Bone Marrow Biopsy - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

BONE MARROW BIOPSY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J...

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BONE MARROW BIOPSY 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 2004 by ICON Group International, Inc. Copyright 2004 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., 1960Bone Marrow Biopsy: 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: 0-497-00166-7 1. Bone Marrow Biopsy-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 bone marrow biopsy. 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 BONE MARROW BIOPSY............................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Bone Marrow Biopsy..................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 5 CHAPTER 2. ALTERNATIVE MEDICINE AND BONE MARROW BIOPSY............................................ 37 Overview...................................................................................................................................... 37 National Center for Complementary and Alternative Medicine.................................................. 37 Additional Web Resources ........................................................................................................... 38 General References ....................................................................................................................... 39 CHAPTER 3. PATENTS ON BONE MARROW BIOPSY ........................................................................ 41 Overview...................................................................................................................................... 41 Patents on Bone Marrow Biopsy ................................................................................................. 41 Patent Applications on Bone Marrow Biopsy.............................................................................. 50 Keeping Current .......................................................................................................................... 52 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 55 Overview...................................................................................................................................... 55 NIH Guidelines............................................................................................................................ 55 NIH Databases............................................................................................................................. 57 Other Commercial Databases....................................................................................................... 59 APPENDIX B. PATIENT RESOURCES ................................................................................................. 61 Overview...................................................................................................................................... 61 Patient Guideline Sources............................................................................................................ 61 Finding Associations.................................................................................................................... 64 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 67 Overview...................................................................................................................................... 67 Preparation................................................................................................................................... 67 Finding a Local Medical Library.................................................................................................. 67 Medical Libraries in the U.S. and Canada ................................................................................... 67 ONLINE GLOSSARIES.................................................................................................................. 73 Online Dictionary Directories ..................................................................................................... 74 BONE MARROW BIOPSY DICTIONARY................................................................................. 75 INDEX .............................................................................................................................................. 101

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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 bone marrow biopsy 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 bone marrow biopsy, 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 bone marrow biopsy, 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 bone marrow biopsy. 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 bone marrow biopsy, 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 bone marrow biopsy. 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 BONE MARROW BIOPSY Overview In this chapter, we will show you how to locate peer-reviewed references and studies on bone marrow biopsy.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and bone marrow biopsy, 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 “bone marrow biopsy” (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: •

The Problem: Abdominal Distension and Pedal Edema Source: Contemporary Gastroenterology. 5(1): 35-36, 38. January 1992. Summary: This article is from a series in which leading gastroenterologists describe their diagnostic and therapeutic approaches to a challenging clinical case. Marshall M. Kaplan, M.D., of Tufts University, discusses the case of a previously healthy elderly woman who presented with abdominal distension, pedal edema, and weakness. The author reports the results of the various diagnostic tests used in the case, including a chest radiograph, bone marrow biopsy, ultrasound, and CT scan. The article concludes with the physician's diagnosis of Budd-Chiari syndrome and a brief discussion of the appropriate treatment. 1 figure. (AA-M).

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Cutaneous and Systemic Manifestations of Mastocytosis Source: American Family Physician. 59(11): 3047-3054. June 1999. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This journal article provides health professionals with information on the cutaneous and systemic manifestations of mastocytosis. This disorder is characterized by an excessive number of apparently normal mast cells in the skin and, occasionally, in other organs. Characteristic skin lesions, called urticaria pigmentosa, are present in most patients, but clinical presentation can vary from a pruritic rash to unexplained collapse and sudden death. These lesions are typically tan to red-brown macules that appear on the trunk and spread symmetrically. Patients often have a long history of chronic and acute symptoms that were unrecognized as mastocytosis. Skin lesions may or may not accompany systemic mastocytosis, which can involve the gastrointestinal tract, the bone marrow, or other organs. Even when the physician considers the disease as a possibility, diagnosis can be difficult because of the special technical requirements necessary for biopsy and because of the problems with biochemical testing. A suggested diagnostic evaluation for adults with suspected cutaneous mastocytosis includes a skin biopsy, a bone marrow biopsy, and a complete blood count. If systemic involvement is suspected, endoscopy is warranted, and a bone marrow biopsy and biochemical tests should be performed. Drug therapy is initiated to stabilize mast cell membranes, to reduce the severity of the attacks, and to block the action of inflammatory mediators. The mainstay of therapy histamine H1 and H2 blockers and the avoidance of triggering factors. 1 figure, 4 tables, and 21 references.

Federally Funded Research on Bone Marrow Biopsy The U.S. Government supports a variety of research studies relating to bone marrow biopsy. These studies are tracked by the Office of Extramural Research at the National Institutes of 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 bone marrow biopsy. 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 bone marrow biopsy. The following is typical of the type of information found when searching the CRISP database for bone marrow biopsy:

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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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Project Title: IMAGING MARKERS OF PROGRESSION & RESPONSE IN PROSTATE CANCER Principal Investigator & Institution: Larson, Steven M.; Chief, Nuclear Medicine Service; Sloan-Kettering Institute for Cancer Res New York, Ny 100216007 Timing: Fiscal Year 2002 Summary: Clinical progression of prostate cancer is based on key molecular changes in the cancer cell, and this knowledge of tumor biology is now being incorporated into the therapeutic plan for locally aggressive or advanced tumors. In this translational research project our primary goal is to evaluate the role for whole body Positron Emission Tomography (PET) imaging in the diagnosis and therapy of prostate cancer. Our preliminary studies have shown that whole body Positron Emission Tomography (PET) imaging detects abnormal metabolism in a majority of tumor sites in patients preselected for progression of prostate cancer. Furthermore, these pilot studies suggest that changes in metabolism during therapy are an early indicator of tumor response. To evaluate a role for PET in diagnosis, we will study pre-surgical patients with prostate cancer and a high likelihood of loco-regional metastases based on well-established clinical nomograms. A comparison will be made to conventional diagnostic imaging methodologies and surgery will be the gold standard. In addition, to assess the role of PET in therapy, we will perform PET studies before and after treatment in patients with progressive prostate cancer, who are undergoing experimental drug therapies directed at rapidly dividing cells or key molecular targets such as androgen receptor and her-2neu receptor. PET radiotracers will include 18FDOG and 11C-methionine, selected to image changes in glycolysis, and amino acid transport and retention during disease progression and response. A third tracer of androgen receptor expression 18Ffluorodihydrotestosterone (18F-DHT) will be investigated in terms of its pharmacokinetics and biodistribution, as a pilot project. Two major hypotheses will be tested in this project:(1) Metabolic alterations in glycolysis and or amino-acid transport and retention, reflect changes in tumor 1 biology that offer sufficient competitive advantage to the tumor cell that these biochemical changes as measured by PET s will correlate with clinical measures of biologic aggressiveness, including tumor progression, time to PSA recurrence, time to metastasis and survival, in both locally aggressive and metastatic tumors (2) Changes in the uptake of FOG and or methionine from pre and post treatment scans, as measured by PET, correlate with response to targeted experimental therapies. As a secondary goal, a molecular profile will be determined from surgical specimens of the primary tumor and from metastatic bone marrow biopsy material when available. The objective will be to associate non-invasive PET metabolic image data with differences in tumor phenotype measured by immunohistochemical markers such as Ki-67. p27, p53, cyclin 01, Glut transporters hexokinase, and androgen receptor. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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.3 3

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

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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 bone marrow biopsy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “bone marrow biopsy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for bone marrow biopsy (hyperlinks lead to article summaries): •

A bone marrow biopsy technique suitable for use in neonates. Author(s): Sola MC, Rimsza LM, Christensen RD. Source: British Journal of Haematology. 1999 November; 107(2): 458-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10583240

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A case of plasmacytoma in muscle as a complication of needle tract seeding after percutaneous bone marrow biopsy. Author(s): Kansara G, Hussain M, Dimauro J. Source: American Journal of Clinical Pathology. 1989 May; 91(5): 604-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2718961

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A comparison of flow cytometry, bone marrow biopsy, and bone marrow aspirates in the detection of lymphoid infiltration in B cell disorders. Author(s): Sah SP, Matutes E, Wotherspoon AC, Morilla R, Catovsky D. Source: Journal of Clinical Pathology. 2003 February; 56(2): 129-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12560392

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A method for transmission and scanning electron microscopy of undecalcified human bone marrow biopsy specimens using cryofracture. Author(s): Kuto F, Nagaoka T, Hayashi M, Hirasawa Y, Tokuhiro H. Source: Journal of Clinical Pathology. 1982 February; 35(2): 240-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7040486

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A new bone marrow biopsy needle with core securing device. Author(s): Islam A. Source: Journal of Clinical Pathology. 1982 March; 35(3): 359-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7068929

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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A new trephine for closed bone marrow biopsy. Author(s): Landys K. Source: Acta Haematologica. 1980; 64(4): 216-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6781201

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A randomized, placebo-controlled study of outpatient premedication for bone marrow biopsy in adults with lymphoma. Author(s): Wolanskyj AP, Schroeder G, Wilson PR, Habermann TM, Inwards DJ, Witzig TE. Source: Clinical Lymphoma. 2000 September; 1(2): 154-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11707825

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A rapid procedure, by collagenase treatment and cytocentrifugation, for the cytological evaluation of bone marrow biopsy specimens. Author(s): Mononen I, Jansson SE. Source: Clinical and Laboratory Haematology. 1986; 8(2): 149-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3015480

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A second bone marrow biopsy as a cause of a false diagnosis of myelofibrosis. Author(s): Salgado C, Feliu E, Blade J, Rozman M, Aguilar JL, Rozman C. Source: British Journal of Haematology. 1992 March; 80(3): 407-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1581222

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A study of the value of closed bone marrow biopsy. Author(s): Mills AE. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1976 November 13; 50(48): 1928-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1006461

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Acute myeloid leukemia: immunohistologic findings in paraffin-embedded bone marrow biopsy specimens. Author(s): Horny HP, Campbell M, Steinke B, Kaiserling E. Source: Human Pathology. 1990 June; 21(6): 648-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1693593

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An appraisal of the value of the bone marrow biopsy in the assessment of proliferative lesions of the bone marrow. Author(s): Krause JR. Source: Histopathology. 1983 September; 7(5): 627-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6578999

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Aplastic anaemia in adults. Further evidence concerning the significance of the inflammatory infiltrate in methacrylate-embedded bone marrow biopsy specimens. Author(s): te Velde J, Haak HL. Source: Bibl Haematol. 1978; 45: 96-102. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=371607

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Aplastic anaemia. Histological investigation of methacrylate embedded bone marrow biopsy specimens; correlation with survival after conventional treatment in 15 adult patients. Author(s): Te Velde J, Haak HL. Source: British Journal of Haematology. 1977 January; 35(1): 61-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=869995

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Aplastic anaemia: residue analysis of chlorinated hydrocarbons in human bone marrow biopsy specimens by high resolution gas chromatography. Author(s): Anselstetter V, Ballschmiter K, Dmochewitz S, Heimpel H. Source: Acta Haematologica. 1985; 73(1): 6-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3923773

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Apoptosis in bone marrow biopsy samples involving stromal and hematopoietic cells in 50 patients with myelodysplastic syndromes. Author(s): Raza A, Gezer S, Mundle S, Gao XZ, Alvi S, Borok R, Rifkin S, Iftikhar A, Shetty V, Parcharidou A, et al. Source: Blood. 1995 July 1; 86(1): 268-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7795232

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Aspiration does not influence interpretation of bone marrow biopsy cellularity. Author(s): Wolff SN, Katzenstein AL, Phillips GL, Herzig GP. Source: American Journal of Clinical Pathology. 1983 July; 80(1): 60-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6858966

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Assessment of the value of immunohistochemistry in the subtyping of acute leukemia on routinely processed bone marrow biopsy specimens with particular reference to macrophage-associated antibodies. Author(s): Horny HP, Wehrmann M, Steinke B, Kaiserling E. Source: Human Pathology. 1994 August; 25(8): 810-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8056422

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Bilateral trephine bone marrow biopsy for staging non-Hodgkin's lymphoma--a second look. Author(s): Ebie N, Loew JM, Gregory SA. Source: Hematol Pathol. 1989; 3(1): 29-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2745358

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Bone marrow aspirate immunofluorescent and bone marrow biopsy immunoperoxidase staining of plasma cells in histologically occult plasma cell proliferative marrow disorders. Author(s): Menke DM, Greipp PR, Colon-Otero G, Solberg LA Jr, Cockerill KJ, Hook CC, Witzig TE. Source: Archives of Pathology & Laboratory Medicine. 1994 August; 118(8): 811-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7520228

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Bone marrow biopsy (BMB). I. Generalities, material and method, normal structure of bone marrow, pathological conditions. Author(s): Macavei I, Galatar N. Source: Morphol Embryol (Bucur). 1989 January-March; 35(1): 33-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2524655

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Bone marrow biopsy (BMB). II. Bone marrow biopsy in myeloproliferative disorders. Author(s): Macavei I, Galatar N. Source: Morphol Embryol (Bucur). 1989 April-June; 35(2): 117-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2529429

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Bone marrow biopsy (BMB). III. Bone marrow biopsy in Hodgkin's disease (HD). Author(s): Macavei I, Galatar N. Source: Morphol Embryol (Bucur). 1990 January-March; 36(1): 25-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2149408

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Bone marrow biopsy and blood culture in evaluating HIV patients. Author(s): Levin M. Source: The American Journal of Medicine. 1998 November; 105(5): 457-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9831436

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Bone marrow biopsy and bone scan to detect skeletal metastases. Author(s): Mirza I, Cuello B, Ramachandran A, Johns W. Source: Clinical Nuclear Medicine. 2001 August; 26(8): 677-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452172

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Bone marrow biopsy and clinical staging in chronic lymphocytic leukemia. Author(s): Lipshutz MD, Mir R, Rai KR, Sawitsky A. Source: Cancer. 1980 September 15; 46(6): 1422-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7417943

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Bone marrow biopsy as prognostic indicator in childhood acute lymphoblastic leukemia--another opinion. Author(s): Rizzari C, Conter V. Source: Medical and Pediatric Oncology. 1998 May; 30(5): 315-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9544233

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Bone marrow biopsy changes following chemotherapy for acute leukemia. Author(s): Wittels B. Source: The American Journal of Surgical Pathology. 1980 April; 4(2): 135-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6929657

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Bone marrow biopsy changes in acute myeloid leukaemia. I: Observations before chemotherapy. Author(s): Islam A, Catovsky D, Goldman JM, Galton DA. Source: Histopathology. 1985 September; 9(9): 939-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3864727

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Bone marrow biopsy changes in the iliac bone mimicking multiple colonic polypi. Author(s): Singer J, Cole J, Vas W. Source: Australasian Radiology. 1990 August; 34(3): 262-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2275689

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Bone marrow biopsy during induction chemotherapy for acute myeloid leukaemia identifies only 50% of patients with resistant disease. Author(s): Roberts MM, Juttner CA, To LB, Kimber RJ. Source: Leukemia Research. 1988; 12(10): 817-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3199841

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Bone marrow biopsy findings in angioimmunoblastic lymphadenopathy. Author(s): Ghani AM, Krause JR. Source: British Journal of Haematology. 1985 October; 61(2): 203-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4041367

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Bone marrow biopsy findings in childhood anemia: prevalence of transient erythroblastopenia of childhood. Author(s): Farhi DC, Luebbers EL, Rosenthal NS. Source: Archives of Pathology & Laboratory Medicine. 1998 July; 122(7): 638-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9674545

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Bone marrow biopsy for staging Hodgkin's lymphoma: the value of bilateral or unilateral trephine biopsy. Author(s): Luoni M, Fava S, Declich P. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1996 February; 14(2): 682-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8636790

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Bone marrow biopsy for the staging of non-Hodgkin's lymphoma: bilateral or unilateral trephine biopsy? Author(s): Luoni M, Declich P, De Paoli Af1p4, Fava S, Marinoni P, Montalbetti L, Sangalli G, Sciuccati P, Tocci A, Tosi A, et al. Source: Tumori. 1995 November-December; 81(6): 410-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8804465

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Bone marrow biopsy imprint preparations: use for molecular diagnostics in leukemias. Author(s): Crisan D, Farkas DH. Source: Ann Clin Lab Sci. 1993 November-December; 23(6): 407-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8291896

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Bone marrow biopsy imprints (touch preparations) for assessment of iron stores. Author(s): Pasquale D, Chikkappa G. Source: American Journal of Hematology. 1995 March; 48(3): 201-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7532354

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Bone marrow biopsy in 50 AIDS patients: a diagnostic approach. Author(s): Ricci D, Ponzoni M, Zoldan MC, Germagnoli L, Faravarelli A. Source: Pathologica. 1995 December; 87(6): 640-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8927423

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Bone marrow biopsy in adult acute lymphoblastic leukemia: morphological characteristics and contribution to the study of prognostic factors. Author(s): Thomas X, Le QH, Danaila C, Lheritier V, Ffrench M. Source: Leukemia Research. 2002 October; 26(10): 909-18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12163052

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Bone marrow biopsy in children: a study of 111 patients. Author(s): Cozzutto C, De Bernardi B, Comelli A, Guarino M. Source: Medical and Pediatric Oncology. 1979; 6(1): 57-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=440205

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Bone Marrow Biopsy

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Bone marrow biopsy in chronic lymphocytic leukaemia: a study of 208 cases. Author(s): Montserrat E, Rozman C. Source: Haematologia. 1983; 16(1-4): 73-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6679490

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Bone marrow biopsy in chronic lymphocytic leukemia. Author(s): Rozman C, Montserrat E. Source: Nouv Rev Fr Hematol. 1988; 30(5-6): 369-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3065734

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Bone marrow biopsy in chronic lymphocytic leukemia: a review of its prognostic importance. Author(s): Montserrat E, Rozman C. Source: Blood Cells. 1987; 12(2): 315-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3304470

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Bone marrow biopsy in chronic myeloid leukemia: significance of some histological parameters. Author(s): Lambertenghi-Deliliers G, Pozzoli E, Benazzi E, Maiolo AT, Foa P, Polli E. Source: Haematologica. 1986 March-April; 71(2): 113-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3087831

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Bone marrow biopsy in clinical medicine: an overview. Author(s): Frisch B, Bartl R, Burkhardt R. Source: Haematologia. 1982; 15(3): 245-85. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6764442

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Bone marrow biopsy in diagnosis of Whipple's disease. Author(s): Rausing A. Source: Acta Med Scand. 1973 January-February; 193(1-2): 5-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4122282

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Bone marrow biopsy in hemophagocytic syndrome. Author(s): Florena AM, Iannitto E, Quintini G, Franco V. Source: Virchows Archiv : an International Journal of Pathology. 2002 October; 441(4): 335-44. Epub 2002 June 19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12404058

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Bone marrow biopsy in Hodgkin's disease and other neoplastic diseases. Author(s): Han T, Stutzman L, Rogue AL. Source: Jama : the Journal of the American Medical Association. 1971 August 30; 217(9): 1239-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4935857

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Bone marrow biopsy in lymphomas. Author(s): Srinivasan U, Talvalkar GV, Advani SH. Source: Indian Journal of Cancer. 1978 June; 15(2): 49-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=750361

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Bone marrow biopsy in malignant disease. Author(s): Weiss RB. Source: Postgraduate Medicine. 1974 July; 56(1): 111-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4365994

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Bone marrow biopsy in monoclonal gammopathies: correlations between pathological findings and clinical data. The Cooperative Group for Study and Treatment of Multiple Myeloma. Author(s): Riccardi A, Ucci G, Luoni R, Castello A, Coci A, Magrini U, Ascari E. Source: Journal of Clinical Pathology. 1990 June; 43(6): 469-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2199532

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Bone marrow biopsy in multiple myeloma: a clinical pathological study. Author(s): Aghai E, Avni G, Lurie M, Quitt M, Hornstein L, Froom P. Source: Isr J Med Sci. 1988 June; 24(6): 298-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3403226

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Bone marrow biopsy in myelodysplastic syndromes: morphological characteristics and contribution to the study of prognostic factors. Author(s): Rios A, Canizo MC, Sanz MA, Vallespi T, Sanz G, Torrabadella M, Gomis F, Ruiz C, San Miguel JF. Source: British Journal of Haematology. 1990 May; 75(1): 26-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2375920

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Bone marrow biopsy in non-haematologic malignancies. Author(s): Gopal R, Advani SH, Talwalkar GV, Soman CS, Nair CN. Source: Indian Journal of Cancer. 1980 December; 17(4): 245-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7228107

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Bone marrow biopsy in non-Hodgkin's lymphoma. Author(s): Roath S, Smith AG, Choudhury D. Source: Journal of Clinical Pathology. 1991 April; 44(4): 350-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2030162

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Bone marrow biopsy in non-Hodgkin's lymphoma. Author(s): Soman CS, Abraham EK. Source: Indian Journal of Cancer. 1988 December; 25(4): 218-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3243570

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Bone marrow biopsy in patients with carcinoma of the prostate. Author(s): Chua DT, Ackermann W, Veenema RJ. Source: The Journal of Urology. 1969 November; 102(5): 602-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5347769

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Bone marrow biopsy in patients with malignant neoplasms other than lymphomas or leukemia. Author(s): Cohen Y, Gershoni-Baruch R, Lichtic C. Source: Acta Haematologica. 1979; 62(4): 181-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=119409

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Bone marrow biopsy in polycythaemia vera. Author(s): Krasznai G, Nagy G, Racz M. Source: Acta Med Acad Sci Hung. 1969; 26(4): 309-16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5380803

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Bone marrow biopsy in solid cancer. Author(s): Cohen Y, Zidan J, McShan D. Source: Acta Haematologica. 1982; 68(1): 14-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6812351

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Bone marrow biopsy in staging malignant lymphoma. Author(s): Mehta JB, Singhal SB, Mehta BC. Source: J Assoc Physicians India. 1990 October; 38(10): 818, 821. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2084104

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Bone marrow biopsy in staging of malignant lymphomas. Author(s): Singh T, Harjinder, Gaiha M. Source: J Assoc Physicians India. 1989 August; 37(8): 513-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2621187

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Bone marrow biopsy in the diagnosis of fever of unknown origin in patients with acquired immunodeficiency syndrome. Author(s): Benito N, Nunez A, de Gorgolas M, Esteban J, Calabuig T, Rivas MC, Fernandez Guerrero ML. Source: Archives of Internal Medicine. 1997 July 28; 157(14): 1577-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9236559

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Bone marrow biopsy in the evaluation of lymphoma, carcinoma and granulomatous disorders. Author(s): Ellman L. Source: The American Journal of Medicine. 1976 January; 60(1): 1-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1251839

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Bone marrow biopsy in the initial staging of Hodgkin's disease. Author(s): Doll DC, Ringenberg QS, Anderson SP, Hewett JE, Yarbro JW. Source: Medical and Pediatric Oncology. 1989; 17(1): 1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2913470

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Bone marrow biopsy in the metastatic work-up of solid tumors in children. Author(s): Penchansky L. Source: Cancer. 1984 October 1; 54(7): 1447-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6467167

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Bone marrow biopsy in the staging of malignant epithelial tumors. Author(s): Schmid C, Marocolo D, Tombesi V, Beretta G. Source: Appl Pathol. 1983 November-December; 1(6): 343-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6679794

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Bone marrow biopsy in the staging of malignant lymphoma. Author(s): Malhotra H, Dhabhar B, Advani SH. Source: J Assoc Physicians India. 1990 August; 38(8): 603. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2246218

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Bone marrow biopsy in the staging of small cell lung cancer. Author(s): Franciosi V, Bisagni G, Ceci G, Boni C, De Lisi V, Di Blasio B, Lottici R, Passalacqua R, Cocconi G. Source: Tumori. 1989 December 31; 75(6): 576-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2559525

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Bone marrow biopsy instead of 'marrow juice' for cell kinetic analysis. Comparison of bone marrow biopsy and aspiration material. Author(s): Hiddemann W, Buchner T, Andreeff M, Wormann B, Melamed MR, Clarkson BD. Source: Leukemia Research. 1982; 6(4): 601-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6183535

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Bone marrow biopsy morbidity and mortality. Author(s): Bain BJ. Source: British Journal of Haematology. 2003 June; 121(6): 949-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12786808

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Bone marrow biopsy needle. Modification to counteract reduction in size after sharpening. Author(s): Stavem P. Source: Scand J Haematol. 1968; 5(2): 153-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5673826

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Bone marrow biopsy of aplastic anemia, myelodysplastic syndromes and myeloproliferative disorders. Author(s): Kikuchi M. Source: Nippon Ketsueki Gakkai Zasshi. 1988 December; 51(8): 1339-46. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3247814

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Bone marrow biopsy of the posterior iliac crest with Gidlund's instrument in malignant diseases. Author(s): Landys K, Stenram U. Source: Scand J Haematol. 1975 September; 15(2): 104-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1188314

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Bone marrow biopsy related haemorrhage and low molecular weight heparin. Author(s): Morley NJ, Makris M. Source: British Journal of Haematology. 2003 November; 123(3): 562. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14617026

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Bone marrow biopsy specimens in assessment of remission in acute leukaemias. Author(s): Singh T, Dubey AP, Shanware A, Choudhury P, Galha M. Source: Journal of Clinical Pathology. 1993 October; 46(10): 972. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8227421

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Bone marrow biopsy technic. Artifact induced by aspiration. Author(s): Douglas DD, Risdall RJ. Source: American Journal of Clinical Pathology. 1984 July; 82(1): 92-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6741879

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Bone marrow biopsy with unaltered architecture: a new biopsy device. Author(s): Jamshidi K, Swaim WR. Source: The Journal of Laboratory and Clinical Medicine. 1971 February; 77(2): 335-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5540776

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Bone marrow biopsy. Author(s): Rozman C. Source: Haematologia. 1983; 16(1-4): 63-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6679489

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Bone marrow biopsy. Author(s): Omura GA. Source: The American Journal of Surgical Pathology. 1981 July; 5(5): 517. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6945057

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Bone marrow biopsy. Author(s): Matthias JQ. Source: Nurs Times. 1971 August 5; 67(31): 947-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5557710

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Bone marrow biopsy: a haematologist's view. Author(s): Reid MM. Source: Acta Paediatrica (Oslo, Norway : 1992). 1993 June-July; 82(6-7): 599-601. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8338999

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Bone marrow biopsy: interpretive guidelines for the surgical pathologist. Author(s): Cotelingam JD. Source: Advances in Anatomic Pathology. 2003 January; 10(1): 8-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12502965

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Cartilage in bone marrow biopsy and purple granular deposits in the biopsy touch. Author(s): Anand M, Kumar R, Panikar N, Karak A. Source: Journal of Clinical Pathology. 2003 November; 56(11): 883. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14600144

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Case report: diagnosis of thyroid cancer by bone marrow biopsy in a patient with lymphoma and goiter. Author(s): Vassilopoulou-Sellin R, McLaughlin P, Hickey RC. Source: The American Journal of the Medical Sciences. 1992 December; 304(6): 360-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1456275

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CD34 immunostaining of bone marrow biopsy specimens is a reliable way to classify the phases of chronic myeloid leukemia. Author(s): Orazi A, Neiman RS, Cualing H, Heerema NA, John K. Source: American Journal of Clinical Pathology. 1994 April; 101(4): 426-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7512785

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Central review of bone marrow biopsy specimens from patients with neuroblastoma. Author(s): Reid MM, Roald B. Source: Journal of Clinical Pathology. 1996 August; 49(8): 691-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8881929

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Cholesterol embolism: diagnosis antemortem by bone marrow biopsy. Author(s): Pierce JR Jr, Wren MV, Cousar JB Jr. Source: Annals of Internal Medicine. 1978 December; 89(6): 937-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=717992

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Clinical experience with a new specimen capturing bone marrow biopsy needle. Author(s): Goldenberg AS, Tiesinga JJ. Source: American Journal of Hematology. 2001 November; 68(3): 189-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11754401

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Clinical relevance of bone marrow biopsy in staging and follow-up of breast cancer. Author(s): Cruciani G, Fiorentini GM, Rosti G, Tienghi A, Bardella D, Magni E, Marangolo M. Source: Tumori. 1983 April 30; 69(2): 143-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6679433

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Clinical significance of bone marrow biopsy and plasma cell morphology in MM and MGUS. Author(s): Bartl R, Frisch B. Source: Pathologie-Biologie. 1999 February; 47(2): 158-68. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10192882

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Closed bone marrow biopsy as a diagnostic aid. Author(s): Thomas CE, Johnston CL. Source: Va Med Mon (1918). 1975 August; 102(8): 646-7, 654-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1163103

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Comparative yield of blood culture for fungi and mycobacteria, liver biopsy, and bone marrow biopsy in the diagnosis of fever of undetermined origin in human immunodeficiency virus-infected patients. Author(s): Prego V, Glatt AE, Roy V, Thelmo W, Dincsoy H, Raufman JP. Source: Archives of Internal Medicine. 1990 February; 150(2): 333-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2302009

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Comparison of the diagnostic value of bone marrow biopsy and bone marrow aspiration in neoplastic disease. Author(s): Bearden JD, Ratkin GA, Coltman CA. Source: Journal of Clinical Pathology. 1974 September; 27(9): 738-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4426982

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Complications of bone marrow biopsy. Author(s): Marti J, Anton E, Valenti C. Source: British Journal of Haematology. 2004 February; 124(4): 557-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14984509

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Complications of bone marrow biopsy. Author(s): Salem P, Wolverson MK, Reimers HJ, Kudva GC. Source: British Journal of Haematology. 2003 June; 121(6): 821. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12786790

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Contribution of bone marrow biopsy in the diagnosis and prognosis of polycythemia vera. Author(s): de Mascarel A. Source: Nouv Rev Fr Hematol. 1994 April; 36(2): 165-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8036134

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Contribution of IgH-PCR to the evaluation of B-cell lymphoma involvement in paraffin-embedded bone marrow biopsy specimens. Author(s): Braunschweig R, Baur AS, Delacretaz F, Bricod C, Benhattar J. Source: American Journal of Clinical Pathology. 2003 May; 119(5): 634-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12760281

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Cyclin D1 and E2F-1 immunoreactivity in bone marrow biopsy specimens of multiple myeloma: relationship to proliferative activity, cytogenetic abnormalities and DNA ploidy. Author(s): Wilson CS, Butch AW, Lai R, Medeiros LJ, Sawyer JR, Barlogie B, McCourty A, Kelly K, Brynes RK. Source: British Journal of Haematology. 2001 March; 112(3): 776-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11260083

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Cyclin D1 overexpression in multiple myeloma. A morphologic, immunohistochemical, and in situ hybridization study of 71 paraffin-embedded bone marrow biopsy specimens. Author(s): Athanasiou E, Kaloutsi V, Kotoula V, Hytiroglou P, Kostopoulos I, Zervas C, Kalogiannidis P, Fassas A, Christakis JI, Papadimitriou CS. Source: American Journal of Clinical Pathology. 2001 October; 116(4): 535-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11601138

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Detecting neuroblastoma using bone marrow aspiration and bone marrow biopsy. Author(s): Cheung NK. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2000 January-February; 22(1): 86-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10695829

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Detection of cytomegalovirus-infected cells in bone marrow biopsy specimens obtained before allogeneic bone marrow transplantation from donors and recipients. Author(s): Fest T, Angonin R, Mougin C, Deschaseaux M, Lab M, Cahn JY, Herve P. Source: Transplantation. 1994 June 15; 57(11): 1681-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8009607

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Detection of Kaposi sarcoma-associated herpesvirus in bone marrow biopsy samples from patients with multiple myeloma. Author(s): Hsu HC, Lee YM, Yang CF, Hsiao KJ, Liu TT, Ho CK, Ho CH, Wang SY, Liu WT. Source: Cancer. 2001 April 15; 91(8): 1409-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11301386

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Detection of metastatic neuroblastoma in bone marrow biopsy specimens with an antibody to neuron-specific enolase. Author(s): Crary GS, Singleton TP, Neglia JP, Swanson PE, Strickler JG. Source: Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc. 1992 May; 5(3): 308-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1495935

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Detection of mycobacteria in bone marrow biopsy specimens taken to investigate pyrexia of unknown origin. Author(s): Riley UB, Crawford S, Barrett SP, Abdalla SH. Source: Journal of Clinical Pathology. 1995 August; 48(8): 706-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7560193

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Detection of skeletal involvement in Hodgkin's disease: a comparison of radiography, bone scanning and bone marrow biopsy in 38 patients. Author(s): Ferrant A, Rodhain J, Michaux JL, Piret L, Maldague B, Sokal G. Source: Cancer. 1975 May; 35(5): 1346-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1122485

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Diagnosis of intestinal carcinoid tumor by bone marrow biopsy. Author(s): Ariza A, Bitterman P, Nash I. Source: Conn Med. 1986 May; 50(5): 307-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3709181

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Diagnosis of metastatic carcinoma by bone marrow biopsy versus bone marrow aspiration. Author(s): Roeckel IE. Source: Ann Clin Lab Sci. 1974 May-June; 4(3): 193-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4825620

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Diagnostic and prognostic value of bone marrow biopsy in aplastic anemia. A study of 119 cases. Author(s): Najean Y, Arrago JP, Delsol G, Diebold J, Horchowski N. Source: Nouv Rev Fr Hematol. 1986; 28(5): 281-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3808938

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Diagnostic significance of bone marrow biopsy in chronic renal disease. Author(s): Fong TP, Smith EC, Thomas W Jr, Westerman MP. Source: Nephron. 1974; 12(2): 81-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4837747

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Diagnostic value of bone marrow biopsy in patients with AA-type renal amyloidosis secondary to ankylosing spondylitis. Author(s): Sungur C, Sungur A, Akpolat T, Arik N. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1996 December; 11(12): 2520-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9017640

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Diagnostic value of bone marrow biopsy in patients with renal disease secondary to familial Mediterranean fever. Author(s): Sungur C, Sungur A, Ruacan S, Arik N, Yasavul U, Turgan C, Caglar S. Source: Kidney International. 1993 October; 44(4): 834-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7505040

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Early reconstitution of haematopoiesis after allogeneic bone marrow transplantation: a prospective histopathological study of bone marrow biopsy specimens. Author(s): van den Berg H, Kluin PM, Vossen JM. Source: Journal of Clinical Pathology. 1990 May; 43(5): 365-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2370305

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Evolution of myelofibrosis in chronic idiopathic myelofibrosis as evidenced in sequential bone marrow biopsy specimens. Author(s): Buhr T, Busche G, Choritz H, Langer F, Kreipe H. Source: American Journal of Clinical Pathology. 2003 January; 119(1): 152-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12520711

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Examination of bone marrow biopsy specimens and staging of small cell lung cancer. Author(s): ten Velde GP, Kuypers-Engelen BT, Volovics A, Bosman FT. Source: European Journal of Cancer (Oxford, England : 1990). 1990; 26(11-12): 1142-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1963546

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Exostosis after iliac bone marrow biopsy. Author(s): Murphy WA. Source: Ajr. American Journal of Roentgenology. 1977 December; 129(6): 1114-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=413373

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Extrarenal uptake of 99mTc-DTPA at the site of bone marrow biopsy. Author(s): Roman MR, Angelides S. Source: Ann Nucl Med. 2002 April; 16(2): 143-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12043909

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Frequent demonstration of human herpesvirus 8 (HHV-8) in bone marrow biopsy samples from Turkish patients with multiple myeloma (MM). Author(s): Beksac M, Ma M, Akyerli C, DerDanielian M, Zhang L, Liu J, Arat M, Konuk N, Koc H, Ozcelik T, Vescio R, Berenson JR. Source: Leukemia : Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 2001 August; 15(8): 1268-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11480570

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Giant cell arteritis detected by bone marrow biopsy. Author(s): Enos WF, Pierre RV, Rosenblatt JE. Source: Mayo Clinic Proceedings. 1981 June; 56(6): 381-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7230901

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Gluteal compartment syndrome and sciatica after bone marrow biopsy: a case report and review of the literature. Author(s): Roth JS, Newman EC. Source: The American Surgeon. 2002 September; 68(9): 791-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12356152

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Histology and immunohistology of bone marrow biopsy in multiple myeloma. Author(s): Pileri S, Poggi S, Baglioni P, Montanari M, Sabattini E, Galieni P, Tazzari PL, Gobbi M, Cavo M, Falini B, et al. Source: European Journal of Haematology. Supplementum. 1989; 51: 52-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2627992

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Histometrical study on the aspiration bone marrow biopsy. Author(s): Takanashi R. Source: Nippon Ketsueki Gakkai Zasshi. 1983 February; 46(1): 54-64. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6858570

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Histopathology of bone marrow biopsy in aplastic anemia. Its relation to the prognosis of the patients. Author(s): Shimamine T, Mori S, Itoyama S, Fujii K, Kamiyama R, Matsuya S. Source: Nippon Ketsueki Gakkai Zasshi. 1981 December; 44(7): 1306-12. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7342638

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Histopathology of myelodysplastic syndromes. The FAB classification (proposals) applied to bone marrow biopsy. Author(s): Delacretaz F, Schmidt PM, Piguet D, Bachmann F, Costa J. Source: American Journal of Clinical Pathology. 1987 February; 87(2): 180-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3812349

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How does iliac crest bone marrow biopsy compare with imaging in the detection of bone metastases in small cell lung cancer? Author(s): Perrin-Resche I, Bizais Y, Buhe T, Fiche M. Source: European Journal of Nuclear Medicine. 1993 May; 20(5): 420-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8390936

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Hypoplastic myelodysplastic syndromes can be distinguished from acquired aplastic anemia by CD34 and PCNA immunostaining of bone marrow biopsy specimens. Author(s): Orazi A, Albitar M, Heerema NA, Haskins S, Neiman RS. Source: American Journal of Clinical Pathology. 1997 March; 107(3): 268-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9052376

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Identification of cytomegalovirus in bone marrow biopsy. Author(s): Penchansky L, Krause JR. Source: Southern Medical Journal. 1979 April; 72(4): 500-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=219548

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Identification of early relapsing patients with adult acute nonlymphocytic leukemia by bone marrow biopsy after initial induction chemotherapy. Author(s): Cassileth PA, Gerson SL, Bonner H, Neiman RS, Lusk EJ, Hurwitz S. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1984 February; 2(2): 107-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6699661

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Immunohistochemical localization of membrane and alpha-granule proteins in human megakaryocytes: application to plastic-embedded bone marrow biopsy specimens. Author(s): Beckstead JH, Stenberg PE, McEver RP, Shuman MA, Bainton DF. Source: Blood. 1986 February; 67(2): 285-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2935204

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Immunohistochemical reference ranges for B lymphocytes in bone marrow biopsy paraffin sections. Author(s): O'Donnell LR, Alder SL, Balis UJ, Perkins SL, Kjeldsberg CR. Source: American Journal of Clinical Pathology. 1995 November; 104(5): 517-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7572811

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Immunohistochemical study of Ulex europaeus agglutinin 1 (UEA-1) binding of megakaryocytes in bone marrow biopsy specimens: demonstration of heterogeneity in staining pattern reflecting the stages of differentiation. Author(s): Liu SM, Li CY. Source: Hematopathol Mol Hematol. 1996; 10(1-2): 99-109. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8792151

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Immunohistochemistry can be used to subtype acute myeloid leukemia in routinely processed bone marrow biopsy specimens. Comparison with flow cytometry. Author(s): Manaloor EJ, Neiman RS, Heilman DK, Albitar M, Casey T, Vattuone T, Kotylo P, Orazi A. Source: American Journal of Clinical Pathology. 2000 June; 113(6): 814-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10874882

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Importance of bone marrow biopsy in the clinical staging of Hodgkin's disease. Author(s): Webb DI, Ubogy G, Silver RT. Source: Cancer. 1970 August; 26(2): 313-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5451214

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Importance of the day 7 bone marrow biopsy as a prognostic measure of the outcome in children with acute lymphoblastic leukemia. Author(s): Schultz KR, Massing B, Spinelli JJ, Gaynon PS, Wadsworth L. Source: Medical and Pediatric Oncology. 1997 July; 29(1): 16-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9142200

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Improved bone marrow biopsy technique. Author(s): Burgio VL. Source: European Journal of Haematology. 1991 October; 47(4): 315-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1954993

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Increase of bone marrow lymphocytes in systemic mastocytosis: reactive lymphocytosis or malignant lymphoma? Immunohistochemical and molecular findings on routinely processed bone marrow biopsy specimens. Author(s): Horny HP, Lange K, Sotlar K, Valent P. Source: Journal of Clinical Pathology. 2003 August; 56(8): 575-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890804

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Increased uptake at sites of bone marrow biopsy mimicking bony metastases on Tc99m MDP bone scintigraphy. Author(s): Lim ST, Sohn MH, Kwak JY, Yim CY. Source: Clinical Nuclear Medicine. 2001 April; 26(4): 365-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11290911

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Intravascular large B-cell lymphoma. A report of five cases initially diagnosed by bone marrow biopsy. Author(s): Estalilla OC, Koo CH, Brynes RK, Medeiros LJ. Source: American Journal of Clinical Pathology. 1999 August; 112(2): 248-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10439806

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Is bone marrow biopsy a prognostic parameter in B-CLL? Author(s): Raphael M, Chastang C, Binet JL. Source: Nouv Rev Fr Hematol. 1988; 30(5-6): 377-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3222148

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Kaposi's sarcoma-associated herpesvirus (KSHV) in bone marrow biopsy from patients with multiple myeloma: PCR amplification of orf26 but not orf72 and orf75 sequences. Author(s): Brousset P, Meggetto F, Laharrague P, Attal M, Delsol. Source: British Journal of Haematology. 2000 January; 108(1): 197-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10712004

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Keratin immunohistochemistry detects clinically significant metastases in bone marrow biopsy specimens in women with lobular breast carcinoma. Author(s): Lyda MH, Tetef M, Carter NH, Ikle D, Weiss LM, Arber DA. Source: The American Journal of Surgical Pathology. 2000 December; 24(12): 1593-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11117779

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Laparoscopy and laparotomy combined with bone marrow biopsy in staging Hodgkin's disease. Author(s): Spinelli P, Beretta G, Bajetta E, Tancini G, Castellani R, Rilke F, Bonadonna G. Source: British Medical Journal. 1975 December 6; 4(5996): 554-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=128399

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Letter: A plea for bone marrow biopsy. Author(s): Staples WG. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1975 November 29; 49(51): 2114. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1209427

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Letter: Bone marrow biopsy and aspiration. Author(s): Rywlin AM. Source: American Journal of Clinical Pathology. 1976 September; 66(3): 617-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=786003

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Leukocyte glucocerebrosidase deficiency diagnostic in adult Gaucher's disease with negative bone marrow biopsy. Some properties of the enzyme in leukocytes and spleen. Author(s): Klibansky C, Hoffmann J, Pinkhas J, Algom D, Dintzman M, Ben-tbassat M, De Vries A. Source: European Journal of Clinical Investigation. 1974 April; 4(2): 85-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4832719

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Leukocyte glucocerebrosidase deficiency diagnostic in adult Gaucher's disease with negative bone marrow biopsy. Some properties of the enzyme in leukocytes and spleen. Author(s): Klibansky C, Hoffmann J, Pinkhas J, Algom D, Dintzman M, Ben-Bassat M, De Vries A. Source: European Journal of Clinical Investigation. 1974 April; 4(2): 101-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4832717

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Localization of Kaposi's sarcoma-associated herpesvirus in bone marrow biopsy samples from patients with multiple myeloma. Author(s): Said JW, Rettig MR, Heppner K, Vescio RA, Schiller G, Ma HJ, Belson D, Savage A, Shintaku IP, Koeffler HP, Asou H, Pinkus G, Pinkus J, Schrage M, Green E, Berenson JR. Source: Blood. 1997 December 1; 90(11): 4278-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9373238

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Magnetic resonance imaging of bone marrow in lymphoproliferative disorders: correlation with bone marrow biopsy. Author(s): Dohner H, Guckel F, Knauf W, Semmler W, van Kaick G, Ho AD, Hunstein W. Source: British Journal of Haematology. 1989 September; 73(1): 12-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2679859

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Magnetic resonance imaging of bone marrow versus bone marrow biopsy in malignant lymphoma. Author(s): Ozguroglu M, Esen Ersavasti G, Demir G, Aki H, Demirelli F, Kanberoglu K, Mandel N, Buyukunal E, Serdengecti S, Berkarda B. Source: Pathology Oncology Research : Por. 1999; 5(2): 123-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10393364

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Metastatic intestinal Kultschitzky-cell carcinoma (carcinoid). Diagnosis of by sternal bone marrow biopsy. Author(s): Schleicher EM, Kane DJ, Heupel HW. Source: Minn Med. 1972 May; 55(5): 425-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5030465

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Modification of a bone marrow biopsy needle. Author(s): Mintz U, Modan B. Source: American Journal of Clinical Pathology. 1973 March; 59(3): 456-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4687360

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Monoclonal antibody detection of carcinoma cells in bone marrow biopsy specimens from breast cancer patients. Author(s): Porro G, Menard S, Tagliabue E, Orefice S, Salvadori B, Squicciarini P, Andreola S, Rilke F, Colnaghi MI. Source: Cancer. 1988 June 15; 61(12): 2407-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3284635

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Motor neuron disease, lymphoproliferative disease, and bone marrow biopsy. Author(s): Louis ED, Hanley AE, Brannagan TH, Sherman W, Murphy P, Lange DJ, Trojaborg W, Younger DS, Lovelace RE, Latov N, Rowland LP. Source: Muscle & Nerve. 1996 October; 19(10): 1334-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8808660

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Multiparameter studies on 650 bone marrow biopsy cores. Diagnostic value of combined utilisation of imprints, cryostat and plastic sections in medical practice. Author(s): Bartl R, Frisch B, Buchenrieder B, Sommerfeld W, Muthmann H, Jager K, Hoffmann-Fezer G, Burkhardt R. Source: Bibl Haematol. 1984; (50): 1-16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6380490

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Multiple lymphoid nodules in bone marrow biopsy in immunocompetent patient with cytomegalovirus infection: an immunohistochemical analysis. Author(s): Magalhaes SM, Duarte FB, Vassallo J, Costa SC, Lorand-Metze I. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2001 July-August; 34(4): 365-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11562730

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Multiple myeloma with bone marrow biopsy features simulating concomitant chronic idiopathic myelofibrosis. Author(s): Schmidt U, Ruwe M, Leder LD. Source: Nouv Rev Fr Hematol. 1995; 37(2): 159-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7644355

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Non-Hodgkin lymphoma: influence of lymphography, CT, and bone marrow biopsy on staging and management. Author(s): Pond GD, Castellino RA, Horning S, Hoppe RT. Source: Radiology. 1989 January; 170(1 Pt 1): 159-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2909090

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PCR analysis of IgH-gene rearrangements in small lymphoid infiltrates microdissected from sections of paraffin-embedded bone marrow biopsy specimens. Author(s): Kremer M, Cabras AD, Fend F, Schulz S, Schwarz K, Hoefler H, Werner M. Source: Human Pathology. 2000 July; 31(7): 847-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10923923

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Potential of bone marrow biopsy in chronic myeloproliferative disorders (MPD). Author(s): Bartl R, Frisch B, Wilmanns W. Source: European Journal of Haematology. 1993 January; 50(1): 41-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8436214

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Practical importance of routine paraffin-embedded bone marrow biopsy in multiple myeloma. Author(s): Carbone A, Manconi R, Sulfaro S, Vaccher E, Zagonel V, Poletti A, Volpe R, Tirelli U, Monfardini S. Source: Tumori. 1987 June 30; 73(3): 315-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3603727

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Premedication with lorazepam before bone marrow biopsy. Author(s): Milligan DW, Howard MR, Judd A. Source: Journal of Clinical Pathology. 1987 June; 40(6): 696-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3611398

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Presence of miliary tubercles associated with myelofibrosis in bone marrow biopsy. A case report. Author(s): Shih LY, Wu CS, Chen L. Source: Taiwan Yi Xue Hui Za Zhi. 1981 March; 80(3): 369-74. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6942122

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Prognostic relevance of histological findings on bone marrow biopsy in myelodysplastic syndromes. Author(s): Lambertenghi-Deliliers G, Annaloro C, Oriani A, Soligo D, Pozzoli E, Polli EE. Source: Annals of Hematology. 1993 February; 66(2): 85-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8448244

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Prognostic significance of bone marrow biopsy in essential thrombocythemia. Author(s): Annaloro C, Lambertenghi Deliliers G, Oriani A, Pozzoli E, Lambertenghi Deliliers D, Radaelli F, Faccini P. Source: Haematologica. 1999 January; 84(1): 17-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10091388

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Prognostic value of bone marrow biopsy in breast cancer. Author(s): Landys K. Source: Cancer. 1982 February 1; 49(3): 513-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7059910

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Prognostic value of bone marrow biopsy in chronic lymphoid leukemia. A study of 98 initial bone marrow biopsies. Author(s): Desablens B, Claisse JF, Piprot-Choffat C, Gontier MF. Source: Nouv Rev Fr Hematol. 1989; 31(3): 179-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2616264

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Prognostic value of bone marrow biopsy in operable breast cancer patients at the time of initial diagnosis: Results of a 20-year median follow-up. Author(s): Landys K, Persson S, Kovarik J, Hultborn R, Holmberg E. Source: Breast Cancer Research and Treatment. 1998 May; 49(1): 27-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9694608

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Proposal for a classification of acute myeloid leukaemia based on plastic-embedded bone marrow biopsy sections. Author(s): Islam A. Source: Leukemia Research. 1993 May; 17(5): 421-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8501969

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Q fever after a journey in Syria: a diagnosis suggested by bone marrow biopsy. Author(s): Bottieau E, De Raeve H, Colebunders R, Van den Ende J, Vervoort T, Van Marck E. Source: Acta Clin Belg. 2000 January-February; 55(1): 30-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10783505

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QBEND10 for the diagnosis of myelodysplastic syndromes in routinely processed bone marrow biopsy specimens. Author(s): Horny HP, Wehrmann M, Schlicker HU, Eichstaedt A, Clemens MR, Kaiserling E. Source: Journal of Clinical Pathology. 1995 April; 48(4): 291-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7542289

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Random bone marrow biopsy in the staging of carcinoma of the prostate. Author(s): Crisp J. Source: British Journal of Urology. 1976 August; 48(4): 265-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=963403

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Recognition of drug resistance during remission induction therapy for acute nonlymphocytic leukemia: utility of day 6 bone marrow biopsy. Author(s): Preisler H, Barcos M, Reese P, Priore RL, Pothier L. Source: Leukemia Research. 1983; 7(1): 67-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6572773

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Scanning electron microscopic study of the human bone marrow biopsy specimens from various hematological diseases. Author(s): Kuto F, Hirasawa Y, Tokuhiro H. Source: Nippon Ketsueki Gakkai Zasshi. 1980 August; 43(4): 667-77. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7223332

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Seeding of malignant lymphoma along the tract after bone marrow biopsy. Author(s): Ginaldi S, Williams CD. Source: Southern Medical Journal. 1985 August; 78(8): 1007-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3839599

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Sequential bone marrow biopsy in chronic lymphocytic leukaemia. Author(s): Rodriguez Fernandez JM, Montserrat E, Rozman C, Rios A, Vallespi MT, Gonzalez Aza C, Alcala A, Gutierrez M, Morey M, Brugues R. Source: Bibl Haematol. 1984; (50): 81-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6466285

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Sequential laparoscopy and laparotomy combined with bone marrow biopsy in staging Hodgkin's disease. Author(s): Beretta G, Spinelli P, Rilke F, Tancini G, Canetta R, Gennari L, Bonadonna G. Source: Cancer Treat Rep. 1976 September; 60(9): 1231-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=138479

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Serum ferritin and bone marrow biopsy iron stores. II. Correlation with low serum iron and Fe/TIBC ratio less than 15%. Author(s): Krause JR, Stolc V. Source: American Journal of Clinical Pathology. 1980 October; 74(4): 461-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7424828

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Severe bleeding complicating percutaneous bone marrow biopsy. Author(s): Ben-Chetrit E, Flusser D, Assaf Y. Source: Archives of Internal Medicine. 1984 November; 144(11): 2284. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6093728

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Significance of bone marrow biopsy in the multiple myeloma. Author(s): Bartl R, Burkhardt R, Gierster P, Sandel P, Fateh-Moghadam A. Source: Bibl Haematol. 1978; 45: 81-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=747638

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Simplified bone marrow biopsy needle for staging of carcinoma of prostate. Author(s): Megalli MR, Veenema RJ, Gursel E. Source: Urology. 1973 February; 1(2): 154-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4771619

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Successful treatment by selective arterial embolization of severe retroperitoneal hemorrhage secondary to bone marrow biopsy in post-polycythemic myelofibrosis. Author(s): Arellano-Rodrigo E, Real MI, Muntanola A, Burrel M, Rozman M, Fraire GV, Cervantes F. Source: Annals of Hematology. 2004 January; 83(1): 67-70. Epub 2003 October 22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574461

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The bone marrow biopsy, osteoscan, and peripheral blood in non-hematopoietic cancer. Author(s): Brochamer WL Jr, Keeling MM. Source: Cancer. 1977 August; 40(2): 836-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=890663

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The bone marrow biopsy. A diagnostic strategy. Author(s): Beckstead JH. Source: Archives of Pathology & Laboratory Medicine. 1986 March; 110(3): 175-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3484942

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The bone marrow biopsy: a diagnostic strategy. Author(s): Head DR, Hughes K, Marty J. Source: Archives of Pathology & Laboratory Medicine. 1986 December; 110(12): 1120-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3778136

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The diagnosis of idiopathic thrombocytopenic purpura in adults: does bone marrow biopsy have a place? Author(s): Westerman DA, Grigg AP. Source: The Medical Journal of Australia. 1999 March 1; 170(5): 216-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10092918

Studies

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The importance of bone marrow biopsy in myelodysplastic disorders. Author(s): Tricot G, De Wolf-Peeters C, Vlietinck R, Verwilghen RL. Source: Bibl Haematol. 1984; (50): 31-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6466284

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The importance of bone marrow biopsy in the staging of patients with lymphosarcoma. Author(s): Vinciguerra V, Silver RT. Source: Blood. 1973 June; 41(6): 913-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4740261

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The Mi15 monoclonal antibody (anti-syndecan-1) is a reliable marker for quantifying plasma cells in paraffin-embedded bone marrow biopsy specimens. Author(s): Costes V, Magen V, Legouffe E, Durand L, Baldet P, Rossi JF, Klein B, Brochier J. Source: Human Pathology. 1999 December; 30(12): 1405-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10667416

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The relative merits of bone marrow biopsy and particle section technics. Author(s): Neiman RS. Source: American Journal of Clinical Pathology. 1977 March; 67(3): 308-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=842506

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The serial study of c-myc expression in bone marrow biopsy specimens during treatment for acute myelogenous leukaemia. Author(s): Banavali SD, Pancoast JR, Tricot G, Larson R, Goldberg J, Raza A, Bismayer JA, Preisler HD. Source: European Journal of Cancer (Oxford, England : 1990). 1993; 29A(8): 1162-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8518028

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The significance of the bone marrow biopsy pattern in chronic lymphocytic leukemia: a prognostic dilemma. Author(s): Zengin N, Kars A, Sungur A, Zengin NI, Hayran M, Tekuzman G, Kansu E, Ruacan S, Firat D. Source: American Journal of Hematology. 1999 December; 62(4): 208-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10589075

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The usefulness of immunohistochemistry in the diagnosis of follicular lymphoma in bone marrow biopsy specimens. Author(s): West RB, Warnke RA, Natkunam Y. Source: American Journal of Clinical Pathology. 2002 April; 117(4): 636-43. Erratum In: Am J Clin Pathol 2002 July; 118(1): 145. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11939740

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The value of bone marrow biopsy for the diagnosis of amyloidosis secondary to tuberculosis. Author(s): Akpolat I, Akpolat T, Yildiz L, Erkan L, Kandemir B. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 1998 March; 2(3): 262. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9599077

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The value of bone marrow biopsy in breast cancer at the time of first relapse. A prospective study. Author(s): Ceci G, Franciosi V, Passalacqua R, Di Blasio B, Boni C, Lottici R, De Lisi V, Nizzoli R, Guazzi A, Cocconi G. Source: Cancer. 1988 March 1; 61(5): 1041-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3338048

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The value of bone marrow biopsy in breast cancer at time of diagnosis. A prospective study. Author(s): Ceci G, Franciosi V, Nizzoli R, De Lisi V, Lottici R, Boni C, Di Blasio B, Passalacqua R, Guazzi A, Cocconi G. Source: Cancer. 1988 January 1; 61(1): 96-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3334955

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The value of bone marrow biopsy in chronic myeloid leukaemia. Author(s): Seewann HL, Lehnert M, Juttner F. Source: Haematologia. 1983; 16(1-4): 67-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6592124

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The value of bone marrow biopsy in the prognosis of hairy cell leukemia (HCL). Author(s): Podzimek K, Kerekes Z, Chrobak L, Skalska H, Voglova J, Mirova S, Dulicek P, Zak P. Source: Neoplasma. 1994; 41(6): 325-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7870215

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The value of sequential bone marrow biopsy and laparotomy and splenectomy in a series of 127 consecutive untreated patients with non-Hodgkin's lymphoma. Author(s): Rosenberg SA, Dorfman RF, Kaplan HS. Source: British Journal of Cancer. 1975 March; 31 Suppl 2: 221-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1237307

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The value of sequential bone marrow biopsy and laparotomy and splenectomy in a series of 200 consecutive untreated patients with non-Hodgkin's lymphoma. Author(s): Ribas-Mundo M, Rosenberg SA. Source: European Journal of Cancer (Oxford, England : 1990). 1979 July; 15(7): 941-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=488154

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The value of the bone scan and bone marrow biopsy staging small cell lung cancer. Author(s): Levitan N, Byrne RE, Bromer RH, Faling LJ, Caslowitz P, Pattern DH, Hong WK. Source: Cancer. 1985 August 1; 56(3): 652-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2988751

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The yield of bone marrow biopsy and culture compared with blood culture in the evaluation of HIV-infected patients for mycobacterial and fungal infections. Author(s): Kilby JM, Marques MB, Jaye DL, Tabereaux PB, Reddy VB, Waites KB. Source: The American Journal of Medicine. 1998 February; 104(2): 123-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9528729

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Therapeutic embolization of a pseudoaneurysm of the superior gluteal artery occurring as a complication of bone marrow biopsy: case report. Author(s): Mahallati H, Owen RJ, Brunet WG, So CB. Source: Canadian Association of Radiologists Journal = Journal L'association Canadienne Des Radiologistes. 1999 August; 50(4): 265-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10459315

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Trephine needle bone marrow biopsy in the initial staging of Hodgkin disease: sensitivity and specificity of the Ann Arbor staging procedure criteria. Author(s): Ellis ME, Diehl LF, Granger E, Elson E. Source: American Journal of Hematology. 1989 March; 30(3): 115-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2644822

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Use of monoclonal anti-actin as a megakaryocyte marker in paraffin wax embedded bone marrow biopsy specimens. Author(s): Boque C, Pujol-Moix N, Linde MA, Murcia C, Guanyabens C, Soler J. Source: Journal of Clinical Pathology. 1989 September; 42(9): 982-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2677054

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Utility of bone marrow biopsy for rapid diagnosis of febrile illnesses in patients with human immunodeficiency virus infection. Author(s): Luther JM, Lakey DL, Larson RS, Kallianpur AR, D'Agata E, Cousar JB, Haas DW. Source: Southern Medical Journal. 2000 July; 93(7): 692-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10923958

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Value of bilateral bone marrow biopsy specimens in non-Hodgkin's lymphoma. Author(s): Juneja SK, Wolf MM, Cooper IA. Source: Journal of Clinical Pathology. 1990 August; 43(8): 630-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2401730

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Value of bone marrow biopsy in the diagnosis of amyloidosis. Author(s): Krause JR. Source: Southern Medical Journal. 1977 September; 70(9): 1072-4, 1079. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=897729

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Value of the bone marrow biopsy in the diagnosis of metastatic carcinoma. Author(s): Contreras E, Ellis LD, Lee RE. Source: Cancer. 1972 March; 29(3): 778-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5060654

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When should we perform bone marrow biopsy in patients with miliary tuberculosis? Author(s): Leibinger F, Guerin JM. Source: Chest. 1995 July; 108(1): 292-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7606982

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CHAPTER 2. ALTERNATIVE MARROW BIOPSY

MEDICINE

AND

BONE

Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to bone marrow biopsy. 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 bone marrow biopsy 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 “bone marrow biopsy” (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 bone marrow biopsy: •

Acute lymphoblastic leukaemia: correlation between morphological/immunohistochemical and molecular biological findings in bone marrow biopsy specimens. Author(s): Krober SM, Greschniok A, Kaiserling E, Horny HP. Source: Molecular Pathology : Mp. 2000 April; 53(2): 83-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10889907

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Immunophenotyping of acute lymphoblastic leukaemia in routinely processed bone marrow biopsy specimens. Author(s): Toth B, Wehrmann M, Kaiserling E, Horny HP. Source: Journal of Clinical Pathology. 1999 September; 52(9): 688-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10655992

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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/

The following is a specific Web list relating to bone marrow biopsy; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Leukemia Source: Integrative Medicine Communications; www.drkoop.com Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 39

Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com

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.

41

CHAPTER 3. PATENTS ON BONE MARROW BIOPSY 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.4 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 “bone marrow biopsy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on bone marrow biopsy, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Bone Marrow Biopsy By performing a patent search focusing on bone marrow biopsy, 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. 4Adapted

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

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The following is an example of the type of information that you can expect to obtain from a patent search on bone marrow biopsy: •

Biopsy and aspiration needle unit Inventor(s): Lee; Peter F. (6425 Vernon Ave., Edina, MN 55436) Assignee(s): none reported Patent Number: 4,314,565 Date filed: October 26, 1979 Abstract: A bone marrow biopsy and aspiration needle unit is disclosed. The unit includes a holding device, with a longitudinal bore therethrough, comprising a collect chuck and handle grips, a replaceable cannula to be interlockably mounted in the holding means, with the cannula's lumen in alignment with the longitudinal bore, and an elongated stylet releaseably mounted in the aligned bores. When the needle unit is also to be used for aspiration, a second cannula of a diameter less than the first cannula is inserted through the aligned bores in the holding device and the first cannula. Excerpt(s): This invention relates to the field of surgical tools and instruments. More particularly, it relates to the field of devices used to collect bone marrow tissue and fluid specimens for biopsy purposes. The advantages of examination of a bone marrow specimen undiluted with blood are well-known. Such an examination is essential for the evaluation of many hematologic disorders. A variety of devices have been used for collecting bone marrow specimens. Early bone marrow biopsies were taken from the sternum in operation-room procedures with scoop-like devices. Nonincisional methods utilizing the posterior iliac crest have proven less costly and less dangerous to the patient, and therefore more satisfactory. Such methods involve the introduction of a needle-like collecting device through the skin tissue, and the penetration of the bone cortex with the collecting device to take a small specimen of bone marrow tissue. Because of the pressure needed to bore through the cortex of the bone, and the subsequent cutting through of the trabeculae of the bone marrow, the cutting/collecting needles of prior devices have included integral finger grips of sturdy construction, such as those disclosed in Jamshidi, U.S. Pat. No. 3,628,524. The presence of such sturdy integral grips on the prior art collecting devices has made such devices expensive to use and maintain: the relatively high initial cost of the devices precludes one-time use, and multiple-time use requires resterilization of the device prior to each use and resharpening of the cutting edges. Needle lumens are difficult to clean. Tissue or proteinaceous matter left in the lumen can result in pyrogens that are unaffected by heat sterilization. Resharpening requires time and special skills. Thus, the amount of handling required by the prior art devices leads to high costs and increased chance for human error. It is often desirable to aspirate fluids from bone tissue in addition to taking bone marrow tissue itself. Numerous devices have been available to aspirate fluids from bone tissue. Such prior art aspiration devices, however, have either been separate from the prior art devices used to take bone marrow tissue samples, or have used a bone marrow biopsy unit for aspiration. However, a bone marrow biopsy unit generally does not have the optimum diameter for aspirating fluids. Web site: http://www.delphion.com/details?pn=US04314565__

Patents 43

•

Biopsy needle Inventor(s): Ausherman; Ronald W. (Alton, IL), Burkholder; Richard A. (St. Charles, MO) Assignee(s): Sherwood Medical Company (St. Louis, MO) Patent Number: 4,793,363 Date filed: September 11, 1986 Abstract: A bone marrow biopsy device is provided that includes a cannula member and a stylet member each having arcuate handles having a length greater than the width thereof, a luer lock connector, and a handle locking arrangement. The cannula member handle has a recess which receives a collar on the stylet member handle. A radial pin and an axially extending luer lock connector are disposed in the recess. The collar has a slot which receives the pin for locking the stylet and cannula members together. Excerpt(s): This invention relates to biopsy needles and more particularly to bone marrow biopsy needles. Some bone marrow biopsy needles are used to obtain bone marrow samples for diagnostic purposes as well as for harvesting marrow for transplant purposes. Such biopsy needles generally include a cannula member having a stainless steel cannula with a hub or handle connected to the proximal end of the cannula, and a stylet member having a stainless steel stylet and a handle or cap connected to the proximal end of the stylet. The cannula is provided with a sharp distal end and receives the stylet which is provided with a sharp pointed distal end that extends distally beyond the distal end of the cannula when the cannula and stylet members are assembled together for penetrating body tissue and bone in order to enter a bone marrow cavity, for example, the iliac crest of the patient. Both handles are hand grasped and considerable pressures are applied to cause the distal ends of the cannula and stylet to penetrate the tissue and bone. Aspiration of a bone marrow sample is accomplished by removing the stylet member from the cannula member while the distal end of the cannula is in the marrow cavity. Then a syringe is connected to the proximal end of the cannula and marrow fluid is aspirated into the syringe. The aspirated sample is then processed for clinical testing. Where harvesting of marrow, such as for a transplant is desired, a relatively large number of biopsy needle insertions and marrow aspirations are generally required in order to accumulate a suitable amount of marrow. Where a biopsy core sample is to be obtained, the distal ends of the cannula and stylet are inserted into the marrow cavity and, after the stylet is removed, the cannula handle is rotated back and forth while applying axial pressure to the cannula to move the cannula through the marrow and collect a sample core within the cannula. The cannula is then carefully removed from the patient and the core sample pushed through the cannula and out the proximal end, such as by employing a probe. Aspirated samples and core samples may be taken from the same patient for a more complete diagnosis. Web site: http://www.delphion.com/details?pn=US04793363__

•

Biopsy needle and removable pad therefor Inventor(s): Jamshidi; Khosrow (610 Winston Ct., St. Paul, MN 55118) Assignee(s): none reported Patent Number: 4,163,446 Date filed: January 31, 1978

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Bone Marrow Biopsy

Abstract: A pad for use in combination with a bone marrow biopsy needle which is adapted to be slipped over the proximal end of the needle to provide an enlarged surface for distributing the pressure across the palm of the user. The pad includes a generally disc-shaped palm engaging surface along with a needle enveloping sleeve for releasable attachment to the biopsy needle. A bore is formed through the wall of the sleeve to provide communication between the interior of the sleeve and the atmosphere, thereby avoiding transfer of air between the pad element and the lumen of the needle when the pad element is mounted on the needle. Excerpt(s): The present invention relates generally to an improved biopsy needle structure, and more specifically to a palm engaging knob which may be releasably mounted on the proximal end of the needle, thereby rendering the device more comfortable in the hands of the user. Bone marrow biopsy needles are well known, and are widely used in the collection of biopsy tissue. Bone marrow biopsy structures are illustrated and disclosed in U.S. Pat. Nos. 3,628,524, and 3,598,108. The device of the present invention is intended to be slipped over the proximal end of the needle structure following removal of the stylet, this normally occurring at the time the surgeon is commencing penetration of the bone surface. Normally, bone marrow biopsy needles may have a proximal end which is relatively small in cross-section, and in certain instances, may be an extension of the elongated needle structure. In order to facilitate penetration of the bone, the distal end of the needle is normally sharpened, and this cutting edge, while moving relative to the surface of the bone, and with a force being applied to the bone, will accomplish penetration. In certain instances, and in some structures, the tip of the needle may be serrated or provided with rasp-like elements, depending upon the application. The force required to penetrate the bone is, of course, applied by the surgeon through the palm of his hand as the biopsy needle structure is being rotated arcuately about its axis. In order to reduce the stress concentration on the palm of the hand, the removable pad element of the present invention is provided, with the device further having a means for eliminating transfer of air into the lumen of the needle when being mounted on the needle end. Web site: http://www.delphion.com/details?pn=US04163446__ •

Bone marrow biopsy device Inventor(s): Fleming, III; James A. (Buffalo Grove, IL), Mittermeier; Werner (Prospect Heights, IL) Assignee(s): Manan Medical Products, Inc. (Northbrook, IL) Patent Number: 6,302,852 Date filed: April 25, 2000 Abstract: The present invention is directed to a bone marrow biopsy needle including an outer cannula having a proximal end, a distal end, a hollow section therebetween and a handle portion associated with the proximal end, and an inner rod having a proximal end, a distal end and a handle cap. The handle portion further includes a grip enhancement member which is formed from a material distinct from at least a portion of the handle portion, such as rubber. The grip enhancement member may take the form of insert members which fit into cavities in the handle portion of the outer cannula. The grip enhancement member not only enhances the gripping surface of the bone marrow biopsy needle, but also provides cushioning for a user and adds weight to the handle portion to facilitate weight distribution throughout the outer cannula handle.

Patents 45

Excerpt(s): The present invention relates in general to bone marrow biopsy devices and, more particularly, to a bone marrow biopsy device with a grip enhancement feature. Bone marrow biopsy devices have been known in the art for many years. In particular, many bone marrow biopsy devices have included a hollow outer cannula with some form of inner rod slidable within the outer cannula. The outer cannula conventionally consists of a proximal end, a distal end and some form of a handle associated with the proximal end. The inner rod may typically take several different forms, including a sharpened stylet for insertion of the bone marrow biopsy needle into a patient, an inner cannula for sampling bone marrow, and/or an ejector rod for forcing the sample out of the outer cannula. The inner rod also typically includes a second or connection handle which may be secured to the handle portion of the outer cannula. For instance, Baldridge, U.S. Pat. No. 5,357,974, Tretinyak, U.S. Pat. No. 4,403,617, Tretinyak, U.S. Pat. No. 4,630,616, Lee, U.S. Pat. No. 4,655,266 and Strasser et al., U.S. Pat. No. 4,838,282 all disclose bone marrow biopsy devices having a first handle mounted on the outer cannula and a second handle mounted on the inner rod. The first and second handle portions of these devices are constructed from the same material, typically a light weight plastic. Moreover, these handles are usually designed to securably mate with one another, for instance by a locking member, such as that taught in Mittermeier et al., Ser. No. 09/137,854, incorporated herein by reference. Web site: http://www.delphion.com/details?pn=US06302852__ •

Bone marrow biopsy instrument Inventor(s): Baldridge; Danny J. (Greers Ferry, AR) Assignee(s): Bethell; John P. (North Little Rock, AR), Robinson; Thomas F. (North Little Rock, AR) Patent Number: 5,357,974 Date filed: March 4, 1993 Abstract: A surgical instrument for performing tissue biopsies with a single tissue penetration. The elongated instrument comprises a hollow aspirate needle for aspirating bone marrow fluid, a hollow biopsy needle telescoped within the aspirate needle, and a solid stylet removably telescoped within the biopsy needle, all of which coaxially fit together. The stylet comprises a sharp distal end extending outwardly from the biopsy needle for initially penetrating body tissue and occluding the interior of the biopsy needle. The biopsy needle comprises a distal end normally projecting from the aspirate needle for thereafter penetrating a bone and obtaining a solid bone marrow sample. The bulbous, biopsy needle distal end is sharpened for captivating a specimen. It has a pair of relief slots dividing it into bulbous halves that are compressed together when the needle coaxially moves through the aspirate needle after withdrawal from tissue.In operation, the instrument is first inserted through skin and muscle tissue to the bone surface. The stylet is then withdrawn. As the instrument subsequently penetrates the cortical bone and enters the bone marrow cavity, the biopsy needle fills with a tissue sample. The biopsy sample is captivated by compression of the bulbous portion as that needle segment is removed. Afterwards, the outer, aspirate needle that remains in place in the bone is suctioned by an attachable syringe, and liquid bone marrow from the marrow cavity is aspirated into the syringe. Excerpt(s): The present invention relates to surgical biopsy instruments. Specifically the present invention relates to bone marrow biopsy instruments and to methods of obtaining specimens of bone, marrow and bone marrow fluid with a single puncture.

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Bone Marrow Biopsy

Art pertinent to the present invention is found in U.S. Patent Class 128, Subclass 754, and to corresponding subclasses within Class 604. Specimens of bone, marrow and the fluids present in the medullary cavity are biopsied to diagnose various diseases such as cancer and leukemia. It is difficult to obtain these specimens, as human bone has a hard outer cortex encapsulating marrow containing medullary cavity. Traditionally, marrow biopsies have been taken with large bore needles. A first needle with a bore osculating stylet is inserted through an incision in the patient's skin. It is pressed through the muscle tissue and the cortex of the bone, into the medullary cavity. The stylet is withdrawn and a syringe is attached to the needle. Bone marrow fluid is drawn using negative pressure. The first needle is withdrawn. A second needle is then inserted in a second location into contact with the bone's outer surface, the periosteum. The stylet is removed and considerable force is used to penetrate the cortex of the bone. Once the needle is deep enough into the medullary cavity the needle is shifted to an angular position and gyrated to free the marrow sample for withdrawal. Web site: http://www.delphion.com/details?pn=US05357974__ •

Bone marrow biopsy needle and method for using the same Inventor(s): Andelin; John B. (4940 140 Ave., NW., Lot 62, Williston, ND 58801-8605), White; Martin T. (5231 S. Misty View La., Taylorsville, UT 84123) Assignee(s): none reported Patent Number: 6,110,128 Date filed: December 11, 1998 Abstract: A biopsy needle assembly that is an improvement over the Jamshidi biopsy needle assembly is provided. The improved biopsy needle assembly includes a cannula with a uniform diameter internal surface defining an inner biopsy tissue sample receiving and retaining bore having projections thereon, and a stylet having rounded edges with at least one V-shaped groove at a distal cutting tip removably received within the bore of the cannula. The projections may be barbs, annular or spiral ribs that line the inner biopsy tissue sample receiving and retaining bore. The stylet may include a quick release knob for engaging with an improved coupling at the proximal end of the cannula. The improved coupling is substantially cylindrical with a cross handle substantially in the middle thereof. The coupling may also include internal threads engaging a syringe. The improved biopsy needle assembly permits more consistent acquisition of an adequate tissue sample for biopsy and is less painful to the patient. Excerpt(s): This invention relates generally to a medical instrument and more particularly to an improved bone marrow biopsy needle and method for using the same. The analysis of bone marrow is an invaluable tool for diagnosing a variety of hematologic and nonhematologic disease processes. Bone marrow is the soft material that fills the cavities of the bones. A bone marrow biopsy is performed to obtain a bone marrow sample for analysis. The bone marrow biopsy is a common, relatively simple procedure. Generally, the biopsy procedure is performed under local anesthesia, with the bone marrow sample obtained from the posterior superior iliac spine. In order to be diagnostically useful, the sample should be of adequate size with little or no distortion of structure. Moreover, a marrow sample should be easily obtained with minimal discomfort or risk to the patient. More specifically, following adequate local anesthesia of the periosteum, the biopsy needle with the stylet locked in place is advanced into the bone cortex and cavity (posterior iliac crest). Once the cortex of the bone is penetrated, the stylet is then removed. The aspirate (fluid from the marrow cavity) is drawn into a

Patents 47

syringe and slides are quickly made from the aspirate. The biopsy needle is then slowly and gently advanced with smooth clockwise-counterclockwise motions until an adequate bone marrow sample is obtained. The biopsy needle is then rotated completely several times along its long axis and slowly removed with alternating rotary motions. This is done to break the sample off from the bone so that when the needle is withdrawn, the sample is retained in the bore of the needle. Once the needle is withdrawn, the bone marrow sample is gently removed with a long probe introduced through the distal cutting tip of the biopsy needle. The bone marrow sample can be expelled through the proximal portion of the biopsy needle and then appropriately analyzed. In recognition of biopsy requirements, many instruments have been devised in order to sample bone marrow. Unfortunately, most of them do not consistently obtain an adequate sample with little or no distortion of structure. The Jamshidi biopsy needle device (Jamshidi and Swaim, J. Lab. Clin. Med., February 1971), for example, has been widely used but suffers from several deficiencies. That biopsy needle device generally includes a generally cylindrical cannula with a tapered distal portion including a sharp cutting Lip. The interior diameter of the distal portion is also tapered radially toward the cutting tip. A proximal end includes a coupling including a pair of finger grips, the coupling threadably engaging with a cap that locks over a knob of a stylet designed to interlock to fit the core. The stylet projects approximately 1 to 2 mm. beyond the cutting tip to protect a cutting edge and provide a means of entering the marrow. The Jamshidi device also accommodates a syringe with a catheter (tapered) tip. Unfortunately, a substantial portion of the sample may be lost during removal of the Jamshidi biopsy needle because the sample slides out of the needle necessitating repeated attempts to obtain an adequate sample. Moreover, the discovery of and loss of the tissue sample after enduring the rather painful procedure is disturbing to most patients. Furthermore, it is frustrating for the doctor to "complete" the procedure only to find the tissue sample lost after removal of the needle from the patient's body. In addition, the use of the Jamshidi needle (and other similar designs) require extensive rotary motion to be employed in an attempt to break the tissue sample off from the bone so it will be retained in the bore of the needle. This maneuver causes substantial and unnecessary pain and anxiety to patients. Web site: http://www.delphion.com/details?pn=US06110128__ •

Bone marrow biopsy needle with cutting and/or retaining device at distal end Inventor(s): Rubinstein; Alan I. (10600 Wilshire Blvd., Los Angeles, CA 90024), Rubinstein; Daniel B. (40 Eliot Crescent, Brookline, MA 02167) Assignee(s): none reported Patent Number: 5,462,062 Date filed: April 6, 1992 Abstract: A bone marrow biopsy needle provided with blades which cut and retain a biopsy core. In one embodiment, the blades of the needle are hinged. In a further embodiment, the cutting blades are provided at the end of an inner tube which travels within an outer tube. In one embodiment, the outer tube is tapered at its distal end to push the blades together. In another embodiment, the cutting blade is pre-curved inward. In yet another embodiment, the distal ends of the cutting blades rest within a curved circumferential recess provided in the needle wall, and, when pushed forward, come together to cut and retain the biopsy core.

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Bone Marrow Biopsy

Excerpt(s): The present invention relates to a bone marrow biopsy needle, and more particularly to a bone marrow biopsy needle with an end closure for retaining the biopsy core. When a bone marrow biopsy is performed, a biopsy core, which consists of a plug of bone and marrow, is withdrawn with a bone marrow biopsy needle from the body of the patient. At times, it is difficult to retain the biopsy core in the needle while the needle is being withdrawn from the patient. With the Jamshidi.RTM. needle, it is difficult to keep the solid biopsy material in the needle as the operator is withdrawing the needle from the patient. A biopsy core approximately 11/2 inches (3.8 mm) is generally needed. Conventionally, it is necessary to shake the needle from side to side, to break the biopsy core loose from the adjacent marrow. This agitation of the bone marrow is uncomfortable for the patient. It also may create a risk of metastasizing malignant cancer, leukemia, or lymphoma cells which are infiltrated in the marrow of the patient, because the bone marrow is highly vascular. The marrow contains a vascular system which is quite complex and includes a vascular sinusoidal system. See Wintrobe, M. M., et al., eds., Clinical Hematology (Lea & Febiger 1981); Anat. Rec. 68:55 (1970); and Weiss, L., "Histopathology of the Bone Marrow," in Regulation of Hematopoiesis, A. S. Gordon, ed., (Appleton-Century Crafts 1970). Web site: http://www.delphion.com/details?pn=US05462062__ •

Bone marrow biopsy, aspiration and transplant needles Inventor(s): Smith; Greg (Newhall, CA), Wadhwani; Suresh (Valencia, CA) Assignee(s): Baxter International Inc. (Deerfield, IL) Patent Number: 5,331,972 Date filed: December 3, 1992 Abstract: Novel bone-marrow biopsy, aspiration and transplant needles are described having several unique features. One unique feature is an offset handle which allows a user to use their index finger to guide a needle into a patient. Another unique feature is a cannula which has multiple cutting teeth that can be used to cut bone when the cannula is axially rotated. Yet another unique feature is a stylet with a highly effective cutting tip. Excerpt(s): The invention relates generally to the field of medical instruments, and more particularly to those instrument employed in biopsy, aspiration, and transplant procedures of bone marrow. In the medical field, it is frequently desirable to take biopsy samples from a patient. Two major fields of biopsy procedures exist. One field is known as "soft-tissue biopsy" and the other field is known as "bone marrow biopsy". In the bone marrow biopsy field, it is always necessary to puncture the bone of a patient in order to retrieve bone marrow which normally exists only in the center of a bone. It may be desirable to retrieve bone marrow for several different reasons. In one type of bone marrow procedure, it is desirable to retrieve a "core" of bone marrow to examine bone marrow architecture. This procedure may be useful in determining whether a patient has cancer and the extent of cancerous cells that may exist. Examining a bone marrow core typically involves an extended period of time in which the core is first prepared and then sliced into thin samples which are examined under a microscope. Web site: http://www.delphion.com/details?pn=US05331972__

Patents 49

•

Coaxial bone marrow biopsy needle assembly Inventor(s): Scarfone; Frank A. (Boca Raton, FL), Turkel; David (Miami, FL) Assignee(s): Symbiosis Corporation (Miami, FL) Patent Number: 5,385,151 Date filed: November 1, 1993 Abstract: A coaxial bone marrow biopsy needle assembly is disclosed. The assembly includes a hollow cannula with a handle having an interlocking device and a trocar insertable in the cannula and having a second handle with another interlocking device which mates with the interlocking device in the cannula handle. The interlocking devices are a spring biased pin radially entering a receiving socket, and a notched projection which extends into the receiving socket. The pin has a ramped portion, and the notched projection has a rounded or conical tip which rides down the ramped portion of the pin and thereby pushes the biased pin radially out of the socket during assembly of the hollow cannula with the trocar. The assembled handles provides a smooth upper surface which fits comfortably in a palm and a lower gripping surface around which fingers easily wrap. The interlocking devices hold the handles securely together keeping the trocar within the cannula during puncture, but are easily separated thereafter. Excerpt(s): This invention relates to surgical biopsy needle instruments. More particularly, this invention relates to an interlocking handle arrangement for a coaxial bone marrow biopsy needle assembly. Known biopsy needles generally include a cannula having a lumen extending therethrough, and a trocar or stylet which is removably inserted through the lumen of the cannula. The proximal ends of the cannula and trocar are provided with some type of gripping means and the distal ends of the cannula and trocar are sharpened to a bone piercing edge. In order to obtain a bone marrow specimen, the trocar and cannula are forced through the outer hard layer of the bone containing the marrow. Once the softer, internal region of the bone is reached, the trocar is withdrawn. A specimen is obtained either by advancing the cannula further into the bone to obtain a core sample, or by coupling a fluid conduit to the proximal end of the cannula and aspirating a liquid sample. When taking a core sample, the cannula containing the core sample of bone marrow is carefully withdrawn so as to retain the marrow material. The bone marrow biopsy procedure is quite painful to the patient and requires much exertion by the physician. Early problems with biopsy needles involved the sharpness of the cannula and trocar and the gripping means used so that the needle could be placed accurately and the bone could be penetrated quickly. U.S. Pat. No. 4,356,828, for example, discloses an improved finger gripping member and U.S. Pat. No. 4,403,617 discloses particular cutting edge configurations for the trocar and cannula. Web site: http://www.delphion.com/details?pn=US05385151__

•

Disposable biopsy needle, particularly for bone marrow samplings Inventor(s): Jeslis; Jerome (Chicago, IL), Rodzen; Richard A. (Bolingbrook, IL), Sessions; Robert W. (Hinsdale, IL) Assignee(s): Ferris Manufacturing Corp. (Hinsdale, IL) Patent Number: 4,258,722 Date filed: December 15, 1978

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Abstract: A disposable biopsy needle, particularly for bone marrow biopsy sampling utilizing a metal cannula and stylet structure, and which otherwise may be formed from inexpensive material such as a suitable plastic. Suitable high production techniques, such as injection molding, may then be employed in the production of the remainder of the components of the structure, whereby the final product not only is of excellent design construction for the intended purpose, but also is of exceptionally low cost in manufacture, readily permitting its disposal following a single use. Excerpt(s): The present invention is directed to a biopsy needle, particularly for bone marrow biopsy sampling, in particular a needle structure which is practical for a single use operation. Biopsy needles have been employed in the medical profession over many years, and in general have been basically metallic structures which will normally include at least a hollow needle or cannula, sharpened at one end for insertion into body tissues, and provided with a detachable stylet which is insertable into the needle for effectively closing the sharpened end thereof during the insertion operation of the needle into the tissue and subject matter to be sampled. Following insertion of the needle assembly, the stylet is removed from the hollow needle and suitable vacuum means, as for example a suitable syringe, is attached to the exposed distal end of the needle for effecting deposit of the biopsy sample in the needle. To facilitate the use of the needle it may be provided with additional structure readily facilitating the holding of the needle and suitable actuation thereof to provide the desired penetration into the object sample. Where a completely metallic structure is employed, as in the prior art, stainless steel or other suitable metal is employed for the entire structure, usually necessitating suitable joining of the various additional components employed, by soldering, welding, or the like. As a result, needles of this type are relatively costly and are not practical for a single use and disposal. Web site: http://www.delphion.com/details?pn=US04258722__

Patent Applications on Bone Marrow Biopsy As of December 2000, U.S. patent applications are open to public viewing.5 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 bone marrow biopsy: •

Bone biopsy instrument having improved sample retention Inventor(s): Krueger, John; (Milwaukee, WI) Correspondence: Kimberly Diliberti, Paralegal; Allegiance Corporation; 1430 Waukegan Road; Mcgaw Park; IL; 60085-6787; US Patent Application Number: 20030050574 Date filed: October 25, 2002 Abstract: The invention disclosed herein relates to a sampling cannula for use in bone marrow biopsy procedures having structural features which facilitate sample retention within the device. In particular, the sampling cannula comprises an open trough-like portion, wherein the trough-like portion comprises at least one wall opening located proximal to the distal end in combination with an interior surface comprising a friction-

5

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

Patents 51

enhancing surface texture adapted to facilitate sample retention. The invention further provides for a bone marrow biopsy system comprising an outer cannula having a sharpened distal tip, a sampling cannula having a distal trough portion in which the interior surface of the sampling cannula is exposed, at least one wall opening located within the trough portion located proximal to the distal tip of the sampling cannula, a friction-enhancing surface texture on at least a portion of the interior surface of the trough portion, wherein the sampling cannula is adapted to be inserted into an outer cannula and to sever a sample from the sampling site by rotational motion of the sampling cannula, and a stylet structured to be removably inserted into the outer cannula. The bone biopsy system can further include an ejector rod for expelling the retained sample from the sampling cannula. Excerpt(s): This application is based on U.S. Provisional Application No. 60/335,694 filed on Oct. 25, 2001 and is a continuation-in-part of U.S. patent application Ser. No. 09/799,143 filed Mar. 5, 2001, now pending, which is a divisional of U.S. patent application Ser. No. 09/522,444 filed Apr. 18, 2001, now U.S. Pat. No. 6,443,910 issued on Sep. 3, 2002. The invention relates to the field of medical devices for use in biopsy procedures. In particular, the invention pertains to a bone marrow biopsy device and method for obtaining bone marrow samples therewith. Biopsy samples from bone tissue are typically collected from a sampling site in a patient by the use of bone biopsy devices. Typical bone biopsy devices include a hollow cannula which surrounds a stylet. The style includes a sharp distal tip which extends distally beyond the tip of the hollow cannula when the stylet is secured within the cannula. The combined cannula and stylet is used to penetrate through the cortex or outer layer of bone so as to sample the softer tissue or marrow within the bone. Once the cannula and stylet have penetrated into the bone, the stylet is removed and the cannula further advanced into the bone to capture a marrow sample. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Bone marrow biopsy needle Inventor(s): Clark, Grant A.; (Bristol, WI), Krueger, John A.; (Miilwaukee, WI) Correspondence: Allegiance Corporation; Attn: Kim Diliberti; 1430 Waukegan Road; Mcgaw Park; IL; 60085-6787; US Patent Application Number: 20010009978 Date filed: March 5, 2001 Abstract: The present invention provides a bone marrow biopsy device 10 that includes a handle, an outer cannula, a stylet, and an inner member. The outer cannula is secured in the handle. The outer cannula defines a distal tip that is tapered to provide a distal cutting edge. The stylet is designed to be inserted in the outer cannula. The stylet defines a sharp distal tip. The inner member is designed to be inserted in the outer cannula. The inner member defines a cutting finger. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/522,444 filed on Apr. 18, 2000, now pending. The present invention relates to medical instruments utilized in securing marrow tissue samples from bone structures. A biopsy medical instrument is an instrument which is designed to take samples of tissue. Typically, a biopsy device that is utilized to obtain samples from the bone consists of a hollow cannula that is surrounding a stylet. The stylet includes a sharp distal tip which extends outwardly from the cannula when the stylet is secured inside the cannula. The

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combined cannula and stylet is used to penetrate through the outer layer of the bone, called the cortex, which is considerably harder than the trasecular bone layer and the tissue within the bone that is sampled, referred to as the marrow. Once the stylet and cannula have penetrated the cortex, the stylet is removed and the cannula is extended further into the medular cavity, thereby capturing marrow tissue for a sample. 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 bone marrow biopsy, 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 “bone marrow biopsy” (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 bone marrow biopsy. You can also use this procedure to view pending patent applications concerning bone marrow biopsy. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

53

APPENDICES

55

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 Institute6: •

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/

6

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

Physician Resources

57

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 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:8 •

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

7

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). 8 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 NLM Gateway9 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.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “bone marrow biopsy” (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 38790 38 960 102 147 40037

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 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.13 Simply search by “bone marrow biopsy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

9

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

10

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). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13

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

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.

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Coffee Break: Tutorials for Biologists14 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.15 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.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for 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/.

14 Adapted 15

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

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. 16 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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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 bone marrow biopsy 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 bone marrow biopsy. 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 bone marrow biopsy. 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 “bone marrow biopsy”:

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Bone Cancer http://www.nlm.nih.gov/medlineplus/bonecancer.html Bone Diseases http://www.nlm.nih.gov/medlineplus/bonediseases.html Lymphoma http://www.nlm.nih.gov/medlineplus/lymphoma.html Multiple Myeloma http://www.nlm.nih.gov/medlineplus/multiplemyeloma.html 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 Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on bone marrow biopsy. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Anemia Source: Camp Hill, PA: Chek-Med Systems, Inc. 200x. [2 p.]. Contact: Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011-1706. (800) 451-5797 or (717) 761-1170. Fax (717) 761-0216. PRICE: $22.00 per pack of 50 brochures; 3 pack minimum. Summary: This brochure helps patients to understand anemia and what it means when they receive this diagnosis from their health care provider. Anemia is defined as a low red blood cell count. The red blood cell carries oxygen to the body's tissues. Inside each red cell is a protein and iron combination that is called hemoglobin that can be measured; low hemoglobin counts mean anemia. A second way to measure anemia is called the hematocrit, a test which checks how many red cells are packed into a specific amount of blood. The brochure offers the range considered normal for these two measures (different for men and women), then reviews the symptoms and the different types of anemia. Mild anemia may be symptomless, and a moderate anemia may cause some fatigue, drowsiness, or even shortness of breath on exertion. However, if the anemia occurs very slowly, the individual often can tolerate a remarkably low red blood cell count, sometimes with very few symptoms. The types of anemia are put into major categories based on cause: blood loss anemia (iron deficiency), large red blood cell anemia (macrocytic anemia), bone marrow failure, red cell destruction (hemolytic anemia), chronic kidney disease, and chronic illness and malignancies. The author of the

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brochure outlines the tests that may be done to determine the level of anemia and its cause, including blood studies, imaging, endoscopy, and bone marrow biopsy. A final section briefly describes the treatments that may be undertaken for anemia, stressing that taking oral iron or receiving a blood transfusion must also be accompanied by efforts to determine the underlying cause of the anemia. 2 figures. •

Mastocytosis: What It Is and How It's Diagnosed and Treated Source: American Family Physician. 59(11): 3059-3060. June 1999. Contact: American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail: [email protected]. Website: www.aafp.org. Summary: This patient information sheet uses a question and answer format to provide people who have mastocytosis with information on the diagnosis and treatment of this disease, which is characterized by an excessive number of mast cells. These cells produce histamine and are made by bone marrow. As part of the immune system, they help fight off infections. Although the cause of mastocytosis is unknown, symptoms may be triggered by cold, heat, certain medications, emotional stress, or insect bites. Symptoms include a red, itchy rash; a rash that looks like freckles; hives; one large lump on the skin; diarrhea; stomach pain; fainting; or difficulty breathing. Diagnostic tests may include a skin biopsy, a bone marrow biopsy, and blood or urine tests. Treatment options include taking antihistamines and avoiding triggers. 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 bone marrow biopsy. 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/

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•

Bone Marrow Biopsy

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 bone marrow biopsy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with bone marrow biopsy. 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 bone marrow biopsy. 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 “bone marrow biopsy” (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 “bone marrow biopsy”. 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 “bone marrow biopsy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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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 “bone marrow biopsy” (or a synonym) into the search box, and click “Submit Query.”

67

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.17

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

17

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

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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)18: •

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/

18

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

Finding Medical Libraries

69

•

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/

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•

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/

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•

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

73

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 bone marrow biopsy: •

Basic Guidelines for Bone Marrow Biopsy Bone marrow biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003934.htm

•

Signs & Symptoms for Bone Marrow Biopsy Anemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000560.htm Leukemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001299.htm

•

Diagnostics and Tests for Bone Marrow Biopsy Biopsy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm Complete blood count Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm

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Bone Marrow Biopsy

Platelets Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003647.htm •

Background Topics for Bone Marrow Biopsy Adolescent test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002054.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Clot Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001124.htm Infant test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002055.htm Preschooler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002057.htm Schoolage test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002058.htm Toddler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002056.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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BONE MARROW BIOPSY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]

Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Acute myelogenous leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute nonlymphocytic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acute nonlymphocytic leukemia: A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute myelogenous leukemia. [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] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Aggressiveness: The quality of being aggressive (= characterized by aggression; militant; enterprising; spreading with vigour; chemically active; variable and adaptable). [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Allogeneic: Taken from different individuals of the same species. [NIH] Allogeneic bone marrow transplantation: A procedure in which a person receives stem cells, the cells from which all blood cells develop, from a compatible, though not genetically

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identical, donor. [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] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] 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] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] 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] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] 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]

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Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [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] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] 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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aplastic anemia: A condition in which the bone marrow is unable to produce blood cells. [NIH]

Arterial: Pertaining to an artery or to the arteries. [EU] Arterial embolization: The blocking of an artery by a clot of foreign material. This can be done as treatment to block the flow of blood to a tumor. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspiration: The act of inhaling. [NIH] 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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

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Bilateral: Affecting both the right and left side of body. [NIH] 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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] 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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [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 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] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [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 with marrow cells. [NIH] Bone marrow aspiration: The removal of a small sample of bone marrow (usually from the hip) through a needle for examination under a microscope. [NIH] Bone marrow biopsy: The removal of a sample of tissue from the bone marrow with a needle for examination under a microscope. [NIH] Bone Marrow Cells: Cells contained in the bone marrow including fat cells, stromal cells, megakaryocytes, and the immediate precursors of most blood cells. [NIH]

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Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bone metastases: Cancer that has spread from the original (primary) tumor to the bone. [NIH]

Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [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] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [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 Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Chemotherapy: Treatment with anticancer drugs. [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]

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Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic leukemia: A slowly progressing cancer of the blood-forming tissues. [NIH] Chronic lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [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] 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] 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] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] 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

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addition to (complementary) or instead of (alternative) standard treatments. These practices 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] Concomitant: Accompanying; accessory; joined with another. [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] 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] Contrast medium: A substance that is introduced into or around a structure and, because of the difference in absorption of x-rays by the contrast medium and the surrounding tissues, allows radiographic visualization of the structure. [EU] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [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 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] Cortical: Pertaining to or of the nature of a cortex or bark. [EU]

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Cryostat: A batchwise operating apparatus in which a cryogenic liquid or solid is used to maintain by evaporation a cryotemperature which needs not be constant but may vary in a predetermined fashion. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyclin: Molecule that regulates the cell cycle. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] 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] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic Imaging: Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] 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] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [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] 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 Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH]

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Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] 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] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [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] 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] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH]

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Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [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]

Febrile: Pertaining to or characterized by fever. [EU] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fever of Unknown Origin: Fever in which the etiology cannot be ascertained. [NIH] Flatus: Gas passed through the rectum. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [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] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body

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through the rectum (flatus) or the mouth (burp). [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 Rearrangement: The ordered rearrangement of gene regions by DNA recombination such as that which occurs normally during development. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [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] Glucokinase: A group of enzymes that catalyzes the conversion of ATP and D-glucose to ADP and D-glucose 6-phosphate. They are found in invertebrates and microorganisms and are highly specific for glucose. (Enzyme Nomenclature, 1992) EC 2.7.1.2. [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] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [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] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Granule: A small pill made from sucrose. [EU] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hairy cell leukemia: A type of chronic leukemia in which the abnormal white blood cells appear to be covered with tiny hairs when viewed under a microscope. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Heartbeat: One complete contraction of the heart. [NIH]

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Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [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] Hemoglobin C: A commonly occurring abnormal hemoglobin in which lysine replaces a glutamic acid residue at the sixth position of the beta chains. It results in reduced plasticity of erythrocytes. [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] Heparin: Heparinic acid. A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterotrophic: Pertaining to organisms that are consumers and dependent on other organisms for their source of energy (food). [NIH] Hexokinase: An enzyme that catalyzes the conversion of ATP and a D-hexose to ADP and a D-hexose 6-phosphate. D-Glucose, D-mannose, D-fructose, sorbitol, and D-glucosamine can act as acceptors; ITP and dATP can act as donors. The liver isoenzyme has sometimes been called glucokinase. (From Enzyme Nomenclature, 1992) EC 2.7.1.1. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [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] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic

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acid can result in impaired hydroxyproline formation. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Idiopathic: Describes a disease of unknown cause. [NIH] Idiopathic myelofibrosis: A progressive disease in which the bone marrow is replaced by fibrous tissue and is unable to produce red blood cells; the cause is unknown. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [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] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] 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] Induction therapy: Treatment designed to be used as a first step toward shrinking the cancer and in evaluating response to drugs and other agents. Induction therapy is followed by additional therapy to eliminate whatever cancer remains. [NIH] 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 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] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH]

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Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [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]

Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [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 Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetic: Pertaining to or producing motion. [EU] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Laparotomy: A surgical incision made in the wall of the abdomen. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukocytosis: A transient increase in the number of leukocytes in a body fluid. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Linkages: 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] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [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] Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenopathy: Disease or swelling of the lymph nodes. [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] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [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] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphocytosis: Excess of normal lymphocytes in the blood or in any effusion. [NIH] Lymphography: Radiographic study of the lymphatic system following injection of dye or contrast medium. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lymphoproliferative: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Lymphoproliferative Disorders: Disorders characterized by proliferation of lymphoid tissue, general or unspecified. [NIH] Lymphosarcoma: An obsolete term for a malignant tumor of lymphatic tissue. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [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] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH]

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Malignant tumor: A tumor capable of metastasizing. [NIH] Mastocytosis: A group of diseases resulting from proliferation of mast cells. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megakaryocytes: Very large bone marrow cells which release mature blood platelets. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [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] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methacrylate: A vinyl monomer. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [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] Modification: A change in an organism, or in a process in an organism, that is acquired 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] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [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] 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] Multiple Myeloma: A malignant tumor of plasma cells usually arising in the bone marrow; characterized by diffuse involvement of the skeletal system, hyperglobulinemia, Bence-Jones proteinuria, and anemia. [NIH] Myelodysplastic syndrome: Disease in which the bone marrow does not function normally. Also called preleukemia or smoldering leukemia. [NIH]

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Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myeloma: Cancer that arises in plasma cells, a type of white blood cell. [NIH] Myeloproliferative Disorders: Disorders in which one or more stimuli cause proliferation of hemopoietically active tissue or of tissue which has embryonic hemopoietic potential. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [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] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is

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comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [NIH] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Particle: A tiny mass of material. [EU] 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 and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] 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] Peripheral blood: Blood circulating throughout the body. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [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] 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]

Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized 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] 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]

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Plasmacytoma: Any discrete, presumably solitary, mass of neoplastic plasma cells either in bone marrow or various extramedullary sites. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Ploidy: The number of sets of chromosomes in a cell or an organism. For example, haploid means one set and diploid means two sets. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polycythemia Vera: A myeloproliferative disorder of unknown etiology, characterized by abnormal proliferation of all hematopoietic bone marrow elements and an absolute increase in red cell mass and total blood volume, associated frequently with splenomegaly, leukocytosis, and thrombocythemia. Hematopoiesis is also reactive in extramedullary sites (liver and spleen). In time myelofibrosis occurs. [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] 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] Preleukemia: Conditions in which the abnormalities in the peripheral blood or bone marrow represent the early manifestations of acute leukemia, but in which the changes are not of sufficient magnitude or specificity to permit a diagnosis of acute leukemia by the usual clinical criteria. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] 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] Primary tumor: The original tumor. [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] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [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] Progressive disease: Cancer that is increasing in scope or severity. [NIH] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH]

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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] 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] 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 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] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] 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] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Pyrexia: A fever, or a febrile condition; abnormal elevation of the body temperature. [EU] Pyrogens: Substances capable of increasing body temperature; they may be of microbial origin, often polysaccharides and may contaminate distilled water. [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] Radiculopathy: Disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. [NIH]

Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects

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are assigned by chance to separate groups that compare different treatments. [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] 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] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Rectum: The last 8 to 10 inches of the large intestine. [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 erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] 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] Remission Induction: Therapeutic act or process that initiates a response to a complete or partial remission level. [NIH] Remission induction therapy: The initial chemotherapy a person receives to bring about a remission. [NIH] Renal amyloidosis: A disease of unknown etiology characterized by the abnormal deposition of amyloid, a translucent homogenous glycoprotein, in various organs and tissues of the body. [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] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is

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usually highly malignant. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [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] Sciatica: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the L4, L5, S1 or S2 spinal nerve roots; often associated with intervertebral disk displacement); or lesions of the cauda equina. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [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] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Serrated: Having notches or teeth on the edge as a saw has. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH]

Dictionary 97

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] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Smoldering leukemia: Disease in which the bone marrow does not function normally. Also called preleukemia or myelodysplastic syndrome. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] 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] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] 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

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specialized and take the place of those that die or are lost. [NIH] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Sternum: Breast bone. [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]

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] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [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]

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] Symphysis: A secondary cartilaginous joint. [NIH] Systemic: Affecting the entire body. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of

Dictionary 99

toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [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] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [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] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [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]

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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] 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]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [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] 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]

101

INDEX A Abdominal, 3, 75, 91, 92, 95 Acquired Immunodeficiency Syndrome, 15, 75 Acrylonitrile, 75, 95 Actin, 35, 75 Acute leukemia, 8, 10, 75, 93 Acute lymphoblastic leukemia, 10, 11, 25, 75 Acute lymphocytic leukemia, 75 Acute myelogenous leukemia, 75 Acute myeloid leukemia, 7, 25, 75 Acute nonlymphocytic leukemia, 24, 75 Acute renal, 75, 86 Adrenal Glands, 75, 76 Aggressiveness, 5, 75 Algorithms, 75, 78 Allogeneic, 20, 22, 75 Allogeneic bone marrow transplantation, 20, 22, 75 Alternative medicine, 76 Amine, 76, 86 Amino acid, 5, 76, 77, 85, 86, 89, 90, 92, 93, 94, 98, 99 Amino Acid Sequence, 76, 77 Amplification, 26, 76 Amyloid, 76, 95 Amyloidosis, 34, 36, 76 Anaemia, 8, 76 Anaesthesia, 76, 87 Anaplasia, 76 Anemia, 10, 62, 73, 76, 86, 90 Anesthesia, 46, 76, 77 Anti-Anxiety Agents, 77, 93 Antibiotic, 77, 93 Antibiotic Prophylaxis, 77, 93 Antibodies, 8, 77, 87, 89, 92 Antibody, 20, 28, 33, 77, 80, 87, 90, 97 Anticonvulsant, 77, 89 Antigen, 77, 80, 87 Anti-inflammatory, 77, 92 Anxiety, 47, 77, 89 Aplastic anemia, 16, 21, 23, 24, 77 Arterial, 32, 77, 94 Arterial embolization, 32, 77 Arteries, 77, 78, 81, 90 Arteritis, 23, 77 Artery, 35, 77, 81, 83

Aspiration, 8, 16, 17, 23, 26, 42, 43, 48, 77 B Bacteria, 77, 83, 99 Bacterium, 77, 86 Basophils, 77, 88 Benign, 77, 79, 91 Bilateral, 8, 11, 36, 78 Bile, 78, 84, 88 Biochemical, 4, 5, 78, 84 Biopsy specimen, 6, 7, 8, 16, 18, 19, 20, 21, 22, 24, 25, 26, 28, 29, 30, 31, 33, 35, 36, 37, 78 Biotechnology, 5, 57, 78 Biotransformation, 78 Bladder, 78, 94, 99 Blood Cell Count, 62, 78, 86 Blood Glucose, 78, 86 Blood Platelets, 78, 90 Blood transfusion, 63, 78 Blood vessel, 78, 79, 83, 85, 86, 88, 89, 97, 99 Blood Volume, 78, 93 Bone marrow aspiration, 19, 20, 21, 78 Bone Marrow Cells, 78, 90 Bone Marrow Transplantation, 79 Bone metastases, 23, 79 Bone scan, 9, 21, 35, 79, 96 Bronchial, 79, 86 C Cannula, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 79 Carbohydrates, 79 Carcinoid, 21, 27, 79 Carcinoma, 14, 15, 21, 26, 27, 28, 30, 32, 36, 79 Case report, 18, 23, 29, 35, 79 Catheter, 47, 79 Cauda Equina, 79, 96 Caudal, 79, 93 Cell Count, 62, 79 Cell Cycle, 79, 82 Cell membrane, 4, 79 Cell Size, 79, 84 Centrifugation, 79, 86 Chemotherapy, 10, 24, 79, 95 Chromatin, 79, 83, 91 Chromosomal, 76, 79

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Chronic, 4, 9, 12, 18, 21, 22, 28, 29, 30, 31, 33, 34, 38, 62, 80, 83, 85, 87, 88, 98 Chronic Disease, 80, 88 Chronic leukemia, 80, 85 Chronic lymphocytic leukemia, 9, 12, 33, 80 Chronic renal, 21, 80 Clinical Medicine, 12, 17, 80 Clinical trial, 4, 57, 80, 81, 94 Cloning, 78, 80 Collagen, 76, 80 Collapse, 4, 80 Complement, 80, 81 Complementary and alternative medicine, 37, 39, 80 Complementary medicine, 37, 81 Computational Biology, 57, 81 Computed tomography, 81, 96 Computerized axial tomography, 81, 96 Concomitant, 28, 81 Connective Tissue, 78, 80, 81, 89, 95 Contraindications, ii, 81 Contrast medium, 81, 89 Controlled study, 7, 81 Conventional therapy, 81 Conventional treatment, 8, 81 Coronary, 81, 90 Coronary Thrombosis, 81, 90 Cortex, 42, 46, 51, 52, 81 Cortical, 45, 81 Cryostat, 28, 82 Cutaneous, 4, 82 Cyclin, 5, 20, 82 Cytomegalovirus, 20, 24, 28, 82 Cytoplasm, 77, 79, 82, 83, 90, 91 D Decarboxylation, 82, 86 Dementia, 75, 82 Density, 79, 82, 84 Diabetes Mellitus, 82, 86 Diagnostic Imaging, 5, 82 Diagnostic procedure, 41, 82 Diarrhea, 63, 82 Diffusion, 82, 87 Digestion, 78, 82, 88, 98 Diploid, 82, 92, 93 Direct, iii, 80, 82, 95 Discrete, 82, 93 Distal, 43, 44, 45, 46, 47, 49, 50, 51, 82 Dorsal, 82, 93, 97 Drug Resistance, 31, 82, 83 Drug Tolerance, 82, 83

Duct, 79, 83, 95 Duodenum, 78, 83, 98 E Edema, 3, 83 Effusion, 83, 89 Emaciation, 75, 83 Emboli, 35, 83 Embolism, 18, 83 Embolization, 35, 83 Embryo, 83, 87 Endoscopy, 4, 63, 83 End-stage renal, 80, 83 Environmental Health, 56, 58, 83 Enzymatic, 76, 80, 83, 86 Enzyme, 26, 27, 83, 85, 86, 88, 100 Eosinophils, 83, 88 Epidermis, 83, 94 Epithelial, 15, 83 Erythema, 83, 99 Erythrocyte Indices, 78, 83 Erythrocytes, 76, 78, 84, 86, 95 Esophagus, 84, 98 Eukaryotic Cells, 84, 87 Excitation, 84, 91 Exogenous, 78, 84 F Family Planning, 57, 84 Fat, 78, 83, 84, 97 Fatigue, 62, 84 Febrile, 35, 84, 94 Ferritin, 31, 84 Fever of Unknown Origin, 15, 84 Flatus, 84, 85 Flow Cytometry, 6, 25, 84 Fluorescence, 84 Fluorescent Dyes, 84 Friction, 50, 84 Fungi, 19, 84, 99, 100 G Gallbladder, 75, 84 Gas, 8, 82, 84, 99 Gastric, 85, 86 Gastrointestinal, 4, 79, 85, 98 Gastrointestinal tract, 4, 85 Gene, 29, 78, 85, 93 Gene Rearrangement, 29, 85 Genotype, 85, 92 Gland, 85, 89, 91, 94, 96, 98 Glucokinase, 85, 86 Glucose, 78, 82, 85, 86, 97 Glucuronic Acid, 85, 86 Glutamic Acid, 85, 86, 91

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Glycine, 76, 85, 91 Glycolysis, 5, 85 Glycoprotein, 85, 95 Goiter, 18, 85 Governing Board, 85, 93 Granule, 24, 85 H Haematoma, 85 Haemorrhage, 16, 85 Hairy cell leukemia, 34, 85 Haploid, 85, 92, 93 Heartbeat, 85, 98 Hematocrit, 62, 78, 83, 86 Hemoglobin, 62, 76, 78, 83, 84, 86 Hemoglobin C, 62, 83, 86 Hemolytic, 62, 86 Hemorrhage, 32, 86, 94 Heparin, 16, 86 Heredity, 85, 86 Heterogeneity, 24, 86 Heterotrophic, 84, 86 Hexokinase, 5, 86 Histamine, 4, 63, 86 Histidine, 86 Histology, 23, 86, 92 Hormone, 86, 98 Hydroxyproline, 76, 80, 86 Hypnotic, 87, 89 I Idiopathic, 22, 28, 32, 87 Idiopathic myelofibrosis, 22, 28, 87 Imaging procedures, 87, 99 Immune response, 77, 87, 98, 99 Immune system, 63, 87, 89, 100 Immunodeficiency, 19, 35, 75, 87 Immunoglobulin, 77, 87, 90 Immunohistochemistry, 8, 25, 26, 33, 87 In situ, 20, 87 In Situ Hybridization, 20, 87 In vivo, 86, 87 Incision, 46, 87, 88 Induction, 10, 24, 87 Induction therapy, 87 Infarction, 81, 87, 90 Infection, 28, 35, 75, 82, 87, 89, 91, 98, 99, 100 Infiltration, 6, 87 Intervertebral, 87, 94, 96 Intervertebral Disk Displacement, 87, 94, 96 Intestinal, 21, 27, 88 Intestines, 75, 85, 88

Intoxication, 88, 100 Intracellular, 87, 88 Invasive, 5, 88, 89 Isoenzyme, 86, 88 K Kb, 56, 88 Kidney Disease, 56, 62, 88 Kinetic, 16, 88 L Laparoscopy, 26, 31, 88 Laparotomy, 26, 31, 34, 35, 88 Lesion, 88, 89 Leucocyte, 88, 89 Leukaemia, 10, 12, 30, 31, 33, 34, 37, 88 Leukemia, 10, 11, 12, 14, 16, 18, 22, 30, 31, 38, 46, 48, 73, 88, 93 Leukocytes, 26, 27, 77, 78, 83, 88, 90, 91 Leukocytosis, 88, 93 Life cycle, 84, 88 Ligament, 88, 94 Linkages, 86, 88 Liver, 19, 75, 76, 78, 82, 84, 85, 86, 88, 93, 96 Liver scan, 88, 96 Localization, 24, 27, 87, 89 Localized, 76, 85, 87, 89, 92, 99 Lorazepam, 29, 89 Lymph, 10, 89 Lymph node, 89 Lymphadenopathy, 10, 89 Lymphatic, 87, 89, 97 Lymphatic system, 89, 97 Lymphoblasts, 75, 89 Lymphocyte, 75, 77, 89 Lymphocyte Count, 75, 89 Lymphocytic, 12, 31, 89 Lymphocytosis, 25, 89 Lymphography, 28, 89 Lymphoid, 6, 28, 29, 30, 77, 88, 89 Lymphoma, 7, 8, 11, 14, 15, 18, 19, 25, 27, 28, 31, 33, 34, 35, 36, 48, 62, 89 Lymphoproliferative, 27, 28, 89 Lymphoproliferative Disorders, 27, 89 Lymphosarcoma, 33, 89 Lysine, 86, 89 M Macrophage, 8, 89 Magnetic Resonance Imaging, 89, 96 Malignant, 13, 14, 15, 16, 25, 27, 31, 48, 75, 89, 90, 91, 96 Malignant tumor, 89, 90 Mastocytosis, 4, 25, 63, 90

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MEDLINE, 57, 90 Medullary, 46, 90 Megakaryocytes, 24, 78, 90 Membrane, 24, 79, 80, 84, 90, 95, 99 Mental, iv, 4, 56, 58, 82, 84, 90, 96 Mercury, 84, 90 Metastasis, 5, 90 Metastatic, 5, 15, 20, 21, 27, 36, 90, 96 Methacrylate, 8, 90 Methionine, 5, 90, 98 MI, 28, 32, 74, 90 Modification, 16, 27, 76, 90 Molecular, 5, 11, 16, 25, 37, 57, 59, 78, 81, 86, 90, 95 Molecule, 77, 80, 82, 84, 90, 95 Monoclonal, 13, 28, 33, 35, 90 Monocytes, 88, 90 Morphological, 11, 13, 37, 83, 90 Morphology, 18, 90 Multiple Myeloma, 13, 20, 22, 23, 26, 27, 29, 32, 62, 90 Myelodysplastic syndrome, 8, 13, 16, 23, 24, 29, 30, 90, 97 Myelogenous, 33, 38, 91 Myeloma, 28, 91 Myeloproliferative Disorders, 9, 16, 29, 38, 91 Myocardium, 90, 91 N Necrosis, 87, 90, 91 Neoplasia, 91 Neoplasm, 91, 95 Neoplastic, 13, 19, 76, 89, 91, 93 Nephropathy, 88, 91 Nerve, 28, 76, 79, 91, 94, 95, 97 Neuroblastoma, 18, 20, 91 Neuropathy, 91, 96 Neurotransmitter, 76, 85, 86, 91, 98 Neutrophils, 88, 91 Nucleic acid, 87, 91 Nucleus, 77, 79, 82, 83, 84, 87, 90, 91 O Occult, 9, 91 Ointments, 91, 92 Opportunistic Infections, 75, 91 Outpatient, 7, 91 P Pancreas, 75, 91 Paraffin, 7, 19, 20, 24, 29, 33, 35, 92 Partial remission, 92, 95 Particle, 33, 92 Pathologic, 78, 81, 92

Pathologist, 17, 92 Patient Education, 62, 68, 70, 74, 92 Pelvic, 92, 94 Peptide, 76, 92, 93, 94 Percutaneous, 6, 31, 92 Peripheral blood, 32, 92, 93 Peritoneum, 92, 95 Petechiae, 85, 92 Petroleum, 92 Pharmacokinetic, 92 Pharmacologic, 76, 92, 98 Phenotype, 5, 92 Physiologic, 82, 92, 95 Plants, 85, 90, 92, 99 Plasma, 9, 18, 33, 77, 78, 79, 86, 90, 91, 92, 93, 95, 96 Plasma cells, 9, 33, 77, 90, 91, 92, 93 Plasmacytoma, 6, 93 Plasticity, 86, 93 Ploidy, 20, 93 Pneumonia, 81, 93 Polycythemia Vera, 19, 38, 93 Polypeptide, 76, 80, 93 Posterior, 16, 42, 46, 82, 91, 93, 96 Practice Guidelines, 58, 93 Preleukemia, 90, 93, 97 Premedication, 7, 29, 93 Prevalence, 10, 93 Primary tumor, 5, 93 Probe, 43, 47, 93 Prognostic factor, 11, 13, 93 Progression, 5, 93 Progressive, 5, 80, 82, 83, 87, 91, 93 Progressive disease, 87, 93 Projection, 49, 93 Prospective study, 34, 94 Prostate, 5, 14, 30, 32, 94 Protein C, 76, 84, 94 Protein S, 78, 94 Proteins, 24, 76, 77, 79, 80, 90, 92, 94, 96, 99 Proteinuria, 90, 94 Pruritic, 4, 94 Pruritus, 94 Psychoactive, 94, 100 Public Policy, 57, 94 Purpura, 32, 85, 94 Pyrexia, 21, 94 Pyrogens, 42, 94 R Radiation, 84, 94, 96, 100 Radiculopathy, 94, 96 Radioactive, 79, 88, 94, 96

105

Radiography, 21, 94 Radioisotope, 94, 99 Radiological, 92, 94 Randomized, 7, 94 Receptor, 5, 77, 95 Recombination, 85, 95 Reconstitution, 22, 95 Rectum, 84, 85, 94, 95 Recurrence, 5, 95 Red blood cells, 84, 86, 87, 95 Refer, 1, 80, 84, 89, 95 Regeneration, 95 Relapse, 34, 95 Remission, 16, 31, 95 Remission Induction, 31, 95 Remission induction therapy, 31, 95 Renal amyloidosis, 21, 95 Retina, 95 Retroperitoneal, 32, 75, 95 Risk factor, 94, 95 Rod, 44, 45, 51, 77, 95 Rubber, 44, 75, 95 S Salivary, 82, 95 Salivary glands, 82, 95 Sarcoma, 20, 26, 27, 95 Scans, 5, 96 Schizoid, 96, 100 Schizophrenia, 96, 100 Schizotypal Personality Disorder, 96, 100 Sciatica, 23, 96 Screening, 80, 96 Secondary tumor, 90, 96 Secretion, 86, 96 Sedative, 89, 96 Semen, 94, 96 Serrated, 44, 96 Serum, 31, 80, 95, 96 Sharpness, 49, 96 Side effect, 89, 96, 98 Signs and Symptoms, 95, 96 Skeletal, 9, 21, 90, 96 Skeleton, 75, 96, 97 Small cell lung cancer, 15, 22, 23, 35, 97 Smoldering leukemia, 90, 97 Smooth muscle, 86, 97, 98 Soft tissue, 78, 97 Solid tumor, 15, 97 Sorbitol, 86, 97 Specialist, 64, 97 Species, 75, 90, 97, 99 Specificity, 35, 93, 97

Spinal Nerve Roots, 94, 96, 97 Spleen, 26, 27, 76, 82, 89, 93, 97 Splenectomy, 34, 35, 97 Splenomegaly, 93, 97 Spondylitis, 21, 97 Staging, 8, 9, 11, 14, 15, 18, 22, 25, 26, 28, 30, 31, 32, 33, 35, 96, 97 Steel, 43, 50, 97 Stem Cells, 75, 97 Sterilization, 42, 98 Sternum, 42, 98 Stimulant, 86, 98 Stomach, 63, 75, 84, 85, 86, 88, 97, 98 Stress, 44, 63, 95, 98, 99 Stromal, 8, 78, 98 Styrene, 95, 98 Subacute, 87, 98 Subclinical, 87, 98 Subcutaneous, 83, 98 Substance P, 95, 96, 98 Sudden death, 4, 98 Sulfur, 90, 98 Symphysis, 94, 98 Systemic, 4, 25, 76, 87, 98 T Thyroid, 18, 85, 98 Thyroid Gland, 85, 98 Topical, 92, 98 Toxic, iv, 91, 98 Toxicokinetics, 98 Toxicology, 58, 98 Toxins, 77, 85, 87, 99 Tracer, 5, 99 Trachea, 98, 99 Transfection, 78, 99 Transfusion, 99 Translation, 76, 99 Translational, 5, 99 Transplantation, 20, 21, 80, 99 Trees, 95, 99 Tuberculosis, 34, 36, 99 U Urethra, 94, 99 Urine, 63, 78, 94, 99 Urticaria, 4, 99 V Vaccines, 99 Vascular, 48, 87, 98, 99 Vasodilator, 86, 99 Venous, 78, 94, 99 Venous blood, 78, 99 Vertebrae, 87, 97, 99

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Veterinary Medicine, 57, 99 Virus, 19, 35, 75, 99 Vitro, 86, 87, 100 W White blood cell, 75, 77, 80, 85, 88, 89, 91, 92, 100

Windpipe, 98, 100 Withdrawal, 45, 46, 100 X X-ray, 81, 84, 96, 100 Y Yeasts, 84, 92, 100

107

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