis ........................................................................................................... 77 Patent Applications on Aortic Stenosis ....................................................................................... 79 Keeping Current .......................................................................................................................... 81 CHAPTER 6. BOOKS ON AORTIC STENOSIS ..................................................................................... 83 Overview...................................................................................................................................... 83 Book Summaries: Online Booksellers........................................................................................... 83 The National Library of Medicine Book Index ............................................................................. 83 Chapters on Aortic Stenosis......................................................................................................... 84 CHAPTER 7. MULTIMEDIA ON AORTIC STENOSIS ........................................................................... 87 Overview...................................................................................................................................... 87 Bibliography: Multimedia on Aortic Stenosis.............................................................................. 87 CHAPTER 8. PERIODICALS AND NEWS ON AORTIC STENOSIS ........................................................ 89 Overview...................................................................................................................................... 89 News Services and Press Releases................................................................................................ 89 Academic Periodicals covering Aortic Stenosis ........................................................................... 91 CHAPTER 9. RESEARCHING MEDICATIONS .................................................................................... 93 Overview...................................................................................................................................... 93 U.S. Pharmacopeia....................................................................................................................... 93 Commercial Databases ................................................................................................................. 94 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 99 Overview...................................................................................................................................... 99 NIH Guidelines............................................................................................................................ 99 NIH Databases........................................................................................................................... 101 Other Commercial Databases..................................................................................................... 104 The Genome Project and Aortic Stenosis................................................................................... 104 APPENDIX B. PATIENT RESOURCES ............................................................................................... 109 Overview.................................................................................................................................... 109 Patient Guideline Sources.......................................................................................................... 109

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Finding Associations.................................................................................................................. 112 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 115 Overview.................................................................................................................................... 115 Preparation................................................................................................................................. 115 Finding a Local Medical Library................................................................................................ 115 Medical Libraries in the U.S. and Canada ................................................................................. 115 ONLINE GLOSSARIES................................................................................................................ 121 Online Dictionary Directories ................................................................................................... 123 AORTIC STENOSIS DICTIONARY.......................................................................................... 125 INDEX .............................................................................................................................................. 167

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with aortic stenosis is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about aortic stenosis, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to aortic stenosis, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on aortic stenosis. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to aortic stenosis, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on aortic stenosis. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON AORTIC STENOSIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on aortic stenosis.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and aortic stenosis, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “aortic stenosis” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Uremic Cardiomyopathy: Reducing the Cardiac Burden in End-Stage Renal Disease Source: Journal of Critical Illness. 13(10): 613-615, 619-623. October 1998. Contact: Available from Cliggott Publishing Company. 55 Holly Hill Lane, Greenwich, CT 06831-0010. (203) 661-0600. Summary: Left ventricular (LV) hypertrophy and dilatation and systolic dysfunction are common in patients receiving hemodialysis and are associated with significantly decreased survival and increased morbidity. In this article, the authors discuss abnormalities of LV structure and function. They cover the diagnosis of uremic cardiomyopathy, review data on the prevalence and outcomes of LV dysfunction, and explore interventions relevant to the management of these patients. Echocardiography is the standard diagnostic tool for cardiomyopathy in patients with end-stage renal disease

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(ESRD). The use of echocardiography to differentiate diastolic from systolic dysfunction can help guide patient management. With few controlled clinical trials specifically examining cardiomyopathy in uremic patients, management generally follows guidelines from studies in the general population. Aims of therapy are to improve quality of life by controlling symptoms of heart failure, ischemic heart disease, cardiac arrhythmias, and dialysis-associated hypotension; and to correct modifiable risk factors, such as hypertension, anemia, uremia, malnutrition, and aortic stenosis. Drug therapy requires great caution in this patient population, and should be begun only after careful consideration of risk and benefit. 1 figure. 6 tables. 38 references. (AA-M). •

Williams Syndrome Source: Journal of Clinical Pediatric Dentistry. 19(4): 301-304. Summer 1995. Summary: This article reports a case of Williams syndrome, a disorder characterized by multiple anomalies, including mental deficiency, an unusual Elfin facies, supravalvular aortic stenosis, and many other cardiovascular anomalies, prenatal and postnatal growth deficiencies, infantile hypercalcemia, impaired renal function and nephrocalcinosis, microcephaly, perceptual and motor function problems, micrognathia, and many dental anomalies. Williams syndrome is a rare syndrome, but it can usually be diagnosed first at dental clinics because of the typical oral and facial features. The authors report the case of an 8 year old Turkish boy with Williams syndrome, giving particular attention to the oral and dental anomalies and the dental treatment procedures that can be followed for these patients. The etiology of high caries rate and anomalies such as delayed dentition (both present in this case) are from delayed mineralization, which is related to infantile hypercalcemia. Since dental treatment of patients with mental retardation is difficult when only using local anesthesia, general anesthesia may be preferred. But many cases cannot be rendered with general anesthesia because of the severity of the cardiac problems. Because of these systemic problems and mental retardation, early dental evaluation and parental counseling for preventive dental regimens have an utmost significance in these medically compromised patients. 8 figures. 2 tables. 9 references. (AA-M).

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Williams Syndrome: Report of a Case Source: Oral Surgery, Oral Medicine, Oral Pathology. 74(6): 756-759. December 1992. Summary: Williams syndrome is a rare anamoly, consisting of idiopathic hypercalcemia that is normally accompanied by aortic stenosis, moderate mental retardation, and a characteristic elfin face. This disease can eventually be detected in the dental or orthodontic clinic, because people with this syndrome have severe dental abnormalities. In this article, a unique case of this type is reported. The authors note that, although the genetic bases of the disease are not clear, an underlying disorder may exist, implying a dominant autosomal inheritance with a great variety of forms. 7 figures. 14 references. (AA-M).

Federally Funded Research on Aortic Stenosis The U.S. Government supports a variety of research studies relating to aortic stenosis. These studies are tracked by the Office of Extramural Research at the National Institutes of

Studies

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Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to aortic stenosis. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore aortic stenosis. The following is typical of the type of information found when searching the CRISP database for aortic stenosis: •

Project Title: ALTERED SIGNALING IN CARDIAC HYPERTROPHY AND FAILURE Principal Investigator & Institution: Scholz, Peter M.; Professor; Surgery; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2001; Project Start 01-JUL-1988; Project End 30-JUN-2002 Summary: Adaptation of the heart to chronic pressure overload leads to cardiac hypertrophy and alterations in signal transduction to compensate for increased sympathetic tone and work. These adaptive changes lead to increases in cGMP levels down regulation of beta adrenergic receptors. The hypothesis of this proposal is that the negative functional effects of cGMP contribute to compensation in hypertrophy and that, when this endogenous brake fails, heart failure develops. The specific aim is to determine if the mechanism of cGMP's negative impact is through changes in cAMP via the cGMP-dependent cAMP phosphodiesterases (PDE) or through interactions of protein kinase G on A and C, to elucidate which of these mechanisms causes the hypertrophied heart to decompensate by contrasting the alterations in the signaling cascade of the compensated with that of failing hypertrophied heart (rapid pacing) and to confirm their relevance by further chronic alteration of the cAMP PDEs. Cardiac myocytes isolated from adult dogs with normal, hypertrophied (aortic stenosis model) and failing hearts will be used to determine the effects of postproduction changes in signaling on function (video edge detection) and O2 consumption (PO2 electrode). The relative importance of these mechanisms in controlling regional function and O2 costs will be tested in the intact heart. The in vivo experiments will be conducted in anesthetized, open-chest dogs 6 months after induction of hypertrophy with or without failure and compared to controls. Regional myocardial work will be assessed from segment length (ultrasonic dimension crystals) and contractile force (miniature force gauges). O2 consumption of the same area will be determined from regional blood flow (radioactive microspheres or flow probe) and regional O2 saturation of hemoglobin (microspectrophotometry). These physiological measurements will be combined with biochemical assays for cAMP, cGMP, the respective phosphodiesterases and protein kinases A, G and C and correlated with Ca transient measurements. The ultimate goal is to determine the mechanism that initiates decompensation and leads to congestive heart failure. Impact of the proposal: the understanding of these mechanisms will permit the

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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development of new therapeutic strategies to prevent the development of congestive heart failure in man. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CARDIAC ANGIOTENSIN: HYPERTROPHY AND FAILURE Principal Investigator & Institution: Lorell, Beverly H.; Associate Professor of Medicine; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-JUN-1995; Project End 31-JUL-2005 Summary: (the applicant's description verbatim): The angiotensin II type 2 (AT2) receptor predominates in the left ventricle (LV) in hypertrophy and heart failure, and AT2 receptor activation suppresses growth and promotes apoptosis in vitro. This project will test the overall hypothesis that AT2 receptor signaling in vivo mediates anti-growth and pro-apoptotic effects in pressure overload hypertrophy. We will use transgenic mice with ventricular targeted overexpression of the AT2 receptor driven by the MLC2V promoter which are subjected to ascending aortic stenosis. Functional consequences will be studied by echocardiography and hemodynamic measurements, analysis of isolated myocyte contraction and intracellular ion regulation using fluorescence video microscopy, and confocal microscopy analysis of in situ cell morphology and apoptosis. Signaling pathways will be studied by immunohistochemistry and immunoblotting using antibodies to specific signaling molecules and identification of phosphorylation state. The Specific Aims are: Aim 1. To determine if AT2 receptor overexpression in transgenic mice suppresses in vivo hypertrophic growth in response to chronic systolic pressure overload from aortic stenosis. We predict that AT2 receptor overexpression severely depresses the development of LV hypertrophy, and promotes the rapid development of heart failure and premature death. Aim 2. To test the hypothesis that AT2 receptor overexpression promotes myocyte apoptosis in mice with pressure overload. Apoptosis will be identified by in situ Tunel and ligase assays using confocal microscopy, and complementary measurement of cytochrome c leakage to the cytosol. Aim 3. To determine if AT2 receptor overexpression in vivo modifies myocyte contractile function, and interferes with Ang II mediated inotropy. These experiments will employ measurements of contractility as well as intracellular pH and Ca2+ in isolated mouse myocytes, and test the hypothesis that AT2 receptor activation suppresses the coupling of Ang II with forward Na+-H+ exchange. Aim 4. To determine if AT2 receptor overexpression in vivo activates the kinin-cGMP pathway. In vitro studies suggest that this system contributes to AT2 receptor signaling, but its contribution, if any, in the adult heart is not understood. Measurements will be made of cGMP levels and kininogenase activation in LV tissues (and atrial tissues in which the transgene is minimally expressed). In addition, the functional effects of inhibition of this pathway on cardiac growth and hemodynamic performance will be tested in vivo in mice with AT2 overexpression, in presence and absence of pressure overload. These integrated molecular physiology studies, which examine in vivo and cellular cardiac physiology, will provide new insights regarding cardioprotective versus deleterious effects of AT2 receptor activation in hypertrophy and heart failure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ELASTIN BIOSYNTHESIS AND PATHOGENESIS OF VASCULAR PATHOLOGY Principal Investigator & Institution: Mecham, Robert P.; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130

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Timing: Fiscal Year 2001 Summary: Elastin is the major extracellular matrix component of large blood vessels. It is the protein responsible for the elastic recoil properties of these tissues and plays an important role in defining vascular will compartments. Several human diseases have recently been linked to mutations in elastin. The objective of this proposal is to better understand how these mutations alter the functional properties of the elastic fiber leading, ultimately, to vascular pathology. Our focus will be supravalcular aortic stenosis, an inherited obstructive vascular disease that causes significant narrowing of large systemic and pulmonary arteries. Recently, autosomal dominant SVAS has been linked to the elastin (ELN) locus on chromosome 7. There are two possible explanations for how mutations in elastin cause SVAS: 1) haploinsufficiency, where a half dose of normal elastin is being produced, or 2) abnormal elastic fibers arising from dominant negative elastin mutations. To test these possibilities, we propose to combine in vitro assays for elastin assembly with expression of mutant proteins in transgenic mice to identify the mechanism whereby mutant proteins alter elastic fiber structure and, ultimately, vascular function. Our specific aims are; 1) To characterize ELN mutations in patients with sporadic and autosomal dominant SVS. 2) Determine if the mutant elastin allele is expressed in cells from patients with SVAS. 3) Ascertain whether mutant tropoelastin is capable of incorporating into, or disrupting normal elastic fibers. 4) Develop mouse models that express common ELN mutations found in SVAS and determine how these mutations alter vascular development and function. In addition to providing answers to the pathogenesis of SVAS, these studies will undoubtedly be instructive in identify domains of elastin that play a critical role in the normal function of this important protein. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ELASTIN GENE MUTATIONS IN SKIN AND VASCULAR DISEASES Principal Investigator & Institution: Urban, Zsolt; None; University of Hawaii at Manoa 2500 Campus Rd Honolulu, Hi 96822 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2003 Summary: The overall goal of this proposal is to understand the role of mutations in the elastin gene in the pathogenetics and pathobiology of two heritable diseases of elastic tissue, supravalcualar aortic stenosis (SVAS) and autosomal dominant cutis laxa (ADCL). Elastin is the major protein in elastic fibers and responsible for the recoil properties of all elastic tissues, including skin and blood vessels. Over the last few years, several investigators, including ourselves, have demonstrated that mutations in the elastin gene are responsible for two phenotypically distinct heritable disorders. SVAS is an autosomal dominant vascular disease characterized principally by arterial wall stenosis, with no obvious pulmonary or dermal phenotype. In contrast, ADCL is primarily a skin disorder characterized by inelastic skin with minimal vascular disease. Both disease have been shown recently to be due to mutations in the elastin gene. While it is not clear how mutations in the gene will result in two separate diseases, from preliminary results presented in the proposal, it seems that the nature of the mutations in the elastin gene will determine either a vascular or a dermal phenotype. The four specific aims that we have outlined in this proposal are intended to elucidate the detailed relationship between the type of mutations in the elastin gene and the influence of these mutations on both tissues morphogenesis, and elastin fiber assembly and elastin tissue function. Changes in elastin gene expression are a characteristic feature of many common elastic tissue disorders ranging from aortic aneurysms to keloids and we expect new insights from our proposed work on SVAS and ADCL to have a significant

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effect on a better understanding of the pathogenesis of these more common connective tissue disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: FUNCTION OF GENES IN WILLIAMS SYNDROME DELETION REGION Principal Investigator & Institution: Francke, Uta; Professor; Genetics; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 31-MAY-2006 Summary: (provided by applicant): With the Human Genome Project promising to provide a catalog of all human genes in the near future, the main challenge of research in the next century is that of functional genomics. The processes that control gene activation and repression in a developmental-stage and cell-type specific manner are fundamental to understanding normal development and discovering the causes of human disease. Spontaneously recurring microdeletions are ideal for a systematic study of the downstream effects of hemizygosity for the defined set of genes in the deletion. Williams-Beuren syndrome (WBS), a neurodevelopmental disorder with a distinct profile of cognitive and behavioral features serves as a model system to study the genetic and molecular basis of cognition, speech, language, and visuo-spatial processing. WBS is caused by recurrent uniform deletions of 1.6 Mb of DNA from chromosome 7q11.23, that arise by inter- or intrachromosomal recombination between flanking duplicated regions. Within the deletion, 16 genes have been identified and characterized. They function as transcription factors, in DNA replication, chromatin assembly, translation, signal transduction and as structural proteins. Only one, the elastin gene has been linked to a specific manifestation, supravalvular aortic stenosis. To evaluate the functional consequences of hemizygosity for the other genes, humans with partial deletions will be identified and mouse models generated with corresponding deletions in the conserved syntenic region on mouse chromosome 5. Target genes of transcription factors and signaling molecules will be identified by microarray studies, comparing gene expression patterns in various tissues from affected humans and deletion mice. Development of a molecular phenotype of WBS links cognitive neuroscience to molecular genetics. Insights gained into the molecular pathways, that lead from the chromosomal deletion to the specific cognitive, behavioral and learning disabilities may have relevance for common developmental disorders, such as attention deficit/hyperactivity disorder and autism, as well as for understanding normal developmental processes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SYNDROME

GENOTYPE/PHENOTYPE

CORRELATIONS

IN

WILLIAMS

Principal Investigator & Institution: Mervis, Carolyn B.; Distinguished University Scholar and Pro; Psychological and Brain Sciences; University of Louisville University of Louisville Louisville, Ky 40292 Timing: Fiscal Year 2001; Project Start 17-MAY-1996; Project End 31-MAR-2005 Summary: Williams Syndrome (WS) is a complex neurodevelopmental disorder involving mild to moderate mental retardation, an unusual personality profile, infantile hypercalcemia, dysmorphic facial features, and supravalvar aortic stenosis (SVAS). WS is a contiguous gene disorder resulting from submicroscopic deletions of chromosome 7q11.23. The goal of the proposed study is to create a medical and behavioral profile of

Studies

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WS ("a quantifiable assay of the WS behavioral profile") and to use this profile to identify specific genes underlying behavioral features of WS and carryout genotypephenotype correlation studies. The specific aims include ascertainment and characterization of individuals who have features that overlap with WS; 2) identification and characterization of the cardinal features of the phenotype of WS and phenotypes of individuals with smaller WS deletions; 3) identification of genes responsible for specific phenotypic features of WS through deliniation of a refined physical map of the WS region, cloning and characterization of genomic DNA within this region, and identification of new genes in the region. An initial specific goal is to identify genes responsible for the personality characteristics of WS as well as other specific phenotype features. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GORDON RESEARCH CONFERENCE ON ELASTIN & ELASTIC FIBERS Principal Investigator & Institution: Sakai, Lynn Y.; Associate Professor; Gordon Research Conferences Box 984, 512 Liberty Ln West Kingston, Ri 02892 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2002 Summary: (provided by applicant): The Elastin and Elastic Fibers Gordon Research Conference will meet for the 12th time in summer of 2001. This Conference is the premier meeting for scientists interested in elastic fiber biology, biochemistry, and pathophysiology. It is also of interest to scientists working in related areas of connective tissue biochemistry and to those interested in cardiovascular, pulmonary, skin, and skeletal biology. The Elastin and Elastic Fibers Gordon Conference is a unique opportunity for senior and junior scientists from around the world to gather every other year and discuss the latest and most cutting edge developments in research. Since changing its name from the Elastin Gordon Conference (1993 and previous years) to the Gordon Conference on Elastin and Elastic Fibers (1995 and subsequent years), this Conference has been moving from a meeting devoted to a single molecule (elastin) to a broader meeting covering elastic fiber structure, biology, and pathophysiology. Recent Conferences have showcased the discoveries that mutations in genes for elastin and for the fibrillins are mutated in the human genetic disorders supravalvular aortic stenosis and Williams Syndrome (ELN), the Marfan syndrome (FBNI), and congenital contractural arachnodactyly (FBN2). The 2001 Conference will highlight investigations of how mutations in elastic fiber components result in connective tissue pathophysiology. In addition, new insights into the function of elastic fiber components (emilin, the fibulins, the latent TGFb binding proteins) will be discussed based upon gene targeting experiments in mice and other functional studies. Finally, interactions between growth factors and elastic fiber components will be a new emphasis at this Conference. These exciting novel areas will also be discussed within the context of special sessions on cardiovascular and pulmonary biology. In order to promote the exchange of the most exciting and highest quality science in this research area, to facilitate collaborations between scientists at all levels, in different parts of the world, and at academic and industrial organizations, and to encourage the careers of young scientists, funds are requested to reimburse Conference fees and travel expenses of invited speakers and other participants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INTRACELLULAR TRAFFICKING OF TROPOELASTIN Principal Investigator & Institution: Davis, Elaine C.; Assistant Professor; Cell Biology; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001; Project Start 15-DEC-1998; Project End 30-NOV-2002 Summary: Elastic fiber assembly is a complicated process that involves the organization of tropoelastin monomers on a microfibril scaffold and the subsequent crosslinking of these monomers into an insoluble elastin matrix. In the vessel wall, elastic fibers form concentric lamellae that are critical for the structural integrity and function of the vessel. Increasing evidence suggests that in virtually all vascular diseases, some aspect of elastic fiber assembly or structure is affected. Our ability to study these aberrant changes, however, is presently restricted by our limited knowledge of how elastic fibers normally assemble in developing tissues. Although significant advances have been made in the characterization of elastic fiber components, we know remarkably little about the intracellular events involved in their targeting and eventual secretion from the cell. Recently, we have shown that within the secretory pathway, tropoelastin is a ligand for a 65-kD FK506 binding protein (FKBP65). Since little is known about FKBP65, our first specific aim is to fully characterize the protein by determining its temporal and tissue specific distribution, establishing its intracellular location and topography, and identifying additional ligands for the protein. Since members of the FKBP family are peptidyl- prolyl cis-trans isomerases that have been implicated in folding and trafficking events, the association of tropoelastin with FKBP65 raises the intriguing hypothesis that FKBP65 plays a role in the folding and/or transport of tropoelastin to membrane assembly sites. Our second specific aim, therefore, is to test this hypothesis by studying the direct binding of tropoelastin to FKBP65 in in vitro assays, determining if FKBP65 has isomerization activity on tropoelastin-specific peptides, and investigating the role of FKBP65 in tropoelastin expression, secretion and assembly by treating cells with the immunosuppressant drug, FK506, to disrupt the FKBP65-tropoelastin interaction. In our third specific aim, we will extend our present studies on the intracellular trafficking of tropoelastin by identifying additional proteins and chaperones that associate with tropoelastin in the secretory pathway and by characterizing the post-Golgi transport of the protein based on our preliminary data that supports a role for an acidic compartment in the transport of tropoelastin to the cell surface. Results from these studies will not only provide fundamental information concerning the intracellular events required for normal elastic fiber assembly, but will ultimately establish an important basis for future studies on elastic fibers in a number of vascular diseases, such as supravalvular aortic stenosis, hypertension and aortic aneurysms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: LOAD INDUCED CARDIAC HYPERTROPHY IN THE ADULT MAMMAL Principal Investigator & Institution: Cooper, George I.; Medicine; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-AUG-1993; Project End 31-JUL-2003 Summary: The hypothesis upon which this Program Project Grant is based is that hemodynamic loading of the heart is the primary regulator of its structure and function. While the prediction of this hypothesis are equally applicable to cardiac physiology, the question which we have chosen as the subject of these studies is that of how increased load interacts directly with the heart to explain the causes and consequences of cardiac hypertrophy. In this context, the five individual projects form a closely interrelated set

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of studies. In Project #1, Dr. McDermott, who has used cardiocytes and tissue loaded in vitro, and myocardium loaded in vivo, to define translational control in hypertrophy, will extend this work to the question of whether the increased translationally active eIF4E that he finds is causally linked to hypertrophy. In Project #2, Dr. Carabello will build on this studies showing less hypertrophy in mitral regurgitation than aortic stenosis, with ventricular remodeling in the former but not in the latter, by asking how failure to re-normalize wall stress induces this process. In Project #3, Dr. Menick will extend his discovery of elements requisite for cardiac expression of the Na-Ca exchanges gene, as well as a novel element important for cardiac expression and hypertrophic upregulation, to studies of transcriptional regulation of a gene encoding a protein critical to calcium homeostasis in hypertrophy. In Project #4, Dr. Cooper will extend his work showing augmented microtubules in hypertrophied myocardium and microtubule stabilization and upregulation of microtubule proteins, to an attempt to establish a cause-and-effect relationship between these changes in gene expression and contractile dysfunction, with an emphasis on the role of isoform-specific changes in tubulin expression. Also, in a new initiative, we will explore our recent discovery suggesting that hypertrophic microtubule alterations may have a role in the altered beta-adrenergic receptor function suggesting that hypertrophic microtubule alterations may have a role in the altered beta- adrenergic receptor function characteristic of cardiac hypertrophy. In the new Project #5, Dr. Zile will exploit his development of a unique, phenotypically stable isolated adult cardiocyte model to study the signalling pathways by which load is coupled to growth in the adult cardiocyte. Thus, the first and fifth projects are concerned with causes of load-induced cardiac hypertrophy in the adult, with the first focused on inducting of increased protein synthesis, and the fifth focused on signals for that induction. The other three projects are concerned with consequences of load-induced cardiac hypertrophy in the adult, being focused on mechanisms by which changes in structural and regulatory elements, whether intracellular or extracellular, alter contractile function and its regulation in cardiac hypertrophy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MEDIATORS OF VASCULAR CALCIFICATION AND BONE DISEASE Principal Investigator & Institution: Giachelli, Cecilia M.; Associate Professor; Bioengineering; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-MAY-2005 Summary: (provided by applicant): Vascular calcification is an actively regulated process contributing to increased morbidity and mortality in, patients with uremia, diabetes, aortic stenosis and bioprosthetic heart valves. Epidemiological studies have linked vascular calcification with osteoporosis and cardiovascular disease, suggesting that common regulatory mechanisms exist, and that ectopic calcification may increase the risk of heart disease. In human blood vessels and valves, both diffuse calcification and ectopic bone have been observed under pathological conditions. The relationship between these types of mineralization is unclear. It is also unknown if media or intimal vascular calcification contributes to formation and/or progression of atherosclerotic lesions. We hypothesize that mineral deposition in blood vessels involves mediators including osteopontin (OPN), osteoprotegerin (OPG) and matrix gla proteins (MGP), that also critically control formation of the skeleton, and that once mineral forms in the vessel wall, an adaptive response ensues and initiates cellular differentiation and inflammatory mechanisms that 1) lead to neointima formation and hence increased susceptibility to plaque formation, and 2) mimic endochondral bone formation that may

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explain the appearance of ectopic bones in calcified vascular lesions. In order to identify common mechanisms! controlling bone and vascular calcification, and to understand the relationship between vascular calcification, cartilaginous metaplasia, and arterial lesion development, three aims are proposed. Aim I will determine the mechanism of medial vascular calcification, neointimal formation, and cartilaginous metaplasia in MGP X OPN mutant mice. Aim 2 will determine the mechanism of bone and tooth defects found in MGP X OPN mice. Aim 3 will determine the effect of hyperlipidemia on cartilaginous metaplasia, vascular calcification and osteoporosis in a mouse model of atherosclerosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR DETERMINANTS OF PEDIATRIC HEART DISEASE Principal Investigator & Institution: Kelly, Daniel P.; Pediatrics; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2003 Summary: The long term objective of this Pediatric SCOR is to determine the molecular bases of defective human cardiac morphogenesis and myocardial function which results in congenital heart disease (CHD) and pediatric cardiomyopathy (CM). The underlying hypothesis is that single gene defects at multiple loci in the human genome cause most pediatric cardiac structural and myopathic diseases. Two corollaries will also be explored, that (i) genetic abnormalities at the same locus have variable expressivity and can result in different phenotypes and (ii) genotype- phenotype correlations exist. A multi-disciplinary approach encompassing 14 investigators, 6 clinical and laboratory projects, and 4 core units at three locations is proposed. Molecular genetic studies of a St. Louis family with dominantly-inherited dilated CM; CM or sudden death secondary to mutations in mitochondrial fatty acid oxidation enzymes; patients with CHD associated with at the human at the human 8p23 locus encompassing the GATA-4 gene, a critical transcription factor in heart; elastin in heart; elastin mutations in supravalvar aortic stenosis; and dominantly-inherited atrial septal defects (ASD) mapped to 5p and 5q are the clinical focus. Mouse gene ablation and transgenic models to delineate (i) the pathogenesis of CM and sudden death in fatty acid oxidation defects, (ii) the essential role and downstream targets of GATA-4 expressed in mouse embryonic endoderm for mesoderm-mediated and downstream morphogenesis, (iii) the mechanisms by which elastin mutations disrupt elastic fiber assembly and vasculogenesis, and (iv) the mechanisms by which mutant mouse homologs of genes defective in human familial ASD result in CHD will be created. The molecular role of syndecans in determination of left-right asymmetry will be studied in the uniquely-manipulable Xenopus embryo system as a model for mechanisms underlying human heterotaxy syndromes and CHD. Characterization of defective human genes causing pediatric heart disease and the mechanisms through which mutations alter cardiac development and myocardial function is necessary before manipulations to prevent CHD and inherited CM are feasible. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: OSTEOBLASTOGENESIS IN AORTIC VALVE CALCIFICATION Principal Investigator & Institution: Rajamannan, Nalini M.; Feinberg Cardiovascular Inst; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2007

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Summary: (provided by applicant): This proposal is for a new K08 application which proposes a detailed plan for the candidate's research and a 4-year goal driven plan for further career development. The candidate's career goal is to become a successful independent scientific investigator. A career development plan is described that delineates the specific goals over the award period and the mechanisms that will be used to achieve them. Through didactic training and ongoing supervision through mentors and advisory committee, the candidate expects to 1) further develop as a basic science investigator, 2) conduct the proposed study with the highest degree of quality 3) present and publish studies in valvular heart disease at National conferences and leading journals 5) compete for advanced sources of funding and 6) develop insights in to the pathogenesis of valvular heart disease. The underlying mechanism for the pathogenesis of calcific aortic stenosis is unknown. This trend is becoming more pronounced with the aging population. Clinical studies indicate parallel risk factors for vascular atherosclerosis and aortic valve disease, the principle causative factor is elevated cholesterol levels. Due to these clinical observations, the PI has developed a translational approach to studying aortic valve disease. It is our hypothesis that calcification of the aortic valve is a direct result of valvular cellular transformation to an osteoblast phenotype that is initiated by hypercholesterolemia. The PI plans to test the hypothesis by the following specific Aims: Aim 1: Using the in vivo rabbit model, analyze the effects of hypercholesterotemia with and without statins in the atherosclerotic and proliferative aortic valve. Aim 2: Using the in vivo rabbit model, analyze the effects of hypercholesterolemia with and without statins in the calcification and mineralization of aortic valve. Aim 3: Using the in vivo rabbit model, determine the specific signaling pathways in the aortic valve which mediate the development of aortic valve atherosclerosis and osteoblastogenesis. Aim 4: Imaging the in vivo rabbit model of aortic valve disease. These studies provide the first in vivo model of aortic valve calcification which correlate the epidemiologic studies of atherosclerotic risk factors to the development of calcific aortic valve disease. If hypercholesterolemia stimulates the development of calcification in the aortic valve then the use of medical therapy such as HMG CoA reductase medications may have a role in the medical therapy of calcific aortic stenosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: POTENTIAL ROLE OF TFII-I IN IMMUNODEFICIENCY Principal Investigator & Institution: Roy, Ananda L.; Professor; Pathology; Tufts University Boston Boston, Ma 02111 Timing: Fiscal Year 2001; Project Start 01-MAR-2000; Project End 28-FEB-2005 Summary: TFII-II is an important multi-functional transcription factor that links events to transcription in several genes. TFII-I is constitutively associated with Bruton's tyrosine kinase (Btk), a non-receptor tyrosine kinase that is essential for normal B cell function, as its mutation causes X-linked agammaglobulinemia (XLA) in humans and Xlinked immune deficiency (xid) in mice. We propose that TFII-I is an important and novel component in linking Btk-mediated signaling to transcription in B cells. Furthermore, the TFII-I gene gets deleted in William's syndrome (WS) which is a neurodevelopmental disorder with multi-system manifestations, including supravalvar aortic stenosis, hypercalcemia in infancy, mental retardation and cognitive defects. Thus, TFIII appears to be involved in two genetic disorders: William's Syndrome and X-linked agammaglobulinemia (XLA). Knowledge gained from these studies may help us better understand a critical Btk dependent pathway that links B cell receptor mediated signal transduction to B cell specific transcription. These studies may also ultimately help

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identify potential target gene(s) that are affected by mutations in Btk. Importantly, these studies may establish possible connections between the neuro-developmental disorders (as in WS) and immuno-developmental disorders (as in XLA). Toward a better understanding of TFII-I function in Btk mediated immune response, we will first map the region(s) in TFII-I important for its physical and functional interactions with BTK. We will determine by deletion and point mutation the region(s) in TFII-I that is important for its interaction with Btk, followed by mapping the sites in TFII-I that are tyrosine phosphorylated by Btk in vitro and in vivo by a combination of site directed mutagenesis, phosphopeptide, finger printing, and mass spectrometric analysis. We will also analyze these mutants in functional transient transfection assays. To determine the functions of TFII-I and its biochemical interactions with Btk in B cells, we will employ in vivo transcriptional analysis. To determine the functions of TFII-I and its biochemical interactions with Btk in B cells, we will employ in vivo transcriptional analysis followed by the interaction studies by co- immunoprecipitation and ectopic expression of mutant forms of TFII-I in B cells. We will also stably express wild type and mutant forms of TFII-I, and Btk in B cell lines, and genetically delete TFII-I from chicken B cells. Finally, to ascertain the localization of TFII-I in the absence and in the presence of non-activated versus activated Btk, first, we will co-express various mutants of TFII-I with Btk in COS cells. Subsequently, we will employ freshly isolated primary splenic B cells derived from wild type, xid and Btk-/- mice and study the localization and tyrosine phosphorylation of TFII-I in the absence and in presence of B cell receptor signaling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF ENDOTHELIAL MMP EXPRESSION AND FUNCTION Principal Investigator & Institution: Galis, Zorina S.; Associate Professor; Medicine; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2007 Summary: (provided by applicant): Numerous observations support the connection between atherosclerotic lesion progression and disturbed blood flow. Changes that allow lesion development require the matrix-degrading action of matrix metalloproteinases (MMPs), which have emerged as key agents of vascular wall remodeling. Due to their destabilizing action, understanding MMP control and function may have important applications for managing acute cardiovascular events. However, little is known about MMP regulation in endothelial cells (EC), the flow sensor of the arterial wall. We propose to investigate the hypothesis that disturbed flow mediates the action of EC MMPs. Previous in vitro studies indicate that oscillatory shear increases oxidative stress in cultured EC and decreases cell viability. We previously demonstrated that reactive oxygen species (ROS) increase MMP expression and activity. We presently hypothesize that shear-induced oxidative stress increases EC MMP production and activity, specifically of the inducible MMP-9, in areas of disturbed flow. We further propose that increased MMP activity has functional consequences related to degradation of EC basement membrane, including increased EC turnover, and potentially EC loss, responsible to plaque erosion, the major failure mode of otherwise stable plaques. To investigate this potential mechanism, which would connect disturbed blood flow, oxidative stress, and endothelial dysfunction via increased MMP activity, we propose these specific aims: I. To investigate whether shear or ROS modulate expression and/or activity), of EC MMP-2 and -9; 2. To identify regulatory elements involved in MMP-9 induction by shear or ROS; 3. To investigate whether effects of disturbed shear upon EC MMP expression/activity are mediated, via oxidative stress; 4.

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To assess whether EC MMPs mediate increased basement membrane degradation and cell turnover under disturbed shear. Unidirectional and disturbed blood flow will be modeled in vitro using cultured human and mouse EC and in vivo, by creating a stenosis by banding of mouse aorta. We will investigate EC MMP transcriptional regulation, mRNA stability, protein, and activity. Computed flow patterns of the aortic stenosis will be superimposed with the in vivo map of EC MMP induction obtained from transgenic mouse overexpressing the MMP-9 promoter driving a LacZ reporter (MMP-9/LacZ), and with maps of EC dysfunction and loss. Specific contribution of MMPs and oxidative stress will be verified in vitro and in vivo using chemical inhibitors and relevant strains of genetically deficient mice. Our preliminary results support our hypothesis and demonstrate the feasibility of these studies, which should help elucidate the contribution of EC-derived MMPs to endothelial dysfunction and progression of atherosclerosis towards acute clinical events. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RESPONSE REMODELING

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Principal Investigator & Institution: Carabello, Blase A.; Professor and Vice Chairman; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001 Summary: During our initial funding period, we examined the mechanisms by which volume overload versus pressure overload caused hypertrophy. We found that despite severe volume overload, there was no increase in protein synthesis rate and that hypertrophy occurred by accumulation due to a decrease in degradation rate. This mechanism produced substantially less hypertrophy than in pressure overload where an increase in protein synthesis rate causes robust cardiac growth. The inadequate hypertrophy in mitral regurgitation, in myocardial infraction and in even some subjects with aortic stenosis, leads to increased wall stress and cardiac dilatation. Although cardiac dilatation initially permits the left ventricle to eject an increased stroke volume, dilatation eventually leads to increasing wall stress, and left ventricular dysfunction. Building on our observations during the first funding period we will now explore a key mechanism leading to the maladaptive situation of cardiac dilatation with increased wall stress. We will test the hypothesis that when there is inadequate hypertrophy to normalize diastolic wall stress, dilatation occurs and this dilation is in large part due to activation of matrix metalloproteases (MMP's). Specific aims of the current funding period are to 1). to examine matrix metalloprotease activity in five situations: a) normal dogs, b) dogs with aortic stenosis manifesting adequate hypertrophy, and no dilatation, c) dogs with aortic stenosis, inadequate hypertrophy, and cardiac dilatation, d) dogs with myocardial infarctions and dogs with mitral regurgitation, 2) to examine extracellular matrix and collagen architecture in connection with MMP activation, 3) to use MMP inhibitors to prevent activation and remodeling, and 4) to identify mechanisms controlling MMP activity. Using our models of human diseases we will define one of the major mechanisms of cardiac dilatation, will establish the regulation of MMP's and will further test our hypothesis by inhibiting dilatation with an MMP inhibitor. These studies will enhance both the scientific understanding of cardiac remodeling and also will address a major clinical problem causing significant cardiac mortality and morbidity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ROLE OF SEROTONIN IN SYMPATHETIC FUNCTION Principal Investigator & Institution: Scrogin, Karie E.; Pharmacol & Exper Therapeutics; Loyola University Medical Center Lewis Towers, 13Th Fl Chicago, Il 60611 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2007 Summary: Following a critical amount of blood loss, compensatory neural responses that normally help maintain blood pressure suddenly fail, causing vasodilation, profound bradycardia and life-threatening hypotension. The central nervous system mechanisms that mediate this sympatholytic response are unknown. A more comprehensive understanding of such mechanisms could lead to novel treatments for circulatory shock and other disorders with aberrant activation of sympatholytic reflexes such as myocardial infarct of the inferoposterior wall of the heart, exertional syncope associated with aortic stenosis or neurogenic syncope. In vivo models devised to examine these responses have been limited due to the effects of anesthesia on autonomic function. The objective of this proposal is to elucidate the role of hindbrain serotonergic cellular- and receptor mediated mechanisms in the sudden loss of sympathetic activity that accompanies severe blood loss in the conscious rat. Specifically, studies have been designed to identify the source of serotonin and the receptor populations that mediate sympathetic withdrawal during hemorrhage. The proposed experiments involve novel uses of classic physiological models to study the role of discrete hindbrain neuronal and receptor populations in the regulation of sympathetic function in unanesthetized rats. Anatomical studies that combine neuronal tract tracing with immunhistochemical markers of neuronal phenotype and function will be used to determine the source and projection site of serotonin involved in sympathetic reflexes. The novel techniques outlined in this proposal will help to determine hindbrain serotonergic cellular and receptor function on sympathetic regulation in general and on hemorrhage responses in particular, a goal which has, until now, been hampered by the confounding influence of anesthesia on hemorrhage responses and serotonergic function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SITOSTEROLEMIA Principal Investigator & Institution: Salen, Gerald; Professor of Medicine; Medicine; Univ of Med/Dent Nj Newark Newark, Nj 07103 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2004 Summary: The major aims of this grant are to define the molecular, biochemical, and clinical defects in sitosterolemia. In this recessively inherited disease, homozygotes show accelerated atherosclerosis with aortic stenosis, fatal myocardial infarctions, tendon and tuberous xanthomas, hemolytic episodes with deformed erythrocytes and thrombocytopenia, and attacks of disabling arthritis. Chemically, plant sterols (sitosterol, stigmasterol, campesterol, and avenosterol) and their respective 5alphadihydro derivatives (sitostanol and campestanol) and cholestanol accumulate in all tissues except brain because of enhanced intestinal absorption and reduced hepatic removal. In addition, cholesterol biosynthesis is discordantly down-regulated in monocytes with upregulated LDL receptors to produce increased cholesterol and plant sterol deposits such that the cells resemble atherogenic foam cells. Key research objectives are (1) locate and clone the sitosterolemia gene responsible for hyperabsorption that has been mapped to 2p21, sequence mutations, and elucidate the mechanism by with the mutated product permits unrestricted uptake and transport of plant sterols through the enterocyte. Strategies include fine mapping with a dense set of microsatilliate markers to narrow the abnormal gene region to approximately 1cM,

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construction of YAC contig and BAC contig with critical cDNAs from the suspected and adjoining regions. Sequence candidate genes from the region for possible mutations. DNA from 40 affected homozygotes from 30 sitosterolemic families have been assembled. (2) Investigate cholesterol and plant sterol metabolism in 3 rat models where campesterol and sitosterol constitute approximately 15 percent of the plasma sterols similar to human sitosterolemia. In these models, we propose to measure sitosterol and cholesterol absorption, assess cholesterol biosynthesis (inhibited in human sitosterolemia) and evaluate the effect of long term cholesterol feeding on development of atherosclerosis, plant sterol and cholesterol accumulation and metabolism. (3) Examine the conversion of sitosterol (24-ethyl cholesterol) to cholic acid and chenodeoxycholic acid and ascertain the pathway. Sitosterolemia is a rare disease but understanding the mechanism of enhanced sterol absorption and accumulation will provide key information to formulate better treatment of atherosclerosis in the general population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SOLID STATE NMR STUDIES OF MINERALIZED ELASTIN Principal Investigator & Institution: Kumashiro, Kristin K.; University of Hawaii at Manoa 2500 Campus Rd Honolulu, Hi 96822 Timing: Fiscal Year 2001; Project Start 24-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): This project will use high-resolution solid-state nuclear magnetic resonance (NMR) to characterize the conformational changes which accompany the mineralization of elastin in the heritable vascular and dermal disorder called pseudoxanthoma elasticum (PXE). The normal elastic fiber lends resiliency to vertebrate tissues, such as the skin and blood vessels. Its major protein component is elastin, which imparts elasticity to these tissues. Elastin is an insoluble, amorphous, and extensively crosslinked biopolymer, and there are no high-resolution crystallographic or solution NMR structures for this protein. Changes in elastic fiber morphology have been associated with the loss of elasticity in heritable and acquired disorders such as Marfan syndrome, supravalvular aortic stenosis, and aortic aneurysms. And, recent work by other laboratories strongly suggests that the calcification of the elastic fibers in PXE patients is a secondary consequence of a primary alteration in the structure and/or assembly of elastin. Therefore, we propose that PXE effects the introduction of new components or abnormal concentrations of typical components in elastic tissue. The abnormal chemical conditions induce conformational changes of elastin, and it is this abnormal state which undergoes mineralization. To obtain the most definitive descriptions of structural changes to elastin on the molecular level, high-resolution solid-state NMR spectroscopy will be utilized. These studies will identify the structural differences between normal elastin and several calcified states, as produced in welldefined chemical conditions. And, the characterization of the abnormal elastin, as found in the tissue of a PXE patient, will be indicative of the conditions which accompany, or even induce, mineralization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: THE GENETIC ETIOLOGY OF LEFT-SIDED CARDIAC DEFECTS Principal Investigator & Institution: Goldmuntz, Elizabeth; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 30-JUN-2008

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Summary: (provided by applicant): Congenital heart disease (CHD) is the most common major birth defect affecting 4-8 per 1000 livebirths. Left-sided cardiac defects (LSCD) include valvar aortic stenosis, coarctation of the aorta and hypoplastic left heart syndrome, and account for at least 10% of CHD. Although LSCD are associated with significant morbidity and mortality, their etiology is largely unknown. Very few, if any, environmental causes have been identified and LSCD are associated with relatively few consistent chromosomal alterations or genetic syndromes. Nonetheless, studies point to a genetic contribution to these conditions, given an increased risk of recurrence and small, multiplex families. LSCD appear to share a common genetic etiology as different defects can occur in different members of a single family. Large multiplex families or affected sibling pairs amenable to genome wide linkage analyses are very rare, consistent in part with a complex mode of inheritence. The goal of this program is to identify genetic factors that contribute to the etiology of LSCD using techniques which dissect complex disorders. This investigation proposes that there are susceptibility loci and novel mutations that contribute to the etiology of LSCD. To investigate this hypothesis, this program will: (I) identify and characterize common susceptibility loci for LSCD using family-based association studies, and (II) identify and characterize rare or novel mutations in candidate genes in subjects with LSCD. A large cohort of subjects has been recruited. Family based association analyses and mutation analyses have already identified potential disease-related alleles and mutations respectively. To accomplish our goals, we will continue to recruit subjects, genotype them for a chosen set of common variants, and test them for association to LSCD. The role of maternal genetic effects for a subset of the putative susceptibility loci will also be evaluated. To complement the association studies, we will screen subjects for mutations of candidate genes by Conformation Sensitive Gel Electrophoresis and direct sequencing. If a sequence variant is identified, control populations will be tested for the same variant to determine disease relevance. The functional significance of mutations will also be assessed. This investigation will begin to dissect the genetic factors that contribute to the development of LSCD. The findings will allow for improved understanding of the disease-mechanism, more precise family counseling, and may identify preventive measures. In addition, these investigations will lead to future studies that assess the relationship of genotype to clinical outcome, and allow us to improve upon our clinical management accordingly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE MOLECULAR GENETIC BASIS OF CARDIAC DEFECTS Principal Investigator & Institution: Wenstrom, Katharine D.; Professor of Obstetrics and Gynecology,; Obstetrics and Gynecology; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 21-JAN-2002; Project End 31-DEC-2003 Summary: (Provided by Applicant): We hypothesize that certain congenital cardiac malformations are caused by hypomethylation at the cellular level during organogenesis, leading to abnormally slow tissue growth and abnormal cell migration. Cellular methylation status strongly influenced by folic acid nutriture and the enzyme methylene tetrahydrafolate reductase (MTHFR) hypomethylation is possible if an inadequate amount of folate reaches the multiplying cells or the fetus inherits mutation in MTHFR. To test this hypothesis, we will access the University of Alabama's Congenital Heart Disease Collection, a multidisciplinary teaching and research registry of archived heart specimens with cardiovascular malformations. This registry, established and maintained by one of the co-investigators (0 F-P), contains over 550 that

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have been catalogued by lesion group and cross referenced by individual defect, with all known etiologies and/or diagnoses (e.g. aneuploidy, genetic syndrome, teratogen exposure, etc) noted. Approximately 100 cardiac specimens representing each of the five basic mechanisms of cardiac development will be selected for study. That is, we will include defects caused by abnormally slow tissue growth (hypoplastic left or right ventricle, aortic stenosis, bifid aortic valve, coarctation of the aorta, pulmonary atresia), abnormally cell migration (conotruncal defects), extraneous cell, (Ebstein anomaly), abnormal growth of the extracellular matrix (AV canal), and abnormal targeted growth (anomalous pulmonary venous return). We will also study a control group of similarly archived normal cardiac specimens. After employing a novel procedure to remove the formalin, DNA will be extracted from the abnormally and normal cardiac tissue samples and tested for the presence or absence of two well-characterized MTHFR mutations. We will then quantitate level of methylation in abnormal and normal heart tissue via an assay utilizing 3H]-methyl-S-adenosylmethionine an extracted genomic DNA. Finally, the specific location of any hypomethylated tissue within each cardiac structure will be determined by exposing representative sections of cardiac tissue to anti Smethylcytosine antibody. If our hypothesis is correct, cardiac defects resulting from abnormally slow tissue growth and abnormal cell migration will be the most hypomethylated. Additionally, confirmation of our hypothesis would suggest that certain types of cardiac malformations might be prevented by folic acid supplementation Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE ROLE OF FIBULIN-5 IN CARDIOVASCULAR REMODELING Principal Investigator & Institution: Yanagisawa, Hiromi; Molecular Biology; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: (provided by applicant): The tunica media of the aorta is comprised of alternating layers of smooth muscle cells and elastic fibers (elastic laminae). The molecules and precise mechanisms involved in the formation, organization and maintenance of these layers has yet to be defined. Recently, we have generated a null mutation in the mouse fibulin-5 gene and observed a striking phenotype of systemic elastinopathy due to a disorganization of elastic fibers. Fibulin-5 belongs to a family of similar extracellular matrix proteins and possesses 6 Ca2+ - binding EGF repeats and a single RGD motif. Fibulin-5 is significantly up-regulated in vascular injury suggesting a role in cardiovascular development and remodeling. Solid-phase binding and immunolocalization studies have indicated that fibulin-5 is a Ca2+ -dependent tropoelastin binding protein. We hypothesize that (i) fibulin-5 provides a scaffold that is essential for organizing elastic fibers by connecting elastin to cell surface integrins, (ii) fibulin-5 functions as a negative regulator of neointima formation via an RGDdependent and/or independent mechanism. To test this hypothesis, we propose the following specific aims: (1) to characterize the vascular defects in the fibulin-5 null mice; (2) to define the molecular and genetic interaction of fibulin-5 and elastin; (3) to explore the role of fibulin-5 in cardiovascular remodeling using a model of vascular injury in fibulin-5 null mice. Results from these studies will not only provide fundamental information concerning the role of fibulin-5 in elastic fiber formation, but will ultimately establish an important basis for future studies on fibulin-5 in vascular diseases, such as supravalvular aortic stenosis, atherosclerosis and aortic aneurysms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “aortic stenosis” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for aortic stenosis in the PubMed Central database: •

A Human Vascular Disorder, Supravalvular Aortic Stenosis, Maps to Chromosome 7. by Ewart AK, Morris CA, Ensing GJ, Loker J, Moore C, Leppert M, Keating M.; 1993 Apr 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=46272

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Long-Term Results of Apico-Aortic Valved Conduit for Severe Idiopathic Hypertrophic Subaortic Stenosis. by Renzulli A, Gregorio R, De Feo M, Ismeno G, Covino FE, Cotrufo M.; 2000; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=101013

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with aortic stenosis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “aortic stenosis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for aortic stenosis (hyperlinks lead to article summaries):

3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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Accelerated progression of calcific aortic stenosis in dialysis patients. Author(s): Perkovic V, Hunt D, Griffin SV, du Plessis M, Becker GJ. Source: Nephron. Clinical Practice [electronic Resource]. 2003; 94(2): C40-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12845236&dopt=Abstract

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Accelerated progression of calcific aortic stenosis in dialysis patients: what we still need to learn. Author(s): Bakri K, Goldsmith DJ. Source: Nephron. Clinical Practice [electronic Resource]. 2003; 94(2): C27-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12845233&dopt=Abstract

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Acquired von Willebrand syndrome in aortic stenosis. Author(s): Vincentelli A, Susen S, Le Tourneau T, Six I, Fabre O, Juthier F, Bauters A, Decoene C, Goudemand J, Prat A, Jude B. Source: The New England Journal of Medicine. 2003 July 24; 349(4): 343-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12878741&dopt=Abstract

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Acute diffuse myocyte necrosis evidenced with 111In-antimyosin antibody scintigraphy in a patient with aortic stenosis. Author(s): Sarda L, Faraggi M, Brochet E, Vissuzaine C, Delahaye N, Le Guludec D. Source: Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology. 1997 September-October; 4(5): 426-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9362020&dopt=Abstract

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An unusual case of aortic stenosis. Author(s): Galrinho A, Loureiro J, Banazol N. Source: Rev Port Cardiol. 2003 February; 22(2): 281-5. English, Portuguese. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12769006&dopt=Abstract

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Anterograde double-balloon valvoplasty for treatment of severe valvar aortic stenosis in a preterm baby weighing 1400 grams. Author(s): Peuster M, Paul T, Hausdorf G. Source: Cardiology in the Young. 2000 January; 10(1): 67-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10695547&dopt=Abstract

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Aortic stenosis after uncomplicated surgical repair of tetralogy of Fallot. Author(s): Galea N, Aquilina O, Grech V. Source: Cardiology in the Young. 2003 June; 13(3): 300-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12903880&dopt=Abstract

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Aortic stenosis and angina with normal coronary arteries: the role of coronary flow abnormalities. Author(s): Irvine T, Kenny A. Source: Heart (British Cardiac Society). 1997 September; 78(3): 213-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9391277&dopt=Abstract

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Aortic stenosis with severe left ventricular dysfunction and low transvalvular pressure gradients: risk stratification by low-dose dobutamine echocardiography. Author(s): Monin JL, Monchi M, Gest V, Duval-Moulin AM, Dubois-Rande JL, Gueret P. Source: Journal of the American College of Cardiology. 2001 June 15; 37(8): 2101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11419894&dopt=Abstract

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Aortic stenosis, von Willebrand factor, and bleeding. Author(s): Hansen PR, Hassager C. Source: The New England Journal of Medicine. 2003 October 30; 349(18): 1773-4; Author Reply 1773-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14596230&dopt=Abstract

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Aortic stenosis, von Willebrand factor, and bleeding. Author(s): Williams RC Jr. Source: The New England Journal of Medicine. 2003 October 30; 349(18): 1773-4; Author Reply 1773-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14593996&dopt=Abstract

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Aortic stenosis, von Willebrand factor, and bleeding. Author(s): Sucker C, Feindt P, Scharf RE. Source: The New England Journal of Medicine. 2003 October 30; 349(18): 1773-4; Author Reply 1773-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14585949&dopt=Abstract

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Aortic stenosis, von Willebrand factor, and bleeding. Author(s): Sadler JE. Source: The New England Journal of Medicine. 2003 July 24; 349(4): 323-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12878737&dopt=Abstract

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Aortic stenosis: a new face for an old disease. Author(s): Alpert JS. Source: Archives of Internal Medicine. 2003 August 11-25; 163(15): 1769-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12912708&dopt=Abstract

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Aortic valve calcification on computed tomography predicts the severity of aortic stenosis. Author(s): Cowell SJ, Newby DE, Burton J, White A, Northridge DB, Boon NA, Reid J. Source: Clinical Radiology. 2003 September; 58(9): 712-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943644&dopt=Abstract

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Aortic valve replacement for patients with mild to moderate aortic stenosis undergoing coronary artery bypass surgery. Author(s): Hilton TC. Source: Clin Cardiol. 2000 March; 23(3): 141-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10761799&dopt=Abstract

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Aortic valve resistance in aortic stenosis: Doppler echocardiographic study and surgical correlation. Author(s): Roger VL, Seward JB, Bailey KR, Oh JK, Mullany CJ. Source: American Heart Journal. 1997 November; 134(5 Pt 1): 924-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9398105&dopt=Abstract

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Aortic valvotomy for congenital valvular aortic stenosis: a 37-year experience. Author(s): Detter C, Fischlein T, Feldmeier C, Nollert G, Reichart B. Source: The Annals of Thoracic Surgery. 2001 May; 71(5): 1564-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11383801&dopt=Abstract

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Association of coronary risk factors with progression of valvular aortic stenosis in older persons. Author(s): Nassimiha D, Aronow WS, Ahn C, Goldman ME. Source: The American Journal of Cardiology. 2001 June 1; 87(11): 1313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11377366&dopt=Abstract

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Asymptomatic aortic stenosis and unexpected death in the trauma patient. Author(s): Omert L, Peitzman AB. Source: The Journal of Trauma. 1997 October; 43(4): 709-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9356076&dopt=Abstract

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Bacterial endocarditis in patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect. Author(s): Gersony WM, Hayes CJ, Driscoll DJ, Keane JF, Kidd L, O'Fallon WM, Pieroni DR, Wolfe RR, Weidman WH. Source: Circulation. 1993 February; 87(2 Suppl): I121-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8425318&dopt=Abstract

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Balloon aortic valvotomy through a carotid cutdown in infants with severe aortic stenosis: results of the multi-centric registry. Author(s): Robinson BV, Brzezinska-Rajszys G, Weber HS, Ksiazyk J, Fricker FJ, Fischer DR, Ettedgui JA. Source: Cardiology in the Young. 2000 May; 10(3): 225-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10824903&dopt=Abstract

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Balloon aortic valvuloplasty for aortic stenosis in neonates, children, and young adults. Author(s): Sandhu SK, Silka MJ, Reller MD. Source: Journal of Interventional Cardiology. 1995 October; 8(5): 477-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10159514&dopt=Abstract

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Balloon aortic valvuloplasty in congenital aortic stenosis. Author(s): Dalvi B. Source: Journal of the American College of Cardiology. 1991 December; 18(7): 1834. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1960337&dopt=Abstract

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Balloon aortic valvuloplasty in the young adult with congenital aortic stenosis. Author(s): Rosenfeld HM, Landzberg MJ, Perry SB, Colan SD, Keane JF, Lock JE. Source: The American Journal of Cardiology. 1994 June 1; 73(15): 1112-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8198039&dopt=Abstract

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Balloon dilatation of aortic stenosis in infants younger than 6 months of age: intermediate outcome. Author(s): Latiff HA, Sholler GF, Cooper S. Source: Pediatric Cardiology. 2003 January-February; 24(1): 17-26. Epub 2002 October 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370791&dopt=Abstract

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Balloon dilatation of supravalvular aortic stenosis: a report of two cases. Author(s): Pinto RJ, Loya Y, Bhagwat A, Sharma S. Source: International Journal of Cardiology. 1994 September; 46(2): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7814169&dopt=Abstract

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Balloon dilation of postoperative persistent coarctation of aorta and valvular aortic stenosis--a case report. Author(s): Shekhar YC, Anand IS. Source: Angiology. 1992 July; 43(7): 614-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1378248&dopt=Abstract

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Balloon dilation of severe aortic stenosis in the neonate: comparison of anterograde and retrograde catheter approaches. Author(s): Magee AG, Nykanen D, McCrindle BW, Wax D, Freedom RM, Benson LN. Source: Journal of the American College of Cardiology. 1997 October; 30(4): 1061-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9316540&dopt=Abstract

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Balloon expandable intravascular stent in infrarenal aortic stenosis. Author(s): Kang EH. Source: Nebr Med J. 1995 November; 80(11): 329-31. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8524437&dopt=Abstract

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Balloon valvotomy for severe aortic stenosis in an infant. Author(s): Kothari SS, Kumar RK, Saxena A, Wasir HS. Source: Indian Pediatrics. 1994 February; 31(2): 222-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7875853&dopt=Abstract

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Balloon valvotomy for severe aortic stenosis with congestive heart failure in adolescents. Author(s): Kumar RK, Dev V, Shrivastava S. Source: American Heart Journal. 1994 February; 127(2): 448-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8296719&dopt=Abstract

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Balloon valvuloplasty for congenital aortic stenosis in pregnancy. Author(s): Lao TT, Adelman AG, Sermer M, Colman JM. Source: British Journal of Obstetrics and Gynaecology. 1993 December; 100(12): 1141-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8297851&dopt=Abstract

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Balloon valvuloplasty for critical aortic stenosis in the newborn: influence of new catheter technology. Author(s): Beekman RH, Rocchini AP, Andes A. Source: Journal of the American College of Cardiology. 1991 April; 17(5): 1172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2007718&dopt=Abstract

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Balloon valvuloplasty versus transventricular dilation for neonatal critical aortic stenosis. Author(s): Cowley CG, Dietrich M, Mosca RS, Bove EL, Rocchini AP, Lloyd TR. Source: The American Journal of Cardiology. 2001 May 1; 87(9): 1125-7, A10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11348619&dopt=Abstract

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Beat-by-beat aortic valve area measurements indicate constant orifice area in aortic stenosis: analysis of Doppler data with varying RR intervals. Author(s): Blackshear JL, Kapples EJ, Lane GE, Safford RE. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 1992 July-August; 5(4): 414-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1510856&dopt=Abstract

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Bicuspid noncalcific aortic stenosis: diagnostic limitations of intraoperative transesophageal echocardiography. Author(s): Fontes ML, Mathew J, Johnson K, Rafferty T. Source: Journal of Cardiothoracic and Vascular Anesthesia. 1998 February; 12(1): 58-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9509358&dopt=Abstract

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Bilateral buttock pain caused by aortic stenosis: a case report of claudication of the buttock. Author(s): Laslett M. Source: Manual Therapy. 2000 November; 5(4): 227-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052902&dopt=Abstract

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Brain natriuretic peptide concentrations in patients with aortic stenosis. Author(s): Prasad N, Bridges AB, Lang CC, Clarkson PB, MacLeod C, Pringle TH, Struthers AD, MacDonald TM. Source: American Heart Journal. 1997 April; 133(4): 477-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9124176&dopt=Abstract

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Brom's three-patch technique for repair of supravalvular aortic stenosis. Author(s): Hazekamp MG, Kappetein AP, Schoof PH, Ottenkamp J, Witsenburg M, Huysmans HA, Bogers AJ. Source: The Journal of Thoracic and Cardiovascular Surgery. 1999 August; 118(2): 252-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10424998&dopt=Abstract

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Calcific aortic stenosis in the elderly: a brief overview. Author(s): Sawhney N, Hassankhani A, Greenberg BH. Source: The American Journal of Geriatric Cardiology. 2003 May-June; 12(3): 178-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732813&dopt=Abstract

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Calcific aortic stenosis: another face of atherosclerosis? Author(s): Novaro GM, Griffin BP. Source: Cleve Clin J Med. 2003 May; 70(5): 471-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12779138&dopt=Abstract

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Calcific aortic stenosis: from bench to the bedside--emerging clinical and cellular concepts. Author(s): Rajamannan NM, Gersh B, Bonow RO. Source: Heart (British Cardiac Society). 2003 July; 89(7): 801-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807865&dopt=Abstract

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Calcific aortic stenosis: new pathophysiologic insights and possible new medical therapy. Author(s): Croft LB, Goldman ME. Source: Current Cardiology Reports. 2003 March; 5(2): 101-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12583851&dopt=Abstract

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Can calcific aortic stenosis be prevented? Author(s): Conti CR. Source: Clin Cardiol. 2002 May; 25(5): 201-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018877&dopt=Abstract

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Can cardiac catheterization accurately assess the severity of aortic stenosis? An in vitro pulsatile flow study. Author(s): Sung HW, Yu PS, Hsu CH, Hsu JC. Source: Annals of Biomedical Engineering. 1997 September-October; 25(5): 896-905. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9300114&dopt=Abstract

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Cardiac systolic rotation and contraction before and after valve replacement for aortic stenosis: a myocardial tagging study using MR imaging. Author(s): Sandstede JJ, Johnson T, Harre K, Beer M, Hofmann S, Pabst T, Kenn W, Voelker W, Neubauer S, Hahn D. Source: Ajr. American Journal of Roentgenology. 2002 April; 178(4): 953-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11906882&dopt=Abstract

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Cardiovascular risk factors in patients with aortic stenosis predict prevalence of coronary artery disease but not of aortic stenosis: an angiographic pair matched casecontrol study. Author(s): Ortlepp JR, Schmitz F, Bozoglu T, Hanrath P, Hoffmann R. Source: Heart (British Cardiac Society). 2003 September; 89(9): 1019-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12923015&dopt=Abstract

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Carotid stent-supported angioplasty in a patient with symptomatic and critical aortic stenosis. Author(s): Li SS, Yiu SF, Chiang CS. Source: Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 2002 August; 56(4): 498-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12124961&dopt=Abstract

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Cerebral embolism after retrograde catheterisation of aortic valve in aortic stenosis. Author(s): Hamon M, Hamon-Kerautret M, Rigattieri S, Babatasi G. Source: Lancet. 2003 July 5; 362(9377): 79; Author Reply 79-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12853211&dopt=Abstract

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Cerebral embolism after retrograde catheterisation of aortic valve in aortic stenosis. Author(s): Kumar S. Source: Lancet. 2003 July 5; 362(9377): 78-9; Author Reply 79-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12853210&dopt=Abstract

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Chordae tendineae rupture resulting in pulmonary edema in a patient with discrete subvalvular aortic stenosis--a case report and literature review. Author(s): Adler O, Kalidindi S, Butt A, Hussain KM. Source: Angiology. 2003 September-October; 54(5): 613-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14565639&dopt=Abstract

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Clinical diagnosis of aortic stenosis in the elderly is difficult. Author(s): Chatterjee K. Source: The American Journal of Geriatric Cardiology. 2003 May-June; 12(3): 161-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732809&dopt=Abstract

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Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in a patient with severe aortic stenosis. Author(s): Ho AM, Karmakar MK. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 November; 49(9): 946-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419722&dopt=Abstract

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Combined PTCA and aortic valvuloplasty for acute myocardial infarction complicated by severe aortic stenosis and cardiogenic shock. Author(s): Whisenant B, Sweeney J, Ports TA. Source: Catheterization and Cardiovascular Diagnosis. 1997 November; 42(3): 283-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9367103&dopt=Abstract

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Comparison of left ventricular geometry and left atrial size and function in patients with aortic stenosis versus those with pure aortic regurgitation. Author(s): Cioffi G, Stefenelli C. Source: The American Journal of Cardiology. 2002 September 15; 90(6): 601-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231084&dopt=Abstract

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Comparison of pulmonary venous flow velocities and left ventricular diastolic and ejection time in patients with moderate mitral and aortic stenosis. Pulmonary venous flow velocities in mitral and aortic stenosis. Author(s): Altunkeser BB, Ozdemir K, Icli A, Gok H. Source: The International Journal of Cardiovascular Imaging. 2003 February; 19(1): 3341. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602480&dopt=Abstract

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Congenital aortic stenosis: is repair an option? Author(s): Lamberti JJ. Source: Adv Cardiol. 2002; 39: 70-3. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060926&dopt=Abstract

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Connection between elastin haploinsufficiency and increased cell proliferation in patients with supravalvular aortic stenosis and Williams-Beuren syndrome. Author(s): Urban Z, Riazi S, Seidl TL, Katahira J, Smoot LB, Chitayat D, Boyd CD, Hinek A. Source: American Journal of Human Genetics. 2002 July; 71(1): 30-44. Epub 2002 May 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12016585&dopt=Abstract

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Current concepts in aortic stenosis. Author(s): Gill EA, Trujillo N. Source: Hosp Pract (Off Ed). 1997 August 15; 32(8): 169-73, 177-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9275969&dopt=Abstract

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De novo 46,XX,t(6;7)(q27;q11;23) associated with severe cardiovascular manifestations characteristic of supravalvular aortic stenosis and Williams syndrome. Author(s): von Dadelszen P, Chitayat D, Winsor EJ, Cohen H, MacDonald C, Taylor G, Rose T, Hornberger LK. Source: American Journal of Medical Genetics. 2000 February 14; 90(4): 270-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10710222&dopt=Abstract

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Deficient coacervation of two forms of human tropoelastin associated with supravalvular aortic stenosis. Author(s): Wu WJ, Weiss AS. Source: European Journal of Biochemistry / Febs. 1999 November; 266(1): 308-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10542079&dopt=Abstract

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Demonstration of supravalvar aortic stenosis by different cardiac imaging modalities in Williams syndrome. Author(s): Youn HJ, Chung WS, Hong SJ. Source: Heart (British Cardiac Society). 2002 October; 88(4): 438. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231615&dopt=Abstract

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Determinants of progression of aortic stenosis in patients aged > or =40 years. Author(s): Wongpraparut N, Apiyasawat S, Crespo G, Yazdani K, Jacobs LE, Kotler MN. Source: The American Journal of Cardiology. 2002 February 1; 89(3): 350-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11809442&dopt=Abstract

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Determinants of symptoms and exercise capacity in aortic stenosis: a comparison of resting haemodynamics and valve compliance during dobutamine stress. Author(s): Das P, Rimington H, Smeeton N, Chambers J. Source: European Heart Journal. 2003 July; 24(13): 1254-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12831820&dopt=Abstract

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Diagnosis of aortic stenosis in the elderly: role of echocardiography. Author(s): Alipour MS, Shah PA. Source: The American Journal of Geriatric Cardiology. 2003 May-June; 12(3): 201-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732817&dopt=Abstract

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Difficult airway management in a patient with severe aortic stenosis, coronary artery disease, and heart failure. Author(s): Kulka PJ, Tryba M, Zenz M. Source: Journal of Clinical Anesthesia. 2002 March; 14(2): 150-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11943531&dopt=Abstract

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Dilatation of congenital valvular aortic stenosis using Inoue balloon. Author(s): Goel PK, Kapoor A, Singh RK. Source: Catheterization and Cardiovascular Diagnosis. 1997 November; 42(3): 328-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9367116&dopt=Abstract

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Dipyridamole myocardial perfusion tomography in patients with severe aortic stenosis. Author(s): Demirkol MO, Yaymaci B, Debes H, Basaran Y, Turan F. Source: Cardiology. 2002; 97(1): 37-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11893828&dopt=Abstract

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Discrepancies between catheter and Doppler estimates of valve effective orifice area can be predicted from the pressure recovery phenomenon: practical implications with regard to quantification of aortic stenosis severity. Author(s): Garcia D, Dumesnil JG, Durand LG, Kadem L, Pibarot P. Source: Journal of the American College of Cardiology. 2003 February 5; 41(3): 435-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12575972&dopt=Abstract

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Discrete subaortic stenosis in adults: increased prevalence and slow rate of progression of the obstruction and aortic regurgitation. Author(s): Oliver JM, Gonzalez A, Gallego P, Sanchez-Recalde A, Benito F, Mesa JM. Source: Journal of the American College of Cardiology. 2001 September; 38(3): 835-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11527642&dopt=Abstract

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Discrete subvalvular aortic stenosis in adults. Author(s): Kasliwal RR, Sharma BD, Kohli V, Mittal S, Trehan N. Source: J Assoc Physicians India. 2001 March; 49: 369-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11291980&dopt=Abstract

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Discrete subvalvular aortic stenosis. Author(s): Sharma BD, Mittal S, Kasliwal RR, Trehan N, Kohli V. Source: J Assoc Physicians India. 2000 November; 48(11): 1103-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11310391&dopt=Abstract

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Dobutamine challenge for low-gradient aortic stenosis. Author(s): Grayburn PA, Eichhorn EJ. Source: Circulation. 2002 August 13; 106(7): 763-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12176940&dopt=Abstract

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Dobutamine echocardiography in patients with aortic stenosis and left ventricular dysfunction: predicting outcome as a function of management strategy. Author(s): Schwammenthal E, Vered Z, Moshkowitz Y, Rabinowitz B, Ziskind Z, Smolinski AK, Feinberg MS. Source: Chest. 2001 June; 119(6): 1766-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11399704&dopt=Abstract

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Doppler echocardiographic assessment of hemodynamic progression of valvular aortic stenosis over time: comparison between aortic valve resistance and valve area. Author(s): Faggiano P, Gualeni A, Antonini-Canterin F, Rusconi C, Nicolosi G. Source: G Ital Cardiol. 1999 October; 29(10): 1131-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10546122&dopt=Abstract

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Doppler echocardiographic assessment of left ventricular filling pressures in elderly patients with moderate/severe aortic stenosis. Author(s): D'Agate DJ, Smith RH, Lazar JM. Source: The American Journal of Geriatric Cardiology. 2002 May-June; 11(3): 173-6, 196. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11986531&dopt=Abstract

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Doppler echocardiographic evaluation of right ventricular diastolic function in isolated valvular aortic stenosis. Author(s): Efthimiadis GK, Parharidis GE, Gemitzis KD, Nouskas IG, Karvounis HI, Styliadis IK, Louridas GE. Source: J Heart Valve Dis. 1999 May; 8(3): 261-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10399658&dopt=Abstract

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Doppler echocardiography as a predictor of pregnancy outcome in the presence of aortic stenosis: A case report. Author(s): Wilansky S, Phan B, Adam K. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 1999 May; 12(5): 324-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10231619&dopt=Abstract

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Early and intermediate-term outcomes of pregnancy with congenital aortic stenosis. Author(s): Silversides CK, Colman JM, Sermer M, Farine D, Siu SC. Source: The American Journal of Cardiology. 2003 June 1; 91(11): 1386-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767444&dopt=Abstract

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Early in vivo hemodynamic results after aortic valve replacement with the St Jude Medical Regent mechanical heart valve in patients with pure aortic stenosis. Author(s): Gelsomino S, Morocutti G, Da Col P, Masullo G, Carella R, Guzzi G, Spedicato L, Livi U. Source: Journal of Cardiac Surgery. 2003 March-April; 18(2): 125-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12757339&dopt=Abstract

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Early recovery of left ventricular function after stentless versus stented aortic valve replacement for pure aortic stenosis and severe cardiac dysfunction. Author(s): Gelsomino S, Morocutti G, Frassani R, Da Col P, Morelli A, Spedicato L, Minen G, Livi U. Source: Semin Thorac Cardiovasc Surg. 2001 October; 13(4 Suppl 1): 120-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11805960&dopt=Abstract

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Echocardiographic prediction of clinical outcome in medically treated patients with aortic stenosis. Author(s): Rossi A, Tomaino M, Golia G, Anselmi M, Fuca G, Zardini P. Source: American Heart Journal. 2000 November; 140(5): 766-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11054623&dopt=Abstract

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Echocardiographic predictors of survival in low gradient aortic stenosis. Author(s): Smith RL, Larsen D, Crawford MH, Shively BK. Source: The American Journal of Cardiology. 2000 October 1; 86(7): 804-7, A10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11018209&dopt=Abstract

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Effect of balloon aortic valvuloplasty of congenital aortic stenosis in children in regression of left ventricular mass. Author(s): Shim D, Michelfelder EC, Lee KJ, Bean J. Source: The American Journal of Cardiology. 2001 April 1; 87(7): 916-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11274954&dopt=Abstract

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Effect of hydroxymethylglutaryl coenzyme a reductase inhibitors on the progression of calcific aortic stenosis. Author(s): Novaro GM, Tiong IY, Pearce GL, Lauer MS, Sprecher DL, Griffin BP. Source: Circulation. 2001 October 30; 104(18): 2205-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11684632&dopt=Abstract

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Effect of three-dimensional valve shape on the hemodynamics of aortic stenosis: three-dimensional echocardiographic stereolithography and patient studies. Author(s): Gilon D, Cape EG, Handschumacher MD, Song JK, Solheim J, VanAuker M, King ME, Levine RA. Source: Journal of the American College of Cardiology. 2002 October 16; 40(8): 1479-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392840&dopt=Abstract

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Effects of balloon valvuloplasty on left anterior descending coronary artery blood flow in a neonate with critical aortic stenosis with transthoracic doppler echocardiography. Author(s): Harada K, Toyono M, Tamura M. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2003 January; 16(1): 88-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514642&dopt=Abstract

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Efficacy of balloon valvuloplasty in patients with critical aortic stenosis and cardiogenic shock--the role of shock duration. Author(s): Buchwald AB, Meyer T, Scholz K, Schorn B, Unterberg C. Source: Clin Cardiol. 2001 March; 24(3): 214-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288967&dopt=Abstract

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Elastin: mutational spectrum in supravalvular aortic stenosis. Author(s): Metcalfe K, Rucka AK, Smoot L, Hofstadler G, Tuzler G, McKeown P, Siu V, Rauch A, Dean J, Dennis N, Ellis I, Reardon W, Cytrynbaum C, Osborne L, Yates JR, Read AP, Donnai D, Tassabehji M. Source: European Journal of Human Genetics : Ejhg. 2000 December; 8(12): 955-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11175284&dopt=Abstract

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Electrocardiographic associations of right precordial Q waves help to distinguish anterior myocardial infarction from aortic stenosis. Author(s): Xiao HB, Ramzy IS, Bowker TJ, Dancy M. Source: International Journal of Cardiology. 2002 February; 82(2): 159-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11853902&dopt=Abstract

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Electrocardiographically gated multi-detector row CT for assessment of valvular morphology and calcification in aortic stenosis. Author(s): Willmann JK, Weishaupt D, Lachat M, Kobza R, Roos JE, Seifert B, Luscher TF, Marincek B, Hilfiker PR. Source: Radiology. 2002 October; 225(1): 120-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12354994&dopt=Abstract

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Electroconvulsive therapy in patients with aortic stenosis. Author(s): Rasmussen KG. Source: Convuls Ther. 1997 September; 13(3): 196-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9342136&dopt=Abstract

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Endothelial alterations and senile calcific aortic stenosis: an electron microscopic observation. Author(s): Lee YS, Chou YY. Source: Proc Natl Sci Counc Repub China B. 1997 October; 21(4): 137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9369023&dopt=Abstract

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Evaluation and management of patients with aortic stenosis. Author(s): Carabello BA. Source: Circulation. 2002 April 16; 105(15): 1746-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11956110&dopt=Abstract

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Evaluation by exercise testing of children with mild and moderate valvular aortic stenosis. Author(s): Yilmaz G, Ozme S, Ozer S, Tokel K, Celiker A. Source: Pediatrics International : Official Journal of the Japan Pediatric Society. 2000 February; 42(1): 48-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10703234&dopt=Abstract

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Evaluation of aortic stenosis severity: role of contrast echocardiography in comparison with conventional echocardiography and cardiac catheterization. Author(s): Almeida AG, Sargento L, Gabriel HM, da Costa JM, Morais J, Madeira F, David C, Oliveira J, da Cunha JC, Vagueiro MC. Source: Rev Port Cardiol. 2002 May; 21(5): 555-72. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174519&dopt=Abstract

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Evidence-based diagnosis of severe aortic stenosis. Author(s): Ghosh AK. Source: Qjm : Monthly Journal of the Association of Physicians. 2001 July; 94(7): 397-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11435636&dopt=Abstract

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Exercise testing, symptoms, and clinical outcome in aortic stenosis. Author(s): McCann GP, Muir DF, Hillis WS. Source: Heart (British Cardiac Society). 2000 January; 83(1): 105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10671074&dopt=Abstract

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Factors affecting Doppler echocardiographic valve area assessment in aortic stenosis. Author(s): Danielsen R, Nordrehaug JE, Vik-Mo H. Source: The American Journal of Cardiology. 1989 May 1; 63(15): 1107-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2705381&dopt=Abstract

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Factors leading to progression of valvular aortic stenosis. Author(s): Bahler RC, Desser DR, Finkelhor RS, Brener SJ, Youssefi M. Source: The American Journal of Cardiology. 1999 November 1; 84(9): 1044-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10569661&dopt=Abstract

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Failure to detect Chlamydia pneumoniae in senile calcific aortic stenosis or calcified congenital bicuspid aortic valve by immunofluorescence, polymerase chain reaction and electron microscopy. Author(s): Rose AG. Source: Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology. 2002 September-October; 11(5): 300-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361842&dopt=Abstract

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False passage in the interventricular septum. Echocardiography in diagnosis and management of a rare complication after closed transventricular valvotomy for critical aortic stenosis. Author(s): Stein JI, Rigler B, Beitzke A. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 1990; 4(9): 517-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2223136&dopt=Abstract

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Familial bilateral blepharoptosis and subvalvular aortic stenosis. Author(s): Bazopoulou-Kyrkanidou E, Neou P, Bartsocas CS, Kyrkanides S, Fanourakis I. Source: Genet Couns. 1995; 6(3): 227-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8588851&dopt=Abstract

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Familial hypercholesterolaemia in association with aortic stenosis. Author(s): Mittal A, Devgan SC, Arora S. Source: J Assoc Physicians India. 1991 April; 39(4): 362-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1938839&dopt=Abstract

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Familial hypercholesterolaemia with supravalvular aortic stenosis. Author(s): Chidambaram N, Prasad PV. Source: J Indian Med Assoc. 1997 September; 95(9): 524-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9529593&dopt=Abstract

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Familial supravalvular aortic stenosis: a genetic study. Author(s): Chiarella F, Bricarelli FD, Lupi G, Bellotti P, Domenicucci S, Vecchio C. Source: Journal of Medical Genetics. 1989 February; 26(2): 86-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2918546&dopt=Abstract

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Familial supravalvular aortic stenosis: a report of two brothers. Author(s): Wu JR, Chen YH, Huang TY. Source: Kaohsiung J Med Sci. 1996 February; 12(2): 128-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8709174&dopt=Abstract

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Fatal aortic rupture: an unusual complication of percutaneous balloon valvuloplasty for acquired valvular aortic stenosis. Author(s): Vrolix M, Piessens J, Moerman P, Vanhaecke J, De Geest H. Source: Catheterization and Cardiovascular Diagnosis. 1989 February; 16(2): 119-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2914316&dopt=Abstract

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Fibrotic aortic stenosis in a patient with dwarfism. Author(s): Huang WY, Nanda NC, Miller A, Aaluri SR, McGiffin DC, Reddy V, Yesilbursa D, Kottakota RJ. Source: Echocardiography (Mount Kisco, N.Y.). 2000 October; 17(7): 701-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11107211&dopt=Abstract

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Flow dependence of measures of aortic stenosis severity during exercise. Author(s): Burwash IG, Pearlman AS, Kraft CD, Miyake-Hull C, Healy NL, Otto CM. Source: Journal of the American College of Cardiology. 1994 November 1; 24(5): 1342-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7930259&dopt=Abstract

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Flow dependence of the aortic valve area in patients with aortic stenosis: assessment by application of the continuity equation. Author(s): Rask LP, Karp KH, Eriksson NP. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 1996 May-June; 9(3): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8736013&dopt=Abstract

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Flow dependence of valve area in aortic stenosis: relation to valve morphology. Author(s): Shively BK, Charlton GA, Crawford MH, Chaney RK. Source: Journal of the American College of Cardiology. 1998 March 1; 31(3): 654-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9502649&dopt=Abstract

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Fluorescent in situ hybridisation (FISH) for hemizygous deletion at the elastin locus in patients with isolated supravalvular aortic stenosis. Author(s): Fryssira H, Palmer R, Hallidie-Smith KA, Taylor J, Donnai D, Reardon W. Source: Journal of Medical Genetics. 1997 April; 34(4): 306-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9138154&dopt=Abstract

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Follow-up after percutaneous balloon valvoplasty for noncalcific aortic stenosis. Author(s): Shrivastava S, Das GS, Dev V, Sharma S, Rajani M. Source: The American Journal of Cardiology. 1990 January 15; 65(3): 250-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2296896&dopt=Abstract

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Forty-one years of surgical experience with congenital supravalvular aortic stenosis. Author(s): Stamm C, Kreutzer C, Zurakowski D, Nollert G, Friehs I, Mayer JE, Jonas RA, del Nido PJ. Source: The Journal of Thoracic and Cardiovascular Surgery. 1999 November; 118(5): 874-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10534693&dopt=Abstract

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Four year follow up of aortic valve replacement for isolated aortic stenosis: a link between reduction in pressure overload, regression of left ventricular hypertrophy, and diastolic function. Author(s): Ikonomidis I, Tsoukas A, Parthenakis F, Gournizakis A, Kassimatis A, Rallidis L, Nihoyannopoulos P. Source: Heart (British Cardiac Society). 2001 September; 86(3): 309-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11514485&dopt=Abstract

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Frequency of angina pectoris and coronary artery disease in severe isolated valvular aortic stenosis. Author(s): Tansuphaswadikul S, Silaruks S, Lehmongkol R, Chakorn T. Source: J Med Assoc Thai. 1999 February; 82(2): 140-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10087721&dopt=Abstract

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Gastrointestinal angiodysplasia and aortic stenosis. Author(s): Warkentin TE, Moore JC, Morgan DG. Source: The New England Journal of Medicine. 2002 September 12; 347(11): 858-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12226167&dopt=Abstract

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Gastrointestinal bleeding in calcific aortic stenosis. Author(s): Gueron M, Sperberg A. Source: The American Journal of Medicine. 1989 August; 87(2): 250. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2787960&dopt=Abstract

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Gastrointestinal hemorrhage after combined percutaneous angioplasty of aortic coarctation and valvuloplasty of aortic stenosis in an infant. Author(s): Moore JW, Lovett EJ, Kirby WC. Source: Pediatric Cardiology. 1993 January; 14(1): 53-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8456026&dopt=Abstract

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Gender differences in left ventricle geometry and function in patients undergoing balloon dilatation of the aortic valve for isolated aortic stenosis. NHLBI Balloon Valvuloplasty Registry. Author(s): Douglas PS, Otto CM, Mickel MC, Labovitz A, Reid CL, Davis KB. Source: British Heart Journal. 1995 June; 73(6): 548-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7626355&dopt=Abstract

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Gender differences in left ventricular function at rest and with exercise in asymptomatic aortic stenosis. Author(s): Legget ME, Kuusisto J, Healy NL, Fujioka M, Schwaegler RG, Otto CM. Source: American Heart Journal. 1996 January; 131(1): 94-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8554026&dopt=Abstract

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Gender differences in left ventricular function in patients with isolated aortic stenosis. Author(s): Favero L, Giordan M, Tarantini G, Ramondo AB, Cardaioli P, Isabella G, Chioin R, Lupia M, Razzolini R. Source: J Heart Valve Dis. 2003 May; 12(3): 313-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12803330&dopt=Abstract

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Gender differences in patients with severe aortic stenosis: impact on preoperative left ventricular geometry and function, as well as early postoperative morbidity and mortality. Author(s): Bech-Hanssen O, Wallentin I, Houltz E, Beckman Suurkula M, Larsson S, Caidahl K. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 1999 January; 15(1): 24-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10077369&dopt=Abstract

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Genetic approaches to cardiovascular disease. Supravalvular aortic stenosis, Williams syndrome, and long-QT syndrome. Author(s): Keating MT. Source: Circulation. 1995 July 1; 92(1): 142-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7788908&dopt=Abstract

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Genetic aspects of supravalvular aortic stenosis. Author(s): Morris CA. Source: Current Opinion in Cardiology. 1998 May; 13(3): 214-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9649945&dopt=Abstract

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Gradient reduction, aortic valve regurgitation and prolapse after balloon aortic valvuloplasty in 32 consecutive patients with congenital aortic stenosis. Author(s): Shaddy RE, Boucek MM, Sturtevant JE, Ruttenberg HD, Orsmond GS. Source: Journal of the American College of Cardiology. 1990 August; 16(2): 451-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2373823&dopt=Abstract

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Green aortic valve: alcaptonuria (ochronosis) with severe aortic stenosis. Author(s): Zund G, Schmid AC, Vogt PR, Grunenfelder J, Turina MI. Source: The Annals of Thoracic Surgery. 1999 June; 67(6): 1805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10391306&dopt=Abstract

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Heart failure in aortic stenosis - improving diagnosis and treatment. Author(s): Zile MR, Gaasch WH. Source: The New England Journal of Medicine. 2003 May 1; 348(18): 1735-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724478&dopt=Abstract

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Heart rate variability in severe aortic stenosis. Author(s): Vukasovic JL, Florenzano F, Adriazola P, Escobar E. Source: J Heart Valve Dis. 1999 March; 8(2): 143-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10224572&dopt=Abstract

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Hemodynamic and volume correlates of left ventricular diastolic relaxation and filling in patients with aortic stenosis. Author(s): Vanoverschelde JL, Essamri B, Michel X, Hanet C, Cosyns JR, Detry JM, Wijns W. Source: Journal of the American College of Cardiology. 1992 October; 20(4): 813-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1388182&dopt=Abstract

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Hemodynamic assessment of aortic stenosis. Author(s): Grayburn PA. Source: The American Journal of the Medical Sciences. 1992 May; 303(5): 345-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1580325&dopt=Abstract

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Hemodynamic assessment of patients with low-flow, low-gradient valvular aortic stenosis. Author(s): Blitz LR, Herrmann HC. Source: The American Journal of Cardiology. 1996 September 15; 78(6): 657-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8831400&dopt=Abstract

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Hemodynamic changes during dipyridamole stress in patients with aortic stenosis. Author(s): Rask LP, Karp KH, Teien DE. Source: J Heart Valve Dis. 1994 September; 3(5): 510-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8000585&dopt=Abstract

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Hemodynamic changes during retrograde left-heart catheterization in patients with aortic stenosis. Author(s): Tamari I, Borer JS, Goldberg HL, Moses JW, Fisher J, Wallis JB. Source: Cardiology. 1991; 78(3): 171-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1868496&dopt=Abstract

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Hemodynamic changes following correction of severe aortic stenosis using the Cutter-Smeloff prosthesis. Author(s): Lee SJ, Haraphongse M, Callaghan JC, Rossall RE, Fraser RS. Source: Circulation. 1970 October; 42(4): 719-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11993311&dopt=Abstract

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Hemodynamic characteristics of congenital aortic stenosis: a quantitative stress echocardiography study. Author(s): Battle RW, Crumb S, Tischler MD. Source: American Heart Journal. 2000 February; 139(2 Pt 1): 346-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10650309&dopt=Abstract

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Hemodynamic determinants of the peak systolic left ventricular-aortic pressure gradient in children with valvar aortic stenosis. Author(s): Beekman RH, Rocchini AP, Gillon JH, Mancini GB. Source: The American Journal of Cardiology. 1992 March 15; 69(8): 813-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1546661&dopt=Abstract

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Hemodynamic effects of nitroprusside on valvular aortic stenosis. Author(s): Zion MM. Source: The American Journal of Cardiology. 1992 December 15; 70(20): 1639-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1466349&dopt=Abstract

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Hemodynamic effects of nitroprusside on valvular aortic stenosis. Author(s): Ikram H, Low CJ, Crozier IG, Shirlaw T. Source: The American Journal of Cardiology. 1992 February 1; 69(4): 361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1734649&dopt=Abstract

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Hemodynamic progression of adult valvular aortic stenosis. Author(s): Ng AS, Holmes DR Jr, Smith HC, Connolly DC, Hynes JK, Ilstrup DM, Danielson GK. Source: Catheterization and Cardiovascular Diagnosis. 1986; 12(3): 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3488128&dopt=Abstract

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Hemodynamic progression of aortic stenosis in adults assessed by Doppler echocardiography. Author(s): Otto CM, Pearlman AS, Gardner CL. Source: Journal of the American College of Cardiology. 1989 March 1; 13(3): 545-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2918158&dopt=Abstract

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Hemodynamic responses to ECT in a patient with critical aortic stenosis. Author(s): Levin L, Wambold D, Viguera A, Welch CA, Drop LJ. Source: The Journal of Ect. 2000 March; 16(1): 52-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10735332&dopt=Abstract

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Hemodynamic rounds series II: abnormal hemodynamics after prosthetic aortic root reconstruction: aortic stenosis or insufficiency? Author(s): Kern MJ, Aguirre FV, Guerrero M. Source: Catheterization and Cardiovascular Diagnosis. 1998 July; 44(3): 336-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9676810&dopt=Abstract

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Hemodynamic stability of valve area, valve resistance, and stroke work loss in aortic stenosis: a comparative analysis. Author(s): Burwash IG, Hay KM, Chan KL. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2002 August; 15(8): 814-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174351&dopt=Abstract

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How can coronary flow reserve be altered by severe aortic stenosis? Author(s): Nemes A, Forster T, Varga A, Vass A, Borthaiser A, Palinkas A, Csanady M. Source: Echocardiography (Mount Kisco, N.Y.). 2002 November; 19(8): 655-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487634&dopt=Abstract

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How often do we operate too late in aortic stenosis? Author(s): Takeda S, Rimington H, Chambers J. Source: J Heart Valve Dis. 1998 July; 7(4): 428-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9697066&dopt=Abstract

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How should we manage symptomatic aortic stenosis in the patient who is 80 or older? Author(s): Sprigings DC, Forfar JC. Source: British Heart Journal. 1995 November; 74(5): 481-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8562230&dopt=Abstract

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Immediate effect of aortic valve replacement for aortic stenosis on left ventricular diastolic chamber stiffness. Author(s): McKenney PA, Apstein CS, Mendes LA, Connelly GP, Aldea GS, Shemin RJ, Davidoff R. Source: The American Journal of Cardiology. 1999 October 15; 84(8): 914-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10532510&dopt=Abstract

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Impact of intraoperative transesophageal echocardiography among patients undergoing aortic valve replacement for aortic stenosis. Author(s): Nowrangi SK, Connolly HM, Freeman WK, Click RL. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2001 September; 14(9): 863-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547271&dopt=Abstract

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Impact of small prosthetic valve size on operative mortality in elderly patients after aortic valve replacement for aortic stenosis: does gender matter? Author(s): Adams DH, Chen RH, Kadner A, Aranki SF, Allred EN, Cohn LH. Source: The Journal of Thoracic and Cardiovascular Surgery. 1999 November; 118(5): 815-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10534686&dopt=Abstract

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Impact of systolic and diastolic dysfunction on postoperative outcome in patients with aortic stenosis. Author(s): Mandinov L, Kaufmann P, Maier W, Hess OM. Source: European Heart Journal. 1997 December; 18(12): 1845-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9447307&dopt=Abstract

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Important pressure recovery in patients with aortic stenosis and high Doppler gradients. Author(s): Gjertsson P, Caidahl K, Svensson G, Wallentin I, Bech-Hanssen O. Source: The American Journal of Cardiology. 2001 July 15; 88(2): 139-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11448410&dopt=Abstract

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In utero management of hydrops fetalis caused by critical aortic stenosis. Author(s): Bitar FF, Byrum CJ, Kveselis DA, Lawrence DA, Smith FC. Source: American Journal of Perinatology. 1997 August; 14(7): 389-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9263557&dopt=Abstract

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Increased plasma natriuretic peptide levels reflect symptom onset in aortic stenosis. Author(s): Gerber IL, Stewart RA, Legget ME, West TM, French RL, Sutton TM, Yandle TG, French JK, Richards AM, White HD. Source: Circulation. 2003 April 15; 107(14): 1884-90. Epub 2003 March 31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668523&dopt=Abstract

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Increased prevalence of aortic stenosis in patients with arteriovenous malformations of the gastrointestinal tract in Heyde syndrome. Author(s): Batur P, Stewart WJ, Isaacson JH. Source: Archives of Internal Medicine. 2003 August 11-25; 163(15): 1821-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12912718&dopt=Abstract

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Independent contribution of left ventricular ejection time to the mean gradient in aortic stenosis. Author(s): Kadem L, Pibarot P, Dumesnil JG, Mouret F, Garitey V, Durand LG, Rieu R. Source: J Heart Valve Dis. 2002 September; 11(5): 615-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358396&dopt=Abstract

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Influence of aortic valve replacement, prosthesis type, and size on functional outcome and ventricular mass in patients with aortic stenosis. Author(s): Bech-Hanssen O, Caidahl K, Wall B, Myken P, Larsson S, Wallentin I. Source: The Journal of Thoracic and Cardiovascular Surgery. 1999 July; 118(1): 57-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10384185&dopt=Abstract

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Influence of St. Jude medical valve in patients with aortic stenosis and small aortic annulus on cardiac function and late survival result. Author(s): Natsuaki M, Itoh T, Okazaki Y, Takarabe K, Furukawa K, Rikitake K, Ohtubo S. Source: Artificial Organs. 2002 October; 26(10): 840-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296922&dopt=Abstract

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Infrarenal aortic stenosis: value of stent placement after percutaneous transluminal angioplasty failure. Author(s): Therasse E, Cote G, Oliva VL, Cusson JR, Wistaff R, Nguyen PV, Bui BT, Perreault P, Lamarre L, Soulez G. Source: Radiology. 2001 June; 219(3): 655-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11376250&dopt=Abstract

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Interventional and surgical management of aortic stenosis and coarctation. Author(s): Magee AG, Blauth CI, Qureshi SA. Source: The Annals of Thoracic Surgery. 2001 February; 71(2): 713-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11235740&dopt=Abstract

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Intra-aortic balloon pump associated with dynamic left ventricular outflow tract obstruction after valve replacement for aortic stenosis. Author(s): Morewood GH, Weiss SJ. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2000 March; 13(3): 229-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10708472&dopt=Abstract

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Is aortic stenosis a preventable disease? Author(s): Chan KL. Source: Journal of the American College of Cardiology. 2003 August 20; 42(4): 593-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12932587&dopt=Abstract

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Is aortic valve resistance more clinically meaningful than valve area in aortic stenosis? Author(s): Antonini-Canterin F, Faggiano P, Zanuttini D, Ribichini F. Source: Heart (British Cardiac Society). 1999 July; 82(1): 9-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10377299&dopt=Abstract

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Is there still a place for open surgical valvotomy in the management of aortic stenosis in children? The view from Southampton. Author(s): Alexiou C, Chen Q, Langley SM, Salmon AP, Keeton BR, Haw MP, Monro JL. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2001 August; 20(2): 239-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11463538&dopt=Abstract

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Isolated supravalvular aortic stenosis: functional haploinsufficiency of the elastin gene as a result of nonsense-mediated decay. Author(s): Urban Z, Michels VV, Thibodeau SN, Davis EC, Bonnefont JP, Munnich A, Eyskens B, Gewillig M, Devriendt K, Boyd CD. Source: Human Genetics. 2000 June; 106(6): 577-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10942104&dopt=Abstract

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Issues and outcomes in the management of supravalvar aortic stenosis. Author(s): McElhinney DB, Petrossian E, Tworetzky W, Silverman NH, Hanley FL. Source: The Annals of Thoracic Surgery. 2000 February; 69(2): 562-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10735699&dopt=Abstract

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Issues in transcatheter treatment of critical aortic stenosis in the newborn infant. Author(s): Piechaud JF. Source: Journal of Interventional Cardiology. 2001 June; 14(3): 351-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12053396&dopt=Abstract

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Jet eccentricity: a misleading source of agreement between Doppler/catheter pressure gradients in aortic stenosis. Author(s): VanAuker MD, Chandra M, Shirani J, Strom JA. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2001 September; 14(9): 853-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11547270&dopt=Abstract

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Konno procedure for congenital aortic stenosis with a single coronary artery from the left coronary sinus. Author(s): Niinami H, Imai Y, Sawatari K, Terada M, Shinoka T, Sugiyama Y. Source: Journal of Cardiac Surgery. 1992 December; 7(4): 351-5; Discussion 355-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1482829&dopt=Abstract

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Lack of association among five genetic polymorphisms of the renin-angiotensin system and cardiac hypertrophy in patients with aortic stenosis. Author(s): Ortlepp JR, Breithardt O, Ohme F, Hanrath P, Hoffmann R. Source: American Heart Journal. 2001 April; 141(4): 671-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11275936&dopt=Abstract

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Left atrial and ventricular ball thrombi complicating rheumatic heart disease with combined mitral and aortic stenosis. Author(s): Lee AY, Chang MC, Chen TJ, Chang WF. Source: Echocardiography (Mount Kisco, N.Y.). 2001 February; 18(2): 159-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11262540&dopt=Abstract

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Left atrial septum thrombus masquerading as a myxoma in a patient with aortic stenosis in sinus rhythm. Author(s): Kerut EK, Dearstine M, Everson CT, Giles TD. Source: Echocardiography (Mount Kisco, N.Y.). 2001 November; 18(8): 709-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11801215&dopt=Abstract

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Left main artery dissection during 4 French coronary angiography in elderly patient with severe aortic stenosis: “speedy recovery” using emergency primary stenting. Author(s): Philippe F, Bouabdallah K, Dibie A, Laborde F. Source: Journal of Interventional Cardiology. 2002 June; 15(3): 219-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12141149&dopt=Abstract

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Left ventricular architecture after valve replacement due to critical aortic stenosis: an approach to dis-/qualify the myth of valve prosthesis-patient mismatch? Author(s): Knez I, Rienmuller R, Maier R, Rehak P, Schrottner B, Machler H, AnelliMonti M, Rigler B. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2001 June; 19(6): 797-805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11404133&dopt=Abstract

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Left ventricular geometry and function in patients with aortic stenosis: gender differences. Author(s): Kostkiewicz M, Tracz W, Olszowska M, Podolec P, Drop D. Source: International Journal of Cardiology. 1999 September 30; 71(1): 57-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10522565&dopt=Abstract

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Left ventricular longitudinal shortening in patients with aortic stenosis: relationship with symptomatic status. Author(s): Tongue AG, Dumesnil JG, Laforest I, Theriault C, Durand LG, Pibarot P. Source: J Heart Valve Dis. 2003 March; 12(2): 142-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701783&dopt=Abstract

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Left ventricular myocardial function in congenital valvar aortic stenosis assessed by ultrasound tissue-velocity and strain-rate techniques. Author(s): Kiraly P, Kapusta L, Thijssen JM, Daniels O. Source: Ultrasound in Medicine & Biology. 2003 April; 29(4): 615-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749932&dopt=Abstract

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Left ventricular remodeling, mechanics, and tissue characterization in congenital aortic stenosis. Author(s): Pacileo G, Calabro P, Limongelli G, Russo MG, Pisacane C, Sarubbi B, Calabro R. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2003 March; 16(3): 214-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618728&dopt=Abstract

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Leptospirosis complicated by severe aortic stenosis. Author(s): Butler CS, Endara SA. Source: Anaesthesia and Intensive Care. 2000 August; 28(4): 434-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10969373&dopt=Abstract

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Lipoprotein(a), Chlamydia pneumoniae, leptin and tissue plasminogen activator as risk markers for valvular aortic stenosis. Author(s): Glader CA, Birgander LS, Soderberg S, Ildgruben HP, Saikku P, Waldenstrom A, Dahlen GH. Source: European Heart Journal. 2003 January; 24(2): 198-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12573277&dopt=Abstract

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Living related donor liver transplantation in a patient with severe aortic stenosis. Author(s): Adachi T, Murakawa M, Uetsuki N, Segawa H. Source: British Journal of Anaesthesia. 1999 September; 83(3): 488-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10655929&dopt=Abstract

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Long axis excursion in aortic stenosis. Author(s): Takeda S, Rimington H, Smeeton N, Chambers J. Source: Heart (British Cardiac Society). 2001 July; 86(1): 52-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11410562&dopt=Abstract

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Long term aortic stenosis on magnetic resonance imaging after direct repair for acute traumatic rupture of the thoracic aorta. Author(s): Meunier JP, Tatou E, Brenot R, David M. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2001 January; 19(1): 82-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11163565&dopt=Abstract

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Long-term results of apico-aortic valved conduit for severe idiopathic hypertrophic subaortic stenosis. Author(s): Renzulli A, Gregorio R, De Feo M, Ismeno G, Covino FE, Cotrufo M. Source: Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 2000; 27(1): 24-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830624&dopt=Abstract

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Long-term results of balloon aortic valvulotomy for congenital aortic stenosis in children and adolescents. Author(s): Jindal RC, Saxena A, Juneja R, Kothari SS, Shrivastava S. Source: J Heart Valve Dis. 2000 September; 9(5): 623-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11041174&dopt=Abstract

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Long-term results of surgical valvuloplasty for congenital valvar aortic stenosis in children. Author(s): Chartrand CC, Saro-Servando E, Vobecky JS. Source: The Annals of Thoracic Surgery. 1999 October; 68(4): 1356-9; Discussion 1359-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10543506&dopt=Abstract

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Low output, low gradient aortic stenosis. Author(s): MacCarthy P, Berger A, de Bruyne B. Source: Heart (British Cardiac Society). 2003 May; 89(5): 474. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695438&dopt=Abstract

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Low-gradient aortic stenosis: operative risk stratification and predictors for long-term outcome: a multicenter study using dobutamine stress hemodynamics. Author(s): Monin JL, Quere JP, Monchi M, Petit H, Baleynaud S, Chauvel C, Pop C, Ohlmann P, Lelguen C, Dehant P, Tribouilloy C, Gueret P. Source: Circulation. 2003 July 22; 108(3): 319-24. Epub 2003 June 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12835219&dopt=Abstract

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Low-output, low-gradient aortic stenosis in patients with depressed left ventricular systolic function: the clinical utility of the dobutamine challenge in the catheterization laboratory. Author(s): Nishimura RA, Grantham JA, Connolly HM, Schaff HV, Higano ST, Holmes DR Jr. Source: Circulation. 2002 August 13; 106(7): 809-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12176952&dopt=Abstract

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Magnetic resonance to assess the aortic valve area in aortic stenosis: how does it compare to current diagnostic standards? Author(s): John AS, Dill T, Brandt RR, Rau M, Ricken W, Bachmann G, Hamm CW. Source: Journal of the American College of Cardiology. 2003 August 6; 42(3): 519-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12906983&dopt=Abstract

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Management of asymptomatic aortic stenosis: masterly inactivity but cat-like observation. Author(s): Vaile JC, Griffith MJ. Source: Heart (British Cardiac Society). 1997 September; 78(3): 215-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9391278&dopt=Abstract

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Management of asymptomatic valvular aortic stenosis. Author(s): Freeman RV, Otto CM. Source: Indian Heart J. 2002 January-February; 54(1): 31-8. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999085&dopt=Abstract

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Management of mild to moderate aortic stenosis at the time of coronary artery bypass grafting. Author(s): Filsoufi F, Aklog L, Adams DH, Byrne JG. Source: J Heart Valve Dis. 2002 January; 11 Suppl 1: S45-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11843520&dopt=Abstract

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Management of patients with asymptomatic moderate aortic stenosis undergoing coronary artery bypass grafting. Author(s): Touati GD, Carmi D, Trojette F, Bidaud M, Popesco D, Ben Amar A, Poulain H. Source: J Heart Valve Dis. 2002 March; 11(2): 210-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12000162&dopt=Abstract

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Management of the elderly aortic stenosis patient with low gradient and low ejection fraction. Author(s): Carabello BA. Source: The American Journal of Geriatric Cardiology. 2003 May-June; 12(3): 165-70; Quiz 170-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732811&dopt=Abstract

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Management of valvar aortic stenosis in children. Author(s): de Wolf D, Daniels O. Source: Pediatric Cardiology. 2002 July-August; 23(4): 375-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170352&dopt=Abstract

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Marfan's syndrome, dextrocardia and situs inversus associated with discrete subaortic stenosis and aortic insufficiency in an adult female: case report. Author(s): Gokce M, Erdol C, Celik S, Baykan M, Erdol H, Sari A, Ahmetoglu A. Source: J Heart Valve Dis. 2001 May; 10(3): 415-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11380111&dopt=Abstract

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Medical treatment of aortic stenosis: promising, or wishful thinking? Author(s): Pearlman AS. Source: Journal of the American College of Cardiology. 2002 November 20; 40(10): 17314. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12446054&dopt=Abstract

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Mitral regurgitation without supravalvular aortic stenosis in Williams syndrome. Author(s): Takagi H, Mori Y, Iwata H, Umeda Y, Fukumoto Y, Matsuno Y, Matsutomo M, Shimokawa K, Nishigaki K, Fujiwara H, Hirose H. Source: Heart and Vessels. 2002 September; 16(6): 257-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12382035&dopt=Abstract

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Mitral valve injury during balloon valvuloplasty for an infant with severe aortic stenosis: spatial evaluation using three-dimensional echocardiography. Author(s): Yamamoto Y, Shiraishi I, Yamagishi M, Hamaoka K. Source: Pediatric Cardiology. 2003 May-June; 24(3): 300-3. Epub 2003 April 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692698&dopt=Abstract

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Natriuretic peptides in patients with aortic stenosis. Author(s): Qi W, Mathisen P, Kjekshus J, Simonsen S, Bjornerheim R, Endresen K, Hall C. Source: American Heart Journal. 2001 October; 142(4): 725-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11579366&dopt=Abstract

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Natural history of discrete subvalvar aortic stenosis: management implications. Author(s): Gersony WM. Source: Journal of the American College of Cardiology. 2001 September; 38(3): 843-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11527643&dopt=Abstract

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Neonate aortic stenosis: importance of myocardial perfusion in prognosis. Author(s): Santos MA, Azevedo VM. Source: Arquivos Brasileiros De Cardiologia. 2002 September; 79(3): 245-55. Epub 2002 October 08. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12386727&dopt=Abstract

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New imaging techniques in the assessment of patients with aortic stenosis. Author(s): Moreno R, Zamorano J. Source: Herz. 2002 May; 27(3): 246-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12096654&dopt=Abstract

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New insights into the progression of aortic stenosis: implications for secondary prevention. Author(s): Choudhury RP, Leyva F. Source: Circulation. 2001 March 27; 103(12): E67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11274006&dopt=Abstract

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Nitroprusside in critically ill patients with aortic stenosis. Author(s): Gogbashian A. Source: The New England Journal of Medicine. 2003 August 21; 349(8): 811-3; Author Reply 811-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12931716&dopt=Abstract

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Nitroprusside in critically ill patients with aortic stenosis. Author(s): Karthikeyan G. Source: The New England Journal of Medicine. 2003 August 21; 349(8): 811-3; Author Reply 811-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12931715&dopt=Abstract

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Nitroprusside in critically ill patients with aortic stenosis. Author(s): Agarwal PK, Kumari R. Source: The New England Journal of Medicine. 2003 August 21; 349(8): 811-3; Author Reply 811-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930936&dopt=Abstract

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Nitroprusside in critically ill patients with left ventricular dysfunction and aortic stenosis. Author(s): Khot UN, Novaro GM, Popovic ZB, Mills RM, Thomas JD, Tuzcu EM, Hammer D, Nissen SE, Francis GS. Source: The New England Journal of Medicine. 2003 May 1; 348(18): 1756-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724481&dopt=Abstract

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Noncompaction of left ventricular myocardium in the presence of calcific aortic stenosis in an adult. Author(s): Sengupta PP, Mohan JC, Arora R. Source: Indian Heart J. 2001 November-December; 53(6): 766-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11838932&dopt=Abstract

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Obstruction to left coronary artery blood flow secondary to obliteration of the coronary ostium in supravalvular aortic stenosis. Author(s): Martin MM, Lemmer JH Jr, Shaffer E, Dick M 2nd, Bove EL. Source: The Annals of Thoracic Surgery. 1988 January; 45(1): 16-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3337571&dopt=Abstract

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Occurrence risk for congenital heart defects in relatives of patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect. Author(s): Driscoll DJ, Michels VV, Gersony WM, Hayes CJ, Keane JF, Kidd L, Pieroni DR, Rings LJ, Wolfe RR, Weidman WH. Source: Circulation. 1993 February; 87(2 Suppl): I114-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8425317&dopt=Abstract

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Octogenarians with aortic stenosis. Outcome after aortic valve replacement. Author(s): Levinson JR, Akins CW, Buckley MJ, Newell JB, Palacios IF, Block PC, Fifer MA. Source: Circulation. 1989 September; 80(3 Pt 1): I49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2766538&dopt=Abstract

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Off-pump apicoaortic conduit insertion for high-risk patients with aortic stenosis. Author(s): Vassiliades TA Jr. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2003 February; 23(2): 156-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559335&dopt=Abstract

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On the natural history of severe aortic stenosis. Author(s): Braunwald E. Source: Journal of the American College of Cardiology. 1990 April; 15(5): 1018-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2312955&dopt=Abstract

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One day old infant with acyanotic congenital heart disease: critical aortic stenosis. Author(s): Gupta A, Mogos C, Schmer V, Gudavalli M. Source: Journal of Perinatal Medicine. 1999; 27(4): 292-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10560081&dopt=Abstract

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Open commissurotomy for critical isolated aortic stenosis in neonates. Author(s): Alexiou C, Langley SM, Dalrymple-Hay MJ, Salmon AP, Keeton BR, Haw MP, Monro JL. Source: The Annals of Thoracic Surgery. 2001 February; 71(2): 489-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11235695&dopt=Abstract

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Open valvotomy for critical aortic stenosis in infancy. Author(s): Burch M, Redington AN, Carvalho JS, Rusconi P, Shinebourne EA, Rigby ML, Paneth M, Lincoln C. Source: British Heart Journal. 1990 January; 63(1): 37-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2310642&dopt=Abstract

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Outcomes after the Norwood operation in neonates with critical aortic stenosis or aortic valve atresia. Author(s): Ashburn DA, McCrindle BW, Tchervenkov CI, Jacobs ML, Lofland GK, Bove EL, Spray TL, Williams WG, Blackstone EH. Source: The Journal of Thoracic and Cardiovascular Surgery. 2003 May; 125(5): 1070-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771881&dopt=Abstract

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Oxygen delivery and uptake relationships in patients with aortic stenosis. Author(s): Schumacker PT, Soble JS, Feldman T. Source: American Journal of Respiratory and Critical Care Medicine. 1994 May; 149(5): 1123-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8173751&dopt=Abstract

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Pathophysiology of valvular aortic stenosis in the elderly. Author(s): Cheitlin MD. Source: The American Journal of Geriatric Cardiology. 2003 May-June; 12(3): 173-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732812&dopt=Abstract

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Planimetry and transthoracic two-dimensional echocardiography in noninvasive assessment of aortic valve area in patients with valvular aortic stenosis. Author(s): Okura H, Yoshida K, Hozumi T, Akasaka T, Yoshikawa J. Source: Journal of the American College of Cardiology. 1997 September; 30(3): 753-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9283536&dopt=Abstract

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Planimetry of aortic valve area using multiplane transoesophageal echocardiography is not a reliable method for assessing severity of aortic stenosis. Author(s): Bernard Y, Meneveau N, Vuillemenot A, Magnin D, Anguenot T, Schiele F, Bassand JP. Source: Heart (British Cardiac Society). 1997 July; 78(1): 68-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9290405&dopt=Abstract

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Prediction of paroxysmal atrial fibrillation after aortic valve replacement in patients with aortic stenosis: identification of potential risk factors. Author(s): Orlowska-Baranowska E, Baranowski R, Michalek P, Hoffman P, Rywik T, Rawczylska-Englert I. Source: J Heart Valve Dis. 2003 March; 12(2): 136-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701782&dopt=Abstract

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Premature closure of the foramen ovale associated with aortic stenosis, left ventricular dilation with thrombus, and early mortality. Author(s): Nowlen TT, Ayres NA, Kearney DL, Nihill MR, Grifka RG. Source: The American Journal of Cardiology. 2000 May 1; 85(9): 1159-61, A9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10781774&dopt=Abstract

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Pressure-volume loops in patients with aortic stenosis. Author(s): Dekker AL, Barenbrug PJ, van der Veen FH, Roekaerts P, Mochtar B, Maessen JG. Source: J Heart Valve Dis. 2003 May; 12(3): 325-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12803332&dopt=Abstract

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Prevalence of aortic root dilatation and small aortic roots in valvular aortic stenosis. Author(s): Crawford MH, Roldan CA. Source: The American Journal of Cardiology. 2001 June 1; 87(11): 1311-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11377365&dopt=Abstract

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Prevalence of coronary artery disease in patients with aortic stenosis with and without angina pectoris. Author(s): Rapp AH, Hillis LD, Lange RA, Cigarroa JE. Source: The American Journal of Cardiology. 2001 May 15; 87(10): 1216-7; A7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11356405&dopt=Abstract

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Progression of aortic valve sclerosis to aortic stenosis. Author(s): Faggiano P, Antonini-Canterin F, Erlicher A, Romeo C, Cervesato E, Pavan D, Piazza R, Huang G, Nicolosi GL. Source: The American Journal of Cardiology. 2003 January 1; 91(1): 99-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505585&dopt=Abstract

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Prophylactic aortic valve replacement in older patients for mild aortic stenosis during coronary bypass surgery. Author(s): Eslami M, Rahimtoola SH. Source: The American Journal of Geriatric Cardiology. 2003 May-June; 12(3): 197-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732816&dopt=Abstract

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QT dispersion is reduced after valve replacement in patients with aortic stenosis. Author(s): Darbar D, Cherry CJ, Kerins DM. Source: Heart (British Cardiac Society). 1999 July; 82(1): 15-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10377301&dopt=Abstract

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QTc dispersion measurement for risk of syncope in patients with aortic stenosis. Author(s): Kosar F, Hisar I, Durmaz T, Ileri M, Tandogan I. Source: Angiology. 2001 April; 52(4): 259-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11330508&dopt=Abstract

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Quadricuspid aortic valve abnormality associated with aortic stenosis and aortic insufficiency. Author(s): Kucukoglu MS, Erdogan I, Okcun B, Baran T, Mutlu H, Uner S. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 2002 January; 15(1): 90-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11781561&dopt=Abstract

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Quadricuspid aortic valve associated with aortic stenosis and regurgitation. Author(s): Nakamura Y, Taniguchi I, Saiki M, Morimoto K, Yamaga T. Source: Jpn J Thorac Cardiovasc Surg. 2001 December; 49(12): 714-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11808094&dopt=Abstract

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Quality of life in octogenarians after valve replacement due to aortic stenosis. A prospective comparison with younger patients. Author(s): Olsson M, Janfjall H, Orth-Gomer K, Unden A, Rosenqvist M. Source: European Heart Journal. 1996 April; 17(4): 583-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8733092&dopt=Abstract

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Quantification of aortic stenosis in mechanically ventilated patients using multiplane transesophageal Doppler echocardiography. Author(s): Blumberg FC, Pfeifer M, Holmer SR, Kromer EP, Riegger GA, Elsner D. Source: Chest. 1998 July; 114(1): 94-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9674453&dopt=Abstract

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Quantification of valvular aortic stenosis by magnetic resonance imaging. Author(s): Friedrich MG, Schulz-Menger J, Poetsch T, Pilz B, Uhlich F, Dietz R. Source: American Heart Journal. 2002 August; 144(2): 329-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12177653&dopt=Abstract

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Quantitative assessment of aortic stenosis by three-dimensional anyplane and threedimensional volume-rendered echocardiography. Author(s): Handke M, Schafer DM, Heinrichs G, Magosaki E, Geibel A. Source: Echocardiography (Mount Kisco, N.Y.). 2002 January; 19(1): 45-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11884254&dopt=Abstract

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Quantitative assessment of aortic stenosis by three-dimensional echocardiography. Author(s): Menzel T, Mohr-Kahaly S, Kolsch B, Kupferwasser I, Kopp H, Spiecker M, Wagner S, Meinert R, Pagnia F, Meyer J. Source: Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography. 1997 April; 10(3): 215-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9109686&dopt=Abstract

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Questions remain regarding patients with aortic stenosis and severe pulmonary hypertension. Author(s): Rahimtoola SH. Source: Journal of the American College of Cardiology. 2003 May 21; 41(10): 1847-8; Author Reply 1848. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12767677&dopt=Abstract

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Rate of change in aortic valve area during a cardiac cycle can predict the rate of hemodynamic progression of aortic stenosis. Author(s): Lester SJ, McElhinney DB, Miller JP, Lutz JT, Otto CM, Redberg RF. Source: Circulation. 2000 April 25; 101(16): 1947-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10779461&dopt=Abstract

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Rate of progression of valvular aortic stenosis in patients > or = 60 years of age. Author(s): Nassimiha D, Aronow WS, Ahn C, Goldman ME. Source: The American Journal of Cardiology. 2001 March 15; 87(6): 807-9, A9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249913&dopt=Abstract

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Regarding “QTc dispersion measurement for risk of syncope in patients with aortic stenosis”. Author(s): RuDusky BM. Source: Angiology. 2001 October; 52(10): 727-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11666139&dopt=Abstract

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Regression of left ventricular hypertrophy during 10 years after valve replacement for aortic stenosis is related to the preoperative risk profile. Author(s): Lund O, Emmertsen K, Dorup I, Jensen FT, Flo C. Source: European Heart Journal. 2003 August; 24(15): 1437-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12909073&dopt=Abstract

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Regression of left ventricular mass one year after aortic valve replacement for pure severe aortic stenosis. Author(s): Kuhl HP, Franke A, Puschmann D, Schondube FA, Hoffmann R, Hanrath P. Source: The American Journal of Cardiology. 2002 February 15; 89(4): 408-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835921&dopt=Abstract

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Regression of ventricular repolarisation inhomogeneity after aortic bileaflet valve replacement in patients with aortic stenosis. Author(s): Tsai CH, Lee TM, Su SF. Source: International Journal of Cardiology. 1999 July 31; 70(2): 141-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10454302&dopt=Abstract

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Relation between cardiovascular risk factors and nonrheumatic severe calcific aortic stenosis among patients with a three-cuspid aortic valve. Author(s): Peltier M, Trojette F, Sarano ME, Grigioni F, Slama MA, Tribouilloy CM. Source: The American Journal of Cardiology. 2003 January 1; 91(1): 97-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505584&dopt=Abstract

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Relation of the total ejection isovolume index to symptoms in aortic stenosis. Author(s): Antonini-Canterin F, Huang G, Cervesato E, Pavan D, Piazza R, Marciano F, Burelli C, Cassin M, Macor F, Nicolosi GL. Source: The American Journal of Cardiology. 2002 September 15; 90(6): 665-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231104&dopt=Abstract

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Reliability of new and old Doppler echocardiographic indexes of the severity of aortic stenosis in patients with a low cardiac output. Author(s): Antonini-Canterin F, Huang G, Cervesato E, Faggiano P, Pavan D, Piazza R, Burelli C, Cassin M, Macor F, Zardo F, Nicolosi GL. Source: Ital Heart J. 2002 April; 3(4): 248-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12025374&dopt=Abstract

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Researchers probe aortic stenosis: an active, potentially treatable disease process? Author(s): Mitka M. Source: Jama : the Journal of the American Medical Association. 2003 May 7; 289(17): 2197-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12734117&dopt=Abstract

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Severe aortic stenosis and reduced ejection fraction: intensive care treatment. Author(s): Melzer C, Gliech V, Baumann G, Theres H. Source: Intensive Care Medicine. 2001 March; 27(3): 617. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11355138&dopt=Abstract

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Severe aortic stenosis in a professional football player. Author(s): Foxford RJ. Source: Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 2003 May; 13(3): 186-7; Discussion 187-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792215&dopt=Abstract

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Severe aortic stenosis with low systolic gradient:the good and bad news. Author(s): Rahimtoola SH. Source: Circulation. 2000 April 25; 101(16): 1892-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10779452&dopt=Abstract

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Severe aortic stenosis with low transvalvular gradient and severe left ventricular dysfunction:result of aortic valve replacement in 52 patients. Author(s): Connolly HM, Oh JK, Schaff HV, Roger VL, Osborn SL, Hodge DO, Tajik AJ. Source: Circulation. 2000 April 25; 101(16): 1940-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10779460&dopt=Abstract

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Severe myocardial ischaemia during mask induction of anaesthesia in an infant with unknown critical supravalvular aortic stenosis. Author(s): Driessen JJ, van Oort AM, Booij LH. Source: Anaesthesia. 2003 June; 58(6): 568-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846623&dopt=Abstract

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Sex differences in left ventricular geometry in aortic stenosis: impact on outcome. Author(s): Milavetz DL, Hayes SN, Weston SA, Seward JB, Mullany CJ, Roger VL. Source: Chest. 2000 April; 117(4): 1094-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10767246&dopt=Abstract

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Stent treatment of obstructing dissection after percutaneous transluminal angioplasty of aortic stenosis caused by nonspecific aortitis. Author(s): Sharma S, Bahl VK, Rajani M. Source: Cardiovascular and Interventional Radiology. 1997 September-October; 20(5): 377-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9271649&dopt=Abstract

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Successful emergency aortic valve replacement following percutaneous cardiopulmonary support for the patient with aortic stenosis and cardiac arrest. Author(s): Matsuhisa H, Mukouhara N, Obo H, Nakagiri K, Kozawa S, Shida T. Source: Jpn J Thorac Cardiovasc Surg. 2003 August; 51(8): 381-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12962417&dopt=Abstract

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Supravalvar aortic stenosis: clinical and hemodynamic profile, and surgical outcome. Author(s): Harikrishnan S, Manohar SR, Nair KK, Tharakan J, Titus T, Kumar VK, Bhat A, Sivasankaran S, Bimal F, Moorthy KM, Kumar RP. Source: Indian Heart J. 2003 January-February; 55(1): 49-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12760588&dopt=Abstract

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Symptomatic aortic stenosis: does systemic hypertension play an additional role? Author(s): Antonini-Canterin F, Huang G, Cervesato E, Faggiano P, Pavan D, Piazza R, Nicolosi GL. Source: Hypertension. 2003 June; 41(6): 1268-72. Epub 2003 April 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707297&dopt=Abstract

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T lymphocyte infiltration in non-rheumatic aortic stenosis: a comparative descriptive study between tricuspid and bicuspid aortic valves. Author(s): Wallby L, Janerot-Sjoberg B, Steffensen T, Broqvist M. Source: Heart (British Cardiac Society). 2002 October; 88(4): 348-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231589&dopt=Abstract

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Technique and results of the modified Ross procedure in aortic regurgitation versus aortic stenosis. Author(s): Stelzer P. Source: Adv Cardiol. 2002; 39: 93-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12060929&dopt=Abstract

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The aortic root in supravalvular aortic stenosis: the potential surgical relevance of morphologic findings. Author(s): Stamm C, Li J, Ho SY, Redington AN, Anderson RH. Source: The Journal of Thoracic and Cardiovascular Surgery. 1997 July; 114(1): 16-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9240289&dopt=Abstract

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The operative outcome in children with supravalvular aortic stenosis. Author(s): Malec E, Januszewska K, Kolcz J, Mroczek T. Source: Przegl Lek. 2003; 60(1): 1-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12884637&dopt=Abstract

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The prognostic value of calcification and impaired valve motion in combined aortic stenosis and coronary artery disease. Author(s): Eitz T, Kleikamp G, Minami K, Korfer R. Source: J Heart Valve Dis. 2002 September; 11(5): 713-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358410&dopt=Abstract

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The risk of the development of aortic stenosis in patients with “benign” aortic valve thickening. Author(s): Cosmi JE, Kort S, Tunick PA, Rosenzweig BP, Freedberg RS, Katz ES, Applebaum RM, Kronzon I. Source: Archives of Internal Medicine. 2002 November 11; 162(20): 2345-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418948&dopt=Abstract

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The ten most commonly asked questions about aortic stenosis. Author(s): Carabello BA. Source: Cardiology in Review. 2002 September-October; 10(5): 262-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215189&dopt=Abstract

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Transesophageal echocardiography-guided transventricular balloon dilation of congenital critical aortic stenosis in the neonate and young infant. Author(s): Hussain A, al Faraidi Y, Abdulhamed J, Bacha EA, Hammer GB, Feinstein JB. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2002 December; 16(6): 76672. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12486662&dopt=Abstract

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Translocation of aortic valve for calcific aortic stenosis. Author(s): Ninomiya M, Makuuchi H, Naruse Y, Kobayashi T, Sato T. Source: Jpn J Thorac Cardiovasc Surg. 2000 January; 48(1): 83-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10714028&dopt=Abstract

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Two contributions concerning mild to moderate aortic stenosis in patients undergoing coronary bypass grafting. Author(s): Yoshida K, Matsumoto M, Sugita T, Nishizawa J, Matsuyama K, Tokuda Y, Matsuo T. Source: J Heart Valve Dis. 2003 March; 12(2): 270-1; Author Reply 271. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701802&dopt=Abstract

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Unstable angina during pregnancy in two patients with premature coronary atherosclerosis and aortic stenosis in association with familial hypercholesterolemia. Author(s): Hameed AB, Tummala PP, Goodwin TM, Nuno I, Wani OR, Karaalp IS, Elkayam U. Source: American Journal of Obstetrics and Gynecology. 2000 May; 182(5): 1152-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10819851&dopt=Abstract

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Use of femoral-femoral cardiopulmonary bypass for urgent aortic valve replacement in a patient with critical aortic stenosis and left ventricular dysfunction. Author(s): Tempe DK, Khanna S, Dubey S, Nigam M. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2001 August; 15(4): 477-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11505354&dopt=Abstract

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Use of the heart rate monitor to modulate physical activity in adolescents with congenital aortic stenosis: an innovative approach. Author(s): Bar-Mor G, Zeevi B, Yaaron M, Falk B. Source: Journal of Pediatric Nursing. 1999 August; 14(4): 273-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10467807&dopt=Abstract

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Use of transesophageal echocardiography to predict significant coronary artery disease in aortic stenosis. Author(s): Tribouilloy C, Peltier M, Rey JL, Ruiz V, Lesbre JP. Source: Chest. 1998 March; 113(3): 671-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9515841&dopt=Abstract

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Usefulness of aortic valve calcium scores by electron beam computed tomography as a marker for aortic stenosis. Author(s): Shavelle DM, Budoff MJ, Buljubasic N, Wu AH, Takasu J, Rosales J, Otto CM, Zhao XQ, O'Brien KD. Source: The American Journal of Cardiology. 2003 August 1; 92(3): 349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12888153&dopt=Abstract

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Usefulness of dobutamine echocardiography in distinguishing severe from nonsevere valvular aortic stenosis in patients with depressed left ventricular function and low transvalvular gradients. Author(s): deFilippi CR, Willett DL, Brickner ME, Appleton CP, Yancy CW, Eichhorn EJ, Grayburn PA. Source: The American Journal of Cardiology. 1995 January 15; 75(2): 191-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7810504&dopt=Abstract

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Usefulness of doppler echocardiography to determine the timing of surgery for supravalvar aortic stenosis. Author(s): Tani LY, Minich LL, Pagotto LT, Shaddy RE. Source: The American Journal of Cardiology. 2000 July 1; 86(1): 114-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10867108&dopt=Abstract

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Usefulness of left atrial size in predicting postoperative symptomatic improvement in patients with aortic stenosis. Author(s): Rossi A, Tomaino M, Golia G, Santini F, Pentiricci S, Marino P, Zardini P. Source: The American Journal of Cardiology. 2000 September 1; 86(5): 567-70, A9-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11009283&dopt=Abstract

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Usefulness of M-mode, 2-dimensional, and Doppler echocardiography in the diagnosis, prognosis, and management of valvular aortic stenosis, aortic regurgitation, and mitral annular calcium in older patients. Author(s): Aronow WS. Source: Journal of the American Geriatrics Society. 1995 March; 43(3): 295-300. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7884122&dopt=Abstract

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Usefulness of the echocardiographic velocity ratio for detection of significant aortic stenosis. Author(s): Karpuz H, Ozsahin M, Aebischer N, Goy JJ, Kappenberger L, Jeanrenaud X. Source: The American Journal of Cardiology. 1999 November 1; 84(9): 1101-3, A10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10569676&dopt=Abstract

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Validation of the ejection fraction-velocity ratio: a new simplified “functioncorrected” index for assessing aortic stenosis severity. Author(s): Antonini-Canterin F, Pavan D, Burelli C, Cassin M, Cervesato E, Nicolosi GL. Source: The American Journal of Cardiology. 2000 August 15; 86(4): 427-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10946037&dopt=Abstract

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Value of automated segmental motion analysis in the assessment of aortic stenosis severity. Author(s): Moreno R, Zamorano JL, Alvarez L, Almeria C, Mataix L, Rodrigo JL, Herrera D, De Marco E, Aubele A, Sanchez-Harguindey L. Source: J Heart Valve Dis. 2002 November; 11(6): 785-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479279&dopt=Abstract

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Value of exercise testing to evaluate the indication for surgery in asymptomatic patients with valvular aortic stenosis. Author(s): Alborino D, Hoffmann JL, Fournet PC, Bloch A. Source: J Heart Valve Dis. 2002 March; 11(2): 204-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12000161&dopt=Abstract

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Valve morphology and the rate of progression in aortic stenosis. Author(s): Chambers J, Bach D, Carabello B, Dumesnil F, Yoshida K; Working Group on Echocardiography of the Society for Heart Valve Disease. Source: J Heart Valve Dis. 2002 January; 11(1): 141-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11843500&dopt=Abstract

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Valve orifice area alone is an insufficient index of aortic stenosis severity: effects of the proximal and distal geometry on transaortic energy loss. Author(s): Heinrich RS, Marcus RH, Ensley AE, Gibson DE, Yoganathan AP. Source: J Heart Valve Dis. 1999 September; 8(5): 509-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10517392&dopt=Abstract

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Valve orifice area in aortic stenosis evaluated by planimetry, Gorlin and continuity equations: a prospective study. Author(s): Joao I, Cotrim C, Duarte JA, Fazendas P, Catarino C, Pereira H, Matias F, de Oliveira LM, Carrageta M. Source: Rev Port Cardiol. 2002 April; 21(4): 421-34. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090128&dopt=Abstract

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Valve replacement for aortic stenosis in patients with poor left ventricular function: comparison of early changes with stented and stentless valves. Author(s): Collinson J, Henein M, Flather M, Pepper JR, Gibson DG. Source: Circulation. 1999 November 9; 100(19 Suppl): Ii1-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10567270&dopt=Abstract

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Valve-sparing operation for balloon-induced aortic regurgitation in congenital aortic stenosis. Author(s): Bacha EA, Satou GM, Moran AM, Zurakowski D, Marx GR, Keane JF, Jonas RA. Source: The Journal of Thoracic and Cardiovascular Surgery. 2001 July; 122(1): 162-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11436050&dopt=Abstract

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Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in The Netherlands. Author(s): Bouma BJ, van der Meulen JH, van den Brink RB, Arnold AE, Smidts A, Teunter LH, Lie KI, Tijssen JG. Source: Heart (British Cardiac Society). 2001 February; 85(2): 196-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11156672&dopt=Abstract

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Ventricular function in aortic stenosis: how low can you go? Author(s): Carabello BA. Source: Journal of the American College of Cardiology. 2002 April 17; 39(8): 1364-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11955856&dopt=Abstract

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When should patients with asymptomatic aortic stenosis be evaluated for valve replacement? Author(s): Colen M, Lindbloom EJ, Meadows S. Source: The Journal of Family Practice. 2002 September; 51(9): 739. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12366888&dopt=Abstract

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Why angina in aortic stenosis with normal coronary arteriograms? Author(s): Gould KL, Carabello BA. Source: Circulation. 2003 July 1; 107(25): 3121-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12835405&dopt=Abstract

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Why angina pectoris in aortic stenosis. Author(s): Gould KL. Source: Circulation. 1997 February 18; 95(4): 790-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9054730&dopt=Abstract

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Why deny ACE inhibitors to patients with aortic stenosis? Author(s): Cox NL, Abdul-Hamid AR, Mulley GP. Source: Lancet. 1998 July 11; 352(9122): 111-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9672278&dopt=Abstract

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Why do so few older people with aortic stenosis have valve replacement surgery? Author(s): Abdul-Hamid AR, Mulley GP. Source: Age and Ageing. 1999 May; 28(3): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10475861&dopt=Abstract

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Why do so few older people with aortic stenosis have valve replacement therapy? Author(s): Jolobe OM. Source: Age and Ageing. 2000 January; 29(1): 86-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10690705&dopt=Abstract

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Why is there discordance between calcific aortic stenosis and coronary artery disease? Author(s): Otto CM, O'Brien KD. Source: Heart (British Cardiac Society). 2001 June; 85(6): 601-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11359728&dopt=Abstract

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Williams syndrome: an uncommon cause of supravalvular aortic stenosis in a child. Author(s): Larson JS, Warner MA. Source: J Cardiothorac Anesth. 1989 June; 3(3): 337-40. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2520660&dopt=Abstract

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CHAPTER 2. NUTRITION AND AORTIC STENOSIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and aortic stenosis.

Finding Nutrition Studies on Aortic Stenosis The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “aortic stenosis” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “aortic stenosis” (or a synonym): •

Association of cholesterol levels, hydroxymethylglutaryl coenzyme-A reductase inhibitor treatment, and progression of aortic stenosis in the community. Author(s): Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Source: Bellamy, M F Pellikka, P A Klarich, K W Tajik, A J Enriquez Sarano, M J-AmColl-Cardiol. 2002 November 20; 40(10): 1723-30 0735-1097

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Chronic L-arginine treatment increases cardiac cyclic guanosine 5'-monophosphate in rats with aortic stenosis: effects on left ventricular mass and beta-adrenergic contractile reserve. Author(s): Charles A. Dana Research Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. Source: Bartunek, J Dempsey, S Weinberg, E O Ito, N Tajima, M Rohrbach, S Lorell, B H J-Am-Coll-Cardiol. 1998 August; 32(2): 528-35 0735-1097

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Critical aortic stenosis in the first month of life: surgical results in 26 infants. Author(s): Victorian Pediatric Cardiac Surgical Unit, Royal Children's Hospital, Melbourne, Australia. Source: Karl, T R Sano, S Brawn, W J Mee, R B Ann-Thorac-Surg. 1990 July; 50(1): 105-9 0003-4975

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Deficient coacervation of two forms of human tropoelastin associated with supravalvular aortic stenosis. Author(s): Department of Biochemistry, University of Sydney, NSW, Australia. Source: Wu, W J Weiss, A S Eur-J-Biochem. 1999 November; 266(1): 308-14 0014-2956

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Depressed inotropic response to beta-adrenoceptor agonists in the presence of advanced cardiac hypertrophy in hearts from rats with induced aortic stenosis and from spontaneously hypertensive rats. Author(s): Department of Pharmacotherapy, Academic Medical Centre, Amsterdam, The Netherlands. Source: Mertens, M J Mathy, M J Pfaffendorf, M van Zwieten, P A J-Hypertens. 1992 November; 10(11): 1361-8 0263-6352

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Evolutive aortic stenosis in hemodialysis patients: analysis of risk factors. Author(s): Service de nephrologie et dialyse, clinique de l'Orangerie, Aubervilliers. Source: Urena, P Malergue, M C Goldfarb, B Prieur, P Guedon Rapoud, C Petrover, M Nephrologie. 1999; 20(4): 217-25 0250-4960

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Intracoronary veratrine and acute aortic stenosis modify renal responses to hypotension in conscious dogs. Author(s): Department of Physiology, East Carolina University School of Medicine, Greenville, North Carolina 27858-4354. Source: Chen, J S Gorman, A J Am-J-Physiol. 1990 July; 259(1 Pt 2): F18-25 0002-9513

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Microvascular angina in a patient with aortic stenosis. Author(s): First Department of Internal Medicine, Miyazaki Medical College, Kiyotake, Japan. Source: Kawamoto, R Imamura, T Kawabata, K Date, H Ishikawa, T Maeno, M Nagoshi, T Fujiura, Y Matsuyama, A Matsuo, T Koiwaya, Y Eto, T Jpn-Circ-J. 2001 September; 65(9): 839-41 0047-1828

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One day old infant with acyanotic congenital heart disease: critical aortic stenosis. Author(s): Department of Pediatrics, New York Methodist Hospital, USA.

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Source: Gupta, A Mogos, C Schmer, V Gudavalli, M J-Perinat-Med. 1999; 27(4): 292-4 0300-5577 •

Percutaneous transluminal aortic valvuloplasty: indications and results in adult aortic stenosis. Author(s): Service des Soins Intensifs Cardiologiques et des Explorations Hemodynamiques Cardiovasculaires, Centre Hospitalier et Universitaire, Hopital Charles Nicolle, Rouen, France. Source: Cribier, A Berland, J Koning, R Bellefleur, J P Mechmeche, R Letac, B Eur-HeartJ. 1988 April; 9 Suppl E149-54 0195-668X

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The effect of treatment with coenzyme Q10 on the mitochondrial function and superoxide radical formation in cardiac muscle hypertrophied by mild aortic stenosis. Source: Guarnieri, C Muscari, C Manfroni, S Caldarera, I Stefanelli, C Pretolani, E J-MolCell-Cardiol. 1987 January; 19(1): 63-71 0022-2828

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND AORTIC STENOSIS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to aortic stenosis. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to aortic stenosis and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “aortic stenosis” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to aortic stenosis: •

A cohort study of childhood hypertrophic cardiomyopathy: improved survival following high-dose beta-adrenoceptor antagonist treatment. Author(s): Ostman-Smith I, Wettrell G, Riesenfeld T. Source: Journal of the American College of Cardiology. 1999 November 15; 34(6): 181322. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10577575&dopt=Abstract

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Adjunct diagnostic test for Angelman syndrome: the tuning fork response. Author(s): Hall BD. Source: American Journal of Medical Genetics. 2002 May 1; 109(3): 238-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11977186&dopt=Abstract

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Arrhythmogenic right ventricular cardiomyopathy and sudden cardiac death in young Koreans. Author(s): Cho Y, Park T, Yang DH, Park HS, Chae J, Chae SC, Jun JE, Kwak JS, Park WH. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2003 November; 67(11): 925-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14578598&dopt=Abstract

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Autism as a neurodevelopmental disorder affecting communication and learning in early childhood: prenatal origins, post-natal course and effective educational support. Author(s): Trevarthen C. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 2000 July-August; 63(12): 41-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10970712&dopt=Abstract

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Benefits and risks of sauna bathing. Author(s): Hannuksela ML, Ellahham S. Source: The American Journal of Medicine. 2001 February 1; 110(2): 118-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11165553&dopt=Abstract

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Block design performance in the Williams syndrome phenotype: a problem with mental imagery? Author(s): Farran EK, Jarrold C, Gathercole SE. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2001 September; 42(6): 719-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11583244&dopt=Abstract

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Cardiac valve replacement without blood transfusion. Author(s): Cooley DA, Bloodwell RD, Beall AC Jr, Hallman GL. Source: American Journal of Surgery. 1966 November; 112(5): 743-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5923405&dopt=Abstract

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Cardioinhibitory carotid sinus hypersensitivity. Intracardiac recordings and clinical assessment. Author(s): Hartzler GO, Maloney JD. Source: Archives of Internal Medicine. 1977 June; 137(6): 727-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=326212&dopt=Abstract

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Cardiomyopathies and oxidative stress. Author(s): Romero-Alvira D, Roche E, Placer L. Source: Medical Hypotheses. 1996 August; 47(2): 137-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8869930&dopt=Abstract

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Cardiovascular surgery in infants performed under hyperbaric conditions. Author(s): Bernhard WF, Navarro RU, Yagi H, Carr JG Jr, Barandiaran L. Source: Vasc Dis. 1966 February; 3(1): 33-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5903592&dopt=Abstract

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Case 1--1993. The role of erythropoietin in Jehovah's Witnesses requiring cardiac surgery. Author(s): Neustein SM, Bronheim D, Galla J, Litwak R, Rand J, Scott BH, Hartman AR, Poppers PJ, Bert AA, Feng WC, et al. Source: Journal of Cardiothoracic and Vascular Anesthesia. 1993 February; 7(1): 95-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8431584&dopt=Abstract

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Changes in the left ventricular outflow tract after transcoronary ablation of septal hypertrophy (TASH) for hypertrophic obstructive cardiomyopathy as assessed by transoesophageal echocardiography and by measuring myocardial glucose utilization and perfusion. Author(s): Kuhn H, Gietzen FH, Schafers M, Freick M, Gockel B, Strunk-Muller C, Jachmann E, Schober O. Source: European Heart Journal. 1999 December; 20(24): 1808-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10581139&dopt=Abstract

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Chronic treatment with sulfhydryl angiotensin-converting enzyme inhibitors reduce susceptibility of plasma LDL to in vitro oxidation, formation of oxidation-specific epitopes in the arterial wall, and atherogenesis in apolipoprotein E knockout mice. Author(s): de Nigris F, D'Armiento FP, Somma P, Casini A, Andreini I, Sarlo F, Mansueto G, De Rosa G, Bonaduce D, Condorelli M, Napoli C. Source: International Journal of Cardiology. 2001 December; 81(2-3): 107-15; Discusssion 115-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11744122&dopt=Abstract

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Clinical and metabolic findings in a patient with phytosterolaemia. Author(s): Watts GF, Mitchell WD. Source: Annals of Clinical Biochemistry. 1992 March; 29 ( Pt 2): 231-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1626933&dopt=Abstract

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Demonstration of sustained sinus and atrial re-entry as a mechanism of paroxysmal supraventricular tachycardia. Author(s): Wu D, Amat-y-leon F, Denes P, Dhingra RC, Pietras RJ, Rosen KM. Source: Circulation. 1975 February; 51(2): 234-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1112003&dopt=Abstract

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Detection of coronary artery disease in patients with severe aortic stenosis with noninvasive methods.

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Author(s): Patsilinakos SP, Kranidis AI, Antonelis IP, Filippatos G, Houssianakou IK, Zamanis NI, Sioras E, Tsiotika T, Kardaras F, Anthopoulos LP. Source: Angiology. 1999 April; 50(4): 309-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10225466&dopt=Abstract •

Diagnostic yield and development of a neurocardiovascular investigation unit for older adults in a district hospital. Author(s): Allcock LM, O'Shea D. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2000 August; 55(8): M458-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10952369&dopt=Abstract

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Does positron emission tomography contribute to the management of clinical cardiac problems? Author(s): Camici PG, Rosen SD. Source: European Heart Journal. 1996 February; 17(2): 174-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8732369&dopt=Abstract

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Early categorization abilities in young children with Williams syndrome. Author(s): Nazzi T, Karmiloff-Smith A. Source: Neuroreport. 2002 July 19; 13(10): 1259-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12151782&dopt=Abstract

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Effect of sulfhydryl group modification on age-associated alteration of actomyosin ATPase activity in human myocardium. Author(s): Yoshida K, Matoba R, Fujitani N, Onishi S. Source: Basic Research in Cardiology. 1990 January-February; 85(1): 2-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2139323&dopt=Abstract

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Effect of verapamil on absolute myocardial blood flow in hypertrophic cardiomyopathy. Author(s): Gistri R, Cecchi F, Choudhury L, Montereggi A, Sorace O, Salvadori PA, Camici PG. Source: The American Journal of Cardiology. 1994 August 15; 74(4): 363-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8059699&dopt=Abstract

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Effective disopyramide treatment in a boy with mid-ventricular hypertrophic obstructive cardiomyopathy. Author(s): Teraguchi M, Ikemoto Y, Kobayashi Y. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2002 July; 66(7): 709-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135145&dopt=Abstract

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Effects of diltiazem on myocardial perfusion abnormalities during exercise in patients with hypertrophic cardiomyopathy. Author(s): Sugihara H, Taniguchi Y, Ito K, Terada K, Matsumoto K, Kinoshita N, Azuma A, Ushijima Y, Maeda T, Nakagawa M. Source: Ann Nucl Med. 1998 December; 12(6): 349-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9972372&dopt=Abstract

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Effects of permanent dual chamber pacing on myocardial perfusion in symptomatic hypertrophic cardiomyopathy. Author(s): Posma JL, Blanksma PK, Van Der Wall EE, Vaalburg W, Crijns HJ, Lie KI. Source: Heart (British Cardiac Society). 1996 October; 76(4): 358-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8983685&dopt=Abstract

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Effects of therapeutic interventions on minimal cardiac transit times and volume parameters in hypertrophic cardiomyopathy. Author(s): Losse B, Feinendegen LE. Source: Zeitschrift Fur Kardiologie. 1987; 76 Suppl 3: 46-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3433874&dopt=Abstract

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Functional changes in coronary microcirculation after valve replacement in patients with aortic stenosis. Author(s): Rajappan K, Rimoldi OE, Camici PG, Bellenger NG, Pennell DJ, Sheridan DJ. Source: Circulation. 2003 July 1; 107(25): 3170-5. Epub 2003 June 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796134&dopt=Abstract

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Transaortic resection of the subaortic membrane. Treatment for subvalvular aortic stenosis. Author(s): Jacobs JP, Palatianos GM, Cintron JR, Kaiser GA. Source: Chest. 1994 July; 106(1): 46-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8020319&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON AORTIC STENOSIS Overview In this chapter, we will give you a bibliography on recent dissertations relating to aortic stenosis. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “aortic stenosis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on aortic stenosis, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Aortic Stenosis ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to aortic stenosis. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Echocardiographic Assessment of Atrioventricular Plane Displacement: Clinical Application in Patients with Coronary Artery Disease, Atrial Fibrillation and Aortic Stenosis by Rydberg, Erik Gosta Rikard; Dr from Lunds Universitet (sweden), 2003, 120 pages http://wwwlib.umi.com/dissertations/fullcit/f148257

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON AORTIC STENOSIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “aortic stenosis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on aortic stenosis, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Aortic Stenosis By performing a patent search focusing on aortic stenosis, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on aortic stenosis: •

Diagnosis of Williams syndrome Inventor(s): Keating; Mark T. (Salt Lake City, UT), Leppert; Mark F. (Salt Lake City, UT), Morris; Colleen A. (Las Vegas, NV) Assignee(s): The University of Utah Research Foundation (Salt Lake City, UT) Patent Number: 5,650,282 Date filed: June 7, 1995 Abstract: The invention relates to the identification of the molecular basis of supravalvular aortic stenosis (SVAS) and Williams syndrome. More specifically, the invention has identified that elastin causes or is involved in the pathogenesis of SVAS and Williams syndrome. Molecular variants of the elastin gene contribute to SVAS and Williams syndrome. The analysis of the elastin gene will provide an early diagnosis of subjects with SVAS and Williams syndrome. The diagnostic method comprises analyzing the DNA sequence of the elastin gene of an individual to be tested and comparing it with the DNA sequence of the native, non-variant elastin gene. In a second embodiment, the elastin gene of an individual to be tested is screened for mutations associated with SVAS or Williams syndrome. Presymptomatic diagnosis of SVAS and Williams syndrome will enable practitioners to prevent vascular obstruction using existing medical therapies like beta adrenergic blocking agents. Excerpt(s): The present invention is directed to a process for the diagnosis and prevention of supravalvular aortic stenosis (SVAS) and Williams syndrome. SVAS and Williams syndrome is diagnosed in accordance with the present invention by analyzing the DNA sequence of the elastin gene of an individual to be tested and comparing the DNA sequence to the known DNA sequence of a normal elastin gene. Alternatively, the elastin gene of an individual to be tested can be screened for mutations associated with SVAS or Williams syndrome. Prediction of SVAS and Williams syndrome will enable practitioners to prevent these disdorders using existing medical therapy. The publications and other materials used herein to illuminate the background of the invention or provide additional details respecting the practice, are incorporated by reference and for convenience are respectively grouped in the appended List of References. Supravalvular aortic stenosis (SVAS) is an inherited vascular disorder (1). As its name implies, narrowing of the ascending aorta is a dominant feature of this disease, but other arteries, including the pulmonary arteries, may be affected. If uncorrected, SVAS may lead to increased intracardiac pressure, myocardial hypertrophy, heart failure and death. The incidence of SVAS is estimated to be 1 in 25,000 live births. The vascular abnormalities typical of SVAS can be inherited as an isolated, autosomal dominant trait (1-3) or as part of a second disease, Williams syndrome, a developmental disorder that affects multiple organ systems (2-4). In addition to vascular disease, manifestations of Williams syndrome include hypertension, mental retardation, an unusually gregarious personality, premature greying of the hair, premature aging of the skin, joint laxity early in life followed by joint contractures, dysmorphic facial features and infantile hypercalcemia (4). The relationship between SVAS and Williams syndrome was previously undefined. Occasionally patients with Williams syndrome have been noted in families with SVAS. Web site: http://www.delphion.com/details?pn=US05650282__

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•

Procedure and catheter instrument for treating patients for aortic stenosis Inventor(s): Ariola, Jr.; John P. (East Providence, RI), Cribier; Alain (Maromme, FR), Letac; Brice (Rouen, FR) Assignee(s): Mansfield Scientific, Inc. (Mansfield, MA) Patent Number: 4,777,951 Date filed: September 19, 1986 Abstract: Dilatation procedures and catheter instrument for treating patients having acquired aortic stenosis, typically in which there are calcific deposits on the leaflets of the aortic valve. A dilatation balloon introduced into the stenosed aortic valve via the aorta while the blood circulation of the patient is maintained by the heart via the aortic valve, is inflated to grossly deflect the leaflets of the valve in a manner avoiding blocking the outer portions of the commissures of the valve. This inflating step enables substantial flow of blood through the outer portions of the commissures during systole despite the presence in the valve of the large inflated balloon. By prolonging the inflation for at least 30 seconds, over a large multiplicity of heart beats the calcific deposits are disturbed to increase the pliability of the leaflets and the degree of their opening, in an action found not to produce emboli. The catheter instrument incorporates means for measuring the pressure gradient across the valve and has features facilitating introduction, retention of position during inflation, withdrawal and re-crossing of the valve to achieve progressive enlargement of the aortic valve. Excerpt(s): This invention relates to an aortic valve dilatation instrument and treatment useful for adult patients having aortic stenosis, especially acquired calcific stenosis, a disease which is prevalent in elderly people. Stenosis of the aortic valve has long been known to cause serious diminishment of blood flow from the heart. The critical position of the aortic valve, preceding the arteries that nourish the heart and brain as well as all other parts of the body, makes this a very serious ailment. For those patients sufficiently well to endure the surgery, it has become common to replace the aortic valve with a prosthetic device while the patient is maintained by an extra-corporeal circulation system that by-passes the heart and valve. There is, however, risk with this major surgical procedure and there remains a large population who are too weak or otherwise do not wish to undergo such surgery. Web site: http://www.delphion.com/details?pn=US04777951__

Patent Applications on Aortic Stenosis As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to aortic stenosis:

9

This has been a common practice outside the United States prior to December 2000.

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Value prosthesis for implantation in body channels Inventor(s): Cribier, Alain; (Maromme, FR) Correspondence: REED SMITH, LLP; ATTN: PATENT RECORDS DEPARTMENT; 599 LEXINGTON AVENUE, 29TH FLOOR; NEW YORK; NY; 10022-7650; US Patent Application Number: 20030014104 Date filed: May 2, 2002 Abstract: A valve prosthesis which is especially useful in the case of aortic stenosis and capable of resisting the powerful recoil force and to stand the forceful balloon inflation performed to deploy the valve and to embed it in the aortic annulus, comprises a collapsible valvular structure and an expandable frame on which said valvular structure is mounted. The valvular structure is composed of physiologically compatible valvular tissue that is sufficiently supple and resistant to allow the valvular structure to be deformed from a closed state to an opened state. The valvular tissue forms a continuous surface and is provided with strut members that create stiffened zones which induce the valvular structure to follow a patterned movement in its expansion to its opened state and in its turning back to its closed state. Excerpt(s): This application is a continuation of co-pending U.S. patent application Ser. No. 09/795,803, filed Feb. 28, 2001, which in turn is a continuation of U.S. patent application Ser. No. 09/345,924, filed Jun. 30, 1999, now abandoned, which is a National Phase filing of PCT patent application No. PCT/EP 97/07337, filed Dec. 31, 1997 and designating the United States, all of which are incorporated herein by reference. The present invention relates to a valve prosthesis for implantation in body channels, more particularly but not only to, cardiac valve prosthesis to be implanted by a transcutaneous catheterization technique. The valve prosthesis can be also applied to other body channels provided with native valves, such as veins or in organs (liver, intestine, urethra. ). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Valve prosthesis for implantation in body channels Inventor(s): Cribier, Alain; (Maromme, FR), Letac, Brice; (Mont-Saint-Aigant, FR) Correspondence: William H. Dippert, Esq.; Cowan, Liebowitz & Latman, P.C.; 1133 Avenue of the Americas; New York; NY; 10036-6799; US Patent Application Number: 20010007956 Date filed: February 28, 2001 Abstract: The present invention is aimed to provide a valve prothesis (IV) especially used in case of aortic stenosis, which structure is capable of resisting the powerful recoil force and to stand the forceful balloon inflation performed to deploy the valve and to embed it in the aortic annulus. A valve prothesis for implantation in a body channel according to the invention comprises a collapsible valvular structure and an expandable frame on which said valvular structure is mounted. The valvular structure is composed of a valvular tissue compatible with the human body and blood, the valvular tissue being sufficiently supple and resistant to allow said valvular structure to be deformed from a closed state to an opened state. Said valvular tissue forms a continuous surface and is provided with guiding means formed or incorporated within, said guiding means creating stiffened zones which induce said valvular structure to follow a patterned

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movement in its expansion to its opened state and in its turning back to its closed state. The valvular structure can be extended to an internal cover which is fastened to the lower end of the valvular structure to prevent from regurgitation. Excerpt(s): The present invention relates to a valve prosthesis for implantation in body channels, more particularly but not only to, cardiac valve prosthesis to be implanted by a transcutaneous catheterization technique. The valve prosthesis can be also applied to other body channels provided with native valves, such as veins or in organs (liver, intestine, urethra,.). The present invention also relates to a method for implanting a valve prosthesis, such as the valve according to the present invention. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with aortic stenosis, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “aortic stenosis” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on aortic stenosis. You can also use this procedure to view pending patent applications concerning aortic stenosis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON AORTIC STENOSIS Overview This chapter provides bibliographic book references relating to aortic stenosis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on aortic stenosis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “aortic stenosis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “aortic stenosis” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “aortic stenosis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Obstructive Lesions: Pulmonic Stenosis, Aortic Stenosis, Coarctation of the Aorta by Karen Uzark; ISBN: 0838572030; http://www.amazon.com/exec/obidos/ASIN/0838572030/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “aortic stenosis” (or synonyms) into the search box, and select “books

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only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •

A clinico-pathological study of 127 proven cases of aortic stenosis with special reference to co-existing mitral valvular disease. Author: Savard, Roger Marc,; Year: 1991; [Minneapolis] 1957

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Aortic stenosis: a clinical study of aortic stenosis, isolated or combined with aortic insufficiency, with special reference to haemodynamic and angiocardiographic observations Author: Cullhed, Ingemar.; Year: 1965; Stockholm: Almqvist; Wiksells, 1964

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Aortic stenosis: haemodynamic and clinical findings in 56 patients Author: Hansen, Per Fritz.; Year: 1967; Copenhagen: Munksgaard, 1967

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Five congenital cardiac defects; a study of the profile and natural history of aortic stenosis, atrial septal defect - primum type, atrial septal defect - secundum type, pulmonic stenosis, ventricular septal defect. Edited by James W. DuShane and William H. Weidman. Author: DuShane, James William,; Year: 1991; New York, 1965

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Idiopathic hypertrophic subaortic stenosis, from the Cardiology Branch and Clinic of Surgery, National Heart Instutite, Bethesda, Maryland. Author: National Heart Institute. Cardiology Branch.; Year: 1974; New York, American Heart Assn., 1964

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Obstructive lesions: pulmonic stenosis, aortic stenosis, coarctation of the aorta Author: Uzark, Karen.; Year: 1963; Norwalk, Conn.: Appleton-Century-Crofts, c1983; ISBN: 0838512054

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Subvalvular aortic stenosis; a clinicopathological review. Author: Menges, Hermann,; Year: 1974; [Minneapolis] 1961

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Systolic and diastolic coronary arterial blood flow in experimental valvular and supravalvular aortic stenosis. Author: Delin, N. A.; Year: 1961; Stockholm [Distributed by Almqvist; Wiksell] 1969

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Systolic time intervals in congenital aortic stenosis: a comparison of simultaneously recorded external and internal indices of left ventricular performance in children Author: Moene, Rudolf Johannes.; Year: 1988; Amsterdam: Mondeel, 1974

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The coronary arteries in calcareous aortic stenosis. Author: Horan, Michael J.; Year: 1991; [Minneapolis] 1947

Chapters on Aortic Stenosis In order to find chapters that specifically relate to aortic stenosis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and aortic stenosis using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates 10

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

Books

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and language you prefer, and the format option “Book Chapter.” Type “aortic stenosis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on aortic stenosis: •

Williams Syndrome: Hypercalcemia, Supravalvular Aortic Stenosis, Elfin Facies, and Mental Retardation Syndrome Source: in Plumridge, D., et al., eds. Student with a Genetic Disorder: Educational Implications for Special Education Teachers and for Physical Therapists, Occupational Therapists, and Speech Pathologists. Springfield, IL: Charles C Thomas Publisher. 1993. p. 171-177. Contact: Available from Charles C Thomas Publisher. 2600 South First Street, Springfield, IL 62794-9265. (212) 789-8980. Fax (217) 789-9130. PRICE: $75.95 plus shipping and handling (cloth); $39.95 plus shipping and handling (paper). ISBN: 0398058393. Summary: Williams syndrome is a multisystem disorder that includes hypercalcemia, supravulvular aortic stenosis, characteristic facial features, distinctive behavioral characteristics, and mental retardation. This chapter on Williams syndrome is from a text for special education teachers, physical therapists, occupational therapists, and speech pathologists on the educational implications of genetic disorders. Topics covered include the physical and characteristic features of the disorder, the genetics of the disorder, the cognitive and behavior profiles, the educational implications, physical therapy, occupational therapy, hearing and speech considerations, psychosocial issues, and prognosis. 1 figure. 8 references.

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CHAPTER 7. MULTIMEDIA ON AORTIC STENOSIS Overview In this chapter, we show you how to keep current on multimedia sources of information on aortic stenosis. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Bibliography: Multimedia on Aortic Stenosis The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in aortic stenosis (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on aortic stenosis: •

Aortic stenosis (congenital) [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; Houston, TX: The Institute, 1982

•

Aortic stenosis [slide] Source: ACCEL Program and Heart House Learning Center, in conjunction with Stuart Pharmaceuticals; produced by Medi-Cine, ltd; Year: 1978; Format: Slide; [London]: Medi-Cine; [Bethesda, Md.: for sale by American College of Cardiology], c1978

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Aortic stenosis [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; [Houston, TX]: The Institute, 1982

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Aortic stenosis [videorecording] Source: a production of Bio-Communications Laboratory, Texas Heart Institute; Year: 1988; Format: Videorecording; Houston, Tex.: The Lab, c1988

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Idiopathic hypertrophic sub-aortic stenosis [videorecording] Source: Medi-Cine ltd; Year: 1976; Format: Videorecording; London: Medi-Cine; [Philadelphia: for loan and sale by Lippincott], c1976

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Management of the small aortic root with aortic stenosis [videorecording]: posterior annular patch procedure Source: [presented by] Texas Heart Institute; Year: 1988; Format: Videorecording; Houston, Tex.: The Institute, c1988

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Pure aortic stenosis [videorecording] Source: Medi-Cine Ltd; Year: 1976; Format: Videorecording; London: Medi-Cine; [Philadelphia: for loan and sale by Lippincott] c1976

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Subvalvular aortic stenosis [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; Houston, TX: The Institute, 1982

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Subvalvular aortic stenosis [videorecording] Source: Medi-Cine Ltd; Year: 1976; Format: Videorecording; London: Medi-Cine; [Philadelphia: for loan and sale by Lippincott], c1976

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Supravalvular aortic stenosis [motion picture]: extended aortoplasty Source: Division of Thoracic and Cardiovascular Surgery, Dept. of Surgery, University of Iowa, Hospitals and Clinics; produced by Motion Picture Unit, University of Iowa; Year: 1976; Format: Motion picture; Iowa City: The University: [for loan and sale by its Audiovisual Center], c1976

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Supravalvular aortic stenosis [videorecording] Source: Medi-Cine Ltd; Year: 1976; Format: Videorecording; London: Medi-Cine; [Philadelphia: for loan and sale by Lippincott] c1976

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Supravalvular aortic stenosis [videorecording] Source: [presented by] the Texas Heart Institute; Year: 1982; Format: Videorecording; Houston, TX: The Institute, 1982

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Surgical treatment of muscular subaortic stenosis by mitral valve replacement [videorecording] Source: Denton A. Cooley; produced by American Medical Film Services; Year: 1974; Format: Videorecording; Houston: Texas Heart Institute; [Indianapolis: for loan or sale by Eli Lilly, 1974]

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CHAPTER 8. PERIODICALS AND NEWS ON AORTIC STENOSIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover aortic stenosis.

News Services and Press Releases One of the simplest ways of tracking press releases on aortic stenosis is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “aortic stenosis” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to aortic stenosis. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “aortic stenosis” (or synonyms). The following was recently listed in this archive for aortic stenosis: •

Arteriovenous malformations of GI tract associated with aortic stenosis Source: Reuters Medical News Date: August 14, 2003

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Acquired von Willebrand syndrome common with severe aortic stenosis Source: Reuters Medical News Date: July 24, 2003

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Nitroprusside improves cardiac function in patients with severe aortic stenosis Source: Reuters Industry Breifing Date: April 30, 2003

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Statin therapy associated with slower progression of aortic stenosis Source: Reuters Medical News Date: December 05, 2002

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Statin treatment slows progression of aortic stenosis Source: Reuters Industry Breifing Date: November 19, 2002

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Aortic stenosis surgery can lead to carotid artery remodeling Source: Reuters Medical News Date: October 31, 2002

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Statin use may slow progression of calcific aortic stenosis Source: Reuters Industry Breifing Date: November 02, 2001

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Exercise testing helpful in evaluation of asymptomatic aortic stenosis Source: Reuters Medical News Date: October 30, 2001

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In aortic stenosis, valvular calcification indicates need for early valve replacement Source: Reuters Medical News Date: August 31, 2000

•

Modifiable factors may accelerate progression of aortic stenosis Source: Reuters Medical News Date: May 30, 2000

•

Increased cardiac torsion may explain diastolic dysfunction in aortic stenosis Source: Reuters Medical News Date: April 21, 2000

•

Clinical prediction rule accurate for detection of aortic stenosis Source: Reuters Medical News Date: October 27, 1998

•

Predictors Of Outcome Of Asymptomatic Aortic Stenosis Identified Source: Reuters Medical News Date: May 08, 1997

•

Calcification Leading To Aortic Stenosis May Be Preventable Source: Reuters Medical News Date: October 13, 1995 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date

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at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “aortic stenosis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “aortic stenosis” (or synonyms). If you know the name of a company that is relevant to aortic stenosis, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “aortic stenosis” (or synonyms).

Academic Periodicals covering Aortic Stenosis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to aortic stenosis. In addition to these sources, you can search for articles covering aortic stenosis that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.”

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If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for aortic stenosis. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with aortic stenosis. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to aortic stenosis: Ascorbic Acid (Vitamin C) •

Systemic - U.S. Brands: Ascorbicap; Cecon; Cee-500; Cemill; Cenolate; Cetane; Cevi-Bid; Flavorcee; Ortho/CS; Sunkist http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202071.html

Asparaginase •

Systemic - U.S. Brands: Elspar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202072.html

Aspirin, Sodium Bicarbonate, and Citric Acid •

Systemic - U.S. Brands: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202072.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA

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through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “aortic stenosis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “aortic stenosis” (or synonyms) into the “For these words:” box. The following is a sample result: •

Williams Syndrome: Hypercalcemia, Supravalvular Aortic Stenosis, Elfin Facies, and Mental Retardation Syndrome Source: in Plumridge, D., et al., eds. Student with a Genetic Disorder: Educational Implications for Special Education Teachers and for Physical Therapists, Occupational Therapists, and Speech Pathologists. Springfield, IL: Charles C Thomas Publisher. 1993. p. 171-177. Contact: Available from Charles C Thomas Publisher. 2600 South First Street, Springfield, IL 62794-9265. (212) 789-8980. Fax (217) 789-9130. PRICE: $75.95 plus shipping and handling (cloth); $39.95 plus shipping and handling (paper). ISBN: 0398058393. Summary: Williams syndrome is a multisystem disorder that includes hypercalcemia, supravulvular aortic stenosis, characteristic facial features, distinctive behavioral characteristics, and mental retardation. This chapter on Williams syndrome is from a text for special education teachers, physical therapists, occupational therapists, and speech pathologists on the educational implications of genetic disorders. Topics covered include the physical and characteristic features of the disorder, the genetics of the disorder, the cognitive and behavior profiles, the educational implications, physical therapy, occupational therapy, hearing and speech considerations, psychosocial issues, and prognosis. 1 figure. 8 references.

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. 14 15

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

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Type “aortic stenosis” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 18730 87 733 2 1 19553

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “aortic stenosis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for

16

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

17

The HSTAT URL is http://hstat.nlm.nih.gov/.

18

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

The Genome Project and Aortic Stenosis In the following section, we will discuss databases and references which relate to the Genome Project and aortic stenosis. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “aortic stenosis” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for aortic stenosis: •

Subaortic Stenosis, Membranous Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?271950

•

Subaortic Stenosis--short Stature Syndrome Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?271960

•

Supravalvular Aortic Stenosis Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?185500

Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

22

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Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html

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Entrez Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “aortic stenosis” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually 23 Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.

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limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “aortic stenosis” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

24

Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on aortic stenosis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to aortic stenosis. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to aortic stenosis. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “aortic stenosis”:

110 Aortic Stenosis

•

Other guides Congenital Heart Disease http://www.nlm.nih.gov/medlineplus/congenitalheartdisease.html Heart Diseases http://www.nlm.nih.gov/medlineplus/heartdiseases.html Heart Failure http://www.nlm.nih.gov/medlineplus/heartfailure.html Heart Valve Diseases http://www.nlm.nih.gov/medlineplus/heartvalvediseases.html Mitral Valve Prolapse http://www.nlm.nih.gov/medlineplus/mitralvalveprolapse.html

Within the health topic page dedicated to aortic stenosis, the following was listed: •

General/Overview Heart Valve Disorders Source: Merck & Co., Inc. http://www.merck.com/mrkshared/mmanual_home/sec3/19.jsp Heart Valves Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4598

•

Diagnosis/Symptoms Chest X-Rays: Helping Detect Heart and Lung Conditions Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HB00019 Echocardiogram Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HB00012 MR Angiography (MRA) Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/mr-angiography.htm Tests to Diagnose Heart Disease Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4739

•

Treatment Aortic Valve Replacement Source: Society of Thoracic Surgeons http://www.sts.org/doc/3620 Heart Valve Replacement http://www.nlm.nih.gov/medlineplus/tutorials/heartvalvereplacementloader.ht ml

Patient Resources

•

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Specific Conditions/Aspects Aortic Regurgitation Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4448 Aortic Valve Calcification (Aortic Valve Sclerosis) Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00245 Aortic Valve Stenosis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00418 Dental Care and Heart Disease Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4548 Heart Murmurs Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4571 Mitral Valve Regurgitation Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00421 Mitral Valve Stenosis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00420 Rheumatic Heart Disease/Rheumatic Fever Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4709

•

Children Heart Murmurs and Your Child Source: Nemours Foundation http://kidshealth.org/parent/medical/heart/murmurs.html Heart Murmurs: Can They Develop Later in Life? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00093

•

Latest News Heart Valves Made with Patient's Own Cells Source: 11/13/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14663 .html

•

Organizations American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=1200000

112 Aortic Stenosis

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/ Society of Thoracic Surgeons http://www.sts.org/section/stspatientinfo/ You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to aortic stenosis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to aortic stenosis. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with aortic stenosis.

Patient Resources

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The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about aortic stenosis. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “aortic stenosis” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “aortic stenosis”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “aortic stenosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “aortic stenosis” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

25

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

116 Aortic Stenosis

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

26

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

117

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

118 Aortic Stenosis

•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

120 Aortic Stenosis

•

South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

121

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on aortic stenosis: •

Basic Guidelines for Aortic Stenosis Aortic stenosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000178.htm

•

Signs & Symptoms for Aortic Stenosis Breathlessness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Chest pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003079.htm Difficulty breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Dizziness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003093.htm

122 Aortic Stenosis

Fainting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm Palpitations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003081.htm Syncope Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm Tachycardia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003077.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •

Diagnostics and Tests for Aortic Stenosis ALT Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003473.htm Angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003327.htm Aortic angiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003814.htm Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Cardiac catheterization Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003419.htm Chest MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003794.htm Chest X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm Doppler ultrasonography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003775.htm ECG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm Echocardiogram Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm Echocardiography Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003869.htm Left cardiac catheterization Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003875.htm

Online Glossaries 123

MRI Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003335.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm •

Surgery and Procedures for Aortic Stenosis Valve replacement Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002954.htm

•

Background Topics for Aortic Stenosis Auscultation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002226.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Heart diseases Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000147.htm Invasive Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002384.htm Physical activity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Symptomatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002293.htm

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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AORTIC STENOSIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablation: The removal of an organ by surgery. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Actin: Essential component of the cell skeleton. [NIH] Actomyosin: A protein complex of actin and myosin occurring in muscle. It is the essential contractile substance of muscle. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Agammaglobulinemia: An immunologic deficiency state characterized by an extremely low level of generally all classes of gamma-globulin in the blood. [NIH] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaptonuria: An inborn error of amino acid metabolism resulting from a defect in the enzyme homogentisate 1,2-dioxygenase and causing an accumulation of homogentisic acid

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in the urine. The condition is characterized by ochronosis in various tissues and arthritis. [NIH]

Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneuploidy: The chromosomal constitution of cells which deviate from the normal by the addition or subtraction of chromosomes or chromosome pairs. In a normally diploid cell the loss of a chromosome pair is termed nullisomy (symbol: 2N-2), the loss of a single chromosome is monosomy (symbol: 2N-1), the addition of a chromosome pair is tetrasomy (symbol: 2N+2), the addition of a single chromosome is trisomy (symbol: 2N+1). [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia

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usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angiodysplasia: Degenerative, acquired lesions consisting of distorted, dilated, thin-walled vessels lined by vascular endothelium. This pathological state is seen especially in the gastrointestinal tract and is frequently a cause of upper and lower gastrointestinal hemorrhage in the elderly. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angioid Streaks: Small breaks in the elastin-filled tissue of the retina. [NIH] Angioplasty: Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called endarterectomy. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]

Anomalies: Birth defects; abnormalities. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterograde: Moving or extending forward; called also antegrade. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH]

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Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Aneurysm: Aneurysm of the aorta. [NIH] Aortic Coarctation: Narrowing of the lumen of the aorta, caused by deformity of the aortic media. [NIH] Aortic Rupture: Tearing of aortic tissue. It may be rupture of an aneurysm or it may be due to trauma. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Aortitis: Inflammation of the wall of the aorta. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atherogenic: Causing the formation of plaque in the lining of the arteries. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH]

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Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Balloon Dilatation: Nonoperative repair of occluded vessels, ducts, or valves by insertion of a balloon catheter. It is used, amoung other things, to treat varices, torn retinas, renal and biliary calculi, gastric, bronchial and rectal stenoses, and heart valves, and includes catheterization with Fogarty and Foley catheters. [NIH] Balloon dilation: A treatment for benign prostatic hyperplasia or prostate enlargement. A tiny balloon is inflated inside the urethra to make it wider so urine can flow more freely from the bladder. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Bilateral: Affecting both the right and left side of body. [NIH]

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Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blepharoptosis: Drooping of the upper lid due to deficient development or paralysis of the levator palpebrae muscle. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Blotting, Western: Identification of proteins or peptides that have been electrophoretically separated by blotting and transferred to strips of nitrocellulose paper. The blots are then detected by radiolabeled antibody probes. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled

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with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bronchial: Pertaining to one or more bronchi. [EU] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiogenic: Originating in the heart; caused by abnormal function of the heart. [EU] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH]

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Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotid Sinus: The dilated portion of the common carotid artery at its bifurcation into external and internal carotids. It contains baroreceptors which, when stimulated, cause slowing of the heart, vasodilatation, and a fall in blood pressure. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU]

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Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH] Choleretic: A choleretic agent. [EU] Cholestanol: A cholesterol derivative found in human feces, gallstones, eggs, and other biological matter. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholic Acid: A major primary bile acid produced in the liver and usually conjugated with glycine or taurine. It facilitates fat absorption and cholesterol excretion. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Claudication: Limping or lameness. [EU] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot

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or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices

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are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH]

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Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium. [NIH] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]

Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU]

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Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decompensation: Failure of compensation; cardiac decompensation is marked by dyspnea, venous engorgement, and edema. [EU] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Clinics: Facilities where dental care is provided to patients. [NIH] Dentition: The teeth in the dental arch; ordinarily used to designate the natural teeth in position in their alveoli. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Dextrocardia: Location of the heart in the right hemithorax, with the apex directed to the right. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotestosterone: Anabolic agent. [NIH]

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Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Diploid: Having two sets of chromosomes. [NIH] Dipyridamole: A drug that prevents blood cell clumping and enhances the effectiveness of fluorouracil and other chemotherapeutic agents. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disopyramide: Alpha-(2-(Bis(l-methylethyl)amino)ethyl)-alpha-phenyl-2-pyridine acetamide. A class I anti-arrhythmic agent (one that interferes directly with the depolarization of the cardiac membrane and thus serves as a membrane-stabilizing agent) with a depressant action on the heart similar to that of guanidine. It also possesses some anticholinergic and local anesthetic properties. [NIH] Dissection: Cutting up of an organism for study. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dobutamine: A beta-2 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Dwarfism: The condition of being undersized as a result of premature arrest of skeletal growth. It may be caused by insufficient secretion of growth hormone (pituitary dwarfism). [NIH]

Dyspnea: Difficult or labored breathing. [NIH] Eccentricity: Oddness of behavior or conduct without insanity. [NIH] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Ectopic: Pertaining to or characterized by ectopia. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH]

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Elastin: The protein that gives flexibility to tissues. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endoderm: The inner of the three germ layers of the embryo. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work.

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Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of

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macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibronectins: Glycoproteins found on the surfaces of cells, particularly in fibrillar structures. The proteins are lost or reduced when these cells undergo viral or chemical transformation. They are highly susceptible to proteolysis and are substrates for activated blood coagulation factor VIII. The forms present in plasma are called cold-insoluble globulins. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Foam Cells: Lipid-laden macrophages originating from monocytes or from smooth muscle cells. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves,

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and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Targeting: The integration of exogenous DNA into the genome of an organism at sites where its expression can be suitably controlled. This integration occurs as a result of homologous recombination. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]

Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ Layers: The three layers of cells comprising the early embryo. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH]

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Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanidine: A strong organic base existing primarily as guanidium ions at physiological pH. It is found in the urine as a normal product of protein metabolism. It is also used in laboratory research as a protein denaturant. (From Martindale, the Extra Pharmacopoeia, 30th ed and Merck Index, 12th ed) It is also used in the treatment of myasthenia and as a fluorescent probe in HPLC. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart Catheterization: Procedure which includes placement of catheter, recording of intracardiac and intravascular pressure, obtaining blood samples for chemical analysis, and cardiac output measurement, etc. Specific angiographic injection techniques are also involved. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Valves: Flaps of tissue that prevent regurgitation of blood from the ventricles to the atria or from the pulmonary arteries or aorta to the ventricles. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH]

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Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homozygotes: An individual having a homozygous gene pair. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrops Fetalis: Edema of the entire body due to abnormal accumulation of serous fluid in the tissues, associated with severe anemia and occurring in fetal erythroblastosis. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophic cardiomyopathy: Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to

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an increase in the number of cells. [NIH] Hypoplasia: Incomplete development or underdevelopment of an organ or tissue. [EU] Hypoplastic Left Heart Syndrome: A condition characterized by underdevelopment of the left cardiac chambers, atresia or stenosis of the aorta or mitral valve or both, and hypoplasia of the aorta. These anomalies are a common cause of heart failure in early infancy. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoblotting: Immunologic methods for isolating and quantitatively measuring immunoreactive substances. When used with immune reagents such as monoclonal antibodies, the process is known generically as western blot analysis (blotting, western). [NIH]

Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be

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clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravascular: Within a vessel or vessels. [EU] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Isomerases: A class of enzymes that catalyze geometric or structural changes within a molecule to form a single product. The reactions do not involve a net change in the concentrations of compounds other than the substrate and the product.(from Dorland, 28th ed) EC 5. [NIH]

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Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligase: An enzyme that repairs single stranded discontinuities in double-stranded DNA molecules in the cell. Purified DNA ligase is used in gene cloning to join DNA molecules together. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH]

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Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental deficiency: A condition of arrested or incomplete development of mind from inherent causes or induced by disease or injury. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated

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during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesoderm: The middle germ layer of the embryo. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microspectrophotometry: Analytical technique for studying substances present at enzyme concentrations in single cells, in situ, by measuring light absorption. Light from a tungsten strip lamp or xenon arc dispersed by a grating monochromator illuminates the optical system of a microscope. The absorbance of light is measured (in nanometers) by comparing the difference between the image of the sample and a reference image. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]

labeled

with

Microtubule Proteins: Proteins found in the microtubules. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired

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from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Monosomy: The condition in which one chromosome of a pair is missing. In a normally diploid cell it is represented symbolically as 2N-1. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH]

Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH]

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Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Natriuresis: The excretion of abnormal amounts of sodium in the urine. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nitroprusside: (OC-6-22)-Pentakis(cyano-C)nitrosoferrate(2-). A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal

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transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Occupational Therapy: The field concerned with utilizing craft or work activities in the rehabilitation of patients. Occupational therapy can also refer to the activities themselves. [NIH]

Ochronosis: Deposition of polymerized homogentisic acid as a brown-black pigment in the connective tissue. It occurs in alkaptonuria, but has also been observed in connection with exposure to certain chemicals (e.g., phenol, trinitrophenol, benzene derivatives). [NIH] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Paralysis: Loss of ability to move all or part of the body. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural

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and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Plant sterols: Plant-based compounds that can compete with dietary cholesterol to be absorbed by the intestines. This results in lower blood cholesterol levels. They may have some effect in cancer prevention. Also known as phytosterols. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized

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regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH]

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Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precordial: Pertaining to the precordium (= region over the heart and lower part of the thorax). [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primum: The first atrial septum to appear in the embryonic heart. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [NIH]

Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The

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predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Kinases: A family of enzymes that catalyze the conversion of ATP and a protein to ADP and a phosphoprotein. EC 2.7.1.37. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Pseudoxanthoma Elasticum: A rare, progressive inherited disorder resulting from extensive basophilic degeneration of elastic tissue, usually presenting after puberty and involving the skin, eye, and cardiovascular system. Characteristic manifestations are small, circumscribed yellowish patches at sites of considerable movement of the skin, angioid streaks in the retina, and a tendency towards hemorrhage and arterial insufficiency. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of

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literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulsatile Flow: Rhythmic, intermittent propagation of a fluid through a vessel or piping system, in contrast to constant, smooth propagation, which produces laminar flow. The quality of blood flow, whether smooth (laminar) or pulsatile, is important to the integrity of the tissues being artificially perfused by various heart assist devices or in regional perfusion. [NIH]

Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called

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erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Rheumatic Heart Disease: Disease of the heart resulting from rheumatic fever and characterized by inflammatory changes in the myocardium or scarring of the valves. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH]

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Saphenous Vein: The vein which drains the foot and leg. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Secundum: The second atrial septum to appear in the embryonic heart. [NIH] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Septum: A dividing wall or partition; a general term for such a structure. The term is often used alone to refer to the septal area or to the septum pellucidum. [EU] Septum Pellucidum: A triangular double membrane separating the anterior horns of the lateral ventricles of the brain. It is situated in the median plane and bounded by the corpus callosum and the body and columns of the fornix. [NIH]

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Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH]

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Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Speech pathologist: A specialist who evaluates and treats people with communication and swallowing problems. Also called a speech therapist. [NIH] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU]

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Sudden cardiac death: Cardiac arrest caused by an irregular heartbeat. [NIH] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Systemic: Affecting the entire body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Systolic pressure: The highest pressure to which blood pressure rises with the contraction of the ventricles. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Taurine: 2-Aminoethanesulfonic acid. A conditionally essential nutrient, important during mammalian development. It is present in milk but is isolated mostly from ox bile and strongly conjugates bile acids. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogen: A substance which, through immediate, prolonged or repeated contact with the skin may involve a risk of subsequent non-hereditable birth defects in offspring. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH]

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Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Plasminogen Activator: A proteolytic enzyme in the serine protease family found in many tissues which converts plasminogen to plasmin. It has fibrin-binding activity and is immunologically different from urinary plasminogen activator. The primary sequence, composed of 527 amino acids, is identical in both the naturally occurring and synthetic proteases. EC 3.4.21.68. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case

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of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trisomy: The possession of a third chromosome of any one type in an otherwise diploid cell. [NIH]

Tropoelastin: A salt-soluble precursor of elastin. Lysyl oxidase is instrumental in converting it to elastin in connective tissue. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [NIH] Tunica Media: The middle coat of blood vessel walls, composed principally of thin, cylindrical, smooth muscle cells and elastic tissue. It accounts for the bulk of the wall of most arteries. The smooth muscle cells are arranged in circular layers around the vessel, and the thickness of the coat varies with the size of the vessel. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are

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not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Plasminogen Activator: A proteolytic enzyme that converts plasminogen to plasmin where the preferential cleavage is between arginine and valine. It was isolated originally from human urine, but is found in most tissues of most vertebrates. EC 3.4.21.73. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Varices: Stretched veins such as those that form in the esophagus from cirrhosis. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Ventricular Remodeling: The geometric and structural changes that the ventricle undergoes, usually following myocardial infarction. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca

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alkaloids. It is a mitotic inhibitor. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenon: A noble gas with the atomic symbol Xe, atomic number 54, and atomic weight 131.30. It is found in the earth's atmosphere and has been used as an anesthetic. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

167

INDEX A Aberrant, 10, 16, 125 Ablation, 12, 71, 125 Abscess, 125, 159 Acceptor, 125, 147, 152 Actin, 125, 151 Actomyosin, 72, 125 Acute renal, 125, 143 Adipocytes, 125, 135, 147 Adrenergic, 5, 11, 66, 78, 125, 140 Adverse Effect, 125, 160 Aerobic, 125, 140 Afferent, 125, 147 Agammaglobulinemia, 13, 125 Agar, 125, 154 Agonist, 125, 138 Airway, 30, 125 Algorithms, 125, 130 Alkaline, 125, 131 Alkaptonuria, 125, 152 Alleles, 18, 126 Alternative medicine, 91, 126 Alveoli, 126, 137 Amino Acid Sequence, 126, 127 Amino Acids, 126, 127, 153, 154, 156, 158, 160, 162, 163, 164 Anaesthesia, 28, 47, 58, 126, 145 Anal, 126, 140 Analogous, 126, 164 Anaphylatoxins, 126, 134 Anatomical, 16, 126, 129, 138, 145, 159 Anemia, 4, 126, 142, 144 Anesthesia, 4, 16, 26, 30, 60, 71, 125, 126, 139 Aneuploidy, 19, 126 Aneurysm, 126, 128, 165 Angina, 22, 37, 54, 60, 63, 66, 126 Angina Pectoris, 37, 54, 63, 126 Angiodysplasia, 38, 127 Angiogenesis, 127, 148 Angiography, 27, 110, 122, 127 Angioid Streaks, 127, 156 Angioplasty, 27, 38, 44, 58, 127 Angiotensin-Converting Enzyme Inhibitors, 71, 127 Angiotensinogen, 127, 158 Annealing, 127, 154 Anomalies, 4, 127, 145, 162

Antagonism, 127, 138 Anterograde, 21, 25, 127 Antibacterial, 127, 161 Antibiotic, 127, 161 Antibodies, 6, 127, 140, 145, 148, 150, 154 Antibody, 19, 21, 127, 128, 130, 134, 144, 145, 146, 148, 150 Anticholinergic, 127, 138 Anticoagulant, 127, 156 Antigen, 127, 128, 134, 140, 144, 145, 146, 148 Antigen-Antibody Complex, 128, 134 Antioxidant, 128, 152 Anus, 126, 128, 129, 157 Aorta, 15, 18, 19, 24, 47, 78, 79, 83, 84, 128, 131, 136, 143, 145, 165 Aortic Aneurysm, 7, 10, 17, 19, 128 Aortic Coarctation, 38, 128 Aortic Rupture, 36, 128 Aortitis, 58, 128 Apoptosis, 6, 128 Arginine, 66, 126, 128, 165 Arrhythmia, 128, 165 Arterial, 7, 12, 14, 71, 84, 128, 144, 156, 162 Arteries, 7, 22, 78, 79, 84, 128, 130, 136, 143, 149, 150, 157, 164 Arteriolar, 128, 158 Arterioles, 128, 130, 149, 150 Arteriovenous, 43, 89, 128, 149 Assay, 9, 19, 128 Asymptomatic, 23, 38, 49, 62, 63, 90, 128 Atherogenic, 16, 128 Atmospheric Pressure, 128, 144 Atresia, 19, 53, 129, 145 Atrial, 6, 12, 28, 46, 53, 61, 71, 75, 84, 129, 155, 159 Atrial Fibrillation, 53, 75, 129 Atrioventricular, 75, 129, 162 Atrioventricular Node, 129, 162 Atrium, 129, 131, 149, 162, 165 Autonomic, 16, 129, 151, 162 B Bacteria, 127, 128, 129, 139, 141, 149, 157, 161, 164 Bacteriophage, 129, 154, 164 Bacterium, 129, 143 Balloon Dilatation, 38, 129 Balloon dilation, 24, 25, 60, 129

168 Aortic Stenosis

Base, 129, 143, 147, 154, 162 Basement Membrane, 14, 129, 140, 147 Benign, 59, 129 Benign prostatic hyperplasia, 129 Benzene, 129, 152 Bilateral, 26, 35, 129 Bile, 130, 133, 142, 147, 162 Biliary, 129, 130, 131 Biochemical, 5, 14, 16, 126, 130, 160 Biological therapy, 130, 143 Biopsy, 130, 153 Biosynthesis, 16, 130, 160 Biotechnology, 20, 84, 91, 101, 130 Bladder, 129, 130, 151, 156, 165 Blepharoptosis, 35, 130 Blood Coagulation, 130, 131, 141, 163 Blood Glucose, 130, 143 Blood Platelets, 130, 160, 163 Blood pressure, 16, 122, 130, 132, 144, 145, 150, 151, 157, 162 Blood transfusion, 70, 130 Blood vessel, 7, 11, 17, 127, 130, 131, 132, 139, 143, 153, 160, 161, 163, 164, 165 Blot, 130, 145 Blotting, Western, 130, 145 Body Fluids, 130, 131, 138 Bone Marrow, 129, 130, 140, 148, 150 Bowel, 126, 131, 146, 147 Bradycardia, 16, 131 Branch, 84, 119, 131, 139, 152, 161, 162, 163 Bronchial, 129, 131 Bypass, 54, 60, 131 C Calcification, 11, 13, 17, 23, 34, 59, 90, 111, 131 Calcium, 11, 61, 131, 134, 138, 144, 148, 149, 160, 165 Calcium channel blocker, 131, 165 Calculi, 129, 131 Carcinogenic, 129, 131, 146, 152, 155 Cardiac arrest, 58, 131, 162 Cardiac catheterization, 27, 34, 122, 131 Cardiac Output, 57, 131, 143, 161 Cardiogenic, 28, 33, 131 Cardiomyopathy, 3, 12, 70, 71, 72, 131 Cardiopulmonary, 58, 60, 131 Cardiopulmonary Bypass, 60, 131 Cardiotonic, 131, 138 Cardiovascular disease, 11, 39, 132 Cardiovascular System, 132, 156 Carotid Sinus, 70, 132 Case report, 24, 26, 28, 32, 49, 132, 133

Case series, 132, 133 Catecholamine, 132, 138 Catheterization, 27, 28, 30, 36, 41, 48, 80, 81, 127, 129, 132, 146 Catheters, 129, 132 Caudal, 132, 154 Causal, 132, 140 Cell Adhesion, 132, 146 Cell Death, 128, 132, 151 Cell Differentiation, 132, 160 Cell Division, 129, 132, 143, 149, 154, 159 Cell proliferation, 29, 132, 160 Cell Survival, 132, 143 Central Nervous System, 16, 129, 132, 142, 160 Cerebral, 28, 132, 140, 162 Cerebrovascular, 132 Character, 127, 133 Chemotactic Factors, 133, 134 Chenodeoxycholic Acid, 17, 133 Choleretic, 133 Cholestanol, 16, 133 Cholesterol, 13, 16, 66, 130, 133, 136, 142, 144, 153 Cholic Acid, 17, 133 Chromatin, 8, 128, 133 Chromosomal, 8, 18, 126, 133 Chromosome, 7, 8, 20, 126, 133, 147, 150, 159, 164 Chronic, 5, 6, 66, 71, 133, 139, 146, 147 CIS, 10, 133 Claudication, 26, 133 Clear cell carcinoma, 133, 137 Clinical study, 84, 133, 136 Clinical trial, 5, 101, 133, 136, 150 Clone, 16, 133 Cloning, 9, 130, 133, 147 Coagulation, 130, 133, 144, 163 Coenzyme, 33, 66, 67, 134 Cofactor, 134, 156, 163 Cognition, 8, 134 Cohort Studies, 134, 140 Colchicine, 134, 164 Collagen, 15, 129, 134, 141, 148, 155 Complement, 18, 126, 134, 135, 142, 146 Complementary and alternative medicine, 69, 74, 134 Complementary medicine, 69, 135 Computational Biology, 101, 135 Computed tomography, 23, 61, 135 Computerized axial tomography, 135 Computerized tomography, 135

Index 169

Concentric, 10, 135 Conception, 135, 141, 155 Confounding, 16, 135 Confusion, 135, 165 Congestive heart failure, 5, 25, 135 Conjugated, 133, 135, 136 Connective Tissue, 8, 9, 130, 134, 135, 141, 152, 164 Connective Tissue Cells, 135 Consciousness, 135, 162 Consumption, 5, 135, 152 Contractility, 6, 127, 135, 138 Contraindications, ii, 135 Control group, 19, 136 Controlled clinical trial, 4, 136 Coronary Angiography, 46, 136 Coronary Artery Bypass, 23, 49, 136 Coronary Circulation, 127, 136 Coronary heart disease, 132, 136 Coronary Thrombosis, 136, 149, 150 Cortex, 136, 158 Crossing-over, 136, 157 Cross-Sectional Studies, 136, 140 Curative, 136, 162 Cyclic, 66, 136, 156 Cytochrome, 6, 136 Cytoplasm, 128, 136, 137, 139, 143, 150, 158 Cytoskeleton, 137, 146, 149 Cytotoxic, 137, 160 D Databases, Bibliographic, 101, 137 Decompensation, 5, 137 Defense Mechanisms, 137, 146 Deletion, 8, 14, 37, 128, 137 Denaturation, 137, 154 Dental Care, 111, 137 Dental Clinics, 4, 137 Dentition, 4, 137 Depolarization, 137, 138, 160 Dermal, 7, 17, 137 DES, 67, 126, 137 Dextrocardia, 49, 137 Diabetes Mellitus, 137, 143 Diagnostic procedure, 77, 91, 137 Dialyzer, 137, 143 Diastole, 137 Diastolic, 4, 15, 29, 32, 37, 40, 42, 43, 84, 90, 137, 144 Diffusion, 137, 146 Digestion, 130, 131, 137, 146, 147, 161 Dihydrotestosterone, 137, 158

Dilatation, 3, 15, 24, 30, 54, 79, 126, 127, 138, 155, 165 Dilatation, Pathologic, 138, 165 Dilation, 15, 25, 54, 138, 165 Diltiazem, 73, 138 Diploid, 126, 138, 150, 154, 164 Dipyridamole, 30, 40, 138 Direct, iii, 10, 13, 18, 47, 93, 138, 158 Disopyramide, 72, 138 Dissection, 46, 58, 138 Distal, 62, 136, 138, 139, 156 Dobutamine, 22, 30, 31, 48, 61, 138 Dorsal, 138, 154 Drug Interactions, 94, 138 Duct, 132, 138 Dwarfism, 36, 138 Dyspnea, 137, 138 E Eccentricity, 45, 138 Ectopic, 11, 14, 138 Edema, 137, 138, 144 Effector, 134, 138, 151 Ejection fraction, 49, 57, 62, 138 Elasticity, 17, 138 Elastin, 7, 8, 9, 10, 12, 17, 19, 29, 33, 37, 45, 78, 127, 134, 139, 141, 164 Electrode, 5, 139 Electrons, 128, 129, 139, 152, 157 Electrophysiological, 139, 165 Emboli, 79, 139 Embolism, 28, 139 Embryo, 12, 132, 139, 142, 145, 149, 155, 161 Embryo Transfer, 139, 155 Endarterectomy, 127, 139 Endemic, 139, 161 Endocarditis, 23, 139 Endocardium, 139 Endoderm, 12, 139 Endothelial cell, 14, 139, 163 Endothelium, 127, 139 Endotoxins, 134, 139 End-stage renal, 3, 139 Energy balance, 139, 147 Environmental Health, 100, 102, 140 Enzymatic, 131, 134, 140, 154 Enzyme, 18, 125, 134, 138, 140, 147, 149, 154, 156, 158, 160, 161, 163, 165, 166 Epidemic, 140, 161 Epidemiologic Studies, 13, 140 Epinephrine, 125, 140, 151, 164 Epithelium, 129, 139, 140

170 Aortic Stenosis

Epitopes, 71, 140 Erythrocytes, 16, 126, 130, 140, 158 Erythropoietin, 71, 140 Esophagus, 129, 140, 161, 165 Exercise Test, 34, 62, 140 Exogenous, 140, 142 Extracellular, 7, 11, 15, 19, 135, 140, 141, 146, 148 Extracellular Matrix, 7, 15, 19, 135, 140, 146, 148 Extracellular Matrix Proteins, 19, 140, 148 Extracellular Space, 140, 141 Extremity, 141, 159 F Facial, 4, 8, 78, 85, 102, 141 Family Planning, 101, 141 Fat, 125, 130, 133, 136, 139, 141, 147, 160 Fatigue, 141, 143 Feces, 133, 141 Femoral, 60, 131, 141 Femoral Artery, 131, 141 Femur, 141 Fertilization in Vitro, 141, 155 Fetus, 18, 140, 141, 155, 161 Fibrin, 130, 141, 154, 163 Fibronectins, 141 Fibrosis, 141, 159 Fluorescence, 6, 141 Fluorouracil, 138, 141 Foam Cells, 16, 141 Folate, 18, 141, 142 Folic Acid, 18, 141 Foramen, 54, 142 Forearm, 130, 142 G Gallstones, 133, 142 Gastric, 129, 142 Gastrointestinal, 38, 43, 127, 140, 142, 160, 161 Gastrointestinal tract, 43, 127, 142, 160, 161 Gene, 7, 8, 9, 11, 12, 13, 16, 19, 45, 78, 84, 126, 130, 142, 144, 147, 159 Gene Expression, 7, 8, 11, 142 Gene Targeting, 9, 142 Genetic Engineering, 130, 133, 142 Genetic testing, 142, 154 Genetics, 8, 29, 33, 36, 37, 45, 69, 85, 102, 142 Genomics, 8, 142 Genotype, 9, 12, 18, 142, 153 Germ Layers, 139, 142

Gland, 142, 156, 159, 161, 163 Glucose, 71, 130, 137, 142, 143 Glutamic Acid, 141, 142, 155 Glycine, 133, 142, 160 Glycosaminoglycans, 141, 142 Governing Board, 142, 155 Grafting, 49, 60, 136, 143, 145 Granulocytes, 143, 160, 166 Grasses, 142, 143 Growth, 4, 6, 9, 11, 15, 18, 127, 128, 132, 138, 143, 153, 163, 164 Growth factors, 9, 143 Guanidine, 138, 143 H Heart attack, 132, 143 Heart Catheterization, 40, 143 Heart failure, 4, 5, 6, 30, 39, 78, 127, 143, 145 Heart Valves, 11, 110, 111, 129, 143 Heartbeat, 143, 162 Heme, 136, 143 Hemodialysis, 3, 66, 137, 143, 147 Hemodynamics, 33, 41, 48, 143 Hemoglobin, 5, 126, 140, 143 Hemolytic, 16, 143 Hemorrhage, 16, 38, 127, 143, 156, 161 Hemostasis, 144, 146, 160 Hepatic, 16, 144 Heredity, 142, 144 Heterodimers, 144, 146 Homeostasis, 11, 144 Homologous, 126, 136, 142, 144, 159, 162 Homozygotes, 16, 144 Hormone, 137, 138, 140, 144, 147, 160, 162, 163 Hybrid, 133, 144 Hydrogen, 125, 129, 137, 140, 144, 147, 150, 152 Hydrops Fetalis, 43, 144 Hydroxylysine, 134, 144 Hydroxyproline, 134, 144 Hyperbaric, 71, 144 Hyperbaric oxygen, 144 Hypercalcemia, 4, 8, 13, 78, 85, 102, 144 Hypercholesterolemia, 13, 60, 144 Hyperlipidemia, 12, 144 Hypersensitivity, 70, 144 Hypertension, 4, 10, 59, 78, 127, 132, 144 Hypertrophic cardiomyopathy, 69, 72, 73, 144 Hypertrophy, 3, 5, 6, 10, 15, 37, 45, 56, 66, 71, 78, 129, 144

Index 171

Hypoplasia, 145 Hypoplastic Left Heart Syndrome, 18, 145 Hypotension, 4, 16, 66, 145 I Id, 67, 73, 110, 111, 112, 118, 120, 145 Idiopathic, 4, 20, 48, 84, 87, 145 Immune response, 14, 128, 145, 161, 166 Immune system, 130, 145, 148, 166 Immunoblotting, 6, 145 Immunofluorescence, 35, 145 Immunohistochemistry, 6, 145 Immunologic, 125, 133, 145 Immunosuppressant, 10, 141, 145 Impairment, 145, 149 Implantation, 80, 81, 135, 145 In situ, 6, 37, 145, 149 In vitro, 6, 7, 10, 11, 14, 27, 71, 139, 145, 154 In vivo, 5, 6, 11, 13, 14, 15, 16, 32, 145 Indicative, 17, 83, 145, 152, 165 Induction, 5, 11, 14, 58, 145 Infancy, 13, 52, 145 Infantile, 4, 8, 78, 145 Infarction, 145 Infection, 125, 130, 133, 145, 148, 166 Infiltration, 59, 146 Initiation, 146, 163 Innervation, 146, 153, 159, 163 Inotropic, 66, 146 Integrins, 19, 146 Intensive Care, 47, 57, 146 Intermittent, 146, 157 Intestinal, 16, 133, 146 Intestine, 80, 81, 131, 146, 147 Intoxication, 146, 166 Intracellular, 6, 10, 11, 146, 156, 157, 160 Intravascular, 25, 143, 146 Intrinsic, 129, 146 Intubation, 132, 146 Invasive, 123, 146, 148 Involuntary, 146, 151 Isomerases, 10, 146 J Joint, 78, 147 K Kb, 100, 147 Kidney Failure, 139, 147 L Labile, 134, 147 Laminin, 129, 141, 147 Large Intestine, 146, 147, 157, 160 Latent, 9, 147

Laxative, 125, 133, 147 Leptin, 47, 147 Lesion, 12, 14, 19, 136, 147, 148 Leukocytes, 130, 133, 143, 147, 150 Library Services, 118, 147 Ligaments, 136, 147 Ligands, 10, 146, 147 Ligase, 6, 147 Linkage, 18, 147 Lipid, 141, 147, 152 Lipid Peroxidation, 147, 152 Liver, 47, 80, 81, 130, 133, 140, 141, 144, 147, 158, 164 Liver Transplantation, 47, 147 Localization, 14, 145, 148 Localized, 146, 147, 148, 153, 154 Lumbar, 28, 148, 159, 163 Lumen, 128, 148 Lymph, 139, 148 Lymphatic, 139, 146, 148, 154 Lymphocyte, 59, 128, 148 Lymphoid, 127, 148 M Magnetic Resonance Imaging, 47, 55, 148 Malnutrition, 4, 148 Mammary, 136, 148 Mammogram, 131, 148, 149 Matrix metalloproteinase, 14, 148 Medial, 12, 148, 163 Mediate, 13, 15, 16, 148 Mediator, 148, 160 MEDLINE, 101, 148 Megaloblastic, 142, 148 Melanin, 148, 153, 164 Membrane, 10, 15, 73, 134, 137, 138, 147, 148, 152, 158, 159, 160, 164 Meninges, 132, 148 Mental deficiency, 4, 148 Mental Retardation, 4, 8, 13, 78, 85, 102, 148 Mentors, 13, 149 Mesoderm, 12, 149 Metaplasia, 12, 149 Metastasis, 148, 149 MI, 39, 123, 149 Microcalcifications, 131, 149 Microcirculation, 73, 149 Microorganism, 134, 149, 166 Microscopy, 6, 35, 129, 149 Microspectrophotometry, 5, 149 Microspheres, 5, 149 Microtubule Proteins, 11, 149

172 Aortic Stenosis

Microtubules, 11, 149 Migration, 18, 149 Mineralization, 4, 11, 13, 17, 149 Mitochondrial Swelling, 149, 151 Mitosis, 128, 149 Mitral Valve, 88, 110, 111, 145, 149 Modification, 72, 142, 149, 157 Molecular, 6, 8, 12, 16, 17, 19, 78, 101, 103, 130, 135, 150, 154, 157, 162, 164 Molecule, 9, 128, 129, 134, 138, 146, 150, 152, 154, 157, 160 Monitor, 60, 150, 152 Monoclonal, 145, 150 Monoclonal antibodies, 145, 150 Monocytes, 16, 141, 147, 150 Mononuclear, 150 Monophosphate, 66, 150 Monosomy, 126, 150 Morphogenesis, 7, 12, 150 Morphological, 139, 150 Morphology, 6, 17, 34, 37, 62, 150 Motility, 150, 160 Multicenter study, 48, 150 Mutagenesis, 14, 150 Mutagens, 150 Mydriatic, 138, 150 Myocardial infarction, 15, 16, 28, 34, 136, 138, 149, 150, 165 Myocardial Ischemia, 126, 150 Myocardium, 11, 51, 72, 127, 149, 150, 151, 158 Myosin, 125, 151 N Natriuresis, 127, 151 Nausea, 151, 165 NCI, 1, 99, 133, 151 Necrosis, 21, 128, 145, 149, 150, 151 Need, 3, 21, 84, 90, 102, 113, 125, 148, 151 Neonatal, 25, 151 Nerve, 125, 126, 146, 148, 151, 153, 155, 158, 159, 161, 163 Nervous System, 125, 132, 148, 151, 161, 162 Neural, 16, 125, 151 Neurogenic, 16, 151 Neuronal, 16, 151 Neurons, 151, 162 Neurotransmitters, 150, 151 Nitrogen, 140, 151, 164 Nitroprusside, 41, 51, 90, 151 Norepinephrine, 125, 151 Nuclear, 17, 21, 139, 151, 152

Nuclei, 139, 142, 148, 149, 152 Nucleus, 128, 133, 136, 150, 152, 161 O Occupational Therapy, 85, 102, 152 Ochronosis, 39, 126, 152 Oncogenic, 146, 152 Organelles, 136, 150, 152 Osteoporosis, 11, 152 Oxidation, 12, 71, 125, 128, 136, 147, 152 Oxidative Stress, 14, 70, 152 Oxygen Consumption, 140, 152, 158 Oxygenator, 131, 152 P Palliative, 152, 162 Paralysis, 130, 152 Paroxysmal, 53, 71, 126, 152 Patch, 26, 88, 152 Pathogenesis, 7, 8, 12, 13, 78, 152 Pathologic, 128, 130, 136, 144, 152, 153, 165 Pathologic Processes, 128, 153 Pathophysiology, 9, 53, 153 Peptide, 26, 43, 147, 153, 154, 156 Percutaneous, 36, 37, 38, 44, 58, 67, 153 Perforation, 142, 153 Perfusion, 30, 50, 71, 73, 153, 157 Peroneal Nerve, 153, 159 Pharmacologic, 126, 153, 163 Phenotype, 7, 8, 9, 12, 13, 16, 19, 70, 153 Phenyl, 138, 153 Phenylalanine, 153, 164 Phospholipases, 153, 160 Phosphorus, 131, 153 Phosphorylated, 14, 134, 153 Phosphorylation, 6, 14, 153 Physical Therapy, 85, 102, 153 Physiologic, 125, 130, 153, 155, 157 Physiology, 6, 10, 66, 139, 153 Pigment, 152, 153 Plant sterols, 16, 153 Plants, 142, 150, 152, 153 Plaque, 11, 14, 127, 128, 154 Plasma, 17, 43, 71, 127, 141, 143, 144, 147, 154, 158 Plasma cells, 127, 154 Plasmin, 154, 163, 165 Plasminogen, 154, 163, 165 Platelet Activation, 154, 160 Platelets, 154, 163 Plexus, 28, 154, 159 Point Mutation, 14, 154 Polymerase, 35, 154 Polymerase Chain Reaction, 35, 154

Index 173

Polypeptide, 126, 134, 154, 166 Posterior, 88, 126, 138, 154 Postmenopausal, 152, 154 Postnatal, 4, 154, 161 Postoperative, 24, 39, 43, 61, 154 Postsynaptic, 155, 160 Potentiation, 155, 160 Practice Guidelines, 103, 155 Precordial, 34, 155 Precursor, 127, 138, 140, 151, 153, 154, 155, 164 Pregnancy Outcome, 32, 155 Prenatal, 4, 70, 139, 155 Prevalence, 3, 27, 31, 43, 54, 155 Primum, 84, 155 Probe, 5, 57, 143, 155 Progression, 11, 14, 21, 23, 30, 31, 33, 35, 41, 51, 54, 56, 62, 66, 90, 155 Progressive, 79, 132, 143, 151, 154, 155, 156 Projection, 16, 137, 152, 155 Prolapse, 39, 110, 155 Proline, 134, 144, 155 Promoter, 6, 15, 155 Prospective study, 62, 155 Prostaglandin, 127, 155 Prostate, 129, 156 Prosthesis, 40, 43, 46, 80, 81, 156 Protease, 156, 163 Protein C, 11, 17, 125, 126, 129, 156, 164 Protein Kinases, 5, 156 Protein S, 11, 15, 84, 130, 156, 158 Proteoglycans, 129, 141, 156 Proteolytic, 134, 154, 156, 163, 165 Proximal, 62, 138, 156, 159 Pseudoxanthoma, 17, 156 Pseudoxanthoma Elasticum, 17, 156 Puberty, 156 Public Policy, 101, 156 Publishing, 3, 20, 156 Pulmonary, 7, 9, 19, 23, 28, 29, 52, 56, 78, 130, 135, 140, 143, 147, 157, 165 Pulmonary Artery, 130, 157, 165 Pulmonary Edema, 28, 147, 157 Pulmonary hypertension, 56, 157 Pulsatile Flow, 27, 157 Pulse, 123, 150, 157 Pupil, 138, 150, 157 Q Quality of Life, 4, 157 R Race, 149, 157 Radiation, 127, 141, 144, 157, 166

Radioactive, 5, 144, 145, 150, 152, 157 Radiological, 110, 153, 157 Reactive Oxygen Species, 14, 157 Receptor, 6, 11, 13, 16, 128, 157, 160 Receptors, Serotonin, 157, 160 Recombination, 8, 142, 157 Rectal, 129, 157 Recurrence, 18, 157 Red blood cells, 140, 143, 157 Reductase, 13, 18, 33, 66, 158 Refer, 1, 134, 148, 152, 158, 159 Refraction, 158, 161 Regurgitation, 11, 15, 28, 31, 39, 50, 55, 59, 61, 63, 81, 111, 143, 158 Remission, 157, 158 Renin, 45, 127, 158 Renin-Angiotensin System, 45, 127, 158 Reproduction Techniques, 155, 158 Resection, 73, 158 Respiration, 150, 158 Restoration, 153, 158, 166 Retina, 127, 156, 158 Retrograde, 25, 28, 40, 158 Rheumatic Heart Disease, 46, 111, 158 Ribosome, 158, 164 Risk factor, 4, 13, 23, 27, 53, 57, 66, 140, 155, 158 Risk patient, 52, 158 S Saphenous, 136, 158, 159 Saphenous Vein, 136, 159 Schizoid, 159, 166 Schizophrenia, 159, 166 Schizotypal Personality Disorder, 159, 166 Sciatic Nerve, 28, 153, 159, 163 Sclerosis, 54, 111, 159 Screening, 133, 159 Secretion, 10, 138, 159 Secretory, 10, 159 Secundum, 84, 159 Segmental, 62, 159 Segmentation, 159 Segregation, 157, 159 Seizures, 152, 159 Senile, 34, 35, 152, 159 Sensibility, 126, 159 Sensor, 14, 159 Septal, 12, 23, 52, 71, 84, 159 Septum, 35, 46, 129, 155, 159 Septum Pellucidum, 159 Sequencing, 18, 154, 160 Serine, 160, 163

174 Aortic Stenosis

Serotonin, 16, 157, 160, 164 Serous, 139, 144, 160 Serum, 126, 134, 160 Shock, 16, 28, 33, 160, 164 Side effect, 93, 125, 130, 160, 163 Signal Transduction, 5, 8, 13, 160 Skeletal, 9, 138, 160 Skeleton, 11, 125, 141, 147, 155, 160 Skull, 160, 162 Small intestine, 133, 144, 146, 160 Smooth muscle, 19, 126, 135, 141, 158, 160, 161, 164 Social Environment, 157, 160 Soft tissue, 130, 160 Specialist, 113, 138, 161 Species, 134, 140, 144, 149, 150, 157, 161, 164 Spectrum, 33, 161 Speech pathologist, 85, 102, 161 Sperm, 133, 161, 164 Spinal cord, 132, 133, 148, 151, 159, 161, 162 Spontaneous Abortion, 155, 161 Sporadic, 7, 161 Stabilization, 11, 161 Stem Cells, 140, 161 Stent, 25, 27, 44, 58, 161 Stillbirth, 155, 161 Stimulant, 138, 161 Stimulus, 135, 139, 146, 161, 163 Stomach, 140, 142, 144, 151, 160, 161 Strand, 154, 161 Stress, 11, 14, 15, 30, 40, 48, 132, 151, 152, 161 Stroke, 15, 42, 100, 131, 132, 161 Stroke Volume, 15, 131, 161 Substance P, 159, 161 Substrate, 146, 161 Sudden cardiac death, 70, 162 Sudden death, 12, 162 Sulfur, 140, 162 Superoxide, 67, 162 Supplementation, 19, 162 Supraventricular, 71, 162 Sympathetic Nervous System, 127, 162 Symptomatic, 27, 42, 46, 59, 61, 73, 123, 162 Synaptic, 160, 162 Syncope, 16, 55, 56, 122, 162 Systemic, 4, 7, 19, 59, 94, 128, 130, 140, 143, 146, 162 Systole, 79, 162

Systolic, 3, 6, 27, 41, 43, 48, 58, 84, 144, 162 Systolic pressure, 6, 162 T Tachycardia, 71, 122, 138, 162 Taurine, 133, 162 Temporal, 10, 162 Teratogen, 19, 162 Teratogenic, 138, 162 Testosterone, 158, 162 Therapeutics, 16, 94, 162 Thermal, 154, 163 Thigh, 141, 163 Thoracic, 23, 26, 35, 37, 39, 42, 43, 44, 45, 46, 47, 48, 51, 52, 53, 59, 63, 88, 110, 112, 163 Thorax, 148, 155, 163 Threshold, 144, 163 Thrombin, 141, 156, 163 Thrombocytopenia, 16, 163 Thrombomodulin, 156, 163 Thrombosis, 146, 156, 161, 163 Thrombus, 46, 54, 136, 145, 150, 163 Thyroid, 163, 164 Tibial Nerve, 159, 163 Tissue Plasminogen Activator, 47, 163 Tomography, 30, 72, 163 Torsion, 90, 145, 163 Toxic, iv, 129, 143, 163 Toxicity, 138, 163 Toxicology, 102, 163 Transcription Factors, 8, 163 Transcutaneous, 80, 81, 163 Transduction, 160, 163 Transfection, 14, 130, 164 Transfusion, 164 Translation, 8, 164 Translational, 11, 13, 164 Trauma, 23, 128, 151, 164 Trisomy, 126, 164 Tropoelastin, 7, 10, 19, 29, 66, 164 Tryptophan, 134, 160, 164 Tuberculosis, 135, 164 Tubulin, 11, 149, 164 Tungsten, 149, 164 Tunica Media, 19, 164 Tyrosine, 13, 164 U Ultrasonography, 122, 164 Unconscious, 137, 145, 164 Urea, 164 Uremia, 4, 11, 147, 164 Urethra, 80, 81, 129, 156, 165

Index 175

Urinary, 131, 163, 164, 165 Urinary Plasminogen Activator, 163, 165 Urine, 126, 129, 130, 143, 151, 165 V Vagina, 137, 165 Valves, 11, 59, 63, 80, 81, 129, 158, 165 Varices, 129, 165 Vascular, 7, 10, 11, 13, 14, 17, 19, 20, 26, 60, 71, 78, 127, 136, 139, 145, 146, 149, 163, 165 Vasoconstriction, 138, 140, 165 Vasodilatation, 132, 165 Vasodilation, 16, 127, 165 Vasodilator, 151, 165 Vein, 126, 128, 152, 158, 159, 165 Venous, 19, 29, 128, 137, 156, 165 Ventricle, 6, 15, 19, 38, 128, 129, 149, 157, 162, 165 Ventricular Dysfunction, 15, 22, 31, 51, 58, 60, 138, 165 Ventricular Function, 32, 38, 61, 63, 165

Ventricular Remodeling, 11, 47, 165 Venules, 130, 149, 165 Verapamil, 72, 165 Veterinary Medicine, 101, 165 Vinblastine, 164, 165 Vincristine, 164, 166 Virus, 129, 142, 154, 164, 166 Vitro, 6, 15, 166 Vivo, 6, 13, 14, 15, 166 W White blood cell, 127, 147, 148, 154, 166 Withdrawal, 16, 79, 166 Wound Healing, 146, 148, 166 X Xenon, 149, 166 X-ray, 122, 123, 135, 141, 148, 152, 166 Y Yeasts, 153, 166 Z Zymogen, 156, 166

176 Aortic Stenosis